May 27, 2010

What An Insurance Company Medical Adjuster Does

Medical adjusters play an integral part in your auto insurance policy–but just what do medical adjusters do, and how does it affect your compensation in the event of a vehicular injury?

In short, an insurance company’s medical adjuster reviews all claims, paperwork, and related evidence to determine injuries sustained by the vehicle’s driver and passengers. It’s the adjuster’s job to determine what injuries are covered by the policy, liability for injuries, and how much the policy will pay for medical claims or losses. This can require reviewing medical records, obtaining information from medical providers, researching legal requirements, and communicating with the customer to determine the extent of coverage. Often the medical claims adjuster will be the primary point of contact with your care provider, and will need to remain informed on all treatments and procedures.

Because injuries arising from vehicular accidents can lead to lawsuits and higher costs for the insurance provider, it’s up to the medical adjuster to be thorough in researching all information pertaining to the injury and situation. Medical claims adjusters must be well-versed in legal compliance, statutes, and personal injury law. One mistake on the part of an adjuster can cost both a company and a policy holder millions. They may have to perform personal evaluations, inspections, and interviews to ensure they have all the necessary information to prevent unfortunate situations. Some believe that private medical claims adjusters are less biased than those employed by an insurance company, but in truth all claims adjusters are held to certain legal standards and are often contractually obligated to be as objective as possible.

Your medical claims adjuster acts in cooperation with the standard claims adjuster, and generally is only involved if the incident with the insured vehicle also involves any injury or other situation that requires medical attention. Most insurance companies will provide information on medical coverage and its extent when you request auto insurance quotes. Depending on the coverage, injuries, and liability in your policy, your adjuster may determine that your auto insurance provider is liable for all, part, or none of your medical expenses. In these cases your adjuster is your ally, and will do their best to ensure that you receive fair compensation.

When researching auto insurance quotes, it’s best to look for a provider that offers a reasonable policy on medical claims. If you can speak with a medical claims adjuster prior to signing a policy, you can often get an inside look at how a particular insurance company’s claims process works, and the protections available under various plans. Overall, the medical adjuster is a major part of the auto insurance process, from initial quote through compensation claims.