Workers Comp Audit Stress Reducer
Use It For Your Next Premium Audit

Claims Adjuster

An employee of an insurance carrier or Third Party Administrator who handles a certain set of claims. The claims adjuster is responsible for setting reserves, paying benefits, and filing state forms among other duties.

Workers comp claims adjusters either work on medical only or lost-time claims.

Lost time claim adjusters usually have their total reserving or payment authority set at certain levels such as $10,000 for payments and $50,000 for reserving.

I started my insurance career as an all-lines adjuster with workers comp comprising 55% of my open files.  At that time in Oklahoma, joint petitions were used to settle most of the litigated files.

Most states require workers comp adjusters to possess licenses.  Some do not require a license to adjust claims.  The adjuster usually has to pass a 25 to 50 question test.  Once licensed, they have to acquire a minimum number of continuing education credits to keep their licenses.

Many states require 12 – 18 hours per year of continuing education credits with courses that have been preapproved by the Department of Insurance.

Most states, except California and a few other states, allow a non-resident adjuster to apply and pay a fee for licensure in their state as long as the adjuster keeps their license up-to-date in their home state.

Workers Comp adjusters usually hold a specialized license in only one line of insurance.   Subrogation becomes an issue with specialized adjusters that may not have a liability background.



Get the latest workers' comp news FREE!

This field is for validation purposes and should be left unchanged.