What does an insurance adjuster do on a home claim?

An insurance adjuster (also called a claims adjuster) is the person who figures out what your insurance company owes on a claim. Triple-I describes the adjuster as someone professionally trained to assess damage.

On a typical home claim, the adjuster:

• Contacts you and sets up an inspection.
• Looks at the damage and decides what caused it, such as wind, hail, fire or a burst pipe.
• Reads your policy to see what is covered, what is excluded and what limits apply.
• Measures and photographs the damage and writes a repair estimate.
• Watches for signs of fraud, which the U.S. Bureau of Labor Statistics lists as part of the job.
• Recommends or approves payment and sends you the estimate.

Licensing rules differ by state and by type of adjuster. In some states, adjusters employed by an insurance company work under the company’s license instead of their own. An adjuster isn’t your insurance agent. The agent sold you the policy; the adjuster handles the claim. New to these terms? Keep our claim glossary open in another tab.

Adjusters are sorted two ways: who employs them, and where they work. You may deal with several on one claim. The NAIC model law for public adjusters puts it simply: company and independent adjusters are paid by your insurer and won’t charge you a fee.

If you’re weighing paid help, our guide on what a public adjuster is and what one costs lays out the fees and trade-offs.

Other people the insurer may send

• Engineers to judge the cause of structural, foundation or roof damage.
• Roof inspectors (sometimes called ladder assists) who climb and photograph the roof for the adjuster.
• Contents specialists who price belongings on large losses.
• Flood adjusters. On a National Flood Insurance Program (NFIP) claim, FloodSmart says to ask for the adjuster’s Flood Control Number (FCN) card and a government photo ID.

If the insurer sends an engineer, you can ask for a copy of the report in writing. Two lessons in the course cover the engineer’s inspection, how to read the report and how to disagree with it in writing.

The visit has two jobs: confirm what caused the damage, and measure everything that needs repair. Expect the adjuster to:

• Look for the cause. Wind lifts shingles, hail leaves dents, water stains spread from a source. Cause decides coverage, so this part matters most.
• Walk every damaged area. Roof slopes, siding, windows, gutters, fences, ceilings, floors and walls.
• Measure. Room sizes, wall heights and roof area. Roofs are counted in squares (one square is 100 square feet).
• Take photos and notes. These become the backbone of the file.
• Check for water. On water claims, many adjusters use moisture meters and look for the leak’s source.
• Ask about age and condition. Roof age, past repairs and upkeep can affect depreciation and coverage.
• Review your papers. Receipts for emergency repairs, hotel bills, your damage list and a room-by-room list of your belongings.

Many adjusters don’t give a final number on the spot.

Many insurers and contractors write estimates in software, and Xactimate is one of the most widely used programs. The software turns the adjuster’s measurements into line items priced from a price list for your area. Each line usually shows:

At the bottom you’ll find totals, any overhead and profit (O&P, a general contractor’s charge for running the job, often added when several trades are needed), and how your deductible applies. The deductible comes off before you’re paid. Many policies pay the ACV first and the held-back depreciation after repairs, which is why the difference between actual cash value and replacement cost matters so much.

Larger payments may need a supervisor’s sign-off, which is one reason answers can take time.

Your adjuster is the other side of a business process, not an enemy. Calm, factual and organized works best.

• Stick to what you know. Say when it happened and what you saw. If you don’t know, say you’ll find out.
• Don’t guess. A wrong guess about the cause, how long a leak was going or your roof’s age can end up in the file.
• Do not downplay damage. “It’s probably fine” can read as no damage.
• Ask before a recorded statement. Ask what it covers, and request a copy afterward.
• Confirm in writing. After every call, send a short email: date, who you spoke with, what was agreed, what happens next.
• Read before you sign. Don’t sign a release or anything labeled final until you understand it.

After the inspection, the adjuster writes up the file, a desk adjuster may review it, and the insurer sends an estimate and a payment or a letter explaining what isn’t covered. How quickly this must happen depends on your state, and your state insurance department can tell you the rule that applies.

Adjusters change often, especially after disasters. Keep a claim diary with every name, date and promise, so a new adjuster can’t send you back to the start. If the estimate looks low, our guide on what to do when an estimate seems too low covers re-inspections and written requests.

Want the full process in order? The course by an NFIP Certified Adjuster has lessons on field adjusters, desk adjusters, engineer inspections and reading estimates.