Claims Adjuster
What Is a Claims Adjuster?
A claims adjuster is the person who reviews what happened, checks your insurance policy, and helps decide what the insurance can pay.
When something goes wrong, pet pros want a real person to explain what to do next. That’s where the claims adjuster comes in. Think of them like a referee. They call the plays based on the rulebook (in this case, your policy), and they explain what’s going on if you need help. But they’re not rooting for either side.
If you’re hearing from a claims adjuster, it usually means your insurance claim is moving forward. They may ask you for more details so they can apply your policy correctly. That’s normal — it doesn’t mean you did anything wrong.
Here’s what to expect when working with a claims adjuster:
- You’ll talk to them early. They usually reach out after an incident is reported or a claim is filed.
- They gather facts. They ask questions, review documents, and explain what happens next.
- They follow the policy. Coverage types, limits, deductibles, exclusions, and who’s listed as an Additional Insured guide their decisions.
- They can help move things along. For covered claims, they may authorize payment, request more info, or coordinate next steps.
- They can help if things escalate. If a covered lawsuit comes up, the claims team may assign an attorney to defend you.
What Does a Claims Adjuster Do?
A claims adjuster’s job is to:
- Review what happened
- Compare the facts to your policy
- Decide what the insurance can pay, depending on your coverage
- Explain what documents are needed and why
- Keep the claim process organized and documented
They’re not there to sell coverage or change your policy. Their role is to apply the policy fairly as written.
Who Does What in the Insurance Claims Process?
Knowing different roles during the claims process can help you contact the right person (saving time and frustration). Here’s the breakdown of four common roles.
Swipe →
| Role | Works for | Main job | When you interact |
|---|---|---|---|
|
Claims adjuster |
Insurer (or may be a contractor) |
Review the loss and determine coverage and payment |
After an incident or when filing a claim |
|
Agency or insurer |
Help you buy and manage coverage |
Before a loss and for policy questions and changes |
|
|
Insurer |
Evaluate risk and set terms and pricing |
At purchase or renewal, usually behind the scenes |
|
|
Customer support |
Insurer or agency |
General account help and directions |
Any time you need help finding the right contact |
Question about your claim process or progress? Talk to the claims adjuster.
Need to change something about your policy? Talk to an agent.
Not sure who set the policy rules? That’s the underwriter.
Need help with who to call? Talk to customer support.
What Do You Need Before Speaking to an Insurance Adjuster?
Having a few basics ready before talking to your claims adjuster keeps the process moving smoothly:
- Your policy number and business name
- A short summary of what happened, when, where, and who was involved
- Photos or video, if available
- Incident notes or documentation
- Vet bills, repair estimates, or other invoices
- Contracts, waivers, and contact info for anyone involved
If you don’t know something yet, it’s okay to say so. Share the facts you do have and avoid guesses. Your claims adjuster may be able to help you fill in the blanks.
Pro Tip: It’s tempting to take responsibility after an incident, but let the claims process work first. You care about the pets you look after, so it’s hard on everyone if one gets hurt. Gather the info you need, but don’t admit fault or promise payment to your client while your claims adjuster is still working. This can severely limit their options for helping you.
Big Takeaway
A claims adjuster is there to gather facts and apply your policy fairly. Clear, factual information helps the process work the way it’s supposed to, so you’re free to put your focus back on pets.
Keep Sniffing Around
- Insurance Claim
- Claim Denial
- Additional Insured
- Policy Limits
- Insurance Agent
- Underwriter
Kyle Jude | Program Manager
Kyle Jude is the Program Manager for PCI, where he helps design and maintain liability coverage specifically for pet professionals. With 10+ years of insurance industry experience, he works closely with carriers, underwriters, and compliance teams to ensure PCI coverage stays accurate, responsive, and relevant to real-world risks. At home, he puts that same expertise to use wrangling his four beloved dogs
Kyle Jude is the Program Manager for PCI, where he helps design and maintain liability coverage specifically for pet professionals. With 10+ years of insurance industry experience, he works closely with carriers, underwriters, and compliance teams to ensure PCI coverage stays accurate, responsive, and relevant to real-world risks. At home, he puts that same expertise to use wrangling his four beloved dogs