I have had many prospective clients tell me that they don’t think they need a public adjuster because they trust their insurance agent. “I’ve known Jacob for years, and he has never done me wrong!” Or “Florence is an old family friend and I trust her completely.” I myself have many friends and acquaintances who are insurance agents by trade and I have nothing but respect for them. I am delighted to hear that you are on good terms with your agent, because that hopefully means they looked out for you when issuing your policy and made sure you have all the coverage you need. However, that does not mean you don’t need me.

 

As with most things in the insurance world, definitions are KEY. So let’s Miriam-Webster this for a moment, shall we?

  • Insurance Agent: /inˈSHo͝orəns ˌājənt/ NOUN – a person employed to sell insurance policies.
  • Insurance Adjuster: /inˈSHo͝orəns ə-ˈjə-stər/ NOUN – a person who works for an insurance company and whose job is to decide how much money the company will pay people when they are injured or when their property is damaged, lost, or stolen.

 

Hold up! Do I really mean to tell you that you that your agent isn’t your claims adjuster? In most cases, that’s exactly what I mean. There are a few exceptions, but they are very rare and chances are good that if anyone with a TV set or the ability to view highway billboards recognizes the name of your insurance company, they aren’t one of the exceptions.

 

It is also worth noting that to become an insurance agent in Georgia, you have to complete pre-licensing education requirements focused on insurance policy provisions/law/ethics, pass a state exam, be fingerprinted, and pass character and fitness requirements. There are similar requirements to become a Georgia licensed public adjuster (licensed to represent policyholders in their claims). However, these requirements DO NOT typically apply to insurance company staff adjusters. All you have to do to be a staff adjuster is be hired by an insurance company and complete their company training program. While it is possible that a staff adjuster is also a licensed independent adjuster (licensed by the state to represent insurance companies), most of the staff adjusters we’ve interacted with are not. I’ll go into the distinctions between the different types of adjusters, inspectors, and contractors involved in the claims process in another post, but for now suffice it to say that insurance agents and adjusters have very distinct roles (and qualifications) in the insurance industry.

 

Now let’s get back to the business at hand. Your insurance agent may be a wonderful person that you would trust with your newborn baby, but that doesn’t mean that they can help with your actual claim. I’ve actually had many conversations with frustrated agents who have developed long term relationships with policyholders, and are now faced with losing them to a different company because the claim handling division snubbed our mutual client when they needed help. In my experience, the extent of the help an agent is able to provide in the claims process is helping an insured get their hands on a complete copy of their policy. Now, that actually can be quite helpful, but it’s not going to get your claim across the finish line successfully. You still need my help.

 

Am I really suggesting that all insurance agents are wonderful people and all claims adjusters are unlicensed and unethical—absolutely not! I have had plenty of clients who were sold policies by insurance agents who definitely didn’t have their best interests at heart, and I likewise have come across plenty of adjusters who genuinely seem to care about the person behind the policy. The problem is, even if you do get a staff adjuster with a “heart of gold”, their hands are often tied by the insurance company’s internal policies (which, spoiler alert, you won’t find outlined anywhere in your insurance policy). For example, just last week I had a conversation with a staff adjuster who told me that if he paid for a dumpster upfront (on a major demolition job), the file would be flagged for audit by upper management. I don’t know about you, but I feel like it’s a pretty reasonable expectation that if my insurance company is paying for the entire roof to come off my house, they’re also going to ensure there is a place to put it on the day it comes off. Maybe that’s just me, but I doubt it.

 

The insurance claims process is set up to protect the financial interests of the insurance companies, and more often than the average policyholder should be comfortable with, they play by their own rules. So what is a policyholder to do? Let me represent you. As I’m writing this post my toddler is listening to Daniel Tiger sing, “When something is new, holding a hand can help you!” which I feel is quite apt to the topic of this post. No matter how well you know (or don’t know) your agent, filing a claim is a new process with new people, and it doesn’t hurt to have someone who has been-there-done-that holding your hand through the process.