Many homeowners who experience a loss for the first time and are not familiar with the insurance claim process contact their insurance agent before anyone else. While the homeowner may instinctively report the claim to the insurance agent because he is the first person to come to mind or there is a relationship built over the years, it is important for homeowners to know that agents are not responsible for handling your claim. Insurance agents sell the policy, and other than helping procure the insurance requested, they generally have no other duty. An insurance agent who receives a call from a homeowner reporting a claim should refer the homeowner to the claims department.

I often hear homeowners express dissatisfaction about how their claim was initially being handled or that there was no immediate response from the insurance company. Many times this is because the homeowner mistakenly believes the insurance agent (especially if he or she is a captive insurance agent) is there to provide claim assistance.

An insurance agent is not the same as an insurance adjuster. It is important for homeowners to understand the difference. The insurance adjuster is the one responsible for handling or adjusting the claim, and if he or she is doing the job right, will assist the homeowner throughout the claim process. Moreover, it is the adjuster and not the agent who will determine if a claim will be covered under the policy and what benefits will be paid, if any. It is easy for homeowners to form the wrong impression sometimes, especially being exposed to so many insurance ads that appear on television. I’ll leave you with this State Farm commercial to illustrate. Can you find what is wrong with this ad—or in my opinion, misleading? (Hint: There is a two or three second segment within the ad. If you just read this blog, I think you will spot it.)

https://youtube.com/watch?v=HxznTayRCYQ%3Frel%3D0

  • Gary

    “Moreover, it is the adjuster and not the agent who will determine if a claim will be covered under the policy and what benefits will be paid, if any.”

    In my experience, this statement is not true most of the time. Coverage decisions are made higher up the food chain, by a Desk Adjuster or File Examiner, after the Field Adjuster has turned in their estimate, photos, notes (which may include a Recorded Verbal Statement), etc. And even they may have to refer the claim to a supervisor if the proposed claim payment exceeds the limit they have been authorized to handle.It’s very rare these days for a coverage decision to rest with the Field Adjuster.