Washington State Insurance Practice Exam

Who is an adjuster in the insurance field?

1. A person who sets insurance rates

2. An individual who investigates and assesses claims

3. A claims assistant who manages customer service

4. An insurer responsible for policy underwriting

The correct answer is: An individual who investigates and assesses claims

In the insurance field, an adjuster is defined as an individual who investigates and assesses claims made by policyholders. This role is crucial because the adjuster evaluates the extent of the insurance company's liability in accordance with the terms of the policy. They gather evidence, interview claimants and witnesses, consult with experts when necessary, and analyze records to determine the validity of a claim. Their findings influence the insurance company's decision on how much compensation will be provided to the insured party. This position requires a deep understanding of policy language and insurance regulations to navigate the claims process effectively. Adjusters play a pivotal role in ensuring that claims are handled fairly and equitably, acting as a bridge between the insurer and the claimant. The other options describe roles that are not aligned with the function of an adjuster. Setting insurance rates is typically the responsibility of actuaries or underwriters, while claims assistants primarily handle administrative tasks and customer service rather than the technical assessment of claims. Policy underwriting is the process of evaluating and deciding on insurance applications, which is a distinct function separate from claims adjustment.