What Do Auto Insurance Claims Adjusters Do?

Last Updated on December 9, 2025

You’ve just had a bad auto loss and filed a claim with your insurance company. Hopefully, nobody was hurt, but let’s say your vehicle was totaled.

Your next call will likely be from the claims adjuster—the person who becomes your main point of contact during the process. To many drivers, adjusters feel like they hold a lot of power over both their finances and their stress levels. So who are these people, and what exactly do they do?

Key Takeaways

1. Auto insurance claims adjusters investigate accidents, verify coverage, and determine how much the insurer should pay—balancing fairness with fraud prevention.
2. Adjusters represent the insurance company, but most are salaried and don’t personally profit from denying or underpaying claims.
3. Their work involves gathering evidence, reviewing reports, speaking with witnesses, and sometimes detecting fraud.
4. A clear, cooperative relationship with your adjuster—and good documentation—can make the claims process smoother and more likely to result in a fair settlement.

Claims Adjusters Defined

At a basic level, claims adjusters investigate claims and decide how they should be paid. It sounds simple, but in reality, it’s one of the most demanding roles in the insurance industry.

They’re part investigator, part communicator, and part decision-maker. Adjusters must figure out what happened, explain decisions to policyholders, and sometimes deny claims or negotiate settlements. Your agent may support you, but it’s the adjuster who directly determines if a claim is covered and for how much.

Playing Sherlock Holmes: The Investigation Side

Claims adjusting isn’t as glamorous as Sherlock Holmes, but there is real detective work involved. Adjusters need to piece together what happened so they can decide:

• Who was at fault
• Whether the policy actually covers the incident
• What the total amount of damages are
• Whether there are any signs of insurance fraud

Fraud doesn’t just happen with large, headline-grabbing cases. Even smaller property damage claims can involve exaggeration or misrepresentation.

Example: An insured calls to say their vehicle caught fire and is a total loss. The adjuster can’t just take their word for it and cut a check. Instead, they may:

• Inspect the vehicle or the scene (or review detailed photos)
• Review the police or fire report
• Talk to officers, witnesses, or fire investigators

If evidence suggests foul play, the adjuster may deny the claim. If it looks like an accident, the adjuster will pay the claim in line with the policy limits and terms.

Who Do Adjusters Work For?

Most auto insurance claims adjusters work directly for an insurance company. This is important, because it means:

• Their job is to protect the company’s financial interests—by paying valid claims fairly, but also by avoiding overpayments or paying for losses that aren’t covered.
• They also protect the company’s reputation—poor claim service can drive customers away and create bad publicity.

Sometimes, if an adjuster initially denies a claim but the customer pushes back, gets their agent involved, and seems genuinely unhappy, the adjuster may reconsider. The company might decide it’s better to pay a borderline claim than risk a serious customer service issue.

There are also independent or “contract” adjusters who don’t work directly for one company. Instead, they are hired on a claim-by-claim basis to handle investigations, often during catastrophes or when a company needs extra help.

Are Claims Adjusters For Us or Against Us?

It’s natural to feel uneasy when the person deciding your payout works for the same company that has to write the check. It can feel like a conflict of interest—especially when you’re depending on that money to repair or replace your car.

However, there are a few key points to keep in mind:

• Most adjusters are salaried. They don’t personally profit from denying your claim or paying you less. Their pay isn’t usually tied to the outcome of individual claims.
• They must follow a process. Adjusters don’t have unlimited discretion; they have to follow state laws, policy language, and internal guidelines.
• Many adjusters genuinely want to help. There certainly are bad claims experiences and some poor adjusters—but many others take pride in helping people during stressful, sometimes life-changing events.
• The process helps prevent abuse. Without investigation and documentation, fraud would be much easier, and legitimate customers would pay the price in higher premiums.

Countless insurers and their claims staff stake their brand on how they handle claims. A good adjuster tries to balance fair payment to the policyholder with protection of the company and its other customers.

FAQs About Claims Adjusters

Final Word: Understanding the Role of Claims Adjusters

Ideally, you’ll never have to file an auto insurance claim. But if you do, the claims adjuster will be at the center of the process. Their job is to investigate what happened, determine what your policy covers, and decide how much the company should pay.

Knowing that they are investigators—not villains—and that they must follow a defined process can make the experience less mysterious and less intimidating. The better you understand their role, the easier it is to communicate, provide the right information, and work toward a fair outcome.