Claims Adjuster

by Pawlicy Advisor
Pet Insurance Terms
Claims Adjuster

What is a Claims Adjuster?

A claims adjuster evaluates pet insurance claims to determine what the insurance company’s policy covers and the amount of money that needs to be reimbursed to the policyholder.

How Claim Adjusters Work

A claims adjuster will verify the claim and determine the fair amount to be reimbursed. To verify the claim, an adjuster will look at receipts and other documentation provided by the policyholder and may speak with other parties involved (i.e. your veterinary office). Claim adjusters often work directly for the insurance company, or they may be an independent party hired by the insurance company.

After evaluating an insurance claim, a claims adjuster will present the insurance company with their findings on the claim and what amount should be reimbursed based on the individual’s insurance policy.

Key Takeaways

  • Claim adjusters evaluate insurance claims and determine what an insurance company should reimburse the policyholder per their policy and the claim.
  • Claim adjusters work for or with the insurance company.
  • A claim adjuster will look at the documentation, receipts, and other evidence to verify an insurance claim.

Related Terms

Claims Expiration
A claims expiration is the period of time you have to file an insurance claim with your insurance carrier.
Read More.
A co-payment, or co-pay, is the amount that you pay out of pocket for a covered service once you’ve hit your deductible.
Read More.
Congenital Condition
A congenital condition is any bodily abnormality present upon birth. Though they exist at birth, congenital conditions are not always apparent at birth and may take years to discover.
Read More.

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