Claims Adjusters, Appraisers, Examiners

If you've ever had to file a claim, you're most likely very familiar with professionals in the insurance field who help determine whether your insurance policy will cover your loss and, if so, how much of it should be paid. The first person in that process is the claims adjuster, who investigates a claim by interviewing the claimant (the person making the claim) and, if it's approved, negotiates with the claimant and settles the claim. During that process, appraisers will estimate the cost or value of an insured item and examiners will review claims after they're submitted to ensure that proper guidelines have been followed. Examiners then authorize or deny a payment. You'll find these positions at property, casualty, life, and health insurance companies, where training is generally on-the-job, as insurance appraisers may only need a high school diploma, while claims adjusters and examiners may need an associate or bachelor's degree. Some experience in the field may be desired as well. For example, auto insurance companies may want those with technical experience in auto damage repair for auto damage appraiser positions, while a legal background may help with product liability cases or workers' compensation. Additionally, licensure and certification can provide those seeking employment and advancement in the claims field with professional credentials.

Certification is a big deal for public adjusters. It really is a way to separate you from those who don’t have it.

James BenekeCertified Public Adjuster

Getting Claims Adjusters, Appraisers, Examiners Licensure and Certification

There are limited degree options for those looking to work in the claims field. Rather, main qualifications for employment as a claims adjuster, appraiser, or examiner often come in the form of licensure or certification. These credentials provide professional credibility, demonstrating to the public and to employers that the holder understands different insurance policies. In addition, nearly every state, with the exception of six, requires licensure to practice, so not having one could severely limit those looking to work in the claims field.

"Claims designations are held in high regard by insurance carriers and independent adjusting companies," said Donna J. Popow, Director of Knowledge Resources for the Ethics Counsel of The Institutes, which provides professional development for those in the insurance field. "They show that the individual is committed to the claims career and that they have the work ethic to complete the designation requirements." Additionally, they can be used as the as the basis for promotion within a company and to establish credibility when called upon to testify in court, said Papow.

Certification generally is elective, and is available widely through national professional associations specific to the industry, based on experience and knowledge. The National Association of Public Insurance Adjusters, for instance, offers two certifications: Certified Professional Public Adjuster (CPPA) and Senior Professional Public Adjuster (SPPA). Both designations require a minimum number of years of experience (five and 10 years, respectively), and passage of an exam. A third certification for less experienced public adjusters is currently being developed, and should be available by spring 2012. The American Society of Certified Auto Appraisers also sponsors certification for the auto insurance appraising industry, which requires that candidates complete four training courses. This certification generally is not required by insurance companies, but it helps auto appraisers remain competitive and enhance their qualifications. Additionally, for appraisers in the real estate sector, there is certification through the National Association of Free Independent Appraisers, focusing on the review of real property appraisal reports, as well as mortgage underwriting. Certification requires the completion of several education courses and completion of an exam.

This expertise demonstrated by certification may give professionals a competitive edge. Because the credential requires a certain number of years in the business and passing a difficult test, it could mean the difference between getting a client or not.

"Certification is a big deal for public adjusters. It really is a way to separate you from those who don't have it," said James Beneke, a public adjuster in Austin, Texas, with SPPA certification. "As a consumer, if you're looking at two people standing in front of you offering to help you with a claim, sometimes that can make the difference in the decisions that they make."

While those in the claims field often elect to obtain certification, they also will have to comply with their state's requirements to allow practice. Licensure is the most common requirement. For example, 44 states mandate that public adjusters be licensed. This ensures credibility for the profession while simultaneously protecting the consumer from fraud and unethical practices.

"Property claims attract all sorts of people who will offer to assist an insured with their claim – roofers, contractors, plumbers, and others will offer to handle claims for free if they are allowed to do the work," said Beneke. "The problem is, in most states, none of these people are licensed (nor can be) to provide both services."

Completion of training and passing an exam are common requirements to ensure minimum level of knowledge and familiarity with state-specific regulations. Some practices may require licenses in multiple states, depending on the clientele. We recommend checking with your employer and state insurance department to find out what is needed.

Maintaining Claims Adjusters, Appraisers, Examiners Licensure and Certification

Once you obtain a license or certification, your work isn't necessarily done. Policies and laws may change and new technologies relevant to your job may be developed, so it is imperative that those in the claims field stay up-to-date to remain competitive. "Technology changes the way we do business almost daily [and] courts change the way we interpret and handle claims frequently," said Popow. "Continuing education is the best way a claim handler can keep abreast of the changes and see how he or she must change the way they do business in order to be competitive and in compliance with the law."

To that end, certification or licensure renewal often requires further training. In most states, recertification may require retaking an exam, for instance, while continuing education credits may be needed to maintain licensure. In Florida, for example, an adjuster must complete 24 hours of continuing education to renew his license every two years, while in Texas, adjusters must complete at least 30 hours of continuing education every two years, with two of those hours in ethics.

"Claims people are often placed in positions that can lead them into an ethical dilemma," said Popow. "It is important that they recognize the possibility of an ethical dilemma arising as well as have the tools needed to arrive at an ethical resolution to the dilemma."

Even if a credential or license does not require continuing education credits to maintain it, professional development is key for those looking to stay relevant and marketable in claims work, as well as possibly lead toward advancement or greater pay. To that end, multiple professional organizations provide opportunities for distance learning, so you can always find convenient, flexible, and affordable options no matter where you work. Depending on your area and specialty, courses through organizations including The Institutes, the National Association of Free Independent Appraisers, the American Society of Appraisers, the International Claim Association, and the Appraisers Association of America are options.

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