Define 'claims adjuster' in an insurance context.

Prepare for the CII Insurance Broking Fundamentals with flashcards and multiple choice questions. Access hints and explanations for each question. Ace your exam!

In the context of insurance, a claims adjuster plays a vital role in the claims process by investigating claims made by policyholders. This professional works on behalf of the insurance company to assess the details surrounding a claim, including gathering evidence, interviewing witnesses, and evaluating documentation. The primary goal of the claims adjuster is to determine liability, which means establishing whether the insurer is responsible for the damage or loss claimed by the policyholder.

Additionally, the claims adjuster reviews the terms of the insurance policy to make sure that the claim aligns with the coverage provided. They help ensure that valid claims are paid promptly, while also protecting the insurance company from fraudulent claims. The thorough analysis conducted by a claims adjuster directly impacts how much compensation is provided to the policyholder, making their role essential for both claim resolution and customer satisfaction.

Other roles mentioned in the options, such as selling insurance policies or underwriting new policies, focus on different aspects of the insurance industry that do not involve the claims process directly. Additionally, maintaining client relationships is important for customer service but does not encompass the specific duties of a claims adjuster. Thus, the definition provided in the correct answer accurately captures the essential functions and responsibilities associated with this role in the insurance field.

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