Claims Adjuster Practice Exam 2025 – 400 Free Practice Questions to Pass the Exam

A claims adjuster must prioritize ensuring that the claim aligns with the terms and conditions stated in the insurance policy. This involves a thorough review of the policy language, the coverage provided, and the specific exclusions or limitations that may apply to the claim in question. The accuracy of this alignment is crucial because it determines whether the insurer is liable to pay the claim.

Understanding the policy's provisions allows the claims adjuster to evaluate the claim correctly, ensuring that any payment made is justified under the agreed terms. This process also helps to avoid potential disputes between the insurer and the insured about what is covered, fostering clarity and trust in the claims process.

While assessing the experience of the insured, verifying statements, and determining litigation potential are important aspects of the claims process, they do not take precedence over the fundamental requirement of policy compliance, which serves as the foundation for any valid claim assessment and approval.