Claims Adjuster how-to

How to Explain a Claim Decision to a Policyholder

Clear explanations reduce disputes.

Updated By the Career Education Institute Curriculum Team
Quick answer

Clear explanations reduce disputes. In short: review; call; point, then complete the remaining steps below.

Step by step

  1. Review the decision and policy language beforehand.

  2. Call the policyholder and explain the decision plainly.

  3. Point to the specific policy provision.

  4. Explain what is covered and what isn’t.

  5. Answer questions and explain the next steps.

  6. Send a written letter and document the call.

Safety reminders for claims adjusters

  • Use ladder safety and fall protection on roofs
  • Watch for structural, electrical and mold hazards
  • Drive safely between inspections
  • Follow safety plans in disaster areas

Policy · Coverage · Deductible · Exclusion · Claimant · Reserve: see the full claims adjuster glossary.

More claims adjuster how-to guides

Learn this in Claims Adjuster trainingTake the practice test
Enroll in trainingTake fit quiz