Claims Help glossary
Plain-language definitions of common claims help terms.
- Adjuster
- The person — often employed by the insurer, sometimes independent — who investigates a claim, estimates the loss, and recommends what the insurer should pay.
- Full definition of Adjuster
- Appeal
- A claim appeal is a formal request asking an insurer to reconsider a denied or underpaid claim. Most health plans must offer an internal appeal and, in many cases, an external review by an independent reviewer. For other types of insurance, the process depends on your policy and your state.
- Full definition of Appeal
- Claim
- A formal request to your insurer for payment under a policy after a covered loss.
- Full definition of Claim
- Denial
- A claim denial is an insurer’s decision not to pay all or part of a claim. The insurer should explain the reason in writing, usually by pointing to specific policy language. If you think the denial is wrong, you can ask the insurer to reconsider, use its appeal process, or contact your state insurance department.
- Full definition of Denial
- Depreciation
- Depreciation is the decrease in an item’s value because of age, wear, or becoming outdated. Policies that pay actual cash value subtract depreciation from the cost to replace damaged property. Replacement cost policies generally pay without that deduction, sometimes only after you repair or replace the item.
- Full definition of Depreciation
- Proof of loss
- A formal, often sworn statement a policyholder submits documenting the details and value of a claimed loss, which the insurer uses to evaluate payment.
- Full definition of Proof of loss
- Public adjuster
- A public adjuster is a licensed professional you can hire to handle a property insurance claim for you, including documenting the damage and negotiating with your insurer. Unlike the insurer’s adjuster, a public adjuster works for you. They’re usually paid a percentage of the claim payment, and each state sets its own licensing rules.
- Full definition of Public adjuster
- Subrogation
- When your insurer pays your claim and then pursues recovery from a third party at fault for the loss — the insurer steps into your shoes.
- Full definition of Subrogation