Insurance Adjuster in New Jersey Workers' Compensation Law

An insurance adjuster, often referred to as a claims adjuster, is a professional employed by an insurance company to evaluate and process claims filed by injured workers. Their role is to determine the validity of the claim and decide the amount of compensation the claimant should receive, if any.

Work Injury Claim marked “REJECTED” by an insurance adjuster in large red letters stamped over an NJ injured worker’s work injury file

Role and Responsibilities

In the context of New Jersey Workers’ Compensation Law, the insurance adjuster is responsible for:

  • Investigating the details of the injury.


  • Reviewing medical reports and records related to the injury.


  • Determining if the injury is work-related and if the claimant is entitled to benefits.


  • Communicating with the injured worker, medical providers, and legal representatives.


  • Providing recommendations and insights to the insurance company’s legal team regarding the claim.

Importance to the Claims Process

Insurance adjusters play a crucial role in the NJ Workers’ Compensation system. Employed by insurance carriers, their primary objective often aligns with minimizing the company’s financial exposure. While they act as the liaison between the injured worker and the insurance company, their evaluations and decisions are influenced by their responsibility to the insurance company. Given this dynamic, it’s paramount for injured workers to understand their rights and, if needed, to seek representation to ensure they are treated fairly.


What Claimants Should Know

While insurance adjusters have a duty to act in good faith, their primary responsibility is to the insurance company. Injured workers in New Jersey should be aware of their rights and be prepared to provide the necessary documentation and evidence to support their claims. Should disagreements or disputes arise, consulting with a knowledgeable NJ work injury attorney may be beneficial.

"An insurance company which insures against rain in Bombay during the summer months cannot complain if its treasury is liquidated by a flood of claims in July."

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