Insurance Agents vs. Adjusters: Roles, Responsibilities, and Why Both Matter

Insurance agents and adjusters perform different functions within the insurance process: Agents help customers obtain and maintain insurance coverage, while adjusters evaluate and manage claims after a loss occurs. Agents are primarily involved in insurance distribution, while adjusters are involved in claims management.

Definition – Insurance Agent

Agents contribute to the policy lifecycle by helping customers secure coverage, explaining policy terms, and assisting with policy-related administrative processes.

Definition – Insurance Claims Adjuster

Adjusters contribute to the claims lifecycle, becoming involved after the policyholder files a claim to seek reimbursement for a covered loss. Depending on the type of adjuster, an insurance adjuster may manage a claim on behalf of the insurer, while public adjusters represent the insured policyholder.

Agents and adjusters make unique contributions to the insurance industry and operate at different stages of the insurance process. This blog explores their differences to help customers, insurance carriers, agencies, adjusting firms, and other organizations make informed decisions to best suit their needs.

Key Takeaways

1. Agents sell insurance policies while adjusters manage insurance claims.
2. Agents and adjusters have different responsibilities.
3. Customers and organizations interact with agents and adjusters at different points.
4. Agents and adjusters can sometimes collaborate in the best interests of the policyholder.
5. Agents and adjusters have different salary structures, earning potential, and expectations.
6. Both agents and many adjusters require licensing, but requirements vary significantly by state and role.
7. The insurance industry needs both agents and adjusters.

What Is the Difference Between an Insurance Agent and Adjuster?

The work of agents and adjusters centers on different moments in a policyholder’s insurance journey. Agents help customers choose, purchase, and maintain insurance coverage, often serving as a primary point of contact for policy-related questions. Adjusters become involved when a loss occurs, working to investigate claims, assess damages, and evaluate coverage under the policy.

The main differences between agents and adjusters are broken down in the following table:

	Agent	Adjuster
Which part of insurance are they a part of?	Policy lifecycle	Claims lifecycle
What are the different types?	Independent or captive	Independent, company/staff, or public
What do they do?	Sell, distribute, and negotiate policies to the customer	Evaluate, manage, and assess claims for the policyholder or carrier
Who do they represent?	The insurer, the customer, or operates as an intermediary depending on the agency relationship and state regulations	The insurer or the insured, depending on the adjuster type
Who do they work for?	Insurance carriers, agencies, or self-employed	Insurance carriers, adjusting firms, or self-employed

Essentially, agents work with insurance policies, while adjusters mainly work with insurance claims.

Definition – Insurance Policy An insurance policy is a legal contract detailing the terms of an agreement between the insurer and the insured. It describes what damages and losses may be covered under a policy.

Definition – Insurance Claim An insurance claim is filed by a policyholder to request reimbursement for a loss covered under an insurance policy. Insurers determine whether coverage applies and, when appropriate, provide payment based on the terms of the policy and the claim settlement.

While the responsibilities of agents and adjusters differ, they are equally important. Both agents and adjusters contribute to helping policyholders navigate the insurance process.

What are the Responsibilities of Agents vs. Adjusters?

Based on their different roles, agents and adjusters have different responsibilities within the insurance industry.

Agents are typically responsible for:

• Sales & Marketing: Generating leads and promoting insurance products.
• Customer Service: Providing advice to help customers choose and understand a policy.
• Policy Analysis: Explaining policy options and analyzing current insurance plans.
• Policy Management: Assisting with applications, paperwork, policy changes, and premium payments.
• Regulatory Compliance: Adhering to insurance regulations and licensing requirements.
• Carrier Representation: Following insurance company guidelines, underwriting requirements, and applicable appointment requirements.

Adjusters are typically responsible for:

• Claims Evaluation: Evaluating insurance claims against policies to determine coverage.
• Loss Investigation: Inspecting reported damages and gathering evidence to verify claim details.
• Damage Assessment: Estimating the extent of loss and determining claim value.
• Settlement Negotiation: Evaluating claims and communicating settlement recommendations or decisions based on policy coverage and applicable regulations.
• Claims Documentation: Maintaining records and preparing claim reports.
• Regulatory Compliance: Following claims-handling regulations and insurer procedures.

Carrying out these different responsibilities leads agents and adjusters to interact with customers and insurance organizations at different stages of the insurance process.

When Do Customers and Insurance Organizations Interact with Agents vs. Adjusters?

How and when agents and adjusters are encountered depends on whether an entity is an individual or a business and what they want to accomplish. Customers, insurance carriers, and other insurance organizations have different relationships with agents and adjusters.

Insurance Entity	When Do They Interact With Agents?	When Do They Interact With Adjusters?
Customer	Buying and maintaining an insurance policy	Managing an insurance claim
Carrier	Appointing agents to sell their insurance policies	Assigning, reviewing, and managing insurance claims
Agency	Contracting with, supporting, and managing producer relationships	Assisting customers with claim-related questions and directing them to appropriate claims resources
Adjusting Firm	Limited direct interaction; may contact an agent only if additional policy context is needed	Employing adjusters and managing claim assignments

Because agents and adjusters serve different roles, they interact with customers and insurance organizations at different points in insurance distribution and claims management. However, at times, agents and adjusters may communicate to better accomplish their respective responsibilities and ensure that insurers and policyholders receive the best possible service.

How Do Agents and Adjusters Collaborate?

Although agents and adjusters serve different functions, they may interact in limited circumstances during the claims process. Agents can assist policyholders by helping them understand their coverage, directing them to the appropriate claims resources, and supporting communication with the insurer. However, adjusters are responsible for investigating claims, evaluating coverage, and determining claim outcomes based on the policy and available information.

The following example demonstrates how agents and adjusters might work together throughout the policy and claims lifecycle:

1. An agent sells an auto insurance policy to a customer.
2. After being injured in a car accident, the policyholder files a claim with their insurer.
3. The carrier assigns a company adjuster to investigate the claim, evaluate the damages, and determine coverage based on the terms of the policy.
4. The policyholder receives a claim determination and settlement offer from the insurer.
5. If the policyholder believes additional review is needed, they may hire a public adjuster to assist with documenting the loss and communicating with the insurer regarding the claim.
6. The public adjuster reviews the damages, supporting documentation, and applicable policy provisions to help the policyholder understand their claim position.
7. During the claims process, the policyholder may contact their agent with questions about their coverage, policy terms, or future insurance needs.
8. The agent can help explain the policy coverage and direct the policyholder to the appropriate claims resources, while the adjuster and insurer continue handling the claim evaluation and settlement process.

As this example shows, agents and adjusters support policyholders at different stages of the insurance process. The agent helps customers understand their coverage options and policy details, while the adjuster evaluates the claim, investigates the loss, and manages the claim process. Although their responsibilities are separate, both roles are important in helping policyholders navigate their insurance experience.

How Much Do Agents and Adjusters Make?

While both roles are essential, earnings can vary for agents and adjusters depending on how much business they conduct. The US Bureau of Labor Statistics reports the following statistics about agent and adjuster income as of 2024:

	Agent	Adjuster
Median Annual wage	$60,370	$76,790
Employment Growth Projection (2024 – 2034)	4% growth	5% decline*

*Although insurance adjuster employment growth is predicted to decline slightly, job opportunities are expected to continue as experienced adjusters retire and positions become available through workforce turnover and seasonal opportunities.

Source: US Bureau of Labor Statistics, Insurance Sales Agents, Claims Adjusters

How Do Agents and Adjusters Get Paid?

Insurance agents can be paid through salaries, commissions, and bonuses after the negotiation of an insurance policy. Adjusters typically receive payments after claims are settled, and specific payments vary by type. While company adjusters are typically salaried employees, compensation for independent adjusters varies and may be based on carrier fee schedules, claim volume, or other contractual arrangements. Public adjusters commonly earn a percentage of the claim settlement, subject to state regulations.

Do Adjusters Get Paid More?

Adjusters may have greater earning opportunities during catastrophe events, while agents may have significant earning potential through commissions, renewals, and business growth. Experienced catastrophe adjusters may earn six-figure incomes during active disaster seasons, although earnings vary significantly based on deployment opportunities, licensing, and claim volume.

What’s the Difference Between Agent and Adjuster Licensing?

Before they can earn income, insurance agents and adjusters both need to be licensed to conduct business in a certain state. However, exact licensing requirements differ by role type and jurisdiction.

While agents generally obtain insurance producer licenses, some states require separate licenses for adjusters. Many states use NAIC guidelines and participate in reciprocity standards, while licensing applications and renewals are often processed through the National Insurance Producer Registry (NIPR).

Licensing Requirement	Agent	Adjuster
Type of License	Producer License	Adjuster License (requirements vary)
License Classification	Lines of Authority (LOA)	Adjuster Type (Independent, Company/Staff, or Public)
Residency Status	Resident and non-resident licensing	Resident, non-resident, or designated home state (DHS) licensing
Reciprocity & Non-Resident Licensing	Broad non-resident reciprocity (varies by state and line of authority)	Varies by state and adjuster type
Continuing Education, Renewals, & Pre-Licensing Education	Typically required	Varies by state and adjuster type
Appointments	Typically required	Generally not required
Examinations	Typically required	Varies by state and adjuster type

These licensing differences also contribute to different compliance challenges. Navigating different state licensing standards, reciprocity rules, and designated home state requirements can make multi-state compliance significantly more complex for adjusters.

Agent Licensing Compliance Challenges	Adjuster Licensing Compliance Challenges
Managing carrier appointments	Managing multi-state reciprocity
Tracking renewals and expirations	Determining which states require licenses
Monitoring continuing education	Monitoring varying adjuster classifications
Maintaining lines of authority	Maintaining DHS licenses

As a whole, agent licensing focuses on sales authority and carrier appointments, while adjuster licensing focuses on claims authority, reciprocity, and state-specific licensing rules. Both agents and adjusters should verify requirements with state departments of insurance, as requirements vary greatly by state and jurisdiction. They can also explore our state insurance licensing guides to learn more about state-specific requirements.

Why the Insurance Industry Needs Agents and Adjusters

“Agents support the relationship. Adjusters interpret the contract. It doesn’t always make the outcome easier to accept, but it does make it easier to explain” — Chantal M. Roberts, Adjuster, CPCU, AIC, RPA, ITP.

Overall, insurance agents and adjusters are both crucial players in the insurance industry, playing key roles in insurance distribution, claims management, and customer support.

Agents market, sell, and negotiate insurance policies, while adjusters manage claims for insurers or policyholders. Additional differences between agents and adjusters include distinct responsibilities, unique relationships with insurance entities, and varying earning potential. However, despite these differences, agents and adjusters may need to collaborate, especially during the claims adjustment process.

Finally, while there are some fundamental licensing differences between agents and adjusters, they share one essential need in common: Maintaining accurate and active licensing records in order to conduct business. For agents, adjusters, and their employers, insurance license management software can help support work that forms the foundation of the insurance industry.

Share this blog on