What Role Does the Adjuster Play?
The adjuster’s job is to determine if a claim is compensable under the Act, approve and monitor all reasonable and necessary medical care, pay benefits that are owed and protect the interests of the injured worker, the insurance company as well as the employer. The adjuster will investigate the claim and determine what benefits are owed. The adjuster will authorize all reasonable and necessary medical procedures.
Adjusters are required to deal with you in good faith. They are not allowed to cause unnecessary delays in payment benefits. Unless you have an attorney, your primary contact throughout your claim will most likely be the claims adjuster assigned to handle your claim. At New Mexico Mutual different adjusters are assigned to different claims, depending on the severity of the injury, and the expertise of the adjuster. It is possible that your claim may be transferred from one adjuster to another as your case develops.