Property/casualty insurers employ a variety of workers that make important decisions about your insurance coverage. Many of these workers have little or no interaction with policyholders so you may not even know they exist. This article will help you understand the various roles that are performed inside an insurance company and how they affect you as a policyholder.

Types of Insurance Companies

Many policyholders rarely interact with their insurers directly since most of their communication takes place through an independent agent.

Other policyholders communicate directly with their insurers. The nature and extent of your communication with your insurer depends largely on the way  your insurer distributes its products. Most insurers that offer commercial insurance coverages distribute their policies via agents or brokers. However, a few insurers sell their policies directly to insurance buyers.

• Direct Writer: Insurance companies that sell policies directly to insurance buyers without the use of agents or brokers are called direct writers. Buyers typically purchase policies via the telephone or a website or by visiting the insurer's sales office. An example of a direct writer is Nationwide Insurance.
• Exclusive Agency Insurer: Some insurers, such as Farmers Insurance and State Farm, sell their products through agents that work exclusively for the insurer. An exclusive agent sells policies on behalf of one insurer only.
• Independent Agency Insurer: Most insurers that sell business insurance policies distribute their products through independent agents and brokers. An independent agent must be appointed by (have a contract with) a particular insurer in order to sell its policies.

Insurance Company Employees

Here are the key roles performed by employees of property/casualty insurance companies. As noted below, some of these are not performed by all insurers.

Customer Service Representative: Since direct writers do not utilize agents or brokers, they normally sell their products through customer service representatives (CSR's). Customers purchase policies by contacting a CSR via telephone or the Internet, or by visiting the insurer's local office. The CSR gathers information from the customer and provides a quote. After the policy is issued, the CSR remains the customer's primary contact for all matters related to the policy other than claims.

Exclusive Agents: When an insurer uses exclusive agents, customers purchase policies directly from an agent. The agent collects information from the customer and provides a quote. Except with regard to claims, the agent remains the policyholder's primary contact after the policy is issued.

Sales Representatives: Some insurers employ sales representatives to recruit new customers. These employees call on potential clients and introduce them to the company's products. In the past, many insurers that utilized independent agents employed sales employees. These employees  generated business by developing relationships with agents. However, in recent years many insurers have reduced or eliminated their sales staff and transferred the sales functions to underwriters.

Commercial Underwriter: Underwriters review insurance applications they have received from CSR's or agents (exclusive or independent) and brokers. An underwriter decides whether your company meets the insurer's underwriting guidelines. To make this decision, the underwriter will review your company's operations, its premium and loss history, financial data and other information. The underwriter will determine whether your company is an average, better than average or below average risk. The risks you present will be reflected in your premium. Good risks pay less than poor risks. Several months before your policy expires, the underwriter will review your loss experience and other information to determine whether your policy should be renewed and if so, the premium that will be charged.

Insurance Adjuster: If you have an accident or loss, you should follow your insurer's instructions for filing a claim. Typically, you may file the initial report via telephone or the Internet. Once a claim has been filed, the insurer will assign an adjuster to your case. The adjuster will review the details of the loss and inspect any property (yours or the claimant's) that has been damaged. He or she will interview witnesses, claimants, physicians, police and other sources of information relevant to the claim. The adjuster will also review your policy to determine whether the loss is covered. He or she may negotiate a settlement with you (or the claimant) and authorize payments.

Claims Examiner: As their title suggests, claims examiners review claim information provided by adjusters to determine whether the claims have been handled properly. Examiners do not review every claim. They focus on those that are complex, severe, questionable or otherwise require extra attention. Examiners enter claim payments, reserve amounts and other data into the insurer's computer system. They may interview witnesses, attorneys, physicians and others involved in the claim. Examiners keep track of claims until they are finalized and all costs have been verified.

Loss Control Representative: Loss control personnel make physical inspections of buildings, vehicles and other property to ensure that it is safe and free of hazards. Inspectors educate policyholders about the hazards that exist on their property and what policyholders can do to make their buildings safer. If you have workers compensation coverage, an inspector may monitor your employees to make sure they are using proper safety equipment to avoid injuries. If you have commercial auto coverage, the loss control rep may inspect your vehicles. Once the inspection is completed, the loss control rep may recommend changes to reduce or eliminate hazards. Some recommendations may be optional. Others may be mandatory, meaning that you must comply in order to retain your coverage. The loss control report is forwarded to the underwriter, who uses the information to further evaluate your risks.

Premium Auditor: Many types of insurance policies are subject to an annual audit. Premium auditors visit your premises to review your financial records. They analyze your payroll, sales and other records to check for accuracy and to make sure laws are being followed. Auditors may conduct some audits by telephone. The auditor will determine your final premium and compare it to your initial (deposit) premium. If the two numbers differ, you may be charged an additional premium or provided a refund.

Actuary: While you may never meet an actuary, these individuals largely determine the rates you pay. Actuaries use mathematical models to make predictions about future losses. They help create new products by developing pricing and by forecasting future experience. Actuaries help insurers determine what rates to charge in order to compete with other insurers but still remain profitable.