Insurance Industry Workers Claims
Labor Lawyers for Insurance Industry Workers
At Blumenthal, Nordrehaug & Bhowmik, our employment lawyers are committed to helping claims adjusters vindicate their rights in the face of wage-and-hour violations. We work on a contingency fee in these types of overtime wage cases in California communities such as Los Angeles, San Diego, San Jose, Fresno and the San Francisco Bay Area.
Claims Adjusters making a fixed Salary without Overtime Pay?
Claims adjusters may still be entitled to receive overtime pay for working more than 8 hours in a workday or 40 hours in a workweek. In order to avoid paying claims adjusters overtime wages, employers have the burden to prove that the employees meet the job duties test of one of the exemptions. With respect to claims adjusters, the administrative exemption is often the only exemption from overtime that is applicable. To qualify for the administrative employee exemption, all of the following tests must be met:
- The employee must be compensated on a salary or fee basis (as defined in the regulations) at a rate not less than $455 per week;
- The employee’s primary duty must be the performance of office or non-manual work directly related to the management or general business operations of the employer or the employer’s customers; and
- The employee’s primary duty includes the exercise of discretion and independent judgment with respect to matters of significance.
Whether they work for an insurance company or other type of company, insurance claims adjusters generally meet the duties requirements for the administrative exemption and are not entitled to overtime pay if their duties include activities such as interviewing insureds, witnesses and physicians; inspecting property damage; reviewing factual information to prepare damage estimates; evaluating and making recommendations regarding coverage of claims; determining liability and total value of a claim; negotiating settlements; and making recommendations regarding litigation.
Your Job Title Does Not Determine Your Right to Overtime
The status of an insurance claims adjuster does not rely on the “claims adjuster” job title alone. There must be a case-by-case assessment to determine whether the employee’s duties meet the requirements for exemption. Here are some types of insurance industry workers frequently misclassified as exempt from overtime pay:
- Appraisers - assesses the cost or value of an insured item, for example inspects damaged vehicles after an accident and estimates the cost of repairs.
- Insurance Claims Adjuster - plans and schedules the work required to process a claim; investigates claims by interviewing the claimant and witnesses, consulting police and hospital records and inspecting property damage to determine the extent of the company’s liability; may also consult with accountants, architects, construction workers, engineers, lawyers and physicians; negotiates with the claimant to settle the claim and may assist in litigation.
- Insurance Claims Examiner - reviews insurance claims submitted to ensure that proper guidelines have been followed; may assist adjusters with complex and complicated claims or when a disaster suddenly greatly increases the volume of claims.
- Insurance Underwriter - identifies and calculates the risk of loss from policyholders, establishes appropriate premium rates, and writes policies that cover these risks.
- Insurance Sales Agent - sells one or more types of insurance, such as property and casualty, life, health, disability and long-term care; may also offer comprehensive financial planning services, such as retirement planning, estate planning or assistance in setting up pension plans for businesses.
If you work in the insurance industry and need advice about your legal right to overtime, the attorneys of Blumenthal, Nordrehaug & Bhowmik can review your situation and advise you accordingly. If you’re classified as exempt from overtime laws or earn a salary, you still might be entitled to back pay for unpaid overtime. Contact us in San Diego, Los Angeles or San Francisco for free legal advice about your employee rights.
