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Adjuster Reason Codes

When an adjuster wishes to decline a form or line item, he or she must select an appropriate ‘Reason Code’ from the list of available codes. It is important that this reason code accurately reflect the reason for their decision.

Reason codes provide valuable statistical information that informs your organization and the industry about the reasons why forms are declined.

When you arrive at the ‘Reason Code Look Up’ screen, you will see a list of codes. By default, all reason codes appear and the list will shorten as you select from the available filters.

Adjusters are encouraged to refrain from using the ‘Other’ code, when possible. This is because the freeform text next to this code cannot be collected or analyzed for privacy reasons.

If you have questions about which codes to use, please speak to a manager at your organization for direction.

For a complete list of reason codes, click here.