Which situation likely requires the involvement of a third party in the claims adjustment process?

In the claims adjustment process, the involvement of a third party is often necessary when there are significant discrepancies between the adjuster's assessment and the claimant's expectations or statements. This situation indicates a potential conflict or misunderstanding that could arise from different evaluations of damages, liability, or policy coverage.

When an adjuster and a claimant have vastly different views on the value of a claim or the circumstances surrounding it, a third-party mediator or arbitrator may be brought in to facilitate discussion and negotiations. This helps ensure that both parties have a fair opportunity to present their information and that the final settlement is equitable, based on the facts of the case and relevant insurance policy terms.

In contrast, simpler claims or those with straightforward incidents typically do not need a third party because the facts are clear and easily agreed upon, allowing for direct negotiations between the adjuster and the claimant.