In theory, the insurance claims process should be straightforward. A policyholder makes a claim following an incident that results in loss, and the insurance company pays out. However, as with most things, it’s rarely so straightforward, and that’s especially true when dealing with high-value claims.
When there’s a lot of money on the line, it’s important that due process is followed to ensure that the insurance company pays out — and the policyholder receives — the correct amount of money.
This is where a loss adjuster comes in. But what is loss adjustment, and what does a loss adjuster do? We’ll run through everything you need to know on this page.
If you’ve ever had to make a high-value claim on your insurance, then you will likely have come into contact with a loss adjuster. They’re appointed by insurance companies to investigate the details of a claim. They’re not needed for all types of claims, however — they’re usually only needed once the claim exceeds a certain value.
Their goal is to determine the facts of the incident. This, in turn, helps the insurance company determine the validity of the claim and, if so, to calculate the value of the payout. A good independent loss adjuster will work methodically and then present a written loss adjustment report to the insurance company.
Some people throw out the terms ‘loss assessor’ and ‘loss adjuster’ interchangeably, but there are big differences between the two. A loss adjuster is a specialist appointed by the insurance company. A loss assessor is a specialist hired by the person or group making the insurance claim.
That’s a significant difference because they essentially represent different parties. Groups who are making high-value claims will typically hire a loss adjuster to put together their own report before presenting it to the insurance company. They can handle many other elements of the insurance claim process, too. For one thing, they know how to negotiate — if an insurance company appears to be undervaluing the value of the claim, then a loss assessor can go to bat for the claimant, drawing upon their extensive knowledge of the insurance industry to ensure the true value of the claim is paid.
Loss assessors work on behalf of the claimant to ensure that they receive the full value of a claim. There are many reasons why a person might need to make a claim — their home could be damaged by a fire or flood, for instance, or they may be the victim of a burglary. A loss assessor, paid for by the claimant, will visit the site of the incident and conduct their own investigation, which they will then compile into a report to ensure that the insurance company pays the maximum value.
A loss assessor can handle virtually every aspect of the insurance claims process on behalf of the claimant. They can complete the paperwork and other essential actions and will also meet with the insurance company — of the loss adjuster working for the insurance company — to negotiate on your behalf.
The main reason individuals and companies hire loss assessors is that they work entirely with claimants and never with insurance companies. As such, when you hire a loss assessor, you’re essentially hiring someone with an in-depth understanding of the insurance industry to go to bat for you against the insurance company.
Insurance companies can’t — and shouldn’t — just pay out a claim without making sure that the claim is merited. This is why they hire loss adjusters, who are professionals who can investigate the claim to ensure that, first and foremost, the claim is a valid one and then calculate the value of the claim.
They work on behalf of insurance companies, but that doesn’t mean that they’re employees of insurance companies or that they’re solely interested in reducing the value of the claim. They’re hired by insurance companies, but they must also follow the codes of conduct as set out by the industry. In some cases, loss adjusters will increase the size of the claim. Ultimately, loss adjustment in insurance is an essential tool that keeps fraudulent claims out of the industry and ensures that the correct value is paid out.
Are loss adjusters independent?
One may think that a loss adjuster is motivated to reduce the value of a claim as they have been appointed by the insurer, this is not the case, there are strict guidelines that must be followed and the codes of conduct that have been outlined by the Chartered Institute of Loss Adjustors.
The work conducted by a loss adjuster is to provide the necessary evidence required to make a settlement that accurately represents the circumstances and allows both the insurer and the claimant to be accurately compensated for the loss.
Loss adjusters visit sites to assess the extent of the damage made in the claim. The most common type of insurance claim that loss adjusters handle is claims against the home. The first thing that a home insurance loss adjuster will do is determine whether the claim is valid under the terms of the insurance policy. For instance, if the damage to the property is due to flood damage, but the policy does not cover flood damage, then the visit may end there.
If the damage is covered under the terms of the policy, then the loss adjuster will determine the extent of the damage and the value of the loss. They’ll take photographs and create other documents, which they will then submit in their loss adjuster report to the insurance company, which will use the documents to calculate the payout.
You can assist the loss adjuster by having as much documentation as possible ready for inspection. For instance, any receipts you have for emergency repair work or receipts for the damaged products that you include in the insurance claim. Proof of ownership can also be useful. In general, the best approach is to avoid throwing anything away before the loss adjuster has visited the property and completed their work.
If you’re looking for loss adjusters in the UK, be sure to get in touch with us here at Reveal PI. We are members of the Chartered Institute of Loss Adjustors and we have extensive experience in assisting insurance companies to manage questionable insurance claims. We have access to a wide variety of advanced tools and working methods that will determine the validity of the claim and the extent of the damage.