What Is an Insurance Loss Adjuster?

An Insurance company will appoint a Loss Adjuster to evaluate your household claim. The Adjuster will usually visit your home to assess the damage and discuss the circumstances. The Adjuster will then report back to the Insurers. A decision will be made about whether or not your claim is covered, and also the financial payout.

Sometimes adjusters will be given instructions to handle the claim on a “delegated authority” basis. This means that they will take all the decisions for the Insurer. They may also be instructed to act on a “delegated authority” basis, which is usually used for large claims. In this case, they will conduct the investigation and report back to Insurance companies, who will make the final decisions and advise the Adjuster.

Why Loss Adjusters are appointed?

An Insurer might appoint an Adjuster for many reasons, including:

  • The claim is for a fixed value (in some instances, as low at PS500).
  • If the Insurer is concerned about policy coverage or requires inspection
  • Investigators should be contacted if there are any concerns about the circumstances or fraud.
  • Complex claims or those of high value may require the assistance of skilled personnel.
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An Adjuster appointed to your claim does not necessarily signify that something is wrong. It may simply be used to manage the claim.

Are Loss Adjusters truly impartial?

Loss Adjusters should be impartial and independent. They are also supposed to act in fairness for both the Policyholders and the Insurer.

Although Adjusters should act impartially and independently, it can be difficult to strictly adhere to this, especially if the Insurer has given the permission for the Loss Adjuster to handle the claim under a delegated authority basis. Insurers expect that the Loss adjuster follows the policy terms and does not overpay Policyholders. In such cases, the Insurer will often look to the Adjuster for repayments. This can, in simple terms, affect the Loss Adjusters profit margin. This means that Loss Adjusters who are dealing with claims on a delegated basis may not be flexible with your claim.

The Insurance company pays Loss Adjuster fees. Many argue that this compromises the impartiality and independence of the Loss Assesser. They are required to make sure that claims are not overspent.

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Loss Adjuster

There are many types of Loss Adjusters. Each one has different skills, experience, and qualifications.

Most senior, experienced, or qualified loss adjusters won’t handle household claims (unless they have a significant size, eg: PS100,000.+), as they will be used for more specific claims.

General household claims adjusters will often be less experienced than others and may not have the necessary qualifications or chartered. This can lead to them making mistakes that could be beneficial or detrimental depending on what they’ve done.

Many household adjusters work in a stressful environment that can often become very busy, especially during severe weather events like storms and floods. This can lead to service issues for Claimants. You may experience delays, struggle to speak with them, or not receive a timely reply.

Even during normal workload periods, you might find that your adjuster is not organized, laidback, or competent in his job. Keep a log of all claims activity, dates/times, and actions. This will help you to file a complaint if you are able to show that you suffered from service issues. You may also be eligible for financial compensation.

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Knowledge is key to a successful claim for household insurance.