Today we’re talking to Martin Chapman, a Morgan Clark Loss Assessor based in the North. Martin has been working in the insurance sector for nearly 25 years and has experience in both domestic and commercial claims. Before joining us, Martin worked as an insurance adjuster, meaning he has experienced the insurance claims process from both sides.
Here are some of the key things that insurance adjusters look for when investigating an insurance claim according to Martin.
When an insurance company sends an insurance adjuster (or Loss Adjuster) to visit a claimant’s property, they will be checking how adequately both the buildings and contents have been insured as this can affect settlement.
However the property has been damaged – whether by fire damage, flooding or other means – one of the first things the insurance adjuster will check is whether the insurance you have taken out is adequate. You can only receive the amount your insurance policy entitles you to, so they will check to make sure your insurance policy covers the full extent of the damage incurred.
The insurance adjuster will also clarify the claim circumstances.
When an insurance adjuster investigates a claim on behalf of an insurer, they will determine that the information provided by the claimant is accurate. They will be checking that any new information given is the same as when the claim was registered and if the damage is consistent with the claim circumstances.
An insurance adjuster will confirm the information provided by the policyholder at policy inception to ensure this is correct.
One of the most common reasons why insurance claims are rejected is because of a lack of information or because incorrect information was given when the policy was taken out. The insurance adjuster might be looking for any false or inaccurate information that could invalidate your insurance claim before going any further.
The information the insurance adjuster checks for can include:
- Who owns the property (insurable interest)
- The number of occupants living in the property, to ensure there were no lodgers or tenants
- Any CCJ’s/bankruptcies/insolvencies/IVA’s or other potential motive
- Previous insurers. Frequent change of insurers used to be a fraud indicator
- Previous addresses, to enable background checks
- Whether the property has been used for business purposes. This is often not disclosed and can increase the risk
- The number of years at the address. This can determine if the damage falls within the period of cover
The insurance adjuster will check that the property and contents are in good condition.
If the property has not been maintained or its contents are not in good condition, this can affect settlement. The insurance adjuster will check the condition of both the property and its content to ensure they have been maintained to an acceptable level by the owner. The policy can change from a ‘new for old’ (or reinstatement) policy to an ‘indemnity’ policy, this means a deduction is taken to reflect poor pre-loss condition.
Once the insurance adjuster has made their assessment, they will determine if referral to a special investigator is warranted.
In some cases, the insurance company may wish to send a special investigator. The insurance adjuster’s previous checks will enable them to determine a ‘score’ to make this decision.
Whatever happens during the insurance claims process, you don’t have to go through it alone. Get in touch today to find out how our Loss Assessors, like Martin, can help you through the entire process, from dealing with insurance adjusters to getting a fair settlement on your insurance claim.