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Loss Adjusters: Your questions answered

Anyone who has been involved in a major insurance claim, such as a fire or flood at their home or business premises, will have likely come into contact with a Loss Adjuster. This guide will provide answers to the frequently asked questions relating to the role of the Loss Adjuster in the insurance claim process...

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What is the role of the Loss Adjuster?

The Loss Adjuster’s job is to investigate insurance claims on behalf of the insurer once they reach a certain size. The Loss Adjuster plays a crucial role in the insurance claims process and is usually the first person you will come into contact with from the insurance company after a claim is logged.

The Loss Adjuster will typically visit your property within a few days of the claim being initiated by the insurance company. The purpose of this visit is to obtain all the necessary facts, in order for your insurance company to determine whether the claim is valid and ensure the amount paid to you is correct, in accordance with your policy. This information is presented to the insurance company in the form of the Loss Adjuster’s report.

My insurance company is sending out a Loss Adjuster, should I be worried?

If the extent of damage to your property requires the appointment of a Loss Adjuster, many people seek their own representation in the form of a Loss Assessor. A Loss Assessor works for you, not the insurer, and will manage all aspects of your insurance claim.

To read more about the difference between Loss Adjusters and Loss Assessors, please click here.

What does a Loss Adjuster look for?

The first duty of the Loss Adjuster is to establish whether the insurance company is liable under the terms of your insurance policy, and if so, to what extent. The Loss Adjuster will typically review the following things:

  • That adequate insurance is in place to cover the loss
  • That all conditions and endorsements in the policy have been met
  • That the loss or damage to the property falls within the terms of the policy
  • That the amount being claimed for is reasonable
  • That only valid items are included in the claim

Ultimately, the Loss Adjuster will be looking to establish the cause of the incident and whether the damage suffered as a result, is covered by the insurance policy.

Who pays the Loss Adjuster’s fee?

The Loss Adjuster’s fee is paid by the insurance company. Their fees are paid as part of the insurance claim.

Are Loss Adjusters impartial?

It is not uncommon for people to wonder how a Loss Adjuster could be impartial when they are appointed and paid by the insurance company. There are codes of conduct set out by The Chartered Institute of Loss Adjusters, General Insurance Standards Council, and The Association of British Insurers that attempt to address this concern and require that Loss Adjusters operating in the UK do so impartially.

Some people still have a very difficult time trying to deal with the Loss Adjuster on their own however. You can watch how some recall their insurance claim experiences here.

How can I help the Loss Adjuster speed up the process?

These items may come in useful when meeting the Loss Adjuster for the first time:

  • Receipts for any emergency repair works that were carried out following the incident
  • Proof of ownership of high value lost or damaged items (receipts, photographic evidence of damaged items etc.)

It is important that you do not throw anything away until the Loss Adjuster has inspected the property and all items have been accounted for. If you dispose of something that cannot be accounted for, you may not be able to claim for it.

What can I do if I am unhappy with the conduct of the Loss Adjuster?

If you have a complaint about the conduct of a Loss Adjuster, you can submit a complaint to the Chartered Institute of Loss Adjusters (CILA). It is important to note that the Chartered Institute of Loss Adjusters has no jurisdiction concerning the settlement of insurance claims – such issues should be raised directly with the insurance company. A complaint can be escalated to the Financial Ombudsman should you not find a resolution with the insurance company.

Will hiring a Loss Assessor annoy the Loss Adjuster?

Appointing a Loss Assessor to handle a claim on your behalf is commonplace these days. They will help to ensure a resolution is met in an efficient and timely manner. With this in mind, there is no reason a Loss Adjuster should deter you from seeking your own representation during the claims process. In fact, many Loss Adjusters have recommended Morgan Clark Loss Assessors to their clients, as it allows them to communicate with a fellow professional, which makes the claims process run more smoothly.

If you find yourself in a position where the Loss Adjuster is trying to dissuade you from using a Loss Assessor, you should question their motives – this could be because they want to save the insurer money by settling your claim as cheaply as possible.

What can I do if my claim is rejected/repudiated?

There are certain circumstances under which the information collected by the Loss Adjuster can result in your claim being rejected. To find out more about the actions you can take in this scenario, please visit this page.

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