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In most simple terms, a Loss Adjuster is an insurance professional. Their 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.
During their visit, the Loss Adjuster should also advise which safety and security measures should be undertaken to mitigate any further loss, and offer advice regarding repair works to the property.
Once the extent of the damage requires the appointment of a Loss Adjuster, they will visit your property. At this point, it is common practice for many policyholders to seek their own representation in the form of a Loss Assessor (often know as an independent or public Loss Adjuster). A Loss Assessor works for you, not the insurer, and will manage all aspects of your insurance claim from start to finish.
Click here to understand the difference between Loss Adjusters and Loss Assessors.
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:
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.
The following information may come in useful when meeting the Loss Adjuster for the first time:
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.
The Loss Adjuster’s fee is paid by the insurance company who instructs them. Their fees are paid as part of the insurance claim.
Codes of conduct set out by The Chartered Institute of Loss Adjusters (CILA), General Insurance Standards Council (GISC), and The Association of British Insurers (ABI) require that Loss Adjusters operating in the UK do so impartially.
However, some policyholders have difficult experiences in dealing with Loss Adjusters by themselves…
“Due to the poor experience with the Loss Adjuster, we never thought that we would have our house returned to the condition before the incident happened, but Martin excelled in his quest to do exactly that. Morgan Clark provided a professional service with reassuring advice throughout what only can be described as the worse experience of our lives. With their help we were given back our home with minimal input from ourselves. Without their help we don’t think we would have received our house back to the standard that we now have. We cannot fault the service we received from them. Thank you.” – Mr Milan
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.
Appointing a Loss Assessor to handle a claim on your behalf is commonplace and will help 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 actually 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.
There are certain circumstances under which the information collected by the Loss Adjuster can result in your claim being rejected. An insurance policy is essentially a contract between you and your insurer, and if you don’t keep your end of the deal, then that contract is broken, and the insurer is not obliged to pay out.
For instance, this could be the result of you providing incorrect information to the insurer when you first took out the policy, the incident being caused by a lack of due care on your part, or if the insurer has adequate evidence to suspect the claim is fraudulent.
If you have had a claim rejected but believe it should not have been, there are steps you can take to try and reverse the decision:
In summary, Loss Adjusters work for the insurance company, while Loss Assessors work for you, the policyholder. You can read more about the differences between Loss Adjusters and Loss Assessors here.