A Loss Adjuster is an external professional appointed by an Insurance company to assess your household claim. The Adjuster will normally attend your property, discuss the claim circumstances and inspect any damage. They will then report to Insurers and a decision is made on whether your claim is covered and also determine the financial payout.
Adjusters may be instructed to deal with the claim on a 'delegated authority' basis - this means they will make the claim decisions fully on behalf of the Insurer. Alternatively, usually on very large claims, they will act on a 'non delegated authority' basis whereby they will undertake the investigations and report back to the Insurance company who will then make the decisions and advise the Adjuster how to proceed.
Why are Loss Adjusters appointed?
An Adjuster may be appointed by an Insurer for a variety of reasons including:
The claim is over a set value (in some cases, as low as £500)
If the Insurer has concerns regarding policy coverage and requires an inspection
If there are concerns with the circumstances or any fraud related concerns to be investigated further
If the claim is of a high value or complex in nature requiring suitably skilled persons to handle
If an Adjuster has been appointed on your claim, it does not necessarily mean that there is something wrong and it may purely be to manage the claim.
Are Loss Adjusters really impartial?
Loss Adjusters are supposed to be independent and impartial and in theory supposed to be acting in fairness on behalf of you the Policyholder and the Insurer.
Adjusters should act independently and impartially however, strictly adhering to this can be difficult, especially when the Insurer has provided the Loss Adjuster with permission to deal with the claim on a delegated authority basis. In this scenario, Insurers expect the Loss Adjuster to strictly comply with the policy wording and ensure a Policyholder is not overpaid - if this is breached, the Insurer will frequently look to the Adjuster to repay any claims overspend which in simple terms can affect the Loss Adjusters profit margin. In view of this, Loss Adjusters dealing with a claim on a delegated basis will generally be inflexible with your claim which may lead to you not being treated fairly due to the strict application of the policy terms
Loss Adjuster fee's are paid by the Insurance company and many argue that this in itself compromises the impartiality of the Loss Adjuster as they are required to keep the insurance company happy by ensuring that they do not overspend on claims.
Types of Loss Adjuster
There are different types of Loss Adjusters with varying levels of skills, experience and qualifications.
Many senior and experienced / qualified loss adjusters will normally not deal with household claims (unless they are of a substantial size eg: £100,000+) as they will be utilised for more specialist claims.
Many of the Adjusters who deal with general household claims will be less experienced and the majority will not be qualified or chartered - this can mean that they may not always make the correct decisions which can be of benefit or detriment to you depending on the decision they have made!
Many household adjusters will work within a pressurised environment which can frequently become extremely busy (especially during weather events such as storms or floods). In real terms, this can result in service issues to Claimants and you may find that you experience delays or struggle to get speaking with them or receive a timely response from them.
Be aware, even during periods where workloads are normal, if you have an adjuster who is unorganised, laidback or not fully competent at his job you may find that this occurs in any case. This is a crucial reason as to why you should keep a log of your claims activity including actions and dates / times because if you suffer due to such service issues, you will be in a position to make a complaint and can use this information to demonstrate the level of problems you have experienced - if your complaint is valid, this will normally be prioritised for resolution and you may even be entitled to some financial compensation.
No comments:
Post a Comment