A loss adjuster is not an insurance company employee, even though he or she might work with insurers. The loss adjuster is a professional whose job description includes the ones below:
Inspect the property and assess household claims
Discuss claim circumstances with the insured party
Inspect damage and report to the insurers.
When the loss adjuster has done all these things the insurer will then take a decision based on the findings of the loss adjuster and other relevant facts.
Depending on the circumstances and the insurance contract, loss adjusters can operate in two ways. The first one is the “delegated authority” method. In this case, the loss adjuster can take decisions concerning the claim on behalf of the insurer. In other instances, the loss adjuster will act on a “non-delegated authority” basis. This means that the loss adjuster will be mandated by the insurer to carry out investigations and report to the insurer. In this case, the insurer takes the decision concerning the claim and tells the loss adjuster what to do.
Why are Loss Adjusters appointed?
These experts can be appointed for a variety of reasons including the ones below:
The claim in question is over a particular amount of amount in value. In some cases, this can be as low as $500.
The insurer has some concerns about fraudulent activity and the claims investigated.
The insurer has several concerns and wants an inspection to be carried out by loss adjusters.
The claim is complex and has high value. This means it requires the attention of skilled people like loss adjusters.
Note that if a loss adjuster is appointed to look into your claim, it doesn’t follow that there is a problem with the claim. It is part of the procedure.
Are Loss Adjusters really impartial?
First off, we have to remember that the whole concept of insurance is based on utmost good faith. This applies to loss adjusters, insurance companies, and clients. In theory, loss adjusters are supposed to be impartial and independent professionals working in the interest of both the insured party and the insurer.
As stated already, loss adjusters are supposed to act impartially and independently. However, in cases where these adjusters have to work in a “delegated authority” capacity, they tend to see things from the perspective of the insurance company and not from that of the insured party. This is because the loss adjuster wants to ensure that the insured party is not overpaid. In cases where the insurance company pays the insured party more than it should have, this will affect the profit margin of the loss adjuster. This is why loss adjusters appear to be on the side of the insurer when they are acting in the delegated authority capacity.
Since the fees of the loss adjusters are paid by the insurance company, this presents a problem in itself. This might affect the independence and the objectivity of the loss adjuster because they want to keep the insurer happy. They can only do this by trying to cut down on the claims of the insured party.
Types of Loss Adjusters
There are different types of Loss Adjusters and these professionals come with different skill levels, qualifications, and experience.
Senior loss adjusters with the right experience and qualifications don’t usually bother with household claims. They can only make exceptions when the claim in question is substantial (at least £100,000 or more).
Many loss adjusters who will be handling general household claims are likely to be inexperienced and relatively young. This means they may not have the competence to make the right decisions.
Again, many adjusters who have to work under pressure can be too busy to give you the time and attention you need. This results in unnecessary delays and makes it more unlikely that you will get a favorable outcome when they work on your claims.
Now, what you need to know is that you have legal rights even if your loss adjuster claims to be working under pressure. You have a valid insurance contract and you have been paying the premiums at the right time. Now it is time for compensation, so you should not accept unethical behavior from the loss adjuster or any other professional. Channel your complaints to the appropriate quarters, and you can even get compensation If you can prove the loss adjuster acted against your interests.…