Loss adjuster is a qualified person who deals with settlement of the insurance claim that arises from the insurance policy and decides on the sum that is paid to a person or group in whose name an insurance policy is held so as the claim is regulated. Loss adjusters settle insurance claims in case of damage of owned goods (e.g. natural disaster or property destruction) and other claims e.g. in case of bodily injury (K. Soultati, I. Sartzetaki 2013, p. 48).
Characteristics of loss adjusters
T. Boobier says that: Loss adjusters are impartial claims specialists paid by insurers (T. Boobier 2005, p. 306). Loss adjusters are very often appointed to assess the condition of real estate after various disasters, including floods (R. Soetanto, D. Proverbs 2004, p. 7). Before the claim is assigned to a specified loss adjuster a short-term insurer has to receive all the essential information about the claim. There are two options: loss adjuster may work for the short-term insurer or operate on his own, but in this case, he is nominated by the short-term insurer. Working on the claim's information contains both on detail of the event and the people involved. Summary and ratification of the data is the most important thing in the claim. It helps to track any fraudulent claims relying on the previous claims of a person or organization covered by insurance. To assess the claim, the loss adjuster has to make sure whether the insured does not fall behind with any premiums and if all the documents are valid. Then the claim adjuster should assess the cause of the loss or damage and the amount of money the insured should receive (Jaarsveld J., Mostert F J., Mostert J H. 2015, p.136).
History of loss adjusters
The history loss adjusters began in 1666 in London during the Great Fire of London. Shortly after these events, fire insurance became a common thing and loss adjusters advised independent surveyors and builders in dealing with claims. The word loss adjuster first appeared in 1941, when the Association of the Fire Loss Adjusters was founded. It was a group of experts involved at the time of a national suffering due to a huge fire caused by the bombing (T. Boobier 2005, p. 306).
Role of loss adjusters
For insurance companies to work flawlessly, loss adjusters should work fairly on insurance claims. Their duties may be different depending on a directive they are given and they can be as follows:
- meeting with the sites involved in the case and making a research about the claim
- conversation with clients in order to gather evidence for reasons of the situation
- collecting helpful materials such as security cameras recordings
- contacting a person who is highly skilled in a specific field if a precise report is needed
- filling out obligatory paperwork
- estimating the size of the physical harm
- making sure that the injured party is entitled to compensation, that the amount is appropriate and whether the amount of money requested is acceptable
- negotiating payments
- making sure that insured person did not omit any important factors of the claim, giving advice on how the damage can be repaired, dealing with cleaning or rescue
- examination or research if any fraud in claims is suspected
- preparation of a report comprising arrangements and suggestions for the insurer
- advising the applicant on how to protect himself so that he avoids accidents or losses in the future (K. Soultati, I. Sartzetaki 2013, p. 49)
- Boobier T. (2005), The war on subsidence — Solutions for an event year and the role of the loss adjuster Journal of Building Appraisal Volume 1, Issue 4
- Jaarsveld J., Mostert F J., Mostert, J H. (2015), The claims handling process of liability insurance in South Africa, Risk governance & control: Financial markets & institutions, 5(1-1)
- Soetanto R., Proverbs D. (2004), Impact of flood characteristics on damage caused to UK domestic properties: the perceptions of building surveyors, Structural Survey Vol. 22, No. 2
- Soultati K., and Sartzetaki I. (2013), Loss adjusters: should divergence across EU member states be dealt with?, European Insurance Law Review, no. 4
Author: Weronika Piotrowska