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Loss Adjusters keep the claims process rolling
Insurance insights

Loss Adjusters keep the claims process rolling

06 Feb 2020 3 mins read

So you’ve made an insurance claim and been told a ‘loss adjuster’ has been assigned. Just who is this person and what do they do? 

It’s the moment of reckoning. There has been an accident or disaster and you need to make an insurance claim and it is up to the insurer to get you sorted as quickly as possible. 

Under the General Insurance Code of Practice, insurance companies are expected to respond to your claim within 10 business days, providing a decision, or feedback, based on the information you supply. To get it processed as quickly as possible, it is important to include as much relevant information as you can when you first submit the claim. Check out our article for tips on submitting a claim. 

There may be times when the insurance provider needs more information about a claim and to get this information they may appoint a loss adjuster, loss assessor or an investigator to help.

What is a loss adjuster?

Once a claim has been made to the insurance company, ‘loss adjusters’ or ‘loss assessors’ are appointed to evaluate the claim and work out the correct amount of money that needs to be paid based on the terms and conditions of your insurance policy.

In preparing their recommendation to the insurer, they will examine the circumstances and legitimacy of your claim, assess the damage or loss and work out whether it is covered under your policy. 

What do loss adjusters actually do?

In a nutshell, loss adjusters investigate insurance claims arising out of losses such as accidents, burglaries, fires, floods or natural disasters. It is their job to determine the amount of damage or loss covered by the insurance policy, recommend benefits based on that coverage, and negotiate payment and settlement. 

As part of their role they may be required to investigate the cause of the loss (e.g. how a fire started), conduct witness interviews, take statements and consult with police, fire authorities, emergency services, government agencies and specialists. They can also engage the services of licensed private investigators, accident reconstructionists and others to gather further information.

A loss adjuster may also be required to inspect and/or evaluate damage, estimate costs or commercial value, examine reports or other documents, evaluate losses and quantify settlement amounts.

Once they have gathered the required information, they then report on their findings, propose solutions and negotiate settlements and agreements between the parties. 

Depending on the circumstances, the loss adjuster may also be called on to take part in dispute resolution proceedings.

Who hires loss adjusters?

Loss adjusters are usually insurance company employees or independent individuals and companies hired by the insurers. After evaluating the loss, they provide their findings and recommendations back to the company so the claims process can continue. 

There are two main types of loss adjuster:

  • Company loss adjuster – is an employee of the insurance company and the person most commonly encountered by claimants.
  • Independent loss adjuster (used by EBM RentCover) – is an external individual or company hired by the insurance company. Independent adjusters are often brought in during very busy times such as in the wake of natural disasters. Claimants (policyholders or the ‘Insured’) can also hire a loss adjuster to provide a second opinion if they suspect their insurance company is not acting in good faith. 
What do I need to do?

If a loss adjuster is appointed to work through your claim, we will let you know at the beginning of the process and keep you regularly updated about their progress.

We are committed to working with you to minimise emotional and financial stress associated with making an insurance claim. So if you have any questions about your claim, our Expert Care Team is always here to help… 1800 661 662. 

Main photo by Freshh Connection on Unsplash

*While we have taken care to ensure the information above is true and correct at the time of publication, changes in circumstances and legislation after the displayed date may impact the accuracy of this article. If you need us we are there, contact 1800 961 017 if you have any questions. 

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