Insurance insights

Loss Adjusters keep the claims process rolling

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?

Under the General Insurance Code of Practice, insurance companies are expected to respond to a 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. They work out what needs to happen based on the terms and conditions of the insurance policy so they can make a recommendation to the insurer.

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 and make a recommendation to the insurer based on that coverage.

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, structural engineers 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 may engage in negotiating 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 sometimes 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. They 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, your insurer will let you know at the beginning of the process and keep you regularly updated about their progress.

Can I request a loss adjuster be appointed to my claim?

If you think it is in your best interest to have a loss adjuster appointed to your claim, you can ask the insurer to do this. However, it is important to note that the outcome of your claim may take longer. During times of natural disasters, this is particularly the case; loss adjusters are booked up during major weather events! So, if an insurer is willing to settle a claim on your behalf without the use of a loss adjuster, this is a good thing.

I need more information about loss adjusters. Who do I call?

At EBM RentCover, 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 or the way we use loss adjusters, our Expert Care Team is here to help… 1800 661 662.

*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 here, contact 1800 661 662 if you have any questions.