In an ideal world, all insurance claims will be dealt with and agreed upon quickly and painlessly, allowing everyone’s life to return to normal. However, with larger or more complex claims or where there may be a query over whether an incident is covered by a policy, insurers or brokers with their own claims teams may need to appoint a loss adjuster.
Remember, loss adjusters are not the enemy. They are professionals appointed by your insurer to confirm the cause and cost of your claim, assessing the extent of any damage caused, and to verify that the claim is covered by your policy. The loss adjuster will advise your insurer of the amount that should be paid out for your claim.
Although they are appointed and paid for by insurers, they remain independent with their own professional body, the Chartered Institute of Loss Adjusters. Their job is to ensure you receive the right, fair amount, not the smallest amount. They have no stake in the amount of the claim.
Pre-empting problems with the right policy
If you have any concerns about a loss adjuster handling your claim, or difficulties dealing with their requests for information, you can appoint a loss assessor to argue your case, but you will have to pay for their services. Some people even take out commercial loss insurance to cover the costs of negotiating claims.
Ideally, this will not be necessary if you have the right cover and policy limits in place to meet your needs, and keep insurers up to date with changes in your circumstances.
All this is a reminder of why it makes sense to work with a specialist broker who knows about your type of building and can help you get appropriate levels of coverage, can prompt you to make sure you adhere to insurers’ conditions and requests for remedial action following an insurance survey. Even better is a broker like Gallagher, with their dedicated in-house claims team, who can advise you through the whole process. Meet a few of our claims team members here.
In many cases, our team can process, approve, and pay claims directly because based on our record, many insurers trust us and give us delegated claims-handling powers. That means you only have to talk to one person. Our authority includes appointing a trusted loss adjuster to £100,000, and we can usually handle and pay claims from start to finish without any reference to insurers.
When we do need to refer a claim to the insurer or where the case is complex or the building particularly unusual, and a loss adjuster is appointed, we can still help you to prepare for their visit.
What happens when a loss adjuster visits?
The priority of a loss adjuster will be to establish whether your insurance policy covers you for the loss, so be sure you get your policy terms right and review your cover – don’t just auto-renew each year.
If the value of your building that you declare falls below real-world prices, you may not be fully insured and any claim you make, no matter how big or small, could be reduced in proportion to how underinsured you have become over the years. Find out more here.
Loss adjusters will investigate the cause of the incident and the value of loss or damage. They will also, of course, look at whether you have met your insurance policy’s terms and conditions and declared the risk honestly. Failure to fit good locks could compromise a burglary claim. Failure to act on the recommendations of an insurance survey would also be a consideration. If poor maintenance is seen to have contributed to damage, that could also lead a loss adjuster to reduce the value of the pay-out accordingly. Not letting the insurers know about flats being sub-let could also compromise your cover.
It’s just not worth the risk – all it should take to put things right if circumstances change is a quick call to your broker.
Loss adjusters will usually take photographs to support their findings. It is usually a good idea for you to do the same for your records. If you follow the Association of British Insurers guide to preparing for a claim, you should be ready to lodge your claim whether or not a loss adjuster’s services are needed.
Complaints and Fair Outcomes
We looked at the Financial Ombudsman reports and found relatively few complaints relating to loss adjusters and outcomes that give the lie to any idea that they are biased towards the insurers. What these cases do highlight is the importance of getting your policy declaration, building valuation, and cover right for your needs.
If in doubt, ask your broker to double-check and advise, but do remember ultimately the responsibility for accurate disclosure lies with you.
Disclaimer:
The sole purpose of this article is to provide guidance on the issues covered. This article is not intended to give legal advice, and, accordingly, it should not be relied upon. It should not be regarded as a comprehensive statement of the law and/or market practice in this area. We make no claims as to the completeness or accuracy of the information contained herein or in the links which were live at the date of publication. You should not act upon (or should refrain from acting upon) information in this publication without first seeking specific legal and/or specialist advice. Arthur J. Gallagher Insurance Brokers Limited accepts no liability for any inaccuracy, omission or mistake in this publication, nor will we be responsible for any loss which may be suffered as a result of any person relying on the information contained herein.
FP1231-2024