Who is Loss Adjuster?
Loss Adjuster is an independent claims specialist who investigates the claims to establish the cause of loss and then quantum of loss based on the supporting documents.
What is the role of a Loss Adjuster?
He plays a crucial role in the entire process of Insurance Claim
On obtaining relevant information about the claim the Loss Adjuster then determines whether the claim is valid and then assesses the amount of legitimate claim (i.e. the amount of claim payable) in line with the policy terms and conditions
Who appoints the Loss Adjuster?
For Post Loss Assessment the Loss Adjuster is generally appointed by the Insurers
Who else can avail services of a Loss Adjuster
The Insured can avail the services of a Loss Adjuster for services such as-
a) Claim Preparation- Loss Adjuster can offer services to guide the Insured in preparing his insurance claim subject to no conflict of interest. The Insured bears the fees charged by the Loss Adjuster for these services, however such charges can form part of claim amount subject to the terms and conditions of the policy
b) Risk Valuation
c) Risk Management Services
How quickly the Loss Adjuster will be on site
In the Loss Scenario the Loss Adjuster is generally appointed by the Insurers. On his appointment he seeks appointment from the Insured and reaches the site at the earliest opportunity. In urgent situation/major claim the loss adjuster may even call you within few hours of instructions.
How does Loss Adjuster help to mitigate the Loss?
The sooner is the claim intimated, the earlier can the loss Adjuster reach the site and can advise the safety and security measures which should be undertaken to mitigate further loss including the urgent repairs required to minimize the loss
What will a Loss Adjuster Generally Look for at the site?
It is critical part of the Loss Adjusters job to establish the cause of the loss/ damage and it’s extent. In order to perform this job, he will take photographs at the scene of damage and seek all the information relevant to the claim including the statements of the eye-witnesses.
What happens after the Loss Adjuster visits the site?
The Loss Adjuster will agree a course of action with the Insured and advise the next steps required to be taken by the Insured to resolve the claim. They will also provide the action plan in writing to the Insured, detailing what steps are required to be taken.
Does the Insured need permission of Loss Adjuster to dispose of the salvage?
Yes. Unless specifically agreed by the Loss Adjuster and/Insurer the Insured should not dispose of the salvage.
How early can the Insured expect payment of claim?
Once the loss Adjuster completes his investigation and is able to establish the cause and assessment of the claim, he then submits his report to the Insurer giving his findings and then the Insurers make a decision about the payment of claim
Can Loss Adjuster commit to the liability and/quantum of claim?
The loss adjuster is an independent party to the claim and works without prejudice. His findings are not binding/mandatory for the Insurers. Hence the Loss Adjuster can never commit to the liability and/quantum. It is the prerogative of the Insurer to decide the aspect of liability
What does Loss Adjuster look for?
The Loss Adjuster needs to establish the cause of loss and if that is established, then the extent of loss. The Loss Adjuster will typically review-
a) If the adequate insurance is in place to cover the loss or is there under-insurance
b) That there is no breach of policy conditions, endorsements and warranties
c) The cause of loss falls within the purview of the policy terms and conditions
d) The amount claimed is reasonable
e) That only the valid items are included in the claim raised by the Insured
Who pays the fees of a Loss Adjuster?
The party who avails the services of the Loss Adjuster pays the fees which is generally the Insurance Company
What is joint survey?
When two or more insurers are involved for the same claim then Loss Adjusters of different companies conduct the joint survey to avoid the disputes at later stage
What is Letter of Intent? and who writes the same?
In certain cases, even if the claim is paid under the Insurance policy the Insurers can recover the same for which the Recovery Rights of your Insurer needs to be protected. Letter of intent is issued to protect these rights of the Insurer. The Insured will have to write/issue the letter of intent to the party who is negligent /responsible for the cause of damage.
Mobile plant claims can be prevented by some simple risk management steps.One of the most common causes of these claims is known as “untrained/unlicensed operators”. This can potentially cause injury and or death.