Sue Regan by

Posted on November 20, 2013

The roles of Loss Adjusters and Loss Assessors are often confused, and although they are both insurance professionals and claims specialists, there is a vast difference between them.

Loss Adjusters are independent, professionally qualified persons and are experts in processing claims from start to finish. Straightforward smaller claims are often negotiated and settled by the Insurance Company’s own claims staff.  However, in the case of larger or more complex claims, Insurers will appoint a Loss Adjuster in order to assess a claim from an impartial point of view.

The Loss Adjuster will establish the cause of the loss, assess the validity of the claim and negotiate a settlement within the terms of the policy that is fair to both the Policyholder and the Insurer.

When Loss Adjusters are assigned to deal with a claim, they will first visit the property to survey the damage, ensure the property is protected and investigate all aspects of the claim fully. They will then prepare reports and liaise directly with the Policyholder as well as the Insurer to ensure that a fair settlement can be reached.  An Adjuster may also liaise with other insurers where there is a chance of recovering all or part of the claim from a third party.

Although a Loss Adjuster is appointed by the Insurer and their fees paid for by the Insurer, they operate under a strict professional code of conduct that requires that only settlements are recommended that are fair to both Insurer and Claimant.

Loss Assessors are very different in that they are appointed by the Policyholder when they need to submit a substantial or complex claim.  An Assessor’s fees are payable by the insured. These costs may not form part of the Insured’s claim.

The Assessor is almost like an employee and is responsible for negotiating the best possible settlement of the claim on the Policyholder’s behalf.  Quite often an Assessor will deal with claims that have previously been declined by the Insurance Company or where delays have occurred in agreeing settlement.

In summary, although both Loss Adjusters and Loss Assessors may work on the same claim, they will work in different ways and from different perspectives in order to reach a fair and timely settlement.

 

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