When it comes to insurance claims, especially when there’s big damage or loss, two main roles come into play: loss adjusters and loss assessors. Both are part of the insurance claims process but they have different roles and represent different interests. Knowing their roles and how they differ is important if you’re going through an insurance claim.
What is a Loss Adjuster?Role and Responsibilities
A loss adjuster such as Claimrite UK is an insurance company employee who assesses and investigates insurance claims. Their main job is to determine the extent of the insurer’s liability for a claim. This means:
- Investigating Claims: Loss adjusters investigate the circumstances of the claim to determine if it’s valid. This means examining the cause of the loss or damage and the extent of the loss.
- Assessing Damages: They quantify the damage or loss to determine how much the insurance company should pay. This might involve consulting with experts like engineers or medical professionals to assess specific parts of a claim.
- Negotiating Settlements: Loss adjusters negotiate with policyholders or their representatives to reach a fair settlement in line with the insurance policy terms and conditions.
- Reporting to Insurers: After the assessment, loss adjusters submit their report to the insurance company. This includes recommendations on the claim settlement.
Who Do They Work For?
Loss adjusters work for insurance companies. They are loyal to the insurer and their main job is to protect the insurer’s interests. They want to make sure claims are valid and settlements are fair but not excessive.
Skills and Qualifications
Loss adjusters have strong analytical skills and often have a background in insurance, finance or a related field. They usually have qualifications from professional bodies like the Chartered Institute of Loss Adjusters (CILA) in the UK which means they meet industry standards.
What is a Loss Assessor?Role and Responsibilities
A loss assessor, on the other hand, is a professional hired by the policyholder to represent their interests during the claims process. Their main job is:
- Representing Policyholders: Loss assessors advocate for the policyholder to get the maximum settlement possible under their insurance policy.
- Preparing and Submitting Claims: They help policyholders prepare and submit their claims. This means gathering all necessary documents and making sure the claim is complete and accurate.
- Negotiating with Insurers: Loss assessors negotiate with loss adjusters and insurance companies to get the best possible settlement for the policyholder.
- Advising Policyholders: They provide expert advice to policyholders about the claims process and what to expect. This includes explaining the policy terms and the insurer’s obligations.
Who Do They Work For?
Loss assessors work for the policyholder, not the insurance company. They are loyal to the individual or business that’s suffered the loss and focused on making sure the policyholder’s rights and interests are protected.
Skills and Qualifications
Like loss adjusters, loss assessors often have a background in insurance, law or finance. They are skilled negotiators with in-depth knowledge of insurance policies and claims process. Many are members of professional bodies like the Institute of Public Loss Assessors (IPLA) in the UK.
Loss Adjusters vs Loss Assessors
While both loss adjusters and loss assessors are important in the insurance claims process, their roles, loyalties and objectives are quite different. Here are the main differences:
1. Representation
- Loss Adjusters: Represent the insurer and protect the insurer’s interests. They want claims to be valid and settlements fair but not excessive.
- Loss Assessors: Represent the policyholder and advocate for their rights. They want to get the maximum settlement possible so the policyholder gets everything they are entitled to under their policy.
2. Employment
- Loss Adjusters: Employed by the insurance company, either directly or through an independent adjusting firm contracted by the insurer.
- Loss Assessors: Hired by the policyholder and independent of the insurance company.
3. Objectives
- Loss Adjusters: Want to settle claims quickly and cheaply and in line with policy terms and conditions.
- Loss Assessors: Want the best possible outcome for the policyholder and often negotiate higher settlements than what’s initially offered.
4. Approach
- Loss Adjusters: Use a structured approach to assess the validity and value of claims, often involving thorough investigations and expert opinions.
- Loss Assessors: Take a proactive approach to claim preparation and negotiation to make sure every detail supports the policyholder’s case for maximum compensation.
Why Use a Loss Assessor?
Policyholders hire a loss assessor for several reasons:
- Expert Guidance: Navigating the insurance claims process is complex and overwhelming. A loss assessor provides expert guidance to ensure the claim is presented correctly and comprehensively.
- Maximising Settlements: Loss assessors are skilled negotiators who can often get higher settlements than policyholders can on their own. They know how to use the policy to the policyholder’s advantage.
- Reducing Stress: Dealing with a major loss is stressful. A loss assessor takes the burden of the claim off the policyholder so they can focus on getting better.
- Levelling the Playing Field: Insurers have loss adjusters to protect their interests. By hiring a loss assessor, policyholders have an expert advocate who can counterbalance the insurer’s expertise.
When to Use a Loss Assessor
A loss assessor may be useful in the following situations:
- Big or Complex Claims: For major claims with big losses or complicated circumstances a loss assessor can be very helpful.
- Disputed Claims: If a claim is disputed or there’s a difference of opinion on the settlement amount a loss assessor can help negotiate a fair outcome.
- Time Poor: Managing an insurance claim is time consuming. Policyholders with limited time or resources may find a loss assessor’s services very useful.
Summary
Loss adjusters and loss assessors play a big part in the insurance claims process. While both deal with claims evaluation and negotiation, their roles and loyalties are different. Loss adjusters are there to protect the insurer’s interests and loss assessors are there to protect the policyholder’s interests. Understanding this is crucial for anyone involved in an insurance claim as it can make a big difference to the outcome of the settlement. By choosing the right person to represent them, policyholders can navigate the claims process better and get the compensation they’re entitled to.
