In a few words, a loss adjuster is someone who investigates and often settles insurance claims on behalf of insurance companies. There are many types of claims that loss adjusters handle, and a few examples include:
- Property claims
- Liability claims
- Material damage claims
- Motor vehicle claims
- Personal injury claims
- Professional negligence claims.
Of course, this list could be elaborated almost exponentially. However, even from this brief summation of the role, one can see the diversity of jobs a loss adjuster may be required to do.
The process of investigating claims involves many tasks. On a basic level, it is finding out the who, what, where, when and how of the incident – and this can also require the loss adjuster to make assessments about the extent and impact of these facts.
In order to do this, an adjuster must:
- Communicate with people and understand not only what they are saying, but what their words mean and why they are saying it. That requires good interviewing, listening and reporting skills.
- Go on site and actually inspect what is there. Being meticulous in what one sees and how it is described.
- Analyse the material and data collected and test it against known standards and benchmarks. This may require the adjuster to “think outside the box”. Sometimes it is a case of “joining the dots” and at other times it is asking the question “what isn’t here?”
- Check all the facts and figures, and ensure that they “add up”. If they don’t, then the adjuster needs to be able to spot the errors or to locate the missing numbers.
- Be aware that some items may be overstated or even deliberately exaggerated and, in those instances, report it and act upon it while always being certain of one’s facts.
- Report clearly and succinctly, in a timely and efficient way.
- Manage the claim – which means not only with the insurer, but all involved, through good communication and timely response.
- Negotiate with those involved and, where appropriate, be pragmatic and “commercial” rather than dogmatic, without exceeding what the policy actually covers.
- Understand how the policy in question operates and what it is intended to cover, without being slavish or overly legalistic.
These are some of the main things that an adjuster does when managing a claim, but this is by no means an exhaustive list.
It is a common misconception that the adjuster is there to make the claim as small as possible – that the adjuster is the “attack drone” of the insurance company.
This is entirely incorrect.
Loss adjusters and insurers know that a satisfied customer is likely to be a repeat customer, and that service is paramount. They also know that, unlike fine wine, a claim does not “improve with age”.
In the end, it is about getting to the correct answer as quickly and efficiently as the circumstances of the matter will allow.