Advice forPolicy Holders
Having an insurance claim occur to your personal or business property can be a difficult time and often your Insurer will appoint a Loss Adjuster to assist with evaluating and settling your claim. The below is some guidance and advice on what a Loss Adjuster does and what options are open to you.
What Does a Loss Adjuster Do, and How Can They Help With Your Claim?
We understand that making an insurance claim is not something you planned for and the experience may involve processes, people and words that are unfamiliar to you. Below, we explain the claim process, the role of a loss adjuster, what to expect and how you can appoint a loss adjuster to work on your behalf.
How a Claim Works
What is a loss adjuster?
A loss adjuster is an impartial person who specialises in the handling and resolution of insurance claims. They can either be appointed by the insurer, and will report directly back to them, or you as the policyholder can appoint one to work on your behalf.
Their aim is evaluate the loss (for example; damage, loss or disruption to earnings), identify the cause, check policies for adequate cover and finally, to recommend the best way to get the individual or company back on their feet. In some cases the Loss adjuster will be employed by the company or the individual of a claim (the Policy Holder) and will negotiate with the loss adjusting and insurance company for a fair outcome.
Why should I appoint a Chartered Loss Adjuster?
If you’re making an insurance claim, you may come across professionals who describe themselves as claim preparers, claim managers, loss assessors, or similar. Whatever the title, it is strongly recommended that you appoint a Chartered Loss Adjuster or at least a qualified CILA member.
A Chartered Loss Adjuster is a qualified member of the Chartered Institute of Loss Adjusters (CILA) and will use the post-nominals ACILA or FCILA. They have passed rigorous examinations, demonstrated professional competence, and must adhere to a strict Code of Conduct. This gives you confidence that they will act with integrity, independence, and technical expertise.
Should you have a concern about the conduct of any claims professional, you should first raise this with their employer or, where applicable, the insurer. If your claim has concluded and you believe that a CILA member acted inappropriately, you may submit a complaint to us. Please note that CILA can only investigate matters involving individuals who are members of the Institute. We therefore advise checking the membership status of any claims professional involved in your case.
What’s the difference between a loss adjuster appointed by the insurer, and one working for the policyholder?
What happens after the insurer is notified of the loss?
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In the first instance a loss adjuster will ask lots of questions. This enables them to get a good understanding of your circumstances and the claim you wish to make. If your claim involves the need for emergency action, for example alternative accommodation, the loss adjuster will provide advice on this. You can appoint your own adjuster at any time, but it is better to have a representative as soon as possible to support you during the initial stages of the claim.
A loss adjuster will typically arrange to meet with you and your representative in person and, if your claim involves damage to property, this meeting may include an inspection of your property. In advance of their visit, the loss adjuster will typically ask you to have ready any information or documentation that supports your claim.
Having gained a good understanding of your claim, the insurer’s loss adjuster will then check your insurance policy to establish whether your claim is covered. This may involve communication with your insurance company, insurance broker and/or other experts.
If you have appointed your own adjuster, following this initial meeting you will work together to obtain information to support your claim, and present this to insurers.
Who pays for the loss adjuster?
If your insurance company has appointed a loss adjuster to handle your claim, your insurance company will pay the fee of that loss adjuster.
If you have appointed a loss adjuster to work on your behalf, you will pay the fee of that loss adjuster.
Some insurance policies include cover for such fees under a “Claims Preparation Clause”. You can also purchase insurance to cover the cost of loss adjuster fees in the event of a claim and so you may wish to check your insurance policies and/or speak to your insurance broker to find out whether you have purchased this type of insurance.
Questions
If you have any questions about the information regarding this process please do not hesitate to contact the team at info@cila.co.uk for more help.
Making A complaint
While we hope that your experience with Loss Adjusters is always positive we understand that this may not always be the case. If you are considering making a complaint please read the Complaint Manual here.