In brief the loss adjuster's role will be to:
1) Verify whether the policy covers the loss or damage
2) Verify the amount (if any) the policy should pay out
The loss adjuster may have full authority to settle the claim on insurers behalf. This is known as delegated authority. Alternatively, the loss adjuster's role may be restricted to providing guidance and recommendations to your insurers.
In any event and whatever the decision, you are entitled to a reasonable explanation of the loss adjuster's view. Please note that sometimes loss adjusters do not have all necessary information, particularly in the early stages of a claim, and may be unable to provide a definitive view.
It can help if you have your insurance policy wording available, together with the latest policy schedule. You can ask the loss adjuster to explain your policy and how this may influence the outcome of your claim.
The loss adjuster will usually send a report to the insurance company and policyholders often ask whether they are entitled to a copy of the report. Such reports are not usually made available. However, you may ask for guidance as to the view of the loss adjuster. If you do not agree, you are entitled to ask for an explanation and, if necessary, the method by which you can challenge any decisions.
Some claims are straight forward and others, for various reasons, are complex. The loss adjuster will ask for a wide variety of information and you are entitled to understand why the information is required.
If the loss adjuster is acting on behalf of an insurer there will usually be strict service level agreements to help ensure that your claim is dealt with speedily and you are treated fairly. Loss adjusters usually try to exceed the levels of service that are required.
Not every case runs smoothly and should you encounter difficulties you should raise concerns at the earliest moment. Firstly, highlight your concern to the individual loss adjuster. Should this not resolve the situation you should escalate the matter to the loss adjuster's manager and / or the firm's Customer Service department and/or to the insurance company.