What is a loss adjuster?

What is a loss adjuster?

The role of a loss adjuster is to provide support and guidance in the event of an insurance claim. To do this there is a need for expert knowledge and skills, along with a full understanding of the insurance cover and the circumstances of the claim. Loss adjusters are typically appointed by insurance companies but can also be appointed by policyholders.

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.

Yes. If you would like help in making an insurance claim, you may choose to appoint a loss adjuster to work on your behalf.

A loss adjuster will guide and support you through the claims process and provide hands on assistance to get your claim resolved. This may include co-ordinating emergency activity, preparing the details of your claim (including supporting documentation), liaising with the different parties involved in your claim and negotiating the method and amount of settlement.

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. The fee charged by a loss adjuster working on behalf of a policyholder is normally an hourly rate or a percentage of the settlement figure, depending on the size and type of claim.

You can 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.

Chartered Loss Adjusters are experienced claims professionals who have achieved the highest qualification in claims. They are members of the CILA and so expected to behave in accordance with the CILA Guide to Professional Conduct.

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Professional Conduct

The professional and ethical standards required of CILA members

Find A Loss Adjuster

The following directory provides details of Chartered Loss Adjusters who typically work on behalf of policyholders. They are members of the CILA and regulated by the Financial Conduct Authority (FCA).

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