WHAT IS A LOSS ADJUSTER?
In short, a Loss Adjuster’s role is to:
-
investigate your claim (the circumstances and the loss),
-
compile the relevant paperwork to validate the loss,
-
quantify your loss,
-
analyse your insurance policy &
-
compare the various aspects of your claim to your insurance policy in order to advise your insurance company accordingly.
Contrary to popular belief, a Loss Adjuster does not get paid extra if a claim is denied, nor does a Loss Adjuster get a percentage of the claim amount. We purely work on an hourly rate.
We are the link between your Claim, your Broker and the Insurance Company.
WHAT DOCUMENTS ARE USUALLY REQUESTED?
The documents to validate your claim depends entirely on the claim itself. However documents often required are (but not limited):
-
Photographs/CCTV Footage of the event
-
Stock Takes
-
Asset Registers
-
Inventory Lists
-
Quotations
-
Proof of Ownership
-
Alarm Reports
-
Damage Reports
-
SAPS Case Numbers etc.
It is your responsibility as the insured to provide adequate documentation to validate your claim.
During the investigation as well as whilst reporting we will request documentation. The quicker you send it, the quicker we can quantify your claim and advise your insurance company on settlement of the claim.
WHAT DELAYS THE CLAIMS PROCESS?
The main variable which regularly slows our processes is when documentation submission is delayed.
In complex claims, often service providers are approached (such as a Quantity Surveyor or Engineer or Forensic Experts). Although we have service providers who are aware of the extreme urgency to settle claims, their reports can take a couple of days. At times, Subject Matter Experts (SME) are approached in the case of specialized machinery for example, who might first need to test damaged equipment.
Lastly, in cases of a natural disaster, such as the Knysna Fires or Durban Riots & Floods, a large volume of claims could be received at once, and settling of claims may take slightly longer.
In normal circumstances, the quickest you can get your claim settled is to have your documentation ready and sent swiftly after our investigation at the site of the loss.
WHAT IS THE CLAIMS PROCESS?
STEP 1
STEP 2
STEP 3
STEP 4
STEP 5
STEP 6
STEP 7
You contact your Broker informing them of the claim.
Your Broker submits the claim to your Insurance Company.
The Insurance Company assigns us (The Loss Adjuster) to investigate the claim.
The Loss Adjuster investigates the claim, assigns SME’s (if required), analyses your policy, quantifies the loss & advises the insurance company.
The Insurance Company decides the course of action.
Payments are made (or not).
Claim is concluded.