Find out what loss adjusters do and how to ensure you’re properly covered for any large claims you may have to make on your home insurance.
Loss adjusters are industry experts in the handling of insurance claims.
When you make a claim on your home insurance policy, your provider may send out a loss adjuster to visit your home.
Typically, a loss adjuster will be sent to investigate substantial insurance claims, such as those resulting from a major incident like a fire or flood.
It's their job to evaluate whether your policy provides cover for the damage or loss you've claimed for and if it does, the level of pay-out you should receive.
A loss adjuster is appointed and paid for by an insurance company to investigate a claim.
Loss adjusters are required to carry out their duties in an impartial manner and to adhere to rules set by the Financial Conduct Authority (FCA).
Your insurer might give the loss adjuster the complete authority to settle a claim on their behalf. Or they'll limit their role to that of providing recommendations and guidance on the claim.
When a loss adjuster visits your home, typically, they'll look to establish:
In general, a loss adjuster works for the insurance company, while a loss assessor works for the policyholder making a claim.
You can appoint a loss assessor if you are making a large insurance claim. They'll work on your behalf, guide you through the claims process and prepare your claim from start to finish.
They're usually paid a percentage of your total claim, so it’s in their best interest to secure you the maximum possible amount from your insurance company as a settlement.
The scope of their job can include:
As an alternative to a loss assessor, there’s also the option to appoint a chartered loss adjuster to work on your behalf on an insurance claim. You can find members of the Chartered Institute of Loss Adjusters (CILA) on their website.
If your insurance company’s loss adjuster agrees that some/ all of the loss or damage you're claiming for is covered by your policy, they'll accept your claim. They'll then prepare an offer of settlement to repair the damage, cover the cost of repairs, or replace items you’ve lost.
Your insurance policy settlement should aim to help put you back in the position you were in before the damage or loss occurred.
If you're unhappy with what you’re offered to settle your claim or feel that the pay-out is too low, you don’t have to accept it.
Take, as an example, that your loss adjuster has asked you to get quotes for building work to repair fire damage. You present the quotes but the loss adjuster feels the costs are too high. They might offer you a lower amount to cover the building work. In such circumstances, if you feel their offer is unfair and would leave you out of pocket or unable to get your repairs done to a satisfactory standard, you may choose not to accept this offer.
You can employ the services of a loss assessor (or your own loss adjuster) to help you negotiate a better deal. Or you can make a complaint to your insurer yourself.
In such cases, you should first speak with the loss adjuster and/or write to your insurer. If you aren’t happy with their reply, you can make a formal complaint using your insurer's official complaints process (details of how to do this will be on their website).
If you still aren’t satisfied with their reply, you can take your complaint to the Financial Ombudsman Service (FOS). It’s a free, independent service which will assess your circumstances in detail and aim to come up with a fair resolution.
The decision made by the FOS is binding on your insurer.
If you're unhappy with the decision of the FOS, you still have the option of taking the insurer to court. However, this may result in expensive legal fees.
Yes, in some cases, a loss adjuster may decide to reject your claim.
Reasons for this can include:
The loss adjuster must always let you know the reason for rejecting your claim.
You can then check your policy and its wording thoroughly to see if you feel the reason for the failure of your claim holds up.
If you feel the loss adjuster is being unfair or is wrong, you can contest their decision.
Again, you can employ your own loss assessor or loss adjuster to independently assess your claim and help to fight your insurer’s decision.
Otherwise, you can follow the complaints process as detailed above.