Difference Between the Roles of a Loss Adjuster and Loss Assessor

This role is relatively new in the terms of the definition, as not many people know about the actual significance of a loss adjuster. In older times, when the insurance was a new phenomenon,  insurance companies used to hire an intermediary who could assess the authenticity of the claim and pay them a little fee for their services. However, as the profession evolved, the role of a loss adjuster has become important, which is why this blog focuses on what a loss adjuster actually does, to highlight the importance of their role.

What Do They Do?

Whenever there is an accident, a fire, a robbery or an incident that causes damage to the property, people file a claim if they have gotten their property insured earlier. To verify the claim and determine the degree of damage done, and subsequent steps required to file the claim, a loss adjuster is hired. A loss adjuster recommends the insurance companies how much is to be paid on the basis of the policy coverage. A loss adjuster works on behalf of both the parties and is impartial.

They also assure the claimants that their claim will be processed smoothly and without any biases.

  • They investigate the event and assess how the incident took place.
  • They negotiate with both parties, and take interviews of the witnesses, gather statements and settle claims according to the policies.
  • They calculate the value of the property, make guidelines for making a claim, calculate the losses, and check if the claim can be quantified.
  • They participate in trials, meetings, and act as a mediator.

Here are some other roles that a loss adjuster plays within their respective field with more or less the same duties:

  • Claim adjuster
  • Claim specialist
  • Property adjuster
  • Liability adjuster
  • Accident loss adjuster
  • Catastrophe adjuster

Often time, people make the mistake of mixing up the role of loss adjuster and loss assessor. The difference between these two is very subtle.

Who Are Loss Assessors?

A loss assessor exclusively works on behalf of the person who is making the claim. He makes sure that your property is valued and the losses are properly covered. He is more like an attorney to you who legally represents you when you are making the claim so you get the value you deserve. The basic duties of a loss assessor include:

  • Representing the claimant to the insurance company, setting meetings with the loss adjusters.
  • Drafting and finalizing the claim on behalf of the person who has suffered the loss.
  • Negotiate with the loss adjuster and the company to make sure the value settled is fair.
  • Handle the cases, which are complex, or those which the insurance companies have earlier refused to take due to complications in the process.

Understanding the Duties of an Insurance Assessor

The role of an insurance assessor is essential in the handling and processing of protection claims. People who file claims usually know nothing or very little about the significance of their role and only try to contact them after a disastrous event or when they need a protection guarantee.

We have chosen to share a few experiences on this profession and their role, to give a more detailed comprehension of what they do and why their role is significant.

It is essential to know that there are diverse ways that insurance agencies approach the administrations of insurance assessors. There are two types of insurance assessors:

  1. Assessors who are not affiliated by a particular organization; they outsource their services to insurance agencies and intermediaries.
  2. Assessors employed and designated by an insurance agency.

Difference Of a Loss Adjuster And Insurance Assessor

Most people cannot differentiate between the roles of a loss adjuster and insurance assessor. Both terms are generally used interchangeably, despite the fact that they have their own specific job profiles serve different purposes.

A Loss Adjuster is hired by the insurance companies. They will to guarantee that your policy is understood and how it can affect the claim that the party has filed.  They generally attempt to make it possible for the insurance companies to pay fewer sums for the claims filed.

A loss Assessor is an expert contracted by the individual documenting the claim with a specific end goal to ensure that the claim gets processed with an effective and justified result. For this, loss assessors take care of all the customs and measures that are required for a guaranteed settlement. A good insurance assessor can play significant role to get the amount you require and will work with you to document the claim. They will likewise cater to your queries and requests and guarantee that you get a lawful experience.

So these are the basic differences between insurance assessors and loss adjusters.

Duties Of Insurance Assessor

An insurance assessor works on the behalf of the claimant. A claimant approaches an insurance assessor to evaluate the accident or the mishap that has affected their insured property. For the property to be assessed and the claim to be filled, it is necessary that your property has a monetary value. Insurance assessor starts with evaluating the property and checks it for the damage done to it.

For example, if a house caught fire and had been damaged, the insurance assessor would go and evaluate the house, check its monetary value, evaluate the damages done, and decide if they are claimable. Once he is done with collecting the evidence and related information, he makes a report of the case and sends it to the insurance company on the behalf of the claimant.

The insurance assessor will see if the insurance company is covering the damage that the client has filled for. If they are, then the insurance assessor would see who is responsible for the fire incident and look for ways to compensate the claimant for the damage done. He also negotiates on the behalf of the claimant and makes sure that the case is properly.

5 Reasons Why Business Continuity Plans Fail

A Business continuity plan is imperative in running a business. It is really important for a medium to large organization to have a business continuity plan in order to ensure the smooth flow of all the operations in all departments of the business.

When it comes to disaster management, business continuity is always an important topic to learn from.

A business continuity plan is crucial for post disaster or emergency for a company otherwise there could be huge losses for a company. But there are times when people just can’t handle it and fail miserably in carrying out a business continuity plan.

Here are 5 reasons why your business continuity plan can fail. Avoid these pitfalls and you will most likely be disaster proof.

  1. Wrong estimations

This is a common theme among all the failed business continuity plans out there. Many times, managers and executives don’t think things through and make really unrealistic expectations in making a plan. They assume that things that require electricity or power will be working should any emergency were to take place. But to the contrary, these are the first things that get ruined during disasters such as floods, earthquakes, storms etc. The best thing to do is to have a backup server for your business. These days everything is cloud based anyway so you can easily recover any important data that might have been lost in the office.

One of the most common misconceptions by people is that they think they live in a disaster free area where nothing can go wrong. You can’t be sure of anything so it’s better to have a business continuity plan just in case.

  1. Not being prepared

Always have safety and emergency kits at hand or easily accessible in the company so that if there is any emergency, the chances of recovery are quick and higher. A fire extinguisher should be in multiple places on every floor. Encourage your employees to have their own medical kits with them in their cars and also give them those where they can keep it in the drawers of their desks.

  1. Not having survival accessories

Having a backup server is all good but you need additional things that will help you to be in contact with your workers. You would need extra batteries, rechargeable flashlights, water and food supplies etc. if the area where you work is evacuated then there is all the more reason for you to need these items. Have a list of all the contact numbers of you workers so that you can reach them whenever you find the means to do so.

  1. No testing

It is good to have a business continuity plan, but it is great to have it tested out so that you are aware of any discrepancies or holes that need to be filled out. You need to have a fool proof plan and in order to have it, a drill or rehearsal for an emergency situation is the key.

  1. Not shared with everyone

A good business continuity plan is always shared with everyone. There is no point if it is lying around with only one person.

2009 Storm & Flood Commentary

Clearys Claims Managers

In 2009, the whole country experienced severe flooding and storm damage.

It was called the worst event in 50 years – indeed, some suggested it was the worst in living memory. Global warming was blamed for the damage or, at least, for having contributed to it. Bad planning and development were also highlighted as causes for many of the properties affected.

Today, only 6 years later, things are as bad as ever – worse indeed, given that the proportion of properties having flood insurance cover is much lower now than it was in 2009.

Following the flooding in 2009, many buildings were repaired with the money paid by Insurers making buildings habitable, comfortable and usable again. Little thought was put into preparing for similar occurrences happening again and certainly not only 6 years later.

This is a tragedy.

Clearys have come across numerous cases of flood damage where there is no insurance cover this time around. TV programmes and interviews are highlighting the extremely difficult circumstances this type of slow, insidious, destructive damage has inflicted on many unfortunate householders, farmers and businesses. Others in vulnerable areas, though not yet affected, are fearful for the future.

Securing assistance from the state is a possibility but the funds available to successful applicants are very low. Even at that, compensation is available only to those who do not have insurance cover and have suffered clear and specific damage. The Irish Red Cross are also distributing funds and humanitarian aid to people exposed to flooding but similar limitations apply to that scheme.

After the 2009 event, there was much work done by the state, through local authorities and the Office of Public Works. Defined areas which would be categorised as flood zones for national flood mapping purposes were identified. The insurers then availed of this service and either withdrew flood cover for property in these areas or hiked premiums for those who were “lucky” enough to be offered cover. Of course they would – what would you do?

The ball was then dropped by the state. No planning was put in place to deal with the obvious: what would happen to all those areas and their inhabitants, businesses and farm owners when flooding returned? Far fewer of them would have insurance cover next time around.

The Irish solution to this Irish problem was for government to call a meeting with the insurance industry after the horse had bolted. Clearly, for many unfortunate victims of recent events, there was no access to funds, allied to which they had the worry and stress of possible further recurrences with no prospect of cover being reinstated. Even if cover was available, it would be prohibitively expensive.

It appears to me that a possible solution for the state, property and business owners, insurers and, indeed, charities is to define a plan for residents and businesses that are in this “Catch 22” situation: Let the state assist them in buying insurance cover going forward and stop all future development, without appropriate flood protection, in these areas.

This scheme could include loss of profits cover for farmers and businesses. Cover could be capped so the potential recoveries deal with ‘humanitarian’ issues if they arise. The claims would be dealt with by the insurance industry. The state would have no involvement in the process nor would the charities.

Ultimately, it should be clear to everyone that continuing to reside in flood zones carries a risk and that, over time, people should have the choice and wherewithal to move away from them.

Such a scheme would mean that the cost to the state could be evenly spread over time and insurers could remain on the pitch with all the structures to deal with this problem at no additional cost to them.

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Handling of Insurance Claims for Small and Medium-sized Enterprises [SMEs]

This article from the UK’s Financial Conduct Authority provides confirmation of all of the claim issues that we see all of the time. Some of these issues are easily dealt with while some are not. The Executive Summary refers to “unregulated firms such as Loss Adjusters and Third Party Administrators (TPAs)” and are often involved in the claims process. The implication here is that this contributes to difficulties for the consumer/claimant.

The findings section speaks for itself, the main issues being:

  1. who should drive the claim?
  2. significant under insurance (Para 1-14).

Our view is that the insurer is in the driving seat. They write the policy, they control payments, they deal with all background investigation into disclosure & claims history, warranty & liability investigation and forensic investigation. Clearly a mine field.

It is clear that the claimant must, in any claim situation, have access to specialist claim advice. It is only then that the pitch is levelled to some degree.

Prepare for strong winds and cold temperatures this winter

Follow these tips to help prepare for high winds and freezing temperatures this winter.

When strong winds are forecast:

  • Make sure that the property is well maintained and drains are cleared regularly
  • Roofs should be inspected regularly for loose slates/tiles and poor guttering.
  • Trees should be maintained and dead/vulnerable branches should be removed.
  • Outdoor items such as patio heaters, furniture, barbeques, bins and animal feeders should be secured or securely stored.
  • Gates, doors, sheds and fences should all be closed and locked.

What you should do after a storm:

  • Contact Clearys Loss Assessors on 1850 28 1850 to register any claim for damage and any discuss repair work required.
  • Do not re-enter structurally damaged buildings until advised that it safe to do so.

article-2530915-1A586FB200000578-664_964x641Preparing for freezing temperatures:

A burst pipe in your attic, if unaddressed, can be as devastating as a flood through the front door. It probably represents the greatest risk posed to your home by freezing conditions. Freeze thaw action can also cause structural damage.

How to prepare for the freeze:

  • Lag/insulate outdoor pipes, attic tanks and supply pipes.
  • If a property is unoccupied, the water should be shut. Run the hot taps to drain the attic tank. If your home is unoccupied for any period during cold weather, leave the heating on to protect pipes from freezing and bursting.
  • Open the attic door to allow heat into your attic. This helps to prevent the pipework and tanks in your attic from freezing.
  • Leave the underside of the attic tank un-insulated to allow warm air to reach the tank.

In the event of a burst pipe:

  • Turn off the water supply immediately.
  • Turn off water dependent appliances including your boiler.
  • If the water leak is from the attic/above ceiling level, turn off the water supply and turn on all hot taps to drain remaining water out of attic tanks as quickly as possible.
  • Engage a professional immediately to stem any flow and make repairs to prevent further damage.
  • Report the incident to Clearys Loss Assessors immediately and do not effect any permanent repairs until all damage has been assessed and repairs are agreed with us.
  • If appliances are affected, turn off the power at the mains board if safe to do so.

In the event of a leak:

  • Retain all damaged material as it may be crucial to establishing the nature of loss, assessing damage and validating your claim.
  • Contact Clearys Loss Assessors on 1850 28 1850 to register any claim for damage and to discuss repair work required.
  • Ventilate, gently heat and dehumidify the property.
  • Do not re-engage utilities until they have been checked by a competent and qualified professional.

What if your Property is Affected by Subsidence?

Subsidence is a tricky problem for a number of reasons. Firstly, it is difficult to prove without lengthy and time-consuming tests. Secondly, there is no ‘home remedy’ – the only way to solve the problem is to hire expert professionals who deal with soil erosion, structural foundations and the like. And thirdly, the longer you leave it unresolved, the worse it will be.

There are many factors that can cause subsidence. It could be because of soil erosion due to inadequate drainage under your property, or if significant tree felling occurs in the vicinity of the building this can cause soil to shift under the foundations. Signs of subsidence include widening cracks in walls or diagonal cracks rather than cracks that run along the joining corner of two walls.

Subsidence

Repairing the visible damage without addressing the problem itself is literally ‘smoothing over the cracks’ – the damage will reappear and will be worse each time. Not only does this leave the problem of subsidence unsolved, it’s also a waste of money, can devalue your property, and will cause ongoing problems.

Unfortunately, if you suspect your property may have subsidence damage, the only thing to do is begin the process of surveying, draining, testing and monitoring with a team of expert professionals who will devise the best course of action. At this point, before any major expenses have been incurred, it is vital to contact a loss assessor. The assessor will visit the property, document the damage (both to the property and to your business as a result), and compile a definitive report which you should then submit to your insurance company to aid your claim. Loss assessors are completely impartial, have expert knowledge, and will work to make sure the most accurate result is achieved from the insurance claim.

To minimise the risk of subsidence, check drains and pipes regularly for blockages or leaks. Make sure that any trees in the vicinity of the building are pruned regularly to reduce their water uptake, and if any new trees are to be planted in the area, they should be a minimum of the length the adult tree will reach from the property. Of course, keep an eye out around the building for tell-tale cracks too, and if necessary, take photos of them periodically to assess whether they are widening or not.

What to do if your business suffers from malicious damage or burglary?

All properties are at risk of malicious damage or burglary, no matter how good the location or how well-respected the business is. It is a potential hazard for any property owner but if it occurs, it is thankfully relatively simple to deal with and resolve.

Malicious damage comes in many forms and many degrees of severity, from simple graffiti or glass breakage to the more extreme end of the scale, such as robbery or arson.

Burglary, Malicious DamageIn all cases, the extent of damage should be determined by a professional loss assessor before an insurance claim is made.

  • The first step you should take when malicious damage or burglary is reported or discovered is to ensure that the building is safe to enter. Inform any employees or others who will need to be aware of the situation and if the damage is particularly extensive, do not open for business until you are certain that no further damage will be caused by doing so.
  • Next, call the guards. Try to leave everything exactly as you found it – avoid moving items or cleaning up until after they have visited the site. They may need to gather evidence, dust for fingerprints, and determine the motives and methods of those responsible for causing the damage. If you have CCTV in operation on the premises, have it ready for them to review as this will be essential to their investigation.
  • At this point you will need the services of Clearys Loss Assessors to gain a full picture of the damage caused. If cleaning up and repairs are vital to make the building secure, and the loss assessor is unable to visit the site immediately, take extensive photographs, video, and written inventory of the damage. However, if at all possible you should wait until they have examined the building before beginning any of this.
  • The next step in the process is to make an insurance claim and, depending on the outcome of the police investigation, press charges against the perpetrators. In either case, you will need to keep extensive and meticulous records of the incident including CCTV, photographs and videos, details of repair works, financial losses, etc.
  • Finally, take precautionary measures to reduce the risk of malicious damage or burglary occurring again. If you have not already done so, install an alarm system and camera surveillance, new durable locks, and if necessary, security personnel to man the property after hours.

9/11, World Trade Center owner versus insurance companies

In 1980, Larry  Silverstein, a successful real –estate businessman from New York,  won a bid from the Port Authority of New York and New Jersey to construct building 7 of the World Trade Center, to the north of the World Trade Center site. Silverstein  signed the lease on July 24, 2001.

Right after that Silverstein took out insurance plan that “fortuitously” covered terrorism. After 9/11 Silverstein took the insurance company to court, claiming he should be paid double because there were 2 attacks. Swiss Re, Lloyd’s, Zurich Financial, Copenhagen Re, and 8 other major insurers all paid Silverstein Properties a total of $4.9 billion. Silverstein received $861 million from insurers for Building 7 alone, as well as over $4 billion for the rest of the Trade Center complex. That $861 million for WTC-7 was paid on the basis of Silverstein’s claim that airplanes were somehow responsible for making Building 7, which was not hit by any plane, disappear at free-fall acceleration

A year after the attacks Larry Silverstein mentioned in the 2002 PBS documentary “America Rebuilds,”:”I remember getting a call from the fire department, telling me that they were not sure they were gonna be able to contain the fire, and I said, ‘You know, we’ve had such a terrible loss of life, may be the smartest thing to do is to pull it’ and they made that decision to pull and then we watched the building collapse”. Larry Silverstein admits to the controlled demolition of Building 7.

The insurance companies have likewise neglected to mention that after doubling his insurance coverage immediately before 9/11, Silverstein multiplied his compensation after 9/11 by claiming double indemnity. According to Silverstein’s spokesman, “the two hijacked airliners that struck the 110-story twin towers Sept. 11 were separate ‘occurrences’ for insurance purposes, entitling him to collect twice on $3.6 billion of policies.” The bizarre double-indemnity claim was approved in 2004.

This trial remain one of the many mysteries in the 9/11 case. However In April 2006, after several months of negotiation aiming toward permitting reconstruction of the WTC complex Silverstein cedes his rights to Building One to the Port Authority allocating a portion of the insurance proceeds to the rebuilding of Building One in favor of the Port Authority. In return the US government issues pro-rata shares Liberty Bond funds for reconstruction of the site, part of which are allocated to Silverstein Properties for purposes of rebuilding the remaining buildings. Hence the costs to rebuild were partially covered by the Liberty Bonds and the construction of the new 7 WTC which began in May 2002 ended in 2006.