Important players often overlooked, or worse, relatively unknown to many outside the insurance industry are insurance loss assessors and loss adjusters.
While most of their dealings are directly with insurance companies, their work has profound repercussions on your insurance claim. So, what exactly is their role? Basically, they are independent claims specialists who investigate complex or contentious claims on behalf of insurance companies.
They assist these companies to establish the cause of the loss, and whether it is covered by the insurance policy. A report is then written to the company assessing the validity of the claim with recommendations on appropriate payment or non - payment. Establishing loss often involves visiting the site to survey and assess the damage. Documenting details, including gathering photographic evidence, are common work methods employed.
Securing the site, including having windows and doors boarded up is vital in preventing further loss. Procedures followed in the process are reminiscent of crime scene investigations made popular by the TV series - CSI. Loss assessors and loss adjusters also recommend local repairs, and advise the policyholder and the insurance company on the most suitable way to go about these repairs.
Better still, for their role, loss assessors and adjustors are paid by the insurance company with no costs borne by the policyholder. If as a claimant you do not agree with the payout or non-payment the insurer is offering, you could request to review the loss assessors' report. Should these contentions persist, you could hire your own loss assessor as a means of getting a second opinion. You would, however, take care of this cost.
Loss assessors and loss adjustors are supervised and licensed by the industry watchdog - the Insurance Regulatory Authority of Uganda (IRA). One of the many prerequisites to licensing these entities is mandatory professional indemnity insurance. This is to protect both the policyholder and insurance company in cases of mistaken and wrongful deductions made by loss assessors and loss adjusters.
The author is a Chartered Insurer and works for the Insurance Regulatory Authority of Uganda.