Co-ownership claims adjuster

In the event of a claim, the insured, whether a co-owner or a syndicate of co-owners, must declare its occurrence to his insurer. The latter will generally appoint a claims adjuster who will guide him through the steps of the claim. The claims adjuster may also be mandated by syndicates of co-owners. This reality is even more true because of the importance of the insurance deductibles, sometimes unreasonable, that they have to bear, leaving them with all the responsibility of managing the loss. Investigating the circumstances of a disaster, assessing the damage caused by a claim and negotiating a settlement are the three key functions of this certified professional.

 

Disaster Investigation Process

The claims adjuster must:

  • Intervene at the request of a client (either the insurer or the insured) at the scene of a claim,
  • Take measurements and photos;
  • Have consent signed for the collection of information;
  • Obtain the insured's declaration;
  • Obtain the declaration of third parties, including that of specialists or service providers;
  • Investigate the precise causes of the disaster,
  • Check the presence of any defects and anomalies,
  • Mandating suppliers and specialists and supervising their work;
  • Provide the insured with explanations relating to the insurance coverage and the acts performed during the investigation;
  • Write a detailed report of observations.

Estimation of damage caused by a disaster

  • Estimate the amount of material damage,
  • Assess the amount of moral damage suffered,

Negotiation of a settlement of the claim

  • Determine the responsibilities of the parties,
  • Determine the admissibility of the loss;
  • Establish the amount of the indemnity
  • Decide on the depreciation to be applied to the damage statement;
  • Recommend a settlement to the insurer and obtain authorization to settle;
  • Transmit the insurer's settlement offer to the insured;
  • Explain the terms of the settlement and the arrangements that the insurer intends to take;
  • Negotiate a settlement to compensate those affected;
  • Entering into a settlement with the insured
  • Have an assignment of receivables signed;
  • Notify the insured that the insurer denies coverage.

Qualifications

In the field, the claims adjuster must be particularly rigorous and methodical in carrying out his investigations and accurately determining the circumstances of the claim. Sense of observation and analytical ability are essential qualities to practice this profession. In direct contact with the victims, he shows courtesy and diplomacy in order to gather as much information as possible. Thanks to his various skills, the claims adjuster has an expert capacity that allows him to establish his authority and conclusions in the context of a case.

Mandate your own claims adjuster?

The syndicate may, at its own expense, call on an independent claims adjuster, where its insurer is not involved in the case. This happens, inevitably, if the cost of repairing the damage is lower than that of the syndicate's insurance deductible. What's more, damages may not be covered due to a lack of insurance or warranty, a limit of coverage, a insurance limit or a denial of coverage. If this is the case, the syndicate must pay compensation. Such a claims adjuster may assist the syndicate, as a consultant, to help settle uninsured losses and the recovery of deductibles.

 WHAT YOU SHOULD KNOW The claims adjuster can practice as part of an expert firm or an insurance company. He was then hired as an employee. He can also move towards a liberal practice by creating his own consulting firm. In this case, the liberal insurance expert is mandated by customers whom he has solicited and retained. 

 WHAT TO KEEP IN MIND: The claims adjuster may practise as part of an expert firm or an insurance company. He was then hired as an employee. He can also move towards a liberal practice by creating his own consulting firm. In this case, the liberal insurance expert is mandated by customers whom he has solicited and retained.

 WARNING! Claims settlement expertise is strictly reserved for holders of a claims adjuster's certificate issued by the Autorité des marchés financiers (the "AMF"). Thus, only a duly qualified person can use the title of claims adjuster. She works in a discipline that is specific to her:

  • Expertise in claims settlement in business property and casualty insurance;
  • Expertise in claims settlement in personal damage insurance.

 

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