Klaim Asuransi

Peran Loss Adjuster dalam proses klaim

Liga Asuransi – Hello extraordinary readers, as an observer or behaviorist in the insurance industry you may be familiar with the term Loss Adjuster. However, knowing the role of a loss adjuster as a whole is actually not an easy question to answer, especially as a Loss Adjuster who specializes in causality claims.

Loss adjusters work not just as lawyers in resolving claims cases, but rather act as ‘investigators’

A brief History

Loss Adjusting has been around for a long time. This body has existed for hundreds of years. To be precise, it dates back to the Great Fire of London in 1666, where the sheer volume of fire damage to properties around London required a professional approach to investigating claims.

According to the Chartered Institute of Loss Adjusters, the term ‘Loss Adjuster’ was first coined in 1941 following the founding of the Association of Fire Loss Adjusters, primarily to deal with claims relating to the bombing of London by the German Luftwaffe during World War II. In 1961 the achievements of claims experts affiliated with the Association of Fire Loss Adjusters received recognition through a Royal Charter, and in turn the Chartered Institute of Loss Adjusters was born, which today remains the oldest and most prestigious institution of its kind in the world. World.

Loss Adjusting generally has its origins in responding to traumatic and devastating events and Loss Adjusters continue in that spirit of responding to events and losses today.

Loss Adjusters are generally (but not exclusively) tasked by insurance companies to investigate the circumstances of claims submitted by policyholders, where they then provide advice to their principals as to whether, in the adjuster’s view, the claim is warranted or not. And if they are covered, how much is due under the insurance policy.

The level of advice given often varies depending on the type of claim. In relation to Casualty claims, it is common to provide advice on whether policyholders are legally responsible for claims made against them. The experience of the instructing party is also a factor that influences the instructions given, for example lawyers generally do not require legal advice from loss adjusters, and some underwriters prefer not to receive advice regarding policy coverage. This is very much, in modern times, a tailor-made approach.

In some cases, a Loss Adjuster will handle a claim from start to finish: whether that means settling the claim or whether the claim is denied (third party claim).

The Adjusters role also requires the ability to resolve disputes, be a good lateral thinker and problem solver, a good researcher, and communicate effectively with multiple parties and at different levels (i.e. some communications will be with the company CEO and attorneys, and on other occasions with domestic property or private vehicle owners). Loss Adjusters will always view each claim on its own merits and do whatever is necessary to advance the claim toward settlement, whatever the final outcome.

Loss Adjusters routinely identify and instruct independent experts to provide their opinion on specific parts of a claim, such as the cause of a fire, or engineering failure. The contacts and relationships that Loss Adjusters have with the experts they use regularly are often invaluable to insurance companies. For example, on claim feedback an elevator expert may show that the perceived ‘damage to the elevator’ in a multi-storey commercial building, was not defective at all and that a simple cleaning and servicing could have avoided the need to replace eleven elevators. The injured parties were ultimately satisfied that they had not had to incur the significant expense and inconvenience of replacing the elevator and the defendants were satisfied that they had avoided the need to consider paying a total of more than $2 million in restoration costs. Expert input to determine determination, and outcomes, is critical.

To become a Loss Adjuster generally requires a lot of study. Most Executive Loss Adjusters have dual qualifications in Loss Adjusting (through the Chartered Institute of Loss Adjusters if in the UK) and Insurance (through the Chartered Insurance Institute if in the UK), and some even have tertiary qualifications in such areas. as engineering or accounting.

Loss Adjusters have independent duties. Regardless of the paymaster, Loss Adjusters have a duty to apply the knowledge and expertise that years of study and experience have provided.

For insurance companies, the benefits of loss adjusters are very real. For example, in dealing with losses due to large fires in Australia and California, earthquakes in Indonesia 

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Proses hanya 24jam
Asuransi Marine Cargo Lebih Untung Dengan MOP
(Marine Open Policy)
Chat kami di WhatsApp untuk info lengkap!