Claims Adjustment

One of the most important documents for insurance adjusters is the loss notice. It’s the starting point for all investigations and contains crucial information that will help you prepare to fulfill your obligations as laid out by the Fair Claims Settlement Practices Statute and Fair Claim Settlement Practices Regulations.

Every individual claim provides valuable information and helps you understand the interpretation of your policy contract. It also shows about the nuances of important policy wording. In order to know what coverage is available to the insured, the limits of liability, the territory limitations, and the exclusions, conditions, and endorsements attached, out claims adjusters will take the time to read through your policy.

Once our adjuster has finished reviewing the claim, they will contact the insured party to arrange a meeting time where they can meet with the insured and any witnesses.

When investigating a policy, our adjuster will look to get answers for questions such as who, what, where, when and how in order to determine the cause. Statements from neighbors or relatives might also be taken to ensure as accurate a claim as possinble is recorded.

The adjuster needs to get copies of all the relevant, past records before processing a claim. They are as follows:

• Leases
• Documents establishing title to real property (deeds and trust deeds)
• The last physical inventory
• Receipts, invoices, purchase orders and other forms of proof of ownership are important pieces of a merchant’s inventory control strategy.
• The banking records of the business should be reviewed at least 6 months before the loss.
• Any other files that may be relevant or have a linkage with what is discussed in the document you uploaded.

To aid the insured in their obligation to prove the loss, when the adjuster first visits a home or office, it’s important to have an agreement about the exact scope of loss. The adjuster should walk through and pinpoint what type of damage was caused by the hazard and agree to any items that were broken or destroyed during the event.

The adjuster may want to get the agreement orally with a tape recorder, or write everything down. The scope of loss must be described as specifically as possible to include items like room dimensions, flooring, wall coverings, fixtures, moldings, and other architectural features must be part of the scope of loss. Details about specifications should also be included.

When settling for an insurance claim, our adjuster will need to obtain evidence from the insured and its employees which may include photos of the damages. We will work to determine the actual cash value of certain property and make a fair settlement.

Our adjuster will review any continuing usual household expenses from the insureds. Once these are added up, they can be deducted from the actual expenditures for the period to determine what other living expenses were incurred.