
Introduction
Incidents and catastrophic events to a business or home come at a time when you least expect them. That is when you need to look up your dusty insurance documents, to see who are the insurers that you need to contact, and what sort of cover you have in the policy, in the event of an insurance claim.
Loss Assessors and Loss Adjusters – Are they the same or different?
The loss adjuster has the insurance company as his or her client, i.e. is employed and appointed by them, and aims to keep any pay-out settlement as small as possible, in favour of the insurer. On the other hand, a loss assessor may act for an insured client, the policyholder, who has suffered loss, either in property, injury, or similar, and assists them to make a claim against the insurers. But they have to be formally appointed in order to do so.
A loss assessor might negotiate with the insurance company who may appoint a loss adjuster acting for them. This usually means negotiating directly with the loss adjuster, in practice.
Arun Associates, chartered building surveyors are used to dealing with and negotiating with loss adjusters, and work alongside loss assessors to enable the insured person to obtain the best outcome for them, and to obtain what they are entitled to.
This might involve the loss assessor locating alternative equivalent premises for the insured party, whilst their property is rebuilt or refurbished following an insured event, such as fire, flood, substantial escape of water, impact damage to property, structural collapse, subsidence, etc. The loss assessor will help to quantify your insurance claim.
Claims and Detail
If the claim is not properly presented with sufficient detail and is in a form which cannot be easily followed by the loss adjuster, then you, as policyholder and client, may lose out financially.
Trading of businesses affected
If it’s a commercial business that is affected by an incident, you need to establish whether you are able to carry on trading in another part of the building, or to find alternative premises in the short and possibly medium term. There needs to be an inventory made of what has been lost or damaged and destroyed, and the degree of damage to see if some items can be repaired or have to be disposed of and replaced.
Losses can include many items, and it is a separate issue as to whether there is loss-of-business insurance, as compared with property and perhaps contents insurance. Loss of trading might involve identifying the service contracts that you had in place to run that business, any penalties or contractual agreements you might have to satisfy with those companies.
You might have lost stock of products or materials, and need to find another source, quickly. Your staff might have to be temporarily furloughed, or laid-off until alternative premises and equipment can be found. Whilst these are not structural property issues, they will affect your business if the insured event / incident has been catastrophic and substantial.
A loss assessor can work closely with experienced building surveyors to establish if there was asbestos in the building affected, structural damage and production of building defects reports. If the premises was not adequately or satisfactorily maintained prior to the insurance incident, then the insurers may pay out a smaller sum than anticipated.
Under-Insured
If the premises was under-insured at time of the incident, again the insurers may reduce the financial settlement, leaving the insured to find the balance of monies for completing a reinstatement of a building or part of it. Under insurance is something that might be challenged by a loss-assessor with the loss-adjuster, but they cannot wave a magic wand where there clearly was an error in the valuation of the insured property, at the time of making the insurance contract with the insurers.
Landlords and tenants
Where there is a landlord and perhaps tenants involved, the landlord often takes out the buildings insurance, so another party can therefore be involved, sometimes resulting in delays to occupants getting back into the premises. A loss-assessor together with building surveyors, can monitor the situation as to where the claim is at in the process with the insurers. Perhaps there is a need for an interim payment or payments to be made? This can help mitigate a shortfall in income, and help towards necessary costs and expenditure.
Coordination of consultants and specialists
Where there is structural damage, Arun Associates’ property surveyors will work with the loss assessors and structural engineers to identify the extent and degree of structural damage, to survey the damaged areas, make detailed records and find supporting evidence for presenting to the loss adjusters, to support an insurance claim. Where specialist reports are needed, we can locate those specialists and manage their input efficiently.
Contracts
Taking out an insurance policy is effectively a contract between the policyholder and the insurance company. The insurers, may, in turn, spread the risk over a number of different insurers. The terms and conditions will become critical in determining what degree of financial settlement will ultimately be made to the policyholder.
The loss-assessor can advise on whether any particular offer made is reasonable, and if it truly reflects the policyholder’s contract made with the insurers. Problem areas will usually rely on the client or his/her professional advisers, providing proof and evidence to the insurers on one or more specific points relevant to the insurance claim.
Technical expertise of building surveyors
Where Arun Associates has an input, it is to provide technical expertise in supporting the loss assessor. In some cases, we can recommend loss assessors who we have previously worked alongside in the past. This means there is an established relationship of teamwork, which can save time for everyone.
Not only can we produce building defects reports quickly, condition schedules, photographs, and marked up plans and drawings indicating areas of damage for insurers, our surveyors have been involved in negotiating many insurance-related claims with loss adjusters over many years, so understand the relevant issues.
Fees
So who pays for the loss-assessors? Most clients don’t pay a fee directly, providing they use the builders and surveyors that the loss-assessor recommends. The Insurance company pays reasonable fees as part of a claim for say, reinstatement of property, and the loss assessor and surveyors may receive a management fee from the overall settlement. Every case is different, so we are happy to discuss this in more detail with you.
Please do contact us on a ‘no-obligation’ discussion enquiry at our main telephone number. The earlier you make enquiries, the better the chances of you having all the relevant options available, in order to make decisions.