When disaster strikes, be it a house fire, flood, or commercial theft, having insurance will offer peace of mind. However, navigating the claims process can often be more complex than you expect. This is where loss adjusting can be helpful.

It’s a critical but often overlooked part of the insurance world that ensures fairness, accuracy, and transparency when assessing damages and determining the payout the policyholder deserves.

Understanding loss adjusting can help you as a policyholder, allowing you to make informed decisions and ensuring fair and justified treatment during your stressful times.

What Exactly is Loss Adjusting?

In simple terms, loss adjusting is the process of investigating and evaluating insurance claims. When a policyholder files a claim, a loss adjuster is usually assigned to them to examine the extent of the loss, determine the cause, and ensure that the claim aligns with the terms of the insurance policy.

The loss adjuster acts as a contact between the insurer and the insured. They offer a detailed report to both parties to help them determine whether the claim is valid and how much should be paid out.

However, you also need to know that not all loss adjusters work for the insurance company. There are also independent loss adjusters and public loss adjusters who play significantly different roles. Some of them even represent the best interests of the policyholder.

Difference Between a Loss Adjuster and a Loss Assessor

The terms “loss adjuster” and “loss assessor” are often used interchangeably, but they work differently depending on who they are assigned to.

• A loss adjuster is usually hired by an insurance company. Their primary role is to protect the interests of the policyholder by verifying claims, assessing damages, and recommending settlement amounts based on policy terms.

• An independent loss assessor, on the other hand, is someone who can be hired by a policyholder. They work solely for the claimant, helping them gather evidence, file accurate claims, and negotiate a fair settlement.

Many people are nowadays hiring independent loss adjusters, especially for complex and high-value claims.

Why is Loss Adjusting important in Insurance Claims?

Property damage from storms, floods, fires, and accidents isn’t that uncommon in any region, especially in Toronto. Add in the complexities posed by commercial insurance policies, and you will be able to see why loss adjusting is important.

Here’s what makes it important:

• Ensuring Fair Handling of Claims:

A public loss adjuster ensures a thorough investigation of every claim. This keeps both the insurer and the insured protected by ensuring that only legitimate claims are paid out and that they are paid out in an accurate manner.

• Fraud Prevention:

The insurance sector in Toronto, like many other provinces and regions, faces challenges with fraudulent claims. With the help of loss adjusting, these risks can be mitigated by verifying the legitimacy of every claim with a structured investigative process.

• Supporting Complex Claims:

In significant or complicated cases like factory fires, equipment damage, or structural collapse, independent insurance adjusters are often called in for their expertise. Their analysis can help you ensure a fair and justified payment without any waste of time.

• Offering Advocacy for Policyholders:

If you have suffered a major loss and you feel overwhelmed by paperwork, estimates, and insurer requests, hiring a public loss assessor can be a great help to you. They understand the insurance policies and help you ensure that you receive the compensation you’re entitled to.

As a matter of fact, many policyholders in Canada are surprised to learn that they have the option to hire their own loss assessor to represent their interests.

Types of Loss Adjusters and Assessors in Canada

Depending upon the nature and complexity of the claim, you may come across different professionals in this industry. We share with you the types of loss adjusters and assessors in Canada:

• Insurance Company Loss Adjusters:

These adjusters work directly for the insurer. They focus on minimizing the company’s financial exposure while staying within the guidelines of the insurance policy.

• Independent Loss Adjusters:

Although not employed by a specific insurance company, an independent loss adjuster may be contracted by a policyholder to offer third-party assessments. Their independent nature allows them to conduct more neutral evaluations.

• Public Loss Assessors:

These individuals work entirely for the claimant and help them maximize their insurance payout. A public loss assessor is particularly helpful for disputed or high-value claims.

• Specialist Loss Assessors:

It’s quite often that some claims require technical or niche knowledge, like marine insurance or cyber risk insurance. In such instances, you need to consult specialist loss assessors with expertise in such areas.

When Should You Consider Hiring an Independent Loss Adjuster?

There are some specific scenarios where you need to consult a loss adjuster, as given below:

• High-Value Claims:

When large sums are at stake, having someone who knows the process and the entire policy can help you safeguard your interests.

• Delay or Denial of Claims:

If your claim is being rejected or taking longer than expected a loss assessor can investigate the reason and challenge the decision on your behalf.

• Complex Damages:

Commercial or structural damages often require detailed reporting and negotiation. This is where a professional loss adjuster can help you, as they know how to report every detail in the most effective manner.

• Underpaid Claims:

If you think that the settlement amount offered to you is less than what you deserve, a loss assessor can help you get a reassessment.

To Summarize

Loss adjusting is essential in ensuring that insurance claims are resolved in a fair and efficient manner. While insurance firms rely on loss adjusters working with them, you don’t have to navigate the claims process alone.

When you understand the roles of loss assessors, especially the ones working independently and publicly, you will be able to ensure smoother claims processing and fair treatment. 

Whether you are dealing with residential damage or complex commercial claims, knowing your rights and the resources available can help you expedite your claims process in the best possible manner.

At Onyx Adjusting, we offer smoother and more reliable insurance claims processing with the help of our experienced loss adjusters. These adjusters will help you understand every aspect involved in your insurance policy and guide you through smooth and effective insurance claims. Consult our adjusters now for a favourable and justified settlement.

FAQs

Q1. What is the Job of a Loss Adjuster?

A1. A loss adjuster is an insurance professional appointed by an insurer to investigate and assess insurance claims. Their main job is to evaluate the extent of damage or loss, verify the policy coverage, gather evidence, and negotiate fair settlements to ensure the claims are handled fairly and accurately based on the policy terms.

Q2. What’s the Difference Between Loss Assessors & Loss Adjusters?

A2. The main difference lies in who they represent. Loss adjusters work on behalf of insurance companies to evaluate claims. Their job involves evaluation of the extent of damage or loss, verifying the policy coverage, gathering evidence, and negotiating fair settlements to ensure the claims are handled fairly and accurately based on the policy terms.

Q3. What Exactly is Loss Adjusting?

A3. Loss adjusting is the process of investigating and managing insurance claims to determine the extent of the insurer’s liability. Insurance loss adjusters play an important role in this process by analyzing the validity and value of a claim, ensuring it aligns with the conditions prescribed in the policy, and facilitating a fair resolution between the insurer and the policyholder.