What do adjusters do

3rd December 2015 by Pieter Heydenrych

When experiencing a situation which could potentially result in a claim under your insurance policy, the process of submitting your claim could often prove more stressful than the actual circumstances that led to the claim.

Even when this is not true, depending on the size and nature of your claim, you may have to work with an adjuster appointed to investigate it.  By virtue of the often complex tasks that adjusters are expected to perform, the role of an adjuster is often dramatically misunderstood.

When submitting a claim, you are submitting a demand for payment, under a legal contract, against someone (the insurance company) that has way more money and much more expensive lawyers than you.  This puts you squarely in a potentially unfamiliar and hostile legal environment.

Questions like “Am I covered?“, “How much can I claim?“, and “How do I prove my loss and coverage, to establish my right to claim?” are inherently difficult to answer.  The process could be especially intimidating when this is not an arena that you are personally familiar with.

Irrespective the tasks performed by the appointed adjuster, the primary role of an adjuster is simply this. “To prove the claim.”

Even if sometimes claims are proven to fall outside of the scope of the coverage contract, or the value proves less than expected, the adjusters’ first responsibility remains always to, in good faith, prove the claim, if that is reasonably possible.

In order to ensure the integrity of the process, adjusters are also required to take an unbiased approach. This means that the adjuster has no attachment to developing specific evidence, but rather has to account for all available evidence, no matter the affect on the claim.

Fortunately in my experience most insurance claims are valid, reasonable and provable, and with the help of claimants this gets even simpler.  Really, we are here to help…  All you have to do is let us….

About the author:
Pieter Heydenrych
is the president of Emergency & Environmental Claims Management (EECM Ltd.) an independent adjusting and environmental consulting firm. (http://www.ee-cm.ca/).

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