Home Loss assessor acting for client suggests grossly inflated claim.

[DingDing]

What is the story with loss assessors. I know 2 people who have had house insurance clains lately. In one that was settled the loss assessorr comes along and says that the he will represent the client and get more from the claim than they would on their own.

Generally the loss assessor arrives at the house and will say that the client can claim for outrageous things like in one case the front door etc...

Client thinks they can get 16K for a 6K claim.

Loss adjustor agrees to work for about 10%

Anyway when the insurance loss adjustor visits he will settle for the 6K that the person will have got anyway.

Then he has to pay 10% of the Claim plus VAT which is 12%.

If the loss assessor was any good or had any experience he would have known that the claim was not worth 16K.

I would have got more myself as I would have bargained harder with the assessor.

In the end the client would have got less than if they had no loss assessor when his fees are taken out of it.

In another case that has not been fully resolved the insurance company are organising the work. so when the insurance company are finished the client will owe the loss assessor 12% of the cost of the work done.


Please explain, have I got the wrong end of the stick

 

[peteb]

no. you are completely correct. That is what tends to happen.

 

[kkelliher]

Just to correct some of your points

Loss adjuster represents the insurance company

Loss assessor represents the policy holder

The loss adjuster on behalf of the insurance company will settle for the value assessed irrespective of the existence of a loss assessor or not. A simple builders quote for the cost of the repairs is more realistic and at no cost to a policy holder. Builder can then negotiate will loss adjuster if required and the end result is repairs carried out at no additional cost to policy holder

 

[DingDing]

Sorry it was a loss assessor that I was talking about. I fixed original post.

 

[Ed054]

It is my experience that in a number of cases assessors do overstate claims.
However it is unfair to paint all of us in that light.
I can show plenty of examples where adjusters have underestimated the scope or have made an offer that does not reflect the cost of repairs.
Where an assessor has set out to totally overstate the scope of repairs you should report him/her to the Cebtral Bank who acts as the regulator.

 

[hollacia]

Agree with Ed054, there will always to be unscrupulous people in any profession.

The point of loss adjustors who act on behalf of the insurance company is to get the claim as low as possible because the insurance company wants to pay out as little as possible, the loss assessor wants to reinstate the owner and get the right amount of money which will do this.

Some people are well able to manage their own claims and can readily assess the damage themselves, other's can't and some claims are complex and need expert help.

 

[Claimsman]

Agree with Ed054, there will always to be unscrupulous people in any profession.

The point of loss adjustors who act on behalf of the insurance company is to get the claim as low as possible because the insurance company wants to pay out as little as possible, the loss assessor wants to reinstate the owner and get the right amount of money which will do this.

Some people are well able to manage their own claims and can readily assess the damage themselves, other's can't and some claims are complex and need expert help.

In my experience, the majority of Loss Assessors ( not all Loss Assessors) submit grossly overstated claims. Typically, claim payments ( Adjustments) are less than 50/60% of what Assessors claim on behalf of policyholders. An attempt to obtain more than the entitlement under the policy is clearly acting without scruples.

The role of Loss Adjusters is not to get the claim as low as possible. Yes, they are under increasing pressure to obtain reasonable settlements. However, a Chartered Loss Adjuster will not and should not recommend less than the policyholder is entitled to under the policy.

Of course the Loss Assessor wants to get the right amount of money. However, most loss assessors will want enough money to reinstate the policyholder, plus enough to cover the loss assessors fee, which is more than the policyholder is entitled to.

Some people do need expert help in compiling a claim under the policy...sadly, again in my considerable experience, few Loss Assessors possess this expert ability. There are some excellent Loss Assessors who can provide fantastic support and advice for a policyholder.

However, In most cases, a competent builder will serve a policyholder better than a Loss Assessor.

 

[DingDing]

What are the qualifications for a Loss assessor.

 

[left foot]

What are the qualifications for a Loss assessor.

It all depends, all loss assessors have to be at the least cip general insurance qualified. Some are also qualified Quantity Surveyors, Engineers etc. At the very least they should have sat CIP general Insurance exams which is the lowest and most basic insurance qualification.

The role of Loss Adjusters is not to get the claim as low as possible. Yes, they are under increasing pressure to obtain reasonable settlements. However, a Chartered Loss Adjuster will not and should not recommend less than the policyholder is entitled to under the policy.

The role of a loss adjuster is to get the claim as low as possible FACT. Any that don't aren't doing there job correctly. They are acting for the insurance company who both want and need to keep pay outs to a minimum.

Some people do need expert help in compiling a claim under the policy...sadly, again in my considerable experience, few Loss Assessors possess this expert ability.

What a sweeping generalization, are there any concrete facts to support this point. All loss assessing companies are regulated as are loss adjusting companied by the same regulator. Pointing fingers at one side is the same as pointing it at both sides so by your account loss adjusting companies are as bad if not worse.

However, In most cases, a competent builder will serve a policyholder better than a Loss Assessor.

How is that possible a builder is a builder with little to no insurance qualifications or experience. How is a builder able to deem if a claim is legitimate or not. Insurance companies are sending builders out top cut out both assessors and adjusters. In some cases the work done by these builders can be second rate as it is being done at low prices to cut costs for insurance companies.

What is the cover if this insurance builder does a bad job or in some cases causes additional damage on top if what is there. Is the insured fully covered?? Can he/she use there own trusted builder?? Would they have been better off getting a loss assessor involved??

My point being every claim or case is different, and generalizing cant give the whole story.

 

[hollacia]

Well said left foot.

I hate threads that are started slamming an industry/profession in such generalised ways like this.

 

[kkelliher]

All loss assessing companies are regulated as are loss adjusting companied by the same regulator.

Not correct. Loss Adjusters are not regulated as they do not work for consumers. They work directly for insurance companies and fall under the regulation of the insurance company.

Would they have been better off getting a loss assessor involved??

No. Loss assessors add to the length of time it takes to settle a claim and they also have no direct link into repairs therefore from an insurance companies position they generally dont have a positive role in the process.

the loss assessor wants to reinstate the owner and get the right amount of money which will do this

The loss assessor's Fee (approx 10-15%) comes out of the settlement so unless they work for free they will never put the policy holder in a reinstate position

 

[left foot]

Loss Adjusters are not regulated as they do not work for consumers. They work directly for insurance companies and fall under the regulation of the insurance company.

OK so they are not regulated or they are regulated by the companies that pay there wages = complete conflict of interest.

No. Loss assessors add to the length of time it takes to settle a claim and they also have no direct link into repairs therefore from an insurance companies position they generally dont have a positive role in the process.

Eh what about the insureds position!! or does that not matter???

The loss assessor's Fee (approx 10-15%) comes out of the settlement so unless they work for free they will never put the policy holder in a reinstate position

No loss assessor charges over 10% FACT

Loss assessors work for the insured not the insurance company so obviously they don't have positive role in the eyes of the insurance company.
kkelliher your clear bias for insurance companies POV and not the insureds POV is very clear. Impartiality is what's needed here not biased generalisations.

 

[kkelliher]

OK so they are not regulated or they are regulated by the companies that pay there wages = complete conflict of interest.

the regulation was introduced to protect consumers against people that they engage. They do not engage a loss adjuster and that is the reason behind the regulation of loss adjusters within the insurance company structure given that they are working under the authorisation of the insurance company

No loss assessor charges over 10% FACT

you might want to check your FACTS; or are you a centralised invoice system for all loss assessors?

kkelliher your clear bias for insurance companies POV and not the insureds POV is very clear. Impartiality is what's needed here not biased generalisations.

are you not showing exactly the same bias in the opposite direction? You might want to also read the original posters point which is what we are discussing.

 

[Ed054]

the regulation was introduced to protect consumers against people that they engage. They do not engage a loss adjuster and that is the reason behind the regulation of loss adjusters within the insurance company structure given that they are working under the authorisation of the insurance company





you might want to check your FACTS; or are you a centralised invoice system for all loss assessors?

are you not showing exactly the same bias in the opposite direction? You might want to also read the original posters point which is what we are discussing.

Please note that Loss Assessors fall within the European Communities (Insurance Mediation) Regulations 2005
I have no idea where your idea that the "regulation was introduced to protect consumers against people that they engage" comes from

I would also draw your attention to page 26 section 18 of the Consumer Protection Code where it advises that an insurer must advise their customer that they are entitled to appoint an assessor which runs against what you are suggesting.

 

[left foot]

they are working under the authorisation of the insurance company

Thank you for confirming that loss adjusters are in fact paid by and regulated by the same body.

are you not showing exactly the same bias in the opposite direction? You might want to also read the original posters point which is what we are discussing.

When did i show any bias in the opposite direction; I have asked people to not generalize and that is it. I have pointed out that loss assessors do not charge more than 10% if you can prove me wrong please by all means do.

You on the other hand have been clearly speaking from an insurance companies point of view.

The OP is confused about where he stands in terms of the assessors role in his claim and adjusters role in his claim. I have been stating that not all assessors are the same as what what he encountered.

As far as i can see there have been other posters such as yourself who have painted all assessors with this brush. You have made ungrounded statements and generalizations and all i've done is pint that out. I have not been impartial but have stressed the other side of the page here.

 

[Brendan Burgess]

I worked in an insurance company, admittedly back in the 70s, and I remember clearly a manager or senior clerk trying to reduce a claim. The Inspector was very clear that this was not the policy of the company and that the policyholder should be paid in full in line with their policy.

I am sure that the policy varies from company to company and indeed from individual to individual within the company.

As this thread has moved into letting off steam territory, I am closing it.

Please all read the Posting Guidelines. If you think another poster is in breach of the guidelines, use the report post facility. Do not speculate about the identity of another poster.

Brendan