Loss adjusters and assessors – a changing role

The Gauteng thunderstorms experienced over the past two years, as well as the heavy rains experienced at the beginning of this year, are a stark reminder of changing weather patterns. Because of this, climate change is becoming a topic which is foremost on everyone’s mind. As pointed out by the number of claims received in the wake of the severe thunderstorms over the past two years, this has a significant impact on the insurance industry.

It is a fact that insurers are feeling the effects of climate change in all forms. They are experiencing significant losses due to weather patterns and they also experience fraudulent behaviour from the public, no matter from which socio-economic environment they come from.

Develop a turnaround strategy

So how do insurers turn this around? As a broker I began to notice the following trend. The inevitable pressure of hard rates is having an impact on the industry as insurance companies are becoming stricter when it comes to their criteria for paying out claims, and insurers have to increase first amount payables. They are becoming selective on what business they wish to write and amend their underwriting criteria and contracts. In order to achieve this, they often turn to loss adjusters to assist.

However, there are some challenges with adopting this outlook. Of late, loss adjusters and or assessors are redefining the roles that they used to fulfil. As brokers, we feel that the more claims an assessor repudiates, the more the insurer reappoints that assessor.

Improving industry integrity

The insurance industry is increasingly coming under the spotlight in the public eye. This is because of increased education regarding the industry. Because of this, it is imperative that all industry role players contribute significantly towards clarity and integrity. The public needs to feel as if insurance is contributing towards their lives rather than detracting from it.

So what must happen and what is my point as an independent adviser?

Brokers and advisers should act with integrity and insurers must be more willing to listen to brokers and advisers. Insurers and advisers must have the type of relationships with their clients whereby they feel they can educate these clients.

The crucial role of the assessor

Even if it is not the case, the public must never have the perception that they are being treated unfairly by any role player in the insurance industry.

The duty of a loss adjuster or assessor needs to change within the current climate. Loss adjusters or assessors need to be impartial, adjust and assess fairly, and remember that the insurer wrote the contract so the claimant should be looked at in a positive light.

Furthermore, they must realise that an insurance contract is a contract to indemnify a person against loss.

I believe that together, insurers, brokers and loss adjusters can overcome these current climate changes and treat clients according to the outlines prescribed by the Treating Customers Fairly objectives that the Financial Services Board implemented.

If we can succeed in this, our clients will no longer see insurance as a grudge purchase, instead they will see the benefits and it will become a win-win scenario.

I have compiled a list of duties which I, as a broker, believe a loss adjuster or assessor should ideally be carrying out:

• obtain claim forms,
• interview the client or consumer,
• visiting the claim site to survey any damages,
• obtain quantum,
• gather evidence, such as security camera footage and police reports,
• request detailed reports from specialists such as building surveyors,
• complete relevant paperwork,
• check that the policy will cover the loss and that the client is claiming a reasonable amount,
• investigate further should he or she suspect fraud,
• present a report to insurers recommending the amount payable, and
• advising claimants how to avoid further losses.

Footnote:
Ed – I would like to encourage you as a broker / financial adviser to feel free to contact me with issues such as the one Hendrikus has written about. Your industry colleagues may experience it the same – [email protected]