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The question you want to answer is, 'Can I get my own independent loss adjuster to support me?' The short answer is yes. But who are loss adjusters? How can they help? And are they the best people to help you settle your claim successfully?
Independent loss adjusters are qualified experts at managing insurance claims. They provide support, guidance, and knowledge as insurance professionals with a full understanding of insurance coverage, procedures, and claims. They are typically employed by insurance companies to assess and oversee particularly complex and costly insurance claims. They are responsible for establishing the cause of a loss and determining whether the insurance policy covers it.
An Insurance Claims Adjuster is supposed to act impartially and provide an unbiased representation of an insurance claim. However, insurers will ask their employees to conduct their investigations in a manner that focuses on outcomes that favour the insurer. For example, they may be asked to look out for confusing details surrounding the circumstances of the claim, as ambiguity could help the insurer avoid liability.
Independent Adjusters are most often employed by insurance companies to investigate a complex or substantial claim. Very rarely are they appointed by policyholders. No matter whose behalf they are working on, an insurance claims adjuster should remain unbiased and focused on assessing the facts using their expert opinion. Their conclusions and reports should be proven with evidence and professional knowledge rather than speculative.
An Insurance Claims Adjuster is employed to determine two main points: whether the policy covers the loss/damage of the claim and the amount that should be awarded. Sometimes, the loss adjuster is given delegated authority, otherwise understood as full authority, to settle the claim on the insurer's behalf. Alternatively, the loss adjusters may be asked only to support the negotiations with guidance and recommendations.
During their claim assessment, loss adjusters will ask various questions to understand the full circumstances surrounding your claim. They will gather information through your responses to their questions and by viewing the damage and loss to your property. The information they collect will be used to create a report, which is sent to the insurance company. This report carries a great deal of weight in settling the details of your claim.
Policyholders are not usually given a copy of the loss adjusters' report. However, you can ask for the loss adjusters' conclusions and how they reached them. If you disagree with the loss adjusters' findings, you can ask for further explanations, including how your policy conditions specifically influence the claim. You can also ask how you will challenge any of the verdicts drawn from the assessment. Any issues you have about the loss adjusters' conduct should be raised immediately. If your concerns are not addressed, take them to the establishment directly.
Yes. All policyholders retain the right to appoint an independent loss adjuster to support their commercial or domestic insurance claim. A loss adjuster will guide and assess your claim, providing you with the knowledge and skills to reach a successful outcome. This is particularly important if your insurer contracts a loss adjuster like Questgates to work on their behalf. Utilising a loss adjuster's services usually indicates the claim's complexity. If your insurer has one on their side, it would be wise to appoint one to represent you also.
An independent loss adjuster can coordinate emergency work, prepare details of your claim, negotiate with all representatives, and settle an agreed-upon payout. This is all highly beneficial when competing against insurers and loss adjusters such as Questgates. But are independent loss adjusters the best people to represent you? Insurers typically contract them; therefore, they can be expensive to hire and harder to appoint to work on your behalf.
Independent loss adjusters are experts at assessing claims and understanding complicated insurance policies. Their expertise typically remains with representing insurance companies, but they are independent professionals trained to stay unbiased. If you appoint one to assist you with your claim, they will assess and conclude their findings impartially, delivering clear conclusions from their gathered information.
However, you may find that many independent loss adjusters only work on behalf of insurers as this provides them with a more reliable workload and competitive income. Instead it would be more worthwhile to contact insurance claims professionals with specific skills and experience at handling claims on behalf of the policyholder.
Loss assessors such as Oakleafe Claims are independent insurance experts who work solely on behalf of policyholders. They have the same knowledge and proficiency as loss adjusters, yet their purpose explicitly supports policyholders. They only ever work on your behalf. For this reason, they can be trusted to handle your claim expertly and correctly. Loss assessors work like independent loss adjusters, with the added value of experience and authenticity representing policyholders. They know the common mishaps, pitfalls and biases that loss adjusters and insurance companies use. They have the skills to guide and support you through a complex claims process. Their values lie in encouraging and assisting you, the policyholder specifically.
You are doing your best to navigate through your claim process, and you're informed that Questgates Loss Adjusters are coming to see you on behalf of your insurer. As the UK's leading specialist loss adjusters, they are experts in insurance and complex claims. The prospect of successfully managing your claim is already daunting, and now you feel even more intimidated by the thought of specialist loss adjusters representing your insurer.
Questgates is the UK's leading specialist loss adjuster. If they contact you on behalf of your insurer, you know your insurance company is taking your claim seriously. Employing such a loss adjuster indicates your claim is complex and substantial. For these reasons, you should consider appointing your own representative to support your side of the claim, such as Oakleafe Claims.
As a policyholder, you can employ your loss adjuster to back up your claim, whether for a commercial or domestic claim. Loss adjusters are professionals with expert knowledge of claim assessments, reports, insurance policies and settlements. However, loss adjusters are typically employed by insurance companies, making them expensive and complicated to come by. Loss assessors such as Oakleafe Claims, on the other hand, operate with the sole purpose of supporting policyholders with their claims. They, too, have expert knowledge and experience in insurance claims. More importantly, they have the relevant insight and skills to assist policyholders. They can offer you the guidance, encouragement and expertise you need to proficiently handle your claim, no matter who you are negotiating with.
According to a leading Insurance claims management company, Insurance Complaints are on the rise! About 2 in 10 of the Insurance claims assigned end up with an Insurance complaint. These are valid insurance claims that have been accepted by Insurers but have failed to meet with the policyholders expectations.
It is often surprising that in the event of a water damage insurance claim or fire insurance claim most insurance companies treat their clients, some of whom have been loyal premium payers for many decades, with the opposite level of apathy that they showed when they were taking their premium.
The figures shown below are only those that the FOS (Financial Ombudsman Service) have registered, that have been escalated by the policy holder as a result on the Insurance companies conduct. These do not include the insurance complaints the actual insurers receive. They will outnumber these many times over. Aviva alone for example published complaints figures for the 1st six months of 2017 at 78,436. Yes that’s right 78 thousand four hundred and thirty six from January 2017 to July 2017.
Set up by parliament, the Financial Ombudsman Service or FOS is the UK’s official expert in sorting out problems with Insurance claims and Insurance companies. If a financial business and a customer can’t resolve a complaint between themselves, the Financial Ombudsman can give an unbiased answer about what’s happened. If they decide someone’s been treated unfairly, they have legal powers to put things right.
Figures from the Financial Ombudsman Service have revealed that Direct Line Group, via the business name UK Insurance, was the most complained about provider in the first half of 2017. It is no wonder that many policyholders choose the services of an Insurance Loss Assessor and willingly pay Insurance Claims Fees. The insurer received 1,447 new general insurance complaints during the period. These Insurance complaints exclude PPI. Aviva was the next most complained about with 1,051 followed by Ageas (773), Axa (623) and RSA (622).
There are a number of reasons why you might make an Insurance complaint about your insurance company.
If it is often the case that wording on policies can be very complex and hard to read for some people. Therefore some conditions in the policies which must be met, for example. it is the responsibility of the policyholder to to mitigate any damages from spreading after the incident.
After you make an Insurance complaint, your insurance company will have an opportunity to look at the dispute again and may compensate you. You can follow the FOS online guide to help you through the process to try and resolve the problem. First you will have to complain to your insurance company. Only then can you get the FOS to investigate your complaint, which I add is at no cost. Always try to resolve any misunderstanding amicably and between the parties involved.
If your insurance broker set the policy up, they might also make an Insurance complaint for you. Its always good to try to resolve the Insurance complaint face to face with your loss adjuster or a phone call to the insurance company. Always make sure you write down who you spoke to, times and the particulars of the conversation in case this is needed to be presented as evidence to the FOS.
In the intricate realm of insurance policies and the claims they are designed to cover, there's an eyebrow-raising statistic that every policyholder should be privy to 1 in 5 insurance claims are repudiated, that is, rejected by the insurer.
Simply put, an insurance company can reject an insurance claim by deciding not to honour the claim, often citing various reasons. These could range from non-disclosure of pertinent information to breaches of policy conditions to alleged fraudulent activity. The process leading up to this point can be fraught with misunderstanding and contention, culminating in a scenario no policyholder wants to encounter.
The revelation that a startling 20% of insurance claims are denied may seem surprising, but these figures are not pulled from thin air. An annual report published by the UK's Financial Ombudsman Service in 2021 found that they upheld approximately 1 in 5 complaints about insurance claims being turned down. To shed some light on the magnitude of the situation, consider this: millions of insurance claims are filed in the UK each year across various sectors. A fifth of these claims being turned down indicates a considerable volume of denied claims.
Consider the case of Jane (name changed for confidentiality), a proud homeowner in London. Jane had dutifully paid her home insurance premiums for several years. However, when an unexpected fire caused extensive damage to her home, she was shocked to discover her insurer had rejected her claim.
The insurance company argued that Jane had failed to disclose an essential piece of information when taking out her policy — a small, inconspicuous detail about the electrical wiring of her home. According to the insurer, this represented a material non-disclosure, a basis for Repudiation, meaning her claim was rejected.
Jane disputed this decision, arguing that she had been unaware of the significance of the information and that she had answered all the insurer's questions to the best of her ability when purchasing the policy. Eventually, Jane's contacted us here at Oakleafe, and we took over managing her Claim. We challenged the Insurers and re-presented her Claim, resulting in her receiving the settlement she was entitled to.
Jane's experience underscores the importance of full disclosure when purchasing an insurance policy, but it also serves as a potent reminder of the considerable proportion of claims that insurers deny. The statistic — 1 in 5 insurance claims repudiated — should encourage policyholders to arm themselves with as much knowledge as possible about their insurance policies. Understanding the ins and outs of your policy can be a decisive factor in whether a claim is paid or repudiated.
If your insurance company decide to repudiate meaning your claim is rejected, it's essential first to understand why. Review the insurance policy's terms and conditions to ensure the claim is valid based on your coverage. If you believe the claim was wrongly denied, gather all relevant documents, including reports, repair estimates, or any other evidence supporting your claim. Contact your insurance provider for a detailed explanation of the denial and consider seeking advice from an insurance professional such as Oakleafe Claims. While the thought of having a claim rejected may seem daunting, knowledge and understanding of insurance terms and conditions can go a long way in ensuring the policy serves its purpose when needed. Given the present climate, insurers and policyholders need to work towards a transparent and fair insurance claim process to decrease the number of repudiated claims.
Remember, insurance is intended to serve as a safety net, a lifeline in our times of need. Let's ensure it remains that way. If you have been affected by repudiation, contact us, and one of our highly trained team will be in touch to talk about your current situation.
Insurance Claims, What Should I Do? FAQ. The very first thing you need to do is to engage a Loss Assessor. It is your responsibility to mitigate any damage and prevent it from spreading. Insurance Loss Assessors have vast experience in Insurance Claims Management and are able to handle all aspects of the claim including all communications with the Insurance Company. They would endeavour to get everything you are entitled to and take away the stress. They would help you notify the Insurance Company who would then send a Loss Adjuster to view and inspect the Incident. A Loss Assessor would be there for you every step of the way.
What is a Loss Adjuster and what do they do?
Insurance Loss Adjusters are the opposite of a Loss Assessor, they sent by Insurance Companies. It might seem like they are trying to help but in fact they are employed and paid for by the Insurance Companies. They are there to analyse and investigate the incident and often hire additional 3rd party investigators to determine the cause. Their number one priority is to find ways to limit or even refuse the pay-out settlement known as “repudiation”.
How much can I Claim?
This is strictly dependent on the amount of damage which occurred and the policy that you are covered for. Insurance Companies create big large policies full of many different pages trying to cover up or make certain information hard to find. A Loss Assessor can go through the entire policy and analyse the best possible approach to your Insurance Claim.
What is Liability?
Liability is the legal responsibility or obligation for a company’s action. During a claim an Insurance Company would investigation and determine the cause of the incident. Different actions can be taken depending on the result which can be complicated, but Liability must be accepted before a claim can proceed to the next stage.
How long will my claim take?
Every claim is unique and different in its own sense. The range of complexity can vary from claim to claim especially when dealing with a Business Claim which can lead to Business Interruption. Business Interruption is the process of analysing and calculating financial forecasting of a Business where it would be missing out on if the Loss would not have occurred.
How do you evaluate damage or Loss?
Depending on the type of damage or loss, Insurance Loss Assessors would engage additional specialists to help analyse and assess the loss such as: Chartered Surveyors to inspect property damage, Cyber Security Experts to analyse IT infrastructure and Business Specialists to view sale figures and financial forecasting.
Who pays the settlement?
After liability has been accepted and the final report has been sent to the Insurance Company. It is often agreed between yourself and the Loss Assessor for a small feel for the Claims Handling Service. Remember that an Insurance Loss Assessor is likely to get you 30% more when what your Insurance Company would have offered you making their service vital in getting everything you are entitled to.
White goods appliances – mainly washing machines and tumble dryers – account for as many as 60 house fires a week in the UK alone according to Which?
The number of fires has increased each year for five years.
Which? wants the authorities to tackle the issue of fire damaged properties due to appliance failure within three months. Of course the appliance manufacturers have questioned some of the data that Which? used. There is a growing fanbase of people and organisations that want an overhaul of the UK’s product safety system. This follows the series of well publicised fires such as the Grenfell Tower tragedy, which was started by a faulty fridge freezer. Fire Insurance claims rate into the millions so Insurance Claims Management Companies are being resilient to any claims and it is always advisable to get a Insurance Loss Assessor to check your policy in such an event.
One example of a defect affecting millions of tumble dryers under the Hotpoint, Creda and Indesit brands has apparently led to hundreds of fires since 2004. The Commons Business Committee made public that more than one million potentially dangerous dryers were still being used in people’s homes.
In fact a freedom of information request to fire authorities and the Home Office shows the scale of faulty appliance fires in Britain. faulty kitchen appliances have accounted for over 16,000 fires across the UK over the last 5 years.
Branded washing machines and tumble dryers accounted for one third of fires, followed by cookers and ovens, dishwashers and fridge freezers.
A series of adverts are due to be aired. This is just the first step. According to a claims management company It is essential that consumers have access to this information to let them know there is a risk of smoke and fire damage to their property. They advised the government to create a database of recalled products so people can buy based on fact when it comes to safety.
Rachel Reeves, who chairs the Business Committee, said: “While we welcomed the decision to establish an Office for Product Safety and Standards, we agree the government must make sure it has real teeth and ensure it leads to more people registering their products, a better recall regime and ultimately a reduction in the number of fires that place so many homes and lives at risk. In any case if you did suffer a fire seek the help of a Loss Assessor who will prepare and present the claim for you.
The damage caused by fires are more devastating then most people thing. Even small fires that have been contained still pose a big risk. The Smoke Particulates from Smoke Damage can still cause substantial problems to both the property and the occupants inside of it.
If you have been declined whilst trying to claim on your domestic or commercial insurance, we can help. We can also help with professional services, for example, Brokers, VAR Valuations and Managing Agents.
