Loss Adjusting
Investigate Claims
- Examine the circumstances of insurance claims to verify their legitimacy.
- Conduct interviews with claimants, witnesses, and other involved parties.
- Review police reports, medical records, and other relevant documents.
Assess Damage
- Inspect property damage or loss to determine the extent and value of the damage.
- Work with experts such as engineers, appraisers, and medical professionals to evaluate claims.
Determine Liability
- Analyze insurance policies to determine coverage and exclusions.
- Assess whether the insurance company is liable for the claim and to what extent.
Negotiate Settlements
- Calculate the amount of compensation based on the investigation and assessment.
- Negotiate settlements with claimants or their representatives to reach a fair resolution.
- Prepare settlement reports and documentation.
Document Findings
- Write detailed reports of the investigation, findings, and recommendations.
- Maintain records of communications, documents, and settlement agreements.
Advise and Communicate
- Provide guidance to claimants on the claims process and required documentation.
- Communicate with insurance companies, brokers and other stakeholders.
Compliance
- Ensure that all procedures and settlements comply with legal and regulatory requirements.
- Stay updated with changes in insurance laws and regulations.
Cost Control
- Identify ways to control and reduce costs for the insurance company.
- Prevent fraudulent claims and minimize unnecessary payouts.
Professional loss adjusters play a critical role in the insurance industry by ensuring that claims are handled fairly, efficiently, and in accordance with policy terms and regulations.