Claims adjusters, who are they?

In the event of a claim, you must contact your insurer as soon as possible. He will appoint a claims adjuster who will guide you through the claim process.

Investigating, estimating and negotiating are the three key functions of this certified professional.

The claims adjuster is your key contact, your resource person. Do not hesitate to ask him all your questions, he is there to inform you. Make sure you have his contact information and know when and how to reach him.

The main functions and obligations of the claims adjuster are:

• Investigate the causes of the disaster.
• Validate the protections included in the insurance contract.
• Read the police report and other relevant documents such as the inventory of damaged or stolen property.
• Collect the statement of the victim and those of any witnesses.
• Estimate the damages and losses suffered to proceed with the settlement of the claim.​

The claims adjuster also has an obligation to explain the detailed procedure and the services that will be rendered, in particular:

• The emergency measures to be taken, for example drying out the walls and the floor (carried out by a disaster clean-up company which the insured can choose).
• The identification of the persons engaged for these emergency measures.
• The arrangements it intends to make for damaged goods, following your consent.
• Authorization to purchase replacement goods.
• The application of living expenses or operating losses, if it is a business.
• How to estimate the amount of the settlement (basis of calculation, methods of depreciation, etc.).
• Deadlines in the regulations.

Mandate your own claims adjuster?

Although claims adjusters employed by an insurer are also there to settle your claim, you can, at your own expense, call on a “public” claims adjuster. In particular, he will be able to assist you in certain tasks that the claims adjuster mandated by the insurer would not do, for example, take an inventory of the property claimed by the insured. However, the public claims adjuster cannot settle the claim; he will negotiate on your behalf with the claims adjuster mandated by the insurer.

Your insurer wants to help you get on with the normal course of your life as easily as possible after an unforeseen disaster. When you file a claim EN -opens a pop-up with definition of claim , you will be assigned an adjuster. This is your first point of contact, whose role is to provide you with a positive experience during the claims process.

Essentially, the claims adjuster takes care of everything: checking your policy and coverage, obtaining quotes for the repair and rental of a replacement vehicle, investigating the accident or damage, obtaining reports and necessary documents, assignment of responsibility and establishment of your payment.

A claims adjuster will guide you through the claims process, from initiating your claim to receiving payment.

Here are some of the things an adjuster would do to help you move from submitting your claim to receiving payment.

1. Make initial arrangements. The claims adjuster will contact you with contact information, information about your claim, including claim number, schedule for repairs and replacement vehicle rental (if applicable), and tell you whether or not you have to pay a deductible .
2. Investigate the accident or claim details.The claims adjuster will interview you to obtain your statement about the events that gave rise to the accident or the damage to your property. He may also examine police statements, bodily injury reports or medical records, as well as any other information allowing him to understand the scope of your claim. The interview could be done in person for complex cases, but most of the time the adjuster will get the information over the phone. If necessary, he will interview witnesses, consult experts and communicate with third-party insurers. This information is collected in order to establish liability, assess the situation and finally, to determine the amount of your settlement.
3. Review all documents and expenses. To determine your settlement, the adjuster will review the terms of your policy and assess your degree of fault, cost of repairs, medical expenses , loss of income, living expenses and any other expenses incurred.
4. Determine your settlement. Your adjuster will calculate your settlement amount and let you know. You can discuss this with him if you need clarification, if you feel that expenses have been overlooked, or if you anticipate charges that have not yet been billed to you. Be ready to show him the necessary information and documents.