Articles Of Interest

Insurance claims, when it pays to seek outside help
By Arthur G. Jansen, Sr., CPPA, SPPA

November 15-21, 1996

Most business professionals would never consider filing their own company taxes or representing their company in legal matters. But many still allow their insurance representatives to advise their position in the claims process.

A comparison to this situation is allowing the IRS to handle your taxes.

An alternative is to enlist a public insurance adjuster to advise and assist in the preparation of inventories, estimates and other factual proofs of loss and to handle all the necessary details for compiling and filing claims, as required by the terms of the insurance policies.

Outside Help

U.S. businesses today acknowledge the benefits of outsourcing functions that are not in their core specialities. They invite professionals to assist their operations in accounting, legal and marketing aspects.

The underlying benefits of employing experts are many; however, relying upon certain experts usually provides more professional and beneficial results.

When they deal with insurance related matters, such as analyzing present coverage and risk exposure, most professionals seek the advice of their insurance agent. Rightly so, because the agents’ main function is to access needs and provide appropriate insurance coverage for protection.

Property structure and contents coverage together with business interruption coverage are three common commercial policies involved. If you and your business have been properly advised by your agent, in times of loss, the coverage should adequately protect you and your property, allowing you the opportunity to get your business back in operation.

Dual Role

What many business owners do not know is that in times of loss, it is their responsibility to measure and document the aspects of their loss for presentation to their insurance company.

The insurance company adjuster is responsible for investigating the claim, determining how much of the loss is covered by the insurance policy and recommending the amount settlement. The adjuster assigned to your claim will inspect the damage to your property, analyze evidence of loss and review any repair bills.

When facing a fire, flood or other catastrophe, many business owners or corporate risk managers realize that the claims process is more complicated and contains more gray areas than they had earlier anticipated. While most agents maintain contact and breed loyalty among their clients, when a loss occurs, an adjuster becomes involved and the agent moves back to his pre-incident role of advising and marketing insurance coverage.

The distinct difference in the rules of the agent and adjuster are obvious: One collects money for the insurance company, the other pays funds out. The commonality is that they both work in the best interest of the carrier, or more directly stated, maximize input and minimize output of funds to the insurance company.

This is when the use of a professional loss consultant becomes justified.

Loss Consultant

Public insurance adjusters are experts, employed by business owners (and homeowners). They are trained to understand how insurance companies deal with complex, technical policy requirements.

Public adjusters are employed because their expertise normally assures a higher amount of recovery, a more expeditious settlement and eliminates the hassles associated with dealing with insurance companies.

An accredited public adjuster can make a substantial difference in the recovery of proceeds following a claim. The public adjuster will easily more than justify his fee, which is a small percentage of the claim, depending on the size of the loss and complications involved.

Public insurance adjusters have a surprisingly positive relationship with insurance companies, considering one is taking money away from the other. Sometimes insurance adjusters recommend hiring public adjusters because they realize this will expedite the entire claims process.

If it is the common goal of all parties involved to settle the loss quickly and at a reasonable dollar amount, the process should go smoothly. If the insurance company and/or the insurance adjuster wants more evidence, public adjusters are on the policyholders team to provide it in a concise, professional manner.

An accredited public insurance adjuster is in good standing with the National Association of Public Insurance Adjusters and Texas Association of Public Insurance Adjusters and will present realistic consultation regarding your loss prior to handling a claim.

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