A property insurance adjuster, in particular, is tasked with the complete investigation of the insurance claim regarding damage to a structure and personal property. In the process, the adjuster determines the most appropriate settlement with highly detailed documentation and software. When conducted correctly, a claims investigation can lead to a quick, fair settlement. An experienced adjuster understands this, and always performs a thorough investigation to determine the precise date of loss, provide documentation, and lists all factors that led to the damage.
Let’s take a close look at three common oversights in the investigation and what can be done to avoid them.
1. Confirming the Date of Loss
One of the single most important aspects of claims handling involves conclusively determining — and proving — the date of loss. This aspect of an insurance claim can be deceptively simple. For instance, if the Insured claims hail damages from a recent storm and historical weather data shows an event seven months ago, this can be outside the policy effective dates. Determining the date of loss in all cases is imperative, it is the adjuster’s duty to establish the date of loss as precisely as possible, using whatever resources necessary.
Consulting weather records from the time when the damage occurred, or contractor invoices that document an initial response to the problem – no matter how clear cut the damage, if the date of loss is not conclusive, the claim may not be accurate.
2. Failure to Make Photo Documentation
A successful claim hinges on more than just a thorough written estimate. The adjuster must also take detailed photos of the damage that has occurred. The more details in the photos, will provide a better final product for the desk examiner to swiftly conclude the claim.
Experienced claims adjusters never assume that the damage will speak for itself. Rather, they understand the vital importance of photo documentation in building a well-documented claim.
3. Insufficient Investigation for Subrogation
A claims adjuster does more than help the insured. They also document and preserve evidence for subrogation on behalf of the insurance company. Desk examiners are required to pursue any third parties that may have caused the insurance loss in question.
Subrogation may or may not apply to a given insurance claim. For instance, if a bolt of lightning strikes a tree that falls over and damages a home, there is no third party at play. However, if that tree had recently been weakened due to improper trimming by a tree care company, an insurance company may pursue subrogation.
In that case, the insurance company still pays the homeowner for the damage. The company would then seek reimbursement from the tree care company. The success of this subrogation hinges entirely on the insurance adjuster’s investigation. If an adjuster does not perform due diligence in determining the cause of the property damage, the insurance company may be unable to build a case for subrogation.