The role of loss adjusters in the evolving insurance industry

Candace Jooma, claims manager, Mirabilis

The coverage offered by insurance companies has become more widespread and increased in complexity. This has led to the need for more specialised loss adjusters in the industry. The loss adjusting industry now provides a pool of experts with a wide range of knowledge and experience across a variety of industries such as engineering, marine, agriculture, aviation, and cyber, to name a few.

To provide a transparent claims handling process and to ensure that customers are treated fairly, insurers require the technically sound and objective input of qualified, experienced loss adjusters. Beyond investigating the claim to determine the extent of the insurer’s liability; loss adjusters also assist the insured to navigate through the claims process and play a crucial role in ensuring that all parties involved are treated fairly and reasonably throughout the process.

Loss Adjusters Add Value to the Policyholder Experience

A high level of customer service together with fairness is key in policyholder retention and policyholder satisfaction, and it is important to acknowledge the role that loss adjusters play in this. The policyholder pays a premium for customer service and claims assistance. The loss adjuster is a major player in the claims process and should seek the same outcome as what the insurer and broker would like in each claim – for it to be resolved in a fair and transparent manner so that it is ultimately a positive policyholder experience.

Despite being appointed by the insurer, it is of vital importance that loss adjusters remain impartial to ensure that their core responsibilities, for example verifying quantum, is always independent, not to reduce the amount of the claim as is a common perception but to ultimately lead to the claim being finalised in a fair and accurate manner for all parties involved.

Changes in the Risk Landscape

The Covid-19 pandemic disrupted the global economy and inevitably changed the way claims are handled. This, in turn, forced the loss adjusting industry to adapt and make changes to how claims are assessed. Loss adjusters have since been able to use innovative ways to manage major and complex claims, mainly with the use of technology.

Major and complex claims have become a frequent occurrence in the insurance industry; and we can expect the frequency to increase in light of the current global supply chain issues, inflationary pressures, war in Ukraine and the ongoing pandemic. I think that it is safe to say, though, that the complexity of handling such losses; the difficulty in accessing sites and the many other challenges that arise from such losses will not phase the loss adjusting industry due to technology continuing to be pivotal to facilitating and transforming the handling of such losses.

Earlier in the year, the insurance industry was inundated with claims arising from natural catastrophic related damage as a result of climate change, namely the floods experienced in Kwa- Zulu Natal. This was a dismal reminder of the changing weather patterns and the role of the loss adjuster should be changing too. The claims received in the wake of these floods are an indication of the significant impact this has had on the insurance industry and it highlights the need for loss adjusters to play a crucial role in the fair assessment and settlement of such claims.

Human Touch is Key

Whilst technology has proven to be valuable to the insurance industry and loss adjusting industry alike; there can never be a choice between technology and people. Whilst insurers use data and technology to create a personalised policyholder experience and satisfy policyholders expectations; the “human touch” is still valued by policyholders and should not be replaced by the drive for automated claims processes.

There is no doubt that policyholders appreciate that their claims are able to be acknowledged and attended to immediately; however, they are often of the view that the process is then too onerous on them to prove their claim; and also, they are often not certain of the claims process that follows. It is our experience that policyholders prefer to engage with loss adjusters to obtain a clear understanding of the claims process and constant indicators of the status of their claim. This means that in addition to the loss adjuster having the appropriate skill for the claim at hand, he/she must also maintain a level of empathy to help the policyholder through the claims process.