Dealing with insurance claims adjusters can be a stressful experience, especially if you don’t know what they do or how to prepare to meet with one. Luckily, we are diving into all things insurance adjusters today. Keep reading to learn more about how insurance adjusters work in Canada.
What is an insurance adjuster?
When someone with an insurance policy, whether that’s a high-value home insurance policy or an auto insurance policy, experiences a loss, they may submit a claim to their insurance provider. If they choose to submit a claim, an insurance claims adjuster is the person who will investigate the claim for the insurance company. As you might expect, insurance providers must do their due diligence anytime a claim is filed. If they failed to investigate each claim, the company could end up paying out more money than they need to on claims. Even worse, an insurer could end up paying for a fraudulent claim. Therefore, insurance adjusters play an important role in helping to determine a fair settlement for all parties involved in the claim. Since the insurance adjuster is heavily involved in the claims process, they are usually the ones in direct communication with the policyholder. Please note that in Canada, insurance adjusters are licenced according to the regulatory body in the province or territory they operate in. This means that the claims adjuster you work with has to be licenced to work.
What does an adjuster do?
Now that you know what an insurance adjuster is, let’s dive deeper into what an insurance adjuster does. The job of a claims adjuster is to investigate and verify insurance claims. From there, they use their findings to determine a fair payout amount. Insurance adjusters are called on to settle a wide range of claims, from accident benefits coverage claims relating to car insurance to property damage claims made on home insurance policies.
For example, let’s say that you were involved in an accident and your car was damaged, so you decided to file a claim with your insurance provider. The role of the insurance adjuster would be to inspect the damage to your vehicle, review any existing police reports, speak to eyewitnesses, and talk to anyone else involved in the accident (a pedestrian, passenger, the other driver, etc.). Similarly, if your home suffered property damage, as part of their investigation, an insurance adjuster would inspect your home to understand the extent of the damage and interview the property owner and any witnesses.
Next, the claims adjuster would submit their findings to the insurance company via a report, which would include a detailed description of the incident and an informed recommendation for the claim amount. The claim amount is how much money the policyholder will receive from the insurance provider to pay for the damages. The insurance adjuster will also assess the policyholder’s insurance coverage to determine which parts of the claim, if any, are covered or not covered. One final word on what insurance adjusters do: The claims process differs between insurance companies, which means how long it takes an adjuster to handle your claim is likely to vary as well. Some adjusters may have the authorization to handle claims, especially small ones, quickly through a sped-up settlement process. However, for larger or more complex claims, it may take an adjuster upwards of 60 days to investigate and submit their report to the insurance company.
Independent insurance adjusters
A quick word on independent insurance adjusters. As alluded to above, many insurance companies have a team of in-house insurance adjusters who investigate claims on their behalf. However, this isn’t the case for all insurance companies. Some insurers choose to outsource the claims process to independent insurance adjusters. Independent adjusters are third parties who perform claims adjusting services on a freelance or contract basis. This is especially common among insurance companies that don’t have a branch or physical office space in a certain city. Instead of having an in-house adjuster travel all over the country, they will hire a local independent insurance adjuster to handle claims related to that region. That said, whether an insurance adjuster works independently or is a full-time employee of a specific insurance company, they must still be licenced to work in Canada.
Home insurance adjusters
The term home insurance adjuster is a common one, so we thought we would mention it here. The role of a home insurance adjuster is the same as that of an auto insurance adjuster, except they specifically deal with home insurance claims. For instance if your home was damaged and you filed a claim with your insurer to cover the cost of the repairs, a home insurance adjuster would likely visit your home to inspect the damage, write a report for the insurance company, and settle the claim as quickly as possible.
What to know before filing an insurance claim
Before filing an insurance claim with your provider, which will involve intervention from an insurance adjuster, there are a few things you should know:
Key considerations before filing a home insurance claim
The following is a list of what to know before filing a home insurance claim:
- If the cost of the repair is less or only marginally more than your home insurance deductible, don’t file a claim: Filing a claim for a small repair, especially one that is less than your policy deductible, is generally not recommended. Why? Doing so can increase your home insurance rates, which is unlikely to be worth the hassle and minimal payout.
- Depending on the damage, call the police: If you suspect that your property was damaged due to criminal activity, such as theft or vandalism, get in touch with the police as soon as possible. Failure to contact the police when necessary could slow down the claims process and hurt you in the long run.
- Don’t submit home insurance claims relating to maintenance: Home maintenance is tricky business when it comes to insurance. If you fail to properly maintain your home and it falls into a state of disrepair, leading to damage, your insurer can invalidate your home insurance policy and reject your claims. Therefore, instead of filing a home maintenance-related claim, we recommend using your personal savings to maintain your home year-round.
- Take photos and videos of the damage: After your home suffers damage, make sure to document it. In this day and age, the best way to do so is to take ample photos and video footage of the incident. Take photos from a variety of angles and make sure they are in focus and well lit.
- Notify your mortgage lender: If you are still paying off the mortgage on your home, it is important to contact your mortgage lender following an incident of property damage. Inform them of what happened so that they can be involved in the settlement process.
Key considerations before filing a car insurance claim
The following is a list of information to know before filing a claim with your car insurance provider:
- Review your car insurance policy before filing a claim: Before filing a claim with your insurer, which can raise your rates, make sure that your policy covers you for the loss you are claiming. If you need help understanding your policy, visit the BrokerLink blog, where you will find invaluable resources like types of auto insurance or third party liability insurance explained, or contact a BrokerLink insurance advisor.
- File a car insurance claim for serious car accidents or incidents where someone has been injured: If you get into a serious collision that results in significant damage to your car or the other person’s car or that causes bodily injury to yourself or someone else involved in the accident, filing a claim is important.
- Avoid filing a claim if you were the only person involved in the car accident: Similarly, if the damage from the accident was minor, you were at fault, and you were the only one involved in it, such as if you backed out of your driveway and accidentally hit your fence, it might not be worth filing a claim with your insurer.
The dangers of filing too many claims
Please note that there can be consequences to filing too many insurance claims, which is why policyholders should not file them without careful consideration. Generally speaking, the more claims you file, the higher your insurance premiums will be, whether we’re talking about home insurance, car insurance, or even business insurance. Anytime you apply for a new insurance policy or renew an existing policy, the insurance company will review your claims history. A high number of claims can lead to more expensive rates. Even worse, if an insurance company notices that you have filed an above-average amount of claims, they may be within their rights to cancel your policy before the term is up. A cancelled insurance policy can make it difficult to find coverage moving forward. For instance, if your auto insurance policy is cancelled by your insurance provider, you might be deemed a high-risk driver. Many insurance companies don’t offer policies to high-risk drivers, and the ones that do, charge a premium for them. Therefore, before filing any sort of insurance claim, consider whether doing so is worth it. For expert advice, contact a BrokerLink insurance advisor who can offer a professional opinion on whether filing a claim with your provider makes sense.
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Tips for dealing with insurance adjusters
If you decide to move forward with filing an insurance claim, we want you to be prepared. That is why the experts at BrokerLink have put together a list of tips for dealing with insurance adjusters. The following can help you, whether you are filing a home insurance claim, a car insurance claim, or even a business insurance claim:
1. Record conversations and/or take detailed notes
Shortly after filing a claim, you will likely be contacted by an insurance adjuster acting on your insurance company’s behalf. Anytime you interact with this insurance adjuster, make sure to take detailed notes or even record the conversation. These interactions may happen in person, over the phone, or over email. Keep a record of all of them, both physically and electronically if possible. Make sure to include the date and time of all your conversations. This way, if a dispute comes up down the road, you can refer back to these notes.
2. Don’t wait to file your claim
Our second tip is to file your claim as soon as possible following the incident. Whether you got into a car accident or a small fire broke out in your home, don’t wait to file a claim. In fact, waiting too long can have serious consequences as some insurance companies place a limit on how many days you have to file a claim. Filing a claim after this deadline can lead to your claim being rejected. Therefore, when it comes to filing an insurance claim following a loss, the rule of thumb is the sooner the better.
3. Request a cash advance
If your insurance policy covers you in the event that your home, office, or car becomes temporarily unusable, make sure to request a cash advance from your insurer. For instance, if your home insurance coverage includes “loss of use” or “additional living expenses,” ask for this money upfront, especially if you would otherwise be struggling to pay for them. If your policy has this kind of coverage, you could receive money to cover the cost of a hotel stay, storage and moving costs, travel expenses, and even meals or takeout if you do not have access to a kitchen. Please note that if your insurance company approves a cash advance, the amount you are advanced will be deducted from your final settlement.
4. Speak to an adjuster with a third party present
Generally speaking, we recommend interacting with insurance adjusters only when a third party is present. This doesn’t have to be an attorney, though it could be. It could also be a friend or an independent adjuster you have hired. Hiring an attorney or independent adjuster might be a great option if you are unhappy with the settlement terms or suspect that the insurance company is acting in bad faith.
5. Don’t hesitate to ask questions about the payout offer
If the payout offer from the insurance company is much lower than you were expecting, don’t hesitate to ask for a detailed breakdown of the amount. It is within a policyholder's rights to ask their insurer to justify the claim amount by listing the damages and explaining how they arrived at the number they did.
6. Get the settlement terms in writing
If you come to an agreement with the insurance adjuster, get it in writing. Otherwise, an adjuster could go back on their word before the final settlement. This can be as simple as doing your communications via email with your adjuster.
7. Don’t rush the claims process
Some insurance adjusters will try to rush you into closing your claim quickly. You are under no obligation to settle the process quickly. Take the time you need to review all documents before signing or agreeing to anything. It might even be wise to get a second opinion by contacting your insurance broker.
8. Make an extensive list of the lost or damaged property
Before the claims adjuster arrives on the scene, make a detailed list of the loss or damage that occurred. For example, if you’re dealing with a home insurance claims adjuster, make an itemized list of the damages to your property. The list should note what was damaged, the extent of the damage, the estimated cost and date of the repair or replacement, and the date that the damage occurred. The more detailed you are with your list, the better your chances of being compensated fully for the loss suffered. It can be a good idea to take photos approximately every 6 months to reference in the event that something were to happen you can fall back on these photos to properly record your inventory.
9. Understand the ins and outs of your insurance coverage
Knowing exactly what your policy does and doesn’t cover is important generally, but especially so when dealing with an insurance adjuster. In fact, before you even file a claim, we strongly recommend that you review your coverage to ensure that you are covered for the type of damage you wish to claim. If you aren’t sure how your policy covers you, get in touch with an insurance broker. They can explain exactly what coverage your policy features, as well as what perils it protects against.
10. Never lie to an insurance adjuster
Any time you speak with an insurance professional, whether you are dealing with insurance agents, insurance brokers, or claims adjusters, you always want to speak the truth. Be honest about your personal circumstances and the circumstances surrounding the loss. If the adjuster asks you to sign a statement, make sure to read it through carefully before signing. Remember that making false or misleading statements to an adjuster can have negative repercussions for your claim. At the very least, your insurance company may not compensate you for the claim, while in a worst-case scenario, you could be accused of insurance fraud and have your policy cancelled.
11. Avoid discussion of blame
When discussing the incident with a third party, make every effort to use neutral language and avoid making statements such as: ‘’It's all my fault’’ as this can lead to complications down the line. While you never want to lie to an insurance adjuster, admitting guilt unnecessarily may not be the best move either. For this reason, it is generally recommended that you avoid making statements implying you caused the damage or are responsible for the damage. These kinds of statements could hurt you down the line.
12. Contact your insurance broker
Ultimately, if you are having a hard time dealing with any part of the claims process, we recommend contacting your insurance broker. An insurance broker works independently of insurance companies, which means they are a third party that can offer unbiased, objective advice on your claim. Plus, as licenced insurance professionals, you can always trust their expert opinions. The BrokerLink team has years of experience helping customers file claims and deal with insurance adjusters.
BrokerLink can help you navigate the insurance claims process
If you want to learn more about what insurance adjusters do and the role they play in the insurance claims process, contact BrokerLink today. Our licenced brokers have years of experience helping customers navigate the complicated task of filing a claim. We can help you decide if filing a claim is worth it and ensure that you understand your coverage before initiating the claims process. A BrokerLink insurance advisor can also explain how filing a claim may impact your rates moving forward. Of course, as a trusted insurance brokerage in Canada, BrokerLink can also help with other tasks like finding the right insurance policy for your business or saving you money on home insurance by explaining home insurance tax deductibles. BrokerLink is here to meet your insurance needs. Get in touch today to learn more.
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