FAQs
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When was the last time you met a client who read and understood the insurance policy that covers their home or business?
- Many people have difficulty understanding the technical language of the insurance policy and the complicated procedures they must follow to comply with the policy’s terms and conditions.
- Most people do not realize that insurance company appointed loss adjusters are trained professionals who represent the interests of the insurance company, which employs them.
If a loss occurs, you should give immediate consideration to recommending the services of a loss assessor. This question and answer section will help you understand how a loss assessor works for you and your client.
- In the event of a loss, what steps should I take?
- What is a Loss Assessor?
- What is the difference between a Loss Adjuster and a Loss Assessor?
- How does the system work for Insurance Claims?
- Can a policyholder not prepare their own claim?
- How much does it cost to employ the services of Balcombes Claims Management?
- What is the smallest claim that a Loss Assessor will deal with?
- What about Balcombes Claims Management’s property claims scheme?
- What if I’m not sure if my client’s policy covers the damage?
- Do I receive commission?
- What if your client asks: ‘Why should I engage a loss assessor to obtain what is rightfully due to me’?
- How does a loss assessor determine the actual loss?
- Will a loss assessor help my client receive a more prompt and satisfactory settlement?
- Why should I recommend a Loss Assessor, what’s wrong with the way we have always done it?
- Why Balcombes Claims Management?
- Will using a loss assessor drive up the cost of my claims or get me a bad name with my insurance companies?
In the event of a loss, what steps should I take?
Promptly report the loss to the insurance company – and explain to your client the option of immediately engaging the services of a loss assessor to help them.
What is a Loss Assessor?
A loss assessor is a specialist who understands every procedure involved in negotiating insurance claims and will act on your client’s behalf to guarantee a successful outcome. They are the central element in an insurance claim and the only full-time business service on your client’s side.
A loss assessor will look after all the necessary and often complicated claims paperwork, ensuring that your client receives their full entitlement as quickly as possible. Whether your client’s damage is minimal or extensive, a loss assessor will use their expertise to negotiate their claim, taking the stress and responsibility away from you and your client during this traumatic time for them.
What is the difference between a Loss Adjuster and a Loss Assessor?
Loss Adjusters are appointed by the insurance company when a claim is notified. Their brief is not to prepare the claim, but to ascertain whether or not the conditions of the policy have been observed and to adjust the claim submitted. The insurance company pays their fees.
A Loss Assessor acts exclusively for the Policyholder. Their brief is to quantify, submit and negotiate the insured’s claim and to protect the policyholder’s position.
How does the system work for Insurance Claims?
- When your client reports a loss, the insurance company will request estimates for repair/replacement or appoint a Loss Adjuster to negotiate on their behalf.
- The Adjuster investigates the matter and prepares a report for the Insurers on all the circumstances pertaining at the time of the loss.
- The Policyholder will then be required to submit a fully detailed claim to the Adjuster, itemising all aspects of the loss & their value, and supporting each item with quotations for repair or replacement.
- The Adjuster then considers the claim & forms his own conclusions & recommends to the Insurance Company what sum should be paid in settlement of the claim. In arriving at the
settlement offer he will take into account the total value at risk & the value actually insured under the policy. The adjuster’s report will emphasise any under-insurance, which will have the effect of reducing the amount of the settlement figure. - The onus of substantiating the value of the loss & the Total Value at Risk is the responsibility of the policyholder. If a Loss Assessor is acting for the policyholder, the Loss Adjuster does not have a free hand and will have to negotiate every aspect of the claim with the assessor. In this way the Loss Assessor helps to determine the amount eventually paid by the Insurance Company.
Can a policyholder not prepare their own claim?
Of course, but it stands to reason that the loss assessor who has years of experience and training can do so with more competence than the policyholder. More specifically, a loss assessor will assist in the preparation of inventories, estimates and other factual proof of loss. He or she will handle all the necessary details for compiling claim details, as required by the terms of the insurance policy. The Loss Assessor will also confer with insurance company or their appointed representatives and handle all matters essential to a proper and satisfactory adjustment.
Why do I need help in submitting an insurance claim?
As you know, the typical household or commercial policy contains hundreds of provisions and stipulations – various warranties, endorsements, extensions and exclusions that are constantly changing and many complex details about the insured’s obligations in the event of a loss. Most people do not know or understand these policy provisions – and most do not realize that the burden of proof is on them, the policyholder.
How much does it cost to employ the services of Balcombes Claims Management?
Our fee is a percentage of the claim settlement, agreed with the insured in advance, starting at a maximum of 10% and on a reducing scale for larger claims, depending on the size and type of the loss and the sums insured etc. There is no charge for the initial consultation and no hidden charges thereafter. Our fee is agreed in advance and they pay us nothing until they receive a settlement cheque from the insurance company, which will issue through the broker’s office in the normal way.
Most policies exclude the cost of compiling a claim, however under many buildings policies they include the cost of professional fees necessarily incurred in the reinstatement of the damage.
The use of our services is cost effective. The value of getting their full entitlement and having claims professionally represented will be worthwhile. It makes sense.
What is the smallest claim that a Loss Assessor will deal with?
There is no minimum claim, but our minimum fee is €420.00 so the loss would need to be in excess of €3,500/€4,000 for the service to be cost effective. There is also a difference between a claim for a single item (e.g. a carpet) and multiple items (e.g. damage to plaster, decoration, tiles, etc) even if they are for the same amount.
What about Balcombes Claims Management’s property claims scheme?
We have an ‘add-on’ fee based service which guarantees professional advice an assistance to broker’s clients up to €15,000.00 worth of damage at no additional cost to the policyholder. There are several options, each of which is governed by a Service Level Agreement (copy available on request).
What if I’m not sure if my client’s policy covers the damage?
Our first consultation is free and we can ascertain very quickly if the damage is covered. There is no obligation on your client to instruct us to represent them. We agree a fee in advance with clients. Your client does not pay us anything until they receive a settlement cheque from insurers.
Do I receive commission?
Balcombes Claims Management pay commission to brokers, both on scheme ‘add-on’ income and on direct referral cases. The level of commission is governed by the terms of our Service Level Agreement.
What if your client asks: ‘Why should I engage a loss assessor to obtain what is rightfully due to me’?
Insurance companies offer to pay what is due to you as they see it. They will not make any settlement offer unless and until you submit a claim in writing to them. If you do not claim for it, they will not pay it. Loss assessors are your exclusive representatives. With their experience and knowledge they are better able to obtain a more favorable settlement, ensuring you get all you are entitled to under the terms of the policy. It is a cost-effective service and it makes sense.
How does a loss assessor determine the actual loss?
We take a physical inventory, obtain all pertinent appraisals and make sure all provisions in your client’s policy are properly fulfilled. For buildings damage we have an in-house Quantity Surveyor who will cost the repair/reinstatement work and include an item for professional fees all of which will make a difference in the amount of the final settlement. When we recognise the need for expert opinion e.g. a structural engineer, we have a panel of experts available to us.
Will a loss assessor help my client receive a more prompt and satisfactory settlement?
Yes. They lose no time in complying with the policy requirements to obtain and evaluate the facts and prepare the claim. The knowledgeable and prompt service they render often preserves evidence that may otherwise be overlooked or destroyed. The more thoroughly and completely your client’s claim is compiled and prepared, the faster your loss assessor can accomplish an equitable and proper settlement. Once a policyholder has witnessed the skill and knowledge of the experienced loss assessor, he or she will rarely attempt to settle a claim without the benefit of their specialised assistance. The loss assessor’s most frequent source of new clients is through the recommendations of those they have previously served.
Why should I recommend a Loss Assessor, what’s wrong with the way we have always done it?
The pace of change in society has not been more prevalent in any other area of business than in the insurance industry. There is less competition among insurers and more competition among brokers and against direct writers. Insurers have put Loss Adjusters under more and more pressure to effect savings on claims costs. The Irish Financial Services Regulatory Authority was set up to regulate product providers and intermediaries and to promote consumer protection and education regarding financial services. You as a broker need to keep ahead of these changes and maintain a very strong consumer focus to ensure you deliver value to your client. It is no longer advisable to simply report the matter to the insurer and leave your client to muddle their way though the process and negotiate with the Loss Adjuster themselves.
Why Balcombes Claims Management?
Our tag-line is ‘Protecting the Policyholder’s Position’. Whether you want to have access to our resources on a scheme basis for all your clients, for particular types or size of losses, or on a case by case basis for those you feel need it, we have the solution for you. Just as you would like your client to have professional representation in a Court of Law, you should recommend they have representation in dealing with insurance companies/loss adjusters. You and your client will have the advantage of expert assistance based on great experience in handling numerous insurance problems. Your loss assessor relieves you of the many time-consuming and difficult matters involved in advising, preparing, submitting and negotiating a claim – and helps your client to receive a prompt and fair settlement.
- Ireland’s longest serving Loss Assessing Company, representing policyholder’s interests in since 1970
- Experienced & professional staff, providing you and your client with representation, independent of the insurance company.
- Complimentary copies of our Fire and Flood damage advice books for clients who need them.
- Independent advice from someone ‘on your side’ to accurately assess the impact of the disaster on your client’s life or livelihood and ensuring they are indemnified for all their losses. This leaves you free to look after other productive aspects in your business, and leaves them free to concentrate on the practical steps needed to re-establish their business or domestic life and get their home or business back to normal.
- Your client’s claim will be managed efficiently, quickly and accurately – our speedy settlement negotiators provide a highly professional approach.
Will using a loss assessor drive up the cost of my claims or get me a bad name with my insurance companies?
No. We do not claim for anything that your client is not entitled to. If a claim happens, and there is going to be a payment made by the insurance company anyway, isn’t it preferable that your client gets treated well and feels their policy has lived up to their expectations. Many clients will actively seek out professional advice themselves anyway, and we do not disclose where we receive our instructions. It will reflect better on you if you provide advice, rather than risk having a client feeling dissatisfied. In addition, most insurance company representatives actually prefer to work with an experienced, reasonable Loss Assessor rather than an inexperienced insured.
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