The Role of Insurance Adjusters
Insurance adjusters play a crucial role in assessing claims and determining the extent of insurance companies’ liability. Chantal M. Roberts, an insurance expert with over 25 years of experience, shares her insights into the claims process and offers advice to policyholders on how to navigate it effectively.
Understanding Insurance Policies
Many policyholders are surprised to find that their insurance claims are denied or partially covered. Roberts explains that this often stems from a misunderstanding of what their premiums pay for and the exclusions within their policies. ‘What, exactly, do my premiums pay for?’ is a common question she receives, often followed by frustration when a claim is denied due to a specific exclusion.
Insurance policies are complex legal documents with various exclusions, endorsements, and sublimits. Policyholders often mistakenly believe they have ‘all-risk’ coverage, when in fact, certain damages or losses may not be included. For instance, water damage from a sump pump failure may not be covered unless a specific endorsement is purchased.
The Claims Process
Roberts shares a poignant example of a policyholder whose semi-tractor trailer was totaled, resulting in a $60,000 claim. Despite the significant loss, the claim took months to process, causing financial hardship for the policyholder. This case illustrates the often slow and complex nature of the claims process.
Adjusters like Roberts face pressure from multiple stakeholders, including policyholders, managers, and executives. They must remain professional and objective while dealing with emotionally charged situations. Threats from angry policyholders are not uncommon, highlighting the high-stakes nature of the job.
Improving the Claims Experience
To improve their chances of a smooth claims process, policyholders can take several steps:
- Read and understand their insurance policy before a loss occurs.
- Document their belongings and property through photos.
- Be honest and accurate when filing a claim.
- Keep detailed records of repairs and expenses.
- Ask questions and clarify any doubts with their adjuster.
By taking these steps, policyholders can better navigate the claims process and reduce the likelihood of disputes or delays.
The Human Side of Adjusters
Roberts emphasizes that adjusters are not just professionals following procedures; they are also human beings who carry the weight of other people’s losses. They often face challenging situations and may be subject to stress and pressure. Understanding this can help policyholders approach the claims process with empathy and cooperation.
In conclusion, the relationship between policyholders and insurance adjusters can be complex and emotionally charged. By understanding the role of adjusters, the intricacies of insurance policies, and how to effectively navigate the claims process, policyholders can improve their experience and achieve a more satisfactory outcome.
