Article Categories Insurance

After You Make An Insurance Claim


By: Kumar Nandan


Insurance has always been in existence, in some form or the other, ever since human beings started living as a community. People always helped one another; the entire community lent their support to the single individual who was in distress and the favor was reciprocated.

As it exists today, insurance is a kind of risk management where the policy holder pays a certain amount of premium to the insurance company in return for coverage of financial losses in future. In the event of an unforeseen incident occurring, the policy holder makes an insurance claim, which is then investigated by the company before the final claims settlement is made.

When does a person make an insurance claim?

Insurance companies cover policy holders for a wide range of unforeseen incidents, as mentioned in the policy manual. Examples could be accidents, flood, theft or vandalism. When any of the events transpire, the policy holder then makes a claim with the company.

Claims settlement is done only after the insurance company is convinced of the genuineness of the claim. There are many instances of insurance fraud and it causes losses to the tune of millions every year. Companies spare no effort in digging to the bottom of each claim to ensure its veracity.

Adjusting for Claims

Once a claim is made, if the amount is small the insurance companies usually pay it off after a few preliminary checks. But when the amount is significant, they prefer claims adjusting before payout. It means that the companies adjust a claim by soliciting the services of a trained claim adjusters. When there is an accident, theft or damage which causes financial loss, the policy holder calls the insurance company. The insurance company uses claims adjusters to inspect and report an estimate of the damages, rather than just pay out whatever the policy holder asks.

Claims adjusting is done by obtaining all record statements- medical and police, checking the actually injury suffered visiting the site of damage, investigating and interviewing witness and the policy holder to ensure there is no fraud done and then submitting recommendations to the company.

The claims adjustor objectively evaluates the claim that is made and determines if the repair estimates are reasonable. This is done to prevent possible frauds by policy holders who may inflate the claim amount for additional compensation. Most insurance companies accept the claims adjustor's evaluation as final.

Sometimes, you may feel that the claims adjustor appointed by the company is slow to act or that the estimates made by him are not fair to you. In such instances, you need the help of an adjustor of your own to argue your side of the case. Public adjustors are trained professionals who do claims adjusting by keeping your welfare in mind rather than saving the company a few bucks.

Finding a competent public adjustor makes a lot of sense especially when the losses are significant or when you are emotionally distressed. You need someone by your side who is able to objectively assess the situation and demand a fair compensation from the company in return for the premiums you have paid over the years.

Thus claims adjusting works both ways, the companies as well as the claimant benefit from the services of trained claims adjustors.

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