The Conclusion of an Adjustment How A Claims

Post 5001

Insurers are large organizations with varying levels of authority. The adjuster is the representative at the loss scene. He or she must report, in writing, to superiors with the authority to pay the indemnity required.

Writing a clear and comprehensive report is an essential part of the adjuster’s job. The captioned report should be written immediately after the adjuster’s first meeting with the insured on every file, no matter how small and then supplemented as the claims investigation continues until it reports on the conclusion of the claim.

The length and detail of the report should only be limited by the extent of the loss. The captioned report is written to explain to the adjuster’s supervisor all the adjuster knows about the loss so that decisions required of them by the insurer and the law can be made.

The article provides a detailed list of all the captions required by a complete report at the conclusion of an adjustment. The adjuster must complete a statement of loss at the close of every adjustment. This is the document the adjuster uses to clarify the agreement between the company and the insured. It should be part of the adjuster’s final report and must be completed before the sworn proof of loss is accepted.

A statement of loss is a summary, in numerical form, of the investigation and adjustment. The statement of loss always contains the following information set up in three columns: Insurance: a description of all insurance available to the insured from any source; Loss: a statement of the amount of the loss broken into as many categories of loss as are applicable to the particular claim; and Claim: a statement of the amount of claim, which is usually less than the amount of loss.

To reach the amount of claim the adjuster usually deducts from the amount of loss the deductible, applicable depreciation or betterment, special limits of liability, and/or co-insurance penalties.

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