Insurance adjuster and insured adjuster

Posted in Insurance

It is a novelty, I have been solicited as an Insurance Expert on several occasions since the beginning of the year by public or private persons who had suffered a major loss.

Indeed, until now there has been a strict separation between the two professions.

Gradually, given the complexity of the files and a certain standardization of claims processing by insurance companies, a more personalized and in-depth approach is being sought by high-end clients.

What are the differences between the insurance adjuster and the insured? What is the cost of the service?

Choosing the insurance adjuster or the insured adjuster

In practice, the Insurance Adjuster is always mandated by your company following a claim and the Insurer's Expert chosen by the claimants themselves.

  • As soon as an insured signs a contract with an Insurance Expert, the latter becomes the Insurance Expert's interlocutor. The Insured's Expert makes the link with the Insurance Expert and is in charge of putting together the claim file and attending the expert appraisal meetings.
  • From an ethical point of view, the Insurance Adjuster cannot intervene either for a company or for the insureds of this same company; he cannot treat the file with the same approach or interest, this is the reason why the 2 professions remain distinct but skills are sought on the side of the Insurance Adjusters.
  • Each company applies different internal rules regarding the method of compensation or recurring problems such as compliance, fraud, qualification of supporting documents, for example.
  • The Insurance Damage Adjuster, often linked with a national network (Union of Experts, Texa, Polyexpert... ) works in confidence with the same company for several years.

The Insurance Expert can be himself a specialist (agricultural, financial losses, research in cause of fire, theft...) or a generalist and certified by the CEA, the Company of Experts, our professional union or even call upon a sapiteur, i.e. a specialist in a question (example for landslides).

The Insured's Expert may be affiliated to a different federation of the ECA, such as Fedexa. Some Experts d'assuré have followed the training at the ECA but they are too few in number. In fact, most of the time they are former Insurance Experts who are recruited by some firms.

Who pays in the end?

We must not hide the fact that the economic issue is the main driving force behind all of us. The number of cases to be settled per month and the amount of damages are the two factors in the calculation of the fee.

  • The Insurance Expert knows in advance his rate negotiated with the Company, whereas the Insured Expert is paid according to the amount of the indemnity received by the insured.
  • A change occurred when insurance companies gradually modified their contracts to refuse to take over a part of the fees of Experts d'assurés which is exclusively the responsibility of the insured, most of the time.
  • This is how, as I have experienced in the field, an Insurance Expert, realizing that the claim will not be guaranteed or not sufficiently justified, no longer wastes his time!

 

In conclusion, as always, there are no precise rules; each claim requires a particular approach to the analysis of insurance contracts and the agreements entered into, which is why the qualifications of the Expert appointed by your insurance company are often sufficient and sought after. The argus published in 2017 "there is a need for a skimming off in the profession of the Expert d'assuré".

You are always free to consult an experienced Insurance Adjuster and negotiate the fees to obtain a negotiated compensation.

Tomorrow, I am convinced of the evolution of the profession of Insurance Expert towards new, more commercial missions such as underwriting optional guarantees or even towards the increasingly common intervention as an Expert of the insured as well.

Do not hesitate to consult me for any particular question!

 

 

 

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