Co-ownership claims adjuster

In the event of a loss, it is imperative for the insured, whether a co-owner or a director of a co-ownership syndicate, to report the incident to their insurer as soon as possible. This declaration generally triggers the designation of a claims adjuster by the insurer. This professional is responsible for assisting the insured throughout the claims process, assessing the damages, advising on measures to take, and facilitating administrative procedures. Investigating the circumstances of a loss, evaluating the damage it caused, and negotiating its settlement are the three key functions of this certified professional.

Designation of a claims adjuster by the syndicate

Syndicates of co-owners often have to appoint a claims adjuster themselves. This practice is particularly common due to the high insurance deductibles that syndicates must bear. These deductibles can be so substantial that they force the syndicates to take full responsibility for managing the loss, which often includes coordinating repairs and communicating with the concerned co-owners. The syndicate may thus, at its own expense, call upon an independent claims adjuster when its insurer is not involved in the case. This invariably happens if the cost of repairing the damages is less than the syndicate's insurance deductible. Furthermore, the damages might not be covered due to a lack of insurance or guarantee, a limit of coverage, a insurance limit, or a denial of coverage. In such cases, the syndicate must bear the cost of repairs.

Disaster Investigation Process

The claims adjuster must:

• Intervene at the request of a client (either the insurer or the insured) at the scene of a claim,
• Take measurements and photos;
• Have consent signed for the collection of information;
• Obtain the insured's declaration;
• Obtain the declaration of third parties, including that of specialists or service providers;
• Investigate the precise causes of the disaster,
• Check the presence of any defects and anomalies,
• Mandating suppliers and specialists and supervising their work;
• Provide the insured with explanations relating to the insurance coverage and the acts performed during the investigation;
• Write a detailed report of observations.

Estimation of damage caused by a disaster

• Estimate the amount of material damage,
• Assess the amount of moral damage suffered,

Negotiation of a settlement of the claim

• Determine the responsibilities of the parties,
• Determine the admissibility of the loss;
• Establish the amount of the indemnity
• Decide on the depreciation to be applied to the damage statement;
• Recommend a settlement to the insurer and obtain authorization to settle;
• Transmit the insurer's settlement offer to the insured;
• Explain the terms of the settlement and the arrangements that the insurer intends to take;
• Negotiate a settlement to compensate those affected;
• Entering into a settlement with the insured
• Have an assignment of receivables signed;
• Notify the insured that the insurer denies coverage.

Qualifications

In the field, the claims adjuster must be particularly rigorous and methodical in carrying out his investigations and accurately determining the circumstances of the claim. Sense of observation and analytical ability are essential qualities to practice this profession. In direct contact with the victims, he shows courtesy and diplomacy in order to gather as much information as possible. Thanks to his various skills, the claims adjuster has an expert capacity that allows him to establish his authority and conclusions in the context of a case.

WHAT YOU SHOULD KNOW! An independent claims adjuster can assist the syndicate of co-owners, as a consultant, to help settle uninsured losses and recover deductibles.

WHAT TO KEEP IN MIND:​ The claims adjuster may practise as part of an expert firm or an insurance company. He was then hired as an employee. He can also move towards a liberal practice by creating his own consulting firm. In this case, the liberal insurance expert is mandated by customers whom he has solicited and retained.

WARNING! Claims settlement expertise is strictly reserved for holders of a claims adjuster's certificate issued by the Autorité des marchés financiers (the "AMF"). Thus, only a duly qualified person can use the title of claims adjuster. She works in a discipline that is specific to her:

• Expertise in claims settlement in business property and casualty insurance;
• Expertise in claims settlement in personal damage insurance.

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