The Different Roles in a Property & Casualty Loss

March 13, 2024

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Facing a large property loss, like a building or auto loss/damage due to fire, weather, or flooding can be daunting for an insured. Understanding the roles of the involved parties can help the claims settlement process run more smoothly.

ROLE OF THE RISK MANAGER

For the purpose of this article, the Risk Manager refers to the person responsible for overall coordination of the insurance claim. In large companies, this person is typically the treasurer, human resources manager, or whoever is assigned as the insurance buyer. Their role is to oversee internal preparations of the claim and to be a liaison with the insurance company. 

The Risk Manager’s duties include:

  • Directing the internal data gathering
  • Sharing this data with the insurer’s claim representatives
  • Enlisting experts to aid in the preparation, presentation, and negotiation of the claim 

ROLE OF INSURERS, ADJUSTERS, AND THE ADJUSTMENT TEAM

After a loss is reported, an adjuster is appointed as your principal contact with the insurance carrier. Adjusters represent the insurer as their primary obligation. Primary adjuster duties are to investigate, negotiate, and settle your loss. Adjusters will do what they can to assist, but it’s not their responsibility to prepare your claim.

They will need to talk to the Risk Manager and others, inspect the damage, and gather facts about the value of the loss. Once this is completed, a coverage determination can be made. If this is favorable, the adjuster will finalize a settlement. Adjusters can consult with accountants, engineers, and other experts (the “adjustment team”). Finally, the adjuster presents the facts and information gathered during the adjustment process and reports that information to the insurer(s). If an initial coverage decision presented is not favorable, all is not lost.  There is a fair amount of negotiation in the adjustment process.  A positive relationship and ability to substantiate your position with facts can influence the final settlement.

ROLE OF BROKER
Your broker will assist you in reporting, coordinating, and negotiating the loss and act as your advocate. They can advise you on many aspects of your loss:

  • salvage and clean-up operations
  • temporary protection
  • preparing the claim
  • negotiating with insurer representatives

Your broker is your advocate when dealing with insurers when a difference of opinion or interpretation issue arises. 

Understanding the property insurance claim process and the key stakeholders can alleviate much stress after a large property loss. Start the conversation today. Contact TSIB today and speak with one of our knowledgeable Risk Advisors. 

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TSIB’s Risk Consultants are currently servicing the following locations:
East Coast: New York City, NY; Bergen County, NJ; Fairfield County, CT; Philadelphia, PA
Texas: Austin, San Antonio, Houston, Dallas
California: Orange County, Los Angeles County, Riverside County, San Bernardino County, San Diego County

Topics: Claims, Construction Insurance

Written by The TSIB Team

All Authors and TSIB