What to bear in mind if you need to make a claim and why insurers make use of the dreaded loss adjuster.
Surveyors & Loss Adjusters
If you do have a claim, your insurer may appoint either a surveyor or a loss adjuster (or possibly both!) to assist them in assessing your claim, though this will depend on circumstances and it is by no means necessary in all claims.
Both surveyors and loss adjusters should be totally independent of your insurers, though it may be worth checking, particularly in the case of loss adjusters. If they are independent, then their report and advice to your insurers should be impartial.
A surveyor’s job is to inspect the damage to your boat, to determine the cause and/or verify that it is consistent with the event you have reported, to report the extent of the damage and how it should be dealt with – whether repair is feasible, whether parts can be sourced etc. The surveyor will generally make his report to the insurers, and it is then for them to decide whether the damage is covered under the terms and conditions of your insurance policy, and, if it is, how they intend to settle your claim.
A loss adjuster may become involved if your claim is complicated. This may be because not all the damage to your boat is due to the insured event – there may be other damage needing attention. It is the loss adjuster’s role to sort out where the division of responsibility and costs lies. A loss adjuster may also get involved if there are vastly differing estimates from different repair facilities, or if the estimates contain items that do not appear to be consistent with the insured damage. The loss adjuster should not be deliberately trying to reduce your claim for any valid items – he is only looking for the fair and reasonable liability of your insurers.
In many cases the role of loss adjuster may be fulfilled by the surveyor, particularly if he is experienced and has carried out work for your insurers on many other occasions.
Unfortunately we all have to accept that there are those who make fraudulent claims, and there are those who use their insurance policies to replace items that are wearing out. To protect against this, some insurance policies allow for settlement of some items at ‘market value at time of loss’. This may particularly be applied to those items where their existence prior to the event, or their ‘loss’ due to the event, cannot be easily verified. A common example is outboard motors ‘dropping off or falling overboard’. If replaced with new, this might be just too much temptation for someone with a failing or outdated outboard.
Another important issue is settlement that is reduced to allow for depreciation on some items. Where this is noted in an insurance policy it most often refers to sails, canopies, covers and other items that have a limited lifespan.
One further important feature to watch out for is a policy that allows the insurers to substitute a boat, or parts, of a similar age and condition as yours, rather than to replace with new, or make a cash settlement.