Loss adjuster

Role in a water damage claim[edit]

On an escape of water claim the adjuster's questions are typically the cause of the escape, when it began, whether the damage is consistent with that cause, and which parts of the loss the policy responds to. Where the sums involved are small the insurer may handle the claim without an adjuster; larger or contested claims are more likely to be adjusted.

Because the cause and the date of onset matter to the outcome, the evidence produced by a leak investigation is directly relevant to the adjuster's assessment. That is why detection reports are generally produced with the methods used, photographs and the location identified, rather than as a bare conclusion. ADI Leak Detection states that every investigation ends in a written report by the attending engineer with photographs and video, formatted for insurance claims.^[2]

Gradual damage[edit]

The point most often turning on the adjuster's assessment is whether damage occurred suddenly or gradually, since some policies limit or exclude gradual damage.^[1] A pinhole leak losing a small volume for months and a burst losing the same volume in an afternoon can produce similar damage and be treated quite differently.

This is one of the practical reasons early detection matters beyond the water saved: a leak identified while the damage is limited presents a simpler claim than the same leak found after months of accumulation.

Adjuster and assessor[edit]

A loss adjuster is instructed and paid by the insurer. A loss assessor is engaged by the policyholder to present and negotiate their claim, and is usually paid by the policyholder, often as a proportion of the settlement. Neither role is defined by statute in this context; both are matters of insurance practice, and the terms of any particular engagement govern what each actually does.