Question

Felix is a property claims adjuster for a large property insurer. Janet is a policy owner who recently notified the company that the roof of her home incurred substantial hail damage because of a recent storm. Janet owns her home and is insured under a standard homeowner’s policy with no special endorsements. What questions should Felix ask before the claim is approved for payment by his company? Provide justifications for each question that should be asked.

Answer 1

1.) The first person from the insurer that the insured(Janet) meet when he suffer the loss is the property claims adjuster.The adjuster will help the insured to prove the loss to the insurer and get indemnity promised by the insurer.

2.) The adjuster will investigate the loss, interpret the policy wording and apply the policy wording to the facts discovered in the investigation.

3.)To understand the policy of insurance, the adjuster must read and analyze the policy in a logical manner. The adjuster must know what coverage is available to the insured,the limits of liability, the territory limitations and the exclusions,condition, and endorsement attached.

4.)Before beginning to investigate a claim, the adjustermust first confirm the coverage.

5.) The adjuster will see :-

• when the loss occured.
• The type of coverage the insured has.
• The type of loss.
• The insured name and address.
• Thether there is anything to which the adjuster should give special attention,
• The adjuster will inspect and see whether the claim is true.

6.)The adjuste must take a complete recorded statement from the insured and all witness to the incident that caused the loss.The adjuster must get the answers to the most important of all the question:

who,what,where,why when,and how, with regard to the policy and the loss.

7.) The adjuster should ask about the document establishing title to real property.any other document that might be relevant or material to the investigation.