Insurance assessors perform a very important role in the processing of insurance claims. Insurance clients however know very little about this profession and only get to meet them after an unfortunate accident or in the event of an insurance claim.
We have decided to share some insights on this profession in an attempt to provide a greater understanding of what they do and why their professional services are so important!
It is most important to remember that there are different ways that insurance companies approach the services of assessors. There are 2 types of assessors:
- Assessors belonging to an external company which outsources itself to insurance companies and brokers.
- Assessors appointed “internally” and employed by the insurance company
We would like to invistigate both these options and share insights from both “internal and “external” assessors. For the external or outsourced assessors we will contact a company who uses an outsourced assessing operation and raise specific questions about their operations.
For more insight on the internally appointed assessors we have approached Outsurance, South Africa’s largest direct insurer, and raised the following questions:
• What are the primary functions of an insurance assessor? Is it only to assess damage or does he play a role in the initial appraisal of risk?
An assessor can perform both roles. We split the functions but there is obvious overlap in their expertise. The (upfront) risk assessor understands the cover options, the risk set up and risk management aspects.
The claims assessor will in essence focus on the claim situation (what happened, where, when, how) and will determine whether it fits within the scope of cover and what the repair (or replacement) cost is. This assessor may also offer risk management advice post the claim.
• How does a person become an insurance assessor – are there special training?
Generally the learning is on the job although there are some formal qualifications available. There is also a professional body (Institute of Loss Adjustors http://www.ilasa.org.za/ ). Our assessors are not members of the institute and there is no industry requirement governing this.
The expertise that each assessor has depends on the field of expertise relating to the job e.g. a buildings assessor needs to understand building methods and costings; as such a QS or a builder naturally makes a good assessor from an expertise point of view. In contrast, an assessor who delves into vehicle theft claims needs appropriate expertise. Hence the view that the formal qualification is often less important than the experience.
• What are the deciding factors that Outsurance uses to include an assessor on the Outsurance panel of assessors?
We don’t have a panel. All our assessors are employed by a specific company which is also part of our Group.
• What are the deciding factors that Outsurance uses to appoint a specific assessor to a specific claim?
As noted above, expertise is the major factor coupled with capacity. An additional aspect that we focus on is the assessor’s service delivery which must be in line with our service delivery expectations. (e.g. appearance, time keeping, process management, communication style).
• How many assessors are on the insurance panel of Outsurance?
It’s a rather large contingent which allows us to stay ahead of the pack in terms of assessing quality and service delivery. The number could be regarded as one of the secrets to our success.
• Are there different panels of assessors for home, household business and vehicle insurance?
Yes, bear in mind the ‘panel’ is ‘internal’.
• Does Outsurance expect from insurance assessors to undergo continued training and is this measured?
Continual training internally.
• What are the characteristics you believe are to be found in the best insurance assessors?
Logic! One and one adds up to 2. So we look for people who understand process, step by step stuff and work accordingly. Looking beyond the obvious and surface detail; assessors probe and ask questions. Excellent assessors ask the right ones! Communication ability; an assessor is simultaneously a person who builds rapport with people and gathers info so strong communication is a must.
• Would a insured client have the right to object against an assessment by an assessor? Is a 2nd opinion possible?
We will continue this dicussion in a series of posts about the profession of the insurance assessor.