What is the role of insurance assessors in the claims process?

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:

  1. Assessors belonging to an external company which outsources itself to insurance companies and brokers.
  2. 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?

Always possible.

We will continue this dicussion in a series of posts about the profession of the insurance assessor.

16 thoughts on “What is the role of insurance assessors in the claims process?

  • September 19, 2011 at 7:22 am

    Hi i am curently employed in a construction company and i have been in tne construction and plumbing industry for 7 years now and I want to futher my career by becoming an assesor and i was wondering if anyone can help me by telling how i can do so. I have extensive knowladge about plumbing and construction so i have great advantage in that field of expertise.

  • February 26, 2013 at 12:09 pm

    Can anyone please tell me, how does one become an insurance assessor and where to go for training?

  • April 7, 2013 at 8:11 pm

    I would like to know more about how to become an insurance assessor and which are the institutions that offer that kind of training

  • June 11, 2013 at 7:51 pm

    Please let me know what qualifications are needed to become and insurance assessor and the institutions where this training is held.

  • July 23, 2013 at 1:49 pm

    I need more information in a career as insurance assessor and where to go for training.

  • September 9, 2013 at 8:53 am

    i have good police and security training for more than 13 years … how do i become a assessor

  • October 31, 2013 at 8:31 pm

    I have 5years experience working in construction company , I have a knowledge in Quantity surveying e.g costing , computer skills and understands building regulations and standards. I’m very interested to become an insurance assessor what can I do ?

  • May 1, 2014 at 11:11 am

    is it at all legal for my broker to be the assessor on my claim at the same time, is there not a conflict of interest here?

  • May 21, 2014 at 2:29 pm

    I have quite extensive knowledge on vehicles and I would like to become an insurance assessor. What do I need to do?

  • November 12, 2014 at 11:12 am

    How do I get on to the Outsurance panel of panelbeaters

  • February 10, 2015 at 2:01 pm

    I would like to be pointed in the right direction, I have extensive experience in doing salvage work for various insurance assesors but I only do it part time I would like to do it on a permanent basis for a goods in transit insurance company I enjoy the challenge as each job is different

  • June 23, 2015 at 7:45 am

    Hi there, I’ve been in the Motor Trade for 26 Years now, and would really like to go into being an Assessor ,
    its been on my mind for a very long time, i know a lot about cars and accident repairs etc.

  • July 28, 2015 at 5:47 pm

    Hi. Im qualified motor mechanic
    What do i need to be assesor? there any intitution offer a trrainnee?

  • August 17, 2015 at 9:14 am

    I work in the motor industry. About 20 years experience. What do one need to become an assessor in the motor industry? Is there any training, and if training is available, which institutions do we have to go to?

  • September 7, 2015 at 2:16 pm

    I am a retired businessman and have extensive experience in investigating incidents, accidents, and losses. Is it possible to work on a when needed basis.

  • March 8, 2016 at 2:01 pm

    I’m interested in finding out more on motor vehicle assessor position, currently a financial advisor an was in the motor trade for 10 years.

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