What is a loss adjuster and how can they impact home insurance?

What is a loss adjuster?

A loss adjuster is a professional hired by insurers to investigate home insurance claims. They check the damage, figure out what caused it, and assess repair costs. Unlike a loss assessor, who works for you, a loss adjuster serves the insurance company.

Yes, that means their job is to help your insurer avoid paying out more than they have to. But they're also meant to be accurate and fair.

What do loss adjusters do?

1. Investigate the damage - They examine your property, review photos and speak to you and contractors. It’s not just a quick look; they dig deep into what happened and why.
2. Assess liability- They determine if the cause of damage is covered by your policy. Think burst pipes? Usually yes. Wear and tear? Probably not.
3. Estimate cost- Using software, local market rates, and contractors’ quotes, they build a cost breakdown, such as materials, labour, and professional fees.
4. Negotiate settlement- They prepare a report and recommend a payout. Often they’ll negotiate with you or your assessor if you think items or costs have been missed.

How can loss adjusters impact a home insurance claim?

• Speed – A good adjuster speeds things up. But a busy or distant one can delay an assessment for days.
• Payment amount – Their report directly influences what you get. A conservative adjuster might downplay what’s needed.
• Coverage decisions – They decide if damage is covered. A rejected cause like poor maintenance means you get little or nothing.
• Dispute potential – If you disagree with them, it can lead to delays.

So yes, they can affect how much you receive and how fast it lands in your account.

What loss adjusters will look for

Usually they’re checking:

• Cause of damage – burst pipes vs old pipes, flooding vs just leaking, and also whether something was accidental or not.
• Extent of damage – structural, cosmetic, personal belongings, temporary accommodation.
• Reasonableness of cost – Are repair quotes legitimate? Do materials and labour prices match local rates?
• Policy coverage – Does your home insurance policy cover this kind of loss?

Are loss adjusters’ decisions impartial?

They are paid by the insurer but must be factual and evidence-based. Regulated loss adjusters are bound by professional codes: they can’t lie or distort facts. If you spot unfairness, you can challenge it.

Can I appeal a loss adjuster's decision?

Yes. Here's how:

1. Ask for clarification – they must explain how they reached their decision.
2. Provide more evidence – contractor quotes, photos, before‑and‑after, receipts.
3. Involve your own loss assessor – they can push back professionally.
4. Escalate to the insurer – use your policy’s formal complaints process.
5. Go to the Financial Ombudsman Service – if the insurer turns you down unfairly, they’ll review it for free.