Policyholder’s loss adjuster: when it makes a real difference in an insurance claim

When a loss occurs, most people trust that the insurance company’s loss adjuster will correctly assess the damage. In many cases this is sufficient, but in many others it is not.

Incomplete assessments, missing damage items, incorrect application of underinsurance or claims closed too quickly often result in compensation that is far below the real damage, even when the policy does provide coverage.

This is where a policyholder’s loss adjuster becomes especially relevant.

What a policyholder’s loss adjuster is and who they represent

A policyholder’s loss adjuster is an independent professional who represents the insured, not the insurance company or the compensation body.

Their role is not to create conflict, but to:

• review the initial assessment
• identify technical or valuation errors
• justify damages correctly
• analyse insurance policies and insured values
• and defend a technically sound claim

While the insurer’s adjuster works for the insurance company, the policyholder’s adjuster works to ensure the damage is fully and accurately reflected.

When it makes sense to appoint a policyholder’s loss adjuster

Not every claim requires a policyholder’s loss adjuster. However, their involvement often makes a difference when:

• the compensation offered is clearly low
• damage items have been excluded without clear justification
• underinsurance or proportional rule applies
• multiple insurance policies are involved
• the claim has been closed very quickly
• the damage is complex (water, flood, fire, commercial or industrial losses)

In many cases, there is still room to act even when the claim appears to be closed.

Common mistakes in insurance assessments

Some of the most frequent issues we encounter include:

• missing items due to brief inspections
• hidden damage that appears later
• reconstruction values below market cost
• technical installations incorrectly valued
• incorrect application of underinsurance

In most cases, these are not bad-faith actions, but the result of high workloads and limited time.

Insurance and compensation adjusters: fair assessment, but real limitations

It is important to clarify a common misconception:
insurance company and compensation scheme adjusters are not there to harm the insured. Their role is to provide a fair technical assessment in line with the policy and applicable regulations.

The challenge is the context in which they work.

In practice, adjusters often:

• handle a very high number of claims
• work under strict deadlines
• follow internal procedures
• cannot dedicate days or weeks to a single case

This means they often cannot:

• analyse policy wording in depth
• review complex interpretations of coverage
• identify less visible clauses
• escalate technical questions internally
• reassess claims that are not straightforward

Not due to lack of professionalism, but due to time and workload constraints.

A simple comparison to understand it better

Handling a complex insurance claim without independent representation is, in a way, like going through a legal process without someone defending your position.

It does not mean the system is unfair, but:

• no one is building your technical argument
• no one is analysing every angle in your favour
• no one is dedicating the necessary time to grey areas

And in insurance, many situations are not black or white, but grey, with room for interpretation.

The role of the policyholder’s loss adjuster when multiple policies apply

When several insurance policies are involved — community insurance, landlord, tenant, private insurance or compensation schemes — it is common to see:

• different adjusters involved
• inconsistent valuation criteria
• lack of coordination

In these cases, the policyholder’s loss adjuster acts as a technical link, helping to:

• align valuations
• avoid technical contradictions
• coordinate insured values
• reduce or eliminate unnecessary underinsurance

In many claims, this coordination has significantly improved the final outcome.

Closed claims: is it always too late?

A widespread belief is that once a claim is closed, nothing more can be done. This is not always true.

We have handled cases where:

• additional damage appeared later
• technical errors were identified
• policy clauses were incorrectly applied

In such situations, a technical review allowed the claim to be reopened or supplemented.

What a policyholder’s loss adjuster is not

A policyholder’s loss adjuster:

• does not guarantee a specific outcome
• does not force coverage that does not exist
• does not invent damage

Their role is to organise, justify and technically defend what truly corresponds, preventing errors, haste or poor coordination from reducing compensation.

Conclusion

A policyholder’s loss adjuster is not necessary in every claim, but when complexity, technical issues or lack of coordination arise, they can make a real difference.

Knowing when to act is as important as the loss itself.

Do you think your claim does not reflect all the damage?

We review insurance assessments, policies and valuations to identify errors and determine whether there is still room for improvement.

Sometimes, a second review changes the outcome.