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Ozog, Edward J. You Have to Know Who You're Dealing With. Fire Chief. Vol. 39. No. 7 (July 1995), p 47-49.

Abstract: Should you be asked questions by an insurance adjuster, you should know who the adjuster is, and whom he or she is representing. Insurance adjusters fall into two categories; public adjusters and insurance adjusters.

Public adjusters work for the insured. They are licensed by the state and are paid either on an hourly basis or receive a percentage of the money paid by the insurance company. The public adjuster represents the interests of the insured and will attempt to show that the insured met his or her contractual obligations, in addition to conducting inventory of the premises, assessing the damage, and consequently determining what is owed. In rare cases, usually when the insured is suspected of arson or negligence, the public adjuster will advise the insured to obtain an independent cause and origin investigator.

Insurance adjusters, however, represent the insurance company and will evaluate the contract and the need to adjust the loss. A number of job titles are associated with this category of adjusting; general adjusters, regional and national general adjusters perform the ìout of officeî investigation, on the site. They report to the in-house staff, known as adjusters, claims representatives or claims examiners. Independent adjusters sell their services to insurance companies and may represent several at one time.

Insurance adjusters, in their attempts to establish the facts and evaluate the losses, will hire various experts including independent cause-and-origin investigators, salvors, builders, accountants, engineers or attorneys. The insurance company will conduct a loss control investigation to determine if the fire could have been prevented and how fire suppression methods might have reduced the losses. Recommendations will be made as to preventing such a loss in the future and the insuredís contract might be amended.

Independent cause-and-origin investigators have a fire service background. They will examine elements such as origin, opportunity and motive to identify the responsible party. This investigator will want to conduct a walk-through at the scene with the fire official responsible for the cause and origin report, interview firefighters, obtain official reports and test results, establish origin and confirm the fireís spread, get the official investigatorís opinion and access the course of the investigation. He or she may also send samples to an independent lab.

Insurance companies will also examine an insured's records and books to determine a financial motive for setting the fire. Forensic accountants will analyze cash flow, debts and income statements which might suggest fraud.

Understanding whom the insurance adjuster represents can prevent misunderstandings from occurring. This understanding might also contribute to the recognition of resources of information that might aid in the fire department's own investigation.

For more information, contact:
Fire Chief
35 E. Wacker Drive, Ste. 700
Chicago, IL 60601-2198
Phone: (312) 726-7277

 
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