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INVESTIGATING INSURANCE CLAIMS
June, 2014
 

Michael A. Brogden, Country Manager at Cunningham Lindsey International (Qatar) speaks about the role of a Loss Adjuster in the growing risk landscape of Qatar. 

The insurance industry is experienced in dealing with their insured’s claims, and the process is usually identical whether it is in Qatar, London or in Paris. 

From the moment that a claims request is registered, everyone works tirelessly to provide customers with the high standard of response they expect in a timely manner. The role of a loss adjuster is to deliver the insurance promise to its client’s customers, which includes brokers, reinsurers and of course the insurers themselves. 

Who is a loss adjuster? 

Simply put, loss adjusters are professionally qualified individuals having a Chartered Institute of Loss Adjusters (CILA) designation. Their remit is to make sure that a loss is covered under the confines of the insurance policy in place; the sums insured are adequate, the amounts claimed are fair and reasonable, and those insurers and the insured are both fairly and equitably treated through the accurate interpretation and application of the contract of insurance. 

When instructed, loss adjusters go out and visit claims, inspect the damage and produce reports, which are presented to the customer’s insurance company. Insurers depend upon the skills of the loss adjuster’s fairness and just approach to quickly process their customer’s claim to a good conclusion, whilst at the same time keeping all parties to the process fully updated and informed as matters progress. 

Once a claim has been concluded, the findings and observations contained within the professional reports may be utilised by insurers and insured’s alike to improve overall risk control measures and therefore reduce the likelihood of a reoccurrence of a similar incident. 


Michael A. Brogden, Country Manager, Cunningham Lindsey International (Qatar) 

These are the fundamentals of loss adjusting. However, there is more to the role than just what has been stated so far, particularly when you consider the vast array of insurable risks which exist in a developing country such as Qatar. 

In reality, loss adjusters play a significant role both throughout the insurance claims process, and equally prior to the policy ever being placed (with the provision of Risk Survey reports). Loss adjusters have an extensive knowledge of insurance and are also required to be experts in other areas such as Construction, Accounting, Engineering, Machinery Breakdown, Surveying, Valuation, to name but a few. 

Within our Qatar office, we have Chartered Loss Adjusters, Chartered Surveyors and other experts with complimentary qualifications in Electrical and Mechanical Engineering and Accounting, and these are supported by experts from across our Middle East network, which includes Saudi Arabia, Dubai, Oman and Kuwait. This broad range of skills and expertise, which is unique within Qatar, provides insurers with the range of resources they need to deliver the best, most professional solution to every type of insurance claim, however complex. 

People Business 

 

There is no doubt that we are in the people business. Beyond the technical aspect of the role, there is an essential and very human element to the service that the loss adjuster provides and this is even more important within the business culture of the Middle East which, contrasted with perhaps the UK market, sees us involved at a far more personal level with insurers, brokers and their clients. The importance of excellent soft skills increases when handling highly sensitive claims and losses arising from a large-scale catastrophe. There is no easy way of dealing with events where there has been loss of life, which are regrettable all too common, and this will always present the biggest challenge to even the most experienced loss adjusters and claims professionals throughout our industry. 

 

So, although we are very much in the expertise and validation business, we are also in the communication and trust business – we are at the sharp end of delivering the insurance promise. 

The Claims Climate: 

In recent years, extreme weather events have created ever increasing global losses that are estimated at USD 125 billion in 2013 alone. 

The world is going through a significant sequence of natural events, and it is predicted that due to a combination of climate change and climatic movements, the frequency of natural disasters like earthquakes, floods, tsunamis, hurricanes and tornadoes, will increase in the future. 

Given the location of Qatar within the Arabian Basin, we are thankfully in an area of limited seismic activity, however we must be permanently watchful and prepared for any eventuality in our business. 

We have been at the forefront of many of the high profile incidents over recent years, such as the Thailand Floods of 2011 (insured losses estimated at USD 30,000,000,000), the New Zealand Earthquakes of 2010/2011(insured losses estimated at USD 22,000,000,000) and the Japanese Earthquake and Tsunami of 2011(insured losses estimated at USD 40,000,000,000). 

We also have our fair share of man-made catastrophic events and disasters such as major fires, thefts, building collapses, malicious damage, accidents and mechanical failures and perhaps most notably the environmental disaster caused by the Deepwater Horizon oil spill in 2010. 

Here in Qatar the insurance industry is maturing and is becoming innovative in terms of product range, and indeed its reaction to major losses, as the country continues to grow towards the Qatar National Vision 2030. 

 


Devastating effects of an Earthquake

 

The sheer size, number and complex nature of the buildings, transport networks, tunnels, bridges, power plants etc. under development within Qatar pose their own unique challenges to insurers and loss adjusters alike and we are constantly learning and adapting to understand and interpret new technology and constructional techniques which make this a fascinating and rewarding market to operate within. 

Developments in Technology: 

In order to both handle the increasing number of claims and ensure a fully auditable and compliant process, we have introduced extensive IT solutions and Claims Management Systems throughout our global network of offices, which ensures information sharing, uniformity of operation and adoption of best practice wherever our offices may be. 

Claims are notified quickly, updated and tracked on-line, from first notification of loss, right up to the point of settlement. We can view video footage, with commentary, and photographs of a loss, taken on site and delivered to the concerned desk within minutes. 

We can be dealing with a Qatari owned loss in Europe and reports with full visual evidence can be reviewed within hours of the event. Further, we can submit reports to reinsurers worldwide and hold video conferences with all key players, wherever they may be located, within hours of a major loss within Qatar. 

Important decisions can be taken quickly to ensure that wherever possible, the insured is allowed to resume his business operations without any unnecessary delays through the claims process. 

 

With the advent of innovations as GPS tagging, we can tag locations on behalf of insurers so that they can plot their true underwriting exposures with a degree of accuracy, which is something that was previously unheard of. These innovations, amongst many others, have revolutionised loss adjusting and created a paradigm shift away from its formerly ‘dour’ and studious image. 

 

Transparency: 

Developments in IT have also introduced complete transparency. Our systems can now be integrated with those of the insurers. Tailor-made management information is provided at the touch of a button, and new cost-effective applications are being developed all the time. The process is no longer paper heavy and the wider use of IT has vastly improved customer satisfaction and claims turnaround times. 

Disaster Planning: 

A robust disaster plan is important to any business, but for a loss adjusting organisation, it is an integral part of the work that we do. Loss adjusters have to be in a position to assemble an immediate and structured response to catastrophes of any type or scale. So being able to act fast, mobilise a response team and keep a calm head is crucial. 

Loss adjusters need this planning. To a certain extent, we can predict some events, such as a flood or a hurricane, or at least some advance warning can be provided. However, earthquakes are not so easy to foresee. 

A robust disaster plan needs to cater for each scenario differently. Being in the disaster management business, we are well geared to deal with the unthinkable. 

 

Loss adjusters visit claims, inspect the damage and produce reports, which are presented to the customer’s insurance company. 

 

Scaling Up: 

During large catastrophic events, every claims handling operation will need to scale up their resources. Usually global organisations call in specialists from offices in other parts of the world and this can prove critical, particularly when specific professional skills are in short supply locally. 

These plans were tested in Qatar after the Villaggio fire and more extensively still after Cyclone Gonu hit Oman in 2007 where the Oman market struggled to cope with the aftermath and was welcoming the support that CAT experienced international loss adjusters were able to offer. 

It is a testament to the flexibility and adaptability of both our people and our profession as a whole that we were able to respond to these incidents and still undertake our day to day operations without any noticeable disruption to service levels locally. 

Regulation and Licensing: 

Increasingly since the advent of Sarbanes–Oxley in 2002, which had a far reaching impact throughout the financial world, insurance sector regulatory bodies have provided a sharper focus on professional standards including training, competence, financial governance and transparency and customer satisfaction. 

The Qatar Financial Centre (QFC) Regulatory Authority is no exception, and we are extremely proud to have been the first (and only) international loss adjusting firm to be fully licensed by the QFC to provide professional loss adjusting services within Qatar, since 2008. 

Insurance and loss adjusting is a QFC regulated activity and is closely scrutinised, with a clear emphasis on transparency, compliance, predictability and accountability. 

Under the Law of Qatar Central Bank and Financial Institution Regulations, all loss adjusting firms must be licensed to manage insurance claims within the State of Qatar, with companies who operate without the appropriate licensing (and off shore companies) exposing themselves, and their principles to significant enforcement fines. 

Perhaps more importantly, the QFC licensing adds significant credibility and imbues trust from outside financial and insurance markets and provides a benchmark against which standards can be set and monitored. Isurance is about certainty and the QFC takes its responsibilities seriously to ensure that standards of professionalism and integrity are maintained across the industry, and we applaud their efforts in this regard and proudly carry our QFC license. 

Disaster Planning is an integral part of the Loss Adjusters work profile. 

 

What makes a good loss adjuster? 

Although all good loss adjusters must have varied experience and skills, there are also some common attributes. Highly developed interpersonal skills feature strongly. They are essential to gain the stakeholders’ trust and influence them into making the right decisions, at the right time. 

The best loss adjusters bring their own flair to each claim, often by lateral thinking, adapting and applying previous experience in new situations, and understanding how the policy can be worked to the best advantage of everyone involved. 

This is critical in the Qatar market that is evolving quickly and continually throwing up new problems and challenges and we look forward to both the run unto the 2022 FIFA World Cup which will bring its own unique challenges, and to playing our part in the achievement of Qatar’s National Vision 2030. 

 
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