1. Claims Adjustment – Sharing Roles and Responsibilities1. Claims Adjustment – Sharing Roles and Responsibilitieshttp://chad.ca/en/members/professional-practice/toolbox/claims-adjustment/83/1-claims-adjustment-sharing-roles-and-responsibilities

​​​​​​In damage insurance, the claims adjuster is the individual who investigates the claim, estimates the damages or negotiates the settlement. He is the driving force behind the entire process of claims adjustment.

The adjuster is also responsible for mandating suppliers or specialists to carry out specific work that the adjuster requires in order to fulfill the mandate for which he is exclusively responsible.

Furthermore, though the adjuster may mandate a third party, he remains ethically responsible for the work the third party carries out. Suppliers and specialists who have been mandated by a claims adjuster must confine themselves to performing the work requested of them, remain within their field of specialization and do nothing beyond these limits. It is the responsibility of the claims adjuster to provide a clearly defined mandate.

Following the enactment of the Implementation Directive of the Autorité des marches financiers pertaining to the definition and exclusive activities of claims adjusters, the ChAD created this document in table form that sets out the activities that are exclusively reserved for claims adjusters and distinguishes these activities from those that can be carried out by employees over the phone or by service providers, as long as they comply with certain conditions specified in the AMF Directive.

For more information, see the following documents:

Tool

  • Sharing of Roles and Responsabilities (April 2016)
    You will find this reference tool extremely useful every day in your professional practice since it is applicable to all types of claims adjusters.

Law

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