The Parties
There are four parties involved in the claims process, the insured, the insurer, the broker and the loss adjuster. Each of the parties involved has obligations either under Statute or at Common Law.

The Insured
The Insured’s obligations on the happening of losses are clearly stipulated by way of several policy conditions, and these are all stated in this manual by way of the handling procedures.


The Insurer
In the operative clause of each policy of insurance the Insurer states the circumstances under which they will pay (indemnify) the policyholder; subject of course, to all terms, conditions and exclusions which form part of the document.

Once a claim is established, the Insurer is therefore obliged to put you back in the same financial position that you were in immediately before the loss. That is the legal principle of indemnity which is the least they could follow.  Unfortunately, there are no stipulations as to periods of time for the admittance of liability or for the payment of the loss once agreed between the parties.

The Broker
We are not parties to the actual contract but simply the intermediaries who arrange its implementation. If, in so arranging, we failed to carry out your instructions or placed business with an Insurer whose known reputation was one of unsoundness, and you were not indemnified, then we would be obliged at law to provide fair settlement. This is why we, as professionals are selective in the insurance markets which we use for placement of business. The implied obligation to you is that we shall monitor processing of the claim to final settlement or as otherwise agreed.

The Loss Adjuster
Although appointed by the Insurer, the loss adjuster as another insurance professional is supposed to be acting independently with the sole purpose of making expert recommendations for the settlement of the loss based upon the facts of the particular matter.

The intervention of this other party is intended to eliminate any impression of bias, which would be construed if the Insurers undertook to carry out the task themselves. It is still often the case that Insureds mistrust loss adjusters. It must be noted that Insurers have no obligation whatsoever to accept the recommendations of loss adjusters