If you experience a loss to your home or farm, the first thing you do after ensuring your safety and securing your property is make a claim. Whether through your insurance broker or using an online form, opening a claim starts the process! After the claim is received and a file is opened with your insurance company, the investigation begins…

Claim investigations might be done by your insurance company or by an independent adjusting company hired by your insurance company. The professionals investigating may have different titles such as Claims Examiner or Claim Adjuster or Claim Specialist. Whatever the title, investigating a claim is a thorough and detailed process.

It begins with an adjuster receiving the file and visiting the location of the loss. When visiting, the adjuster will meet with you, the policyholder, and listen to your story. Then, they will walk through your property to take photos, draw a diagram, and study the area. Their job is to observe every detail to understand what happened.

Observations from an Adjuster

Barn Roof Collapse

Scenario: the roof of a barn built in 2001 collapsed after an intense windstorm

Here are some questions the adjuster may ask to find out exactly why the roof collapsed:

• Was the wind the only reason for the roof to collapse?
• What is the design of the barn and how was it engineered?
• Were there any modifications done to the structure that weakened it?
• Have the materials deteriorated? e.g. dry rot or wet rot of the wood, pest infestation
• Was the roof or barn adapted for a different use?
• Is the barn positioned in a way that leaves it more at risk? e.g. parallel to prevailing winds is generally not recommended in colder regions.

At times, an expert such as a structural engineer will be hired to tell us what happened or what the cause of the loss or collapse was if it is not evident.

Pipe Burst in Home

Scenario: a water pipe burst on the second floor of a house that is less than a year old

Here are some questions the adjuster may explore to find out exactly why the pipe burst:

• What time of day did the pipe burst?
• What type of water pipe is it? e.g. main, shower, grey water, potable water, wastewater
• What company plumbed the home, and is there a case of negligence?
• What materials were used to plumb the home and are there any product recalls?
• Was there a weather event that damaged the plumbing system? e.g. pipes on the exterior wall freezing during a cold snap
• Was there any recent work done on the plumbing lines, professional or done by the policyholder?

Finalizing the Investigation

For the average claim, an adjuster will only need to visit the location once. Large claims such as a total loss house fire may require multiple visits to gather all the information. Both independent adjusters and insurance company adjusters will report to the insurance company.  The next step for your insurance company is to review the report and insurance policy in depth to confirm your coverage.