What do I do if I disagree with the insurer's loss adjuster?

Question

José Manuel Alburquerque · Accepted Answer

The insurer's loss adjuster works for the insurer and his or her valuation is not binding on you. You can challenge it with quotes and with a report from an expert of your own. If there is still no agreement, the law allows each party to appoint an expert and, if they cannot agree, a third expert to be brought in. The resulting report is binding on both parties unless either of them challenges it in court, the insured within 180 days and the insurer within 30. First, challenge the valuation Ask in writing for the breakdown of the valuation and, if you can, the loss adjuster's report. Provide quotes from professionals and photos of the damage. If the difference is significant, commission a report from an independent expert. It will also be useful if you end up having to go to court. The statutory expert procedure Each party appoints its expert, who must accept the appointment in writing. The party that has already appointed an expert can ask the other to appoint its own within eight days. If it does not, it is bound by the report of the first party's expert. This also applies to you, so if the insurer asks you to appoint an expert, do not let those eight days go by. If the two experts agree, they sign a record setting out the cause of the insured event, the valuation of the damage and the payout they propose. If not, a third expert is appointed by mutual agreement or, failing that, through the court or a notary. The third expert issues a report within the period set by the parties or, if they do not set one, within 30 days. Each party pays its own expert. The third expert and the other costs are split equally, unless one party made the assessment necessary through a clearly disproportionate valuation, in which case that party bears them alone. After the report You have 180 days from being notified of it to challenge it in court. The insurer has 30. If nobody challenges it, the insurer has five days to pay what it says. If either party challenges it, the insurer must in the meantime pay the minimum amount it may owe. And if the report has become final and the insured has to bring a claim to recover the amount, the insurer will also pay late-payment interest and the costs of the proceedings. This procedure is for your own policy. In personal accident insurance it is also used to settle disputes over the degree of disability, with medical experts. If you are claiming against another person's insurer, that insurer's loss adjuster does not bind you and the dispute about the amount is resolved at trial, with your own expert. If the case concerns injuries from a road traffic accident and you do not agree with the offer, you can ask the “Instituto de Medicina Legal”, the public forensic medicine institute, for a report, which the insurer pays for even if it does not agree. The insurer then has one month to make you a new offer.