Upon receiving a third claim for accidental damage from a policyholder, what is the primary action expected from the claims handler?

The primary action expected from the claims handler upon receiving a third claim for accidental damage from a policyholder is to advise underwriters and appoint a loss adjuster to submit a report. This is because repeated claims can indicate a possible pattern or underlying issue that needs thorough investigation. By involving a loss adjuster, the claims handler ensures an independent and expert assessment of the circumstances surrounding the claim. This step is essential not just for evaluating the validity of the claim but also for managing potential risks associated with ongoing claims frequency.

A loss adjuster brings specialized knowledge and can scrutinize the situation, gather evidence, and provide an objective analysis, allowing the insurer to make informed decisions. Furthermore, notifying the underwriters keeps them apprised of the situation and allows them to consider how this might impact the policyholder’s coverage or future insurability.

Other options, such as closing the claim outright or approving it solely based on previous claims, neglect the necessary due diligence required when there’s a recurring issue. Notifying the policyholder of a potential refusal without proper investigation also overlooks the principle of fair treatment and could lead to dissatisfaction or reputational risks for the insurer. Thus, involving a loss adjuster is the appropriate and professional route to take in managing the claim effectively.