Who is responsible for determining the amount payable on an insurance claim?

Prepare for the CII Certificate in Insurance exam with questions and flashcards designed to help you understand the key principles of general insurance.

The adjuster plays a crucial role in the claims process by investigating and evaluating the details of a claim. They assess the damages, collect relevant information, and determine the legitimacy of the claim based on policy terms and conditions. This means that the adjuster is responsible for calculating the amount payable on a claim, ensuring that the insurer adheres to the policy stipulations and fair assessment processes.

The adjuster's expertise allows them to consider the evidence presented, such as documentation, photographs, witness statements, and other pertinent data, to arrive at a fair settlement amount. Their function is essential in providing an impartial review of the situation, which helps maintain trust and uphold standards in the insurance industry.

The other options involve roles that do not directly influence the monetary outcome of a claim. The policyholder is the one claiming, while the insurer's legal team typically deals with legal matters and disputes rather than the specific assessment of a claim’s value. Similarly, the insurance agent primarily focuses on selling and servicing insurance policies, rather than making decisions about claims.

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