Insurance Claims Adjusting and Public Adjusting

Do you consider yourself a knowledgeable insurance consumer?  Or do you simply know you need it and not much more?  Regardless of your level of interest, if you don’t work in the industry, chances are that the majority of what you know you learned while buying insurance.  This is unfortunate.

Insurance is purchased when there is a risk of loss…you own a home, drive a car, operate a business, etc.  But what happens when you suffer a loss and you must file a claim?  Here’s a brief summary of policyholders’ obligations and insurance companies’ obligations and a key decision policyholders will make during this process.  Hopefully,  if that dreadful day comes, readers will be better prepared.

For the sake of simplicity, we’ll use a homeowner’s claim. (and the damage is obviously in excess of your deductible).  A hurricane has made landfall and you’ve suffered damage to your roof. The roof is missing tiles. There is water damage to drywall and your wood floors.  Also, the screen cage over your pool is down the street. 

What to do:

  1.  Take pictures as soon as possible of all damage
  2. Secure your property from any further loss, meaning block the entrance, cover any openings, etc.
  3. Take inventory of all damages including personal contents
  4. If home is unsafe, leave
  5. Contact your insurance agent or company immediately
  6. Fill out any paperwork requested including making a “proof of loss” statement 
  7. Meet the insurance company adjuster on-site
  8. Document your conversations, texts, emails etc.

What insurance company is obligated to do:

  1. Acknowledge claim in writing within 14 business days of notification by policyholder or agent
  2. Assign a claim number and a company claims adjuster within 10 business days of receipt of policyholder’s “proof of loss” statement
  3. Pay or deny such claim within 90 days of claim notification
  4. Deal fairly and “in good faith” with policyholders within the conditions of the policy

Seems simple, right?  From our hypothetical scenario, you can assume there is coverage (although every claim and every policy is different) and the only variables to be determined are the cost of the damages and how the home will be repaired.  Herein lies the confusion on how your insurance company will settle your claim or to hire a public insurance adjuster.  

A public adjuster is defined as an insurance claims adjuster that works on behalf of the policyholder to quantify the amount of loss and negotiate settlement for a fee.  They do work to maximize your claim payment (after all they have to in order to justify their own fee) and get it settled quickly.  In cases of rare losses or vague insurance policy language there may be a need to acquire their services, but for the large majority of claims honest negotiation with your insurance company will result in both a fair settlement and expedite the needed repairs.

Rather than attempt to dispel the suspicion that insurance companies “do not want to pay” or “want to underpay” on claims or to criticize the services of the public adjuster community, we’d like to share with you some key items to help policyholders (and won’t cost you a thing).

  1. Contact your AllStar Insurance Services agent to review the damages, to explain the coverages within your policy and discuss any potential confusion between you and the insurance company.
  2. Seek out local, honest contractors and subcontractors for competitive quotes on needed home repairs. (we know some too!)
  3. “Penny wise, pound foolish” – do not unnecessarily delay settling your claim as this will delay repairs and possibility of more damage
  4. Understand that inflating costs or unfairly burdening the insurance company leads to industry increased premiums, additional underwriting requirements and less insurance company options

Regardless of what you eventually decide to do, policyholders should ALWAYS allow the company to complete its process so as to not to prejudice their rights under the policy.

If you’ve suffered a loss, have fulfilled your obligations as a policyholder and are still displeased with the settlement offer you may want to contact John Hornbuckle of Compass Claims Consultants in Miami Shores, FL.  John is an honest professional who is very familiar with the cost of materials and labor in South Florida and can help bring some value to your stalled homeowner’s insurance claim settlement.   He can be reached at 305.363.2400 or john@compassclaim.com.