When to Hire a Public Insurance Claim Adjuster

After filing a claim, you might not feel satisfied with your insurance company's settlement offer. A public insurance adjuster can help you negotiate a better claim result.

public insurance claim adjuster helping with home insurance claim

When you file a home or car insurance claim, your insurer usually sends an adjuster to assess the damage. Their job is to investigate your claim and calculate your losses. The insurance company uses the adjuster's findings to decide whether or not to deny your claim, and how much to offer you in a settlement.

Claims are often complex and time consuming. That's especially true with home insurance claims. Because of this, disputes may arise between the insurance company and the home owner. Insurance companies may argue that damage isn't covered, or they'll dispute the amount owed.

Fortunately, studies show that people are more satisfied than ever with their home insurance claims. Even then, disagreements happen – especially after a natural disaster.

It's easy to feel like you have no recourse to fight your insurance company's decision. But hiring a public claim adjuster is a great way to contest your insurer's claim settlement.

This article will cover when you should or shouldn't hire a public adjuster, how to find one, as well as what to expect when you do.

Different Types of Claims Adjusters

First, let's nail down what types of adjusters you might deal with during a claim process. There are three common adjusters:

  1. Company Adjuster: These adjusters work on behalf of the insurer to assess your claim. They are employees of the insurance company.
  2. Independent Adjuster: An independent adjuster usually works as a freelance consultant. Insurance companies hire independent adjusters on a contract basis to handle claims.
  3. Public Adjuster: When consumers need help with their claims, public adjusters come into play. Public adjusters are similar to independent adjusters, but they're hired by the policyholders instead of the insurance company.

Public Adjusters Are There to Help You

Why hire a public adjuster? They will help you assess your claim and advocate for a better settlement on your behalf.

When you're negotiating a claim with your insurance company, it helps to have someone in your corner. The insurance company has more resources, expertise, and experience to get a favorable result on a claim than you. Unless you're a seasoned insurance expert with time on your hands, you're going to have a difficult time successfully disputing a claim.

That's part of what makes a public adjuster so appealing. Their purpose is to fight the insurance company for a better claim outcome. They are there to help you navigate the complexities of insurance – including paperwork.

A home insurance claim – especially a sizeable one—comes with mountains of paperwork. Depending on your situation, you're going to need to complete some or most of the following:

  • Property insurance checklist
  • Damage/loss claim report
  • Claim forms
  • Dwelling scope of loss
  • Temporary living expenses forms
  • Loss of use documents
  • Inventory checklist
  • Inspection report
  • Detailed receipts
  • Repair estimates

Fortunately, you don't have to go at it alone. Aside from lending an administrative hand, there are many other perks that come with hiring a claim adjuster:

  • Policy talk: Adjusters help you decipher your policy to find out what is and isn't covered. Understanding the ins and outs of your policy is the first step to getting a good settlement.
  • Property inspection: A thorough review of the damages to your property is necessary. Your adjuster can conduct this on your behalf. A seasoned adjuster can identify damages you might not notice, like foundational issues, subtle water damages, insulation problems, and more. If you don't know what you're looking for, it's easy to overlook potentially expensive damages. Your adjuster can help you prepare a damage report complete with itemized notes and estimates. Staying on top of your paperwork is a key component to get the most out of your claim.
  • Communicate: Filing a claim requires a constant back and forth with the insurance company, especially if there's a dispute. Claim adjusters can handle the bulk of that communication. That will allow you to focus your time on other areas, like rebuilding your home and earning a living.
  • Estimates: Getting repair estimates is a vital part of the claims process. You need estimates to know how much repairs will cost. Claim adjusters can coordinate estimates and send them to the insurance company. Many adjusters also have a network with contractors and repair personnel.
  • Negotiating: Did you know that you can negotiate a claim settlement with your insurer? Not everyone knows this, but settling a claim is a bit like buying a car. Unfortunately, like car shopping, negotiating a claim can intimidate people who aren't familiar with the process. That's why your adjuster will negotiate with the insurance company on your behalf. This is a crucial part of getting a good claim outcome. Adjusters can use experience and insider insurance knowledge to get you the best possible settlement.
  • Paperwork: As mentioned above, filing an insurance claim is a lengthy process. If your home is severely damaged or destroyed, you're going to have a lot on your plate. There are more pressing matters for you than filling paperwork. An adjuster can handle those duties for you, allowing you to focus on other areas.
  • Referrals: An underrated plus with an adjuster is their ability to connect you with qualified repair personnel. After your home is damaged, finding certified contractors can be a challenge. That's especially true if you don't know what you're looking for. A good adjuster should have a network of contractors and skilled tradespersons. Remember, contractor scams are rampant after disasters. Getting high quality and honest repair help is crucial.

How Public Adjusters Help You Get a Better Claim

Aside from educating you and helping you trudge through maintains of paperwork, the main benefit of an adjuster is their ability to get you a better claim settlement.

When you file a claim, your insurance company will judge the claim. If the claim has merit, they will estimate the damages and repair costs compared to what your policy covers. Based on that equation, they will offer you a settlement.

Home insurance claim disputes arise for many reasons. Below are the most common disputes, plus how your adjuster can help you:

Is it covered?

Your insurance company may argue that a particular damage isn't covered. For example, flood damage isn't covered by a standard home or car insurance plan. Also, many home policies exclude "earth movement" or "pre-existing damage." It's possible that your insurance company may deny your claim based on their belief that pre-existing conditions contributed to or caused the damage.

A good adjuster has insurance expertise and they can decipher what is and isn't covered. They can assess your situation and see how it applies to your policy specifics.

Differing definitions

Did you know that most flood damage policies exclude basements? But how do you define a basement? Is it the bottom floor of a house? Or is it any room below ground level? That's a key discrepancy that can lead to a claim dispute. Here's a great breakdown of the legal proceedings in one of these basement disputes.

If your claim is denied or diminished due to these semantics, you might have a case to dispute. Again, your adjuster can analyze the insurance company's findings to see if your claim has merit.

Value judgements

How much is your stuff worth? A root cause of many claim disputes comes when assessing the value of structures or property. Hopefully you have an extensive inventory list of all your possessions and their value.

Even then, if your policy uses actual cash value (instead of replacement cost) your insurer will incorporate depreciation when replacing your possessions. And with replacement cost, you might not agree with your insurer's conclusions. Imagine you have an expensive leather couch destroyed in a housefire. Your insurer might try to replace it with a similar-but-cheaper leather couch.

Public adjusters can't change the language of your policy. But they can help you decide whether or not your insurer's valuations are fair, and whether you have a legit complaint.

Delays

Maybe you got the claim offer you wanted, but where's the money? Most states require insurance companies to complete your claim within a fair and reasonable amount of time. Unfortunately, that definition blurs when there are considerable repairs to be done. Further complications arise after a natural disaster, when insurers are slammed with claims and disputes. You may find yourself waiting longer than you should to receive your settlement.

If you're looking to speed up the process, a public adjuster can help you. They can work directly with your insurer to grease the wheels. Their understanding of the claim process is a big advantage.

Technicalities

From pre-existing conditions to basement debates, insurance companies will look for any decent reason to deny or minimize your claim. You have to be well-versed in the nuances of insurance policies to be able to fight it. Adjusters can help you navigate the terminology to decide if your claim should've been denied or diminished.

You Don't Always Need a Public Adjuster

While public adjusters are a great resource for many people, they're not always a necessity.

You should only hire an adjuster if you believe your claim was unfairly handled. The fact that you're unsatisfied with your claim result doesn't mean that you were shortchanged. It may very well be that your insurance company acted reasonably when calculating your settlement. If you hire an adjuster and your case doesn't have merit, you're going to lose money paying the adjuster.

Usually, a public adjuster will assess your claim for free. If they believe your claim has merit, they will take your case. Unfortunately, unscrupulous adjusters may take your case even if your case doesn't stand a chance. The adjuster will still pocket their payment without negotiating a better claim.

You probably won't need an adjuster for a minor claim. Most minor claims are straightforward enough that a regular person can handle them. Some experts suggest that you don't need an adjuster for claims under $10,000.

On the other hand, if your losses exceed your claim limit, you won't be able to get more money without legal assistance. In those cases, contacting an attorney might be a better bet. Be aware that an attorney may end up hiring a public adjuster themselves to analyze your case.

In some (rare) cases, insurance companies may respond harshly when dealing with public adjusters. Think of it as a divorce proceeding. If one person hires a powerful lawyer, the other person will likely follow suit.

In any case, be sure to ask plenty of questions before signing any paperwork. Remember, it's okay to say no.

How to Find the Right Public Adjuster

Picking the right public adjuster is a lot like picking a doctor, lawyer, or contractor. It's a big decision and you need to do your research.

First, make sure any prospective adjusters have proper paperwork and certification. You can search for public adjusters through the member directory of the National Association of Public Insurance Adjusters.

If your home is damaged in a natural disaster, be careful. Scams are common in the wake of a natural disaster. Between inflated costs, uncertified personnel, and outright fraudulent behavior, you need to be aware of the threats. Post-disaster fraud is so common that FEMA sends out press releases to remind people of that fact.

That's why it's so important to vet everyone – including adjusters. Here are areas to emphasize and questions to ask when searching for help with your claim:

  • Don’t let anyone but a real claims adjuster negotiate your claim. That includes attorneys and contractors.
  • Ask for referrals. Check if they worked on similar projects or with similar damage before. And verify that past clients felt satisfied by the adjuster's work. If your adjuster isn't able to provide referrals and references, be concerned.
  • Make sure the adjuster who does the preliminary investigation is going to lead the claim dispute. Some companies will send one adjuster to survey the property and 'make the sale,' only to have a less experienced adjuster do the work.
  • Decide on your communication approach. Will the adjuster handle all communication with the insurer on your behalf? Or will you split the communication?
  • Make sure adjusters have certification and licensure in your state.
  • Where are they based? A local adjuster may have more knowledge about state and city laws plus local connections with contractors. Local adjusters will presumably spend less time commuting.
  • Ask how many claims they are working on. After disasters, for example, adjusters deal with numerous claims. They may not have enough time to devote to your case.
  • Do you feel comfortable with the adjuster? You will be spending lots of time with this person. The adjuster will be in and out of your home and you will communicate with them often.

When searching for a public adjuster, you should also be aware of the cost.

How Much Does a Public Adjuster Cost?

Most adjusters charge a percentage of your claim. It usually ranges between five and 15 percent of the claim total. If your adjuster agrees to a 10 percent fee and then helps you negotiate a $5,000 claim, they earn $500. It's possible to negotiate the percentage fee.

Also, you might only feel dissatisfied with a segment of your claim. For example, you may receive a fair offer for the structure damage, but a lowball offer for the possessions claim. If that happens, you can hire an adjuster to represent only the possessions claim. That way, they won't be entitled to a portion of your structure claim.

Some states cap adjuster's fees. The goal is to prevent adjusters from artificially inflating claims to earn higher payouts for themselves. Before you sign any contracts with an adjuster, make sure you are well-informed of your financial commitments.

Disputes with Your Adjuster

Most adjusters are honest and fair. But unfortunately scams and dishonest behavior can occur.

Be wary of adjusters who ask for large deposits, or who ask for an estimate fee. Adjusters should usually provide estimates for free.

Some adjusters ask to be named on any checks that come from the insurance company. You don't need to do this if you don't feel comfortable. But just because your adjusters request to be named on the check doesn't mean they are looking to scam you. Adjusters have dealt with late or nonexistent payment themselves.

Don't let your adjuster inflate your claim. Some adjusters may try to overestimate your costs or include previous damages in the claim. If you file a larger claim, they can get a bigger payout. This is fraudulent and can cause you a lot of trouble down the road with your insurer. Fortunately, you shouldn't have this problem if you hire a licensed appraiser with good references.

If you have a dispute with your adjuster, try to settle it with them. If that doesn't work, contact the NAPIA. They may be able to help mitigate your issues. If you're still stuck in a dispute, file a complaint with your state regulator. Finally, if all else fails, consider legal action.

Frequently Asked Questions

Q: Do I need an adjuster? How do I know if I should hire one?

A: An adjuster's main purpose is to help you get a good settlement from your claim. If you feel unsatisfied with your claim result, an adjuster may be able to help you. They will inspect your claim, your policy, and the damages to see if you are entitled to a higher offer.

Remember, the fact that you're not happy with your claim doesn't necessarily mean that the insurance company is in the wrong. But if you feel that your insurance company interpreted your policy incorrectly, low-balled your damage costs, or short-changed you, an adjuster can help you.

Most adjusters will assess your damages for free to let you know whether or not you have a good case. If you're on the fence about whether or not you deserve a higher claim offer, ask an adjuster to assess your case.

Q: How do I find a good public adjuster?

A: Make sure that any prospective adjusters have proper licensure and certification. You can check the member directory of the National Association of Public Insurance Adjusters.

If possible, hire a local adjuster. They are familiar with local codes, regulations, and laws. That can be beneficial when fighting for a claim and getting repair estimates. Also, out-of-state adjusters may travel to disaster-stricken areas to look for claims. If possible, steer clear of opportunists. Of course, after a disaster there's usually a shortage of adjusters, so hiring a local one might not be possible.

You should ask adjusters for referrals and references. It's smart to use an adjuster who has lots of experience. Find out if their prior customers had a good experience with the adjuster. Also, check if their past projects included claims or damages similar to yours.

An adjuster will work side by side with you on the claim. It's a good idea to hire an adjuster that you feel comfortable with on a personal level.

Q: At what point in the claims process should I hire an adjuster?

A: Some people hire a claims adjuster before they file a claim. Other people wait until they receive an unsatisfactory settlement offer from their insurer.

There is no set time when you should or shouldn't hire a claim adjuster. It depends entirely on your situation. Remember, negotiating a claim is a somewhat open process. If at any point during the process you feel treated unfairly by your insurance company, consult a public adjuster.

Q: My public adjuster recommends that I use a certain contractor for repairs. Should I hire them?

A: You don't have to use a contractor that your adjuster refers to you.

In reality, the adjuster may have your best interest in mind by referring you to a good contractor that they have experience with. But in some cases, adjusters will try to inflate claims and then pressure a person to hire a specific contractor. These schemes usually involve kickbacks and are based on fraudulent assessments.

Again, the fact that your adjuster recommends a certain contractor does not mean they are operating unethically. But you should be wary, and you should consult multiple contractor bids before agreeing to any jobs.

Q: How much does a public adjuster cost?

A: The costs vary depending on the scope of your needs and how experienced your adjuster is.

Most adjusters charge a percentage fee of the claim total. That amount can range from five to 20 percent. Experienced adjusters generally charge more than inexperienced ones. You can try to negotiate an adjuster's percentage fee.

Be wary of adjusters who ask for upfront fees. Also, some adjusters will ask you to sign a release on your claim. That means they will have direct access to claim payments and checks from the insurer will be made out with their name. Your adjuster may tell you that this is required, but it isn't.

Q: I hired a public adjuster but I'm still not satisfied with my claim. What can I do?

A: Depending on your situation, consider hiring a lawyer. If your claim has merit but the insurance company isn't budging, seeking legal help may be your only recourse.

If you've had a dispute with your claim adjuster, contact the NAPIA. They may be able to mediate your dispute. If that fails, your state insurance regulator may be able to lend a hand. Finally, after exhausting those options, consult legal advice.

Q: My public adjuster has offered to work as my contractor. Is that a good idea?

A: No. Contractors aren't allowed to work as public adjusters, and public adjusters aren't allowed to work as contractors. At best, it's a conflict of interest. At worst, it's illegal. If your adjuster offers to do the repair work themselves, find a new adjuster.

Q: My insurance company sent an adjuster to assess my claim. Does that mean I don't need my own public adjuster?

A: No. The adjuster sent by your insurance company works on behalf of the insurer. They are not there to advocate for you and negotiate a higher claim settlement. That's what a public adjuster does.

Claims amounts are up for debate. What is and isn't covered, repair costs, the value of items, and more are all up for discussion. A good adjuster can make strong arguments on your behalf to secure better claim payouts. A company adjuster, on the other hand, is there to minimize costs for their employer, the insurance company.

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