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What Happens AFTER the Insurance Adjuster Visits? | 101 Guide

February 11, 2021

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If you’ve suffered a major disaster at home such as a flood, fire, or theft, you might wonder what happens after the home insurance adjuster comes out. A visit from an insurance adjuster is just one part of getting your claim processed by an insurance agency, but it’s not always the last step in that process!

Note a few tips that will help you better understand what to expect before, during, and after the insurance adjuster visits, and what to do if you disagree with their assessment and payment offered by your policy provider. This will ensure you prepare for their visit and do everything possible to secure a fair compensation for your loss.

How Do Insurance Adjusters Investigate?

To better understand what an insurance adjuster looks for when they visit your home and what happens after they leave, it’s good to note their entire process from start to finish. When an insurance agent receives notices from you that you need to file a claim for loss or damages, they will typically give that information to an adjuster.

The adjuster first starts their investigative process by reviewing your policy, so they understand what’s covered, what’s not covered, and those coverage limits. They will also review your claim or what’s called a loss notice, noting itemized damages, reason for the loss, and other such details.

Once the adjuster has reviewed your policy and claim, they might settle the entire matter over the phone; this is typical for small claims of just a few hundred dollars or so. For instance, if you had a stovetop fire and are only claiming the stove itself as a loss, the adjuster might quickly and easily sign off on reimbursing you for the cost of a new stove.

However, for larger claims, the adjuster will usually meet with you in person and visit your home to inspect the damage and your claimed loss. They will usually ask you questions about what caused the loss, your property’s condition before the loss occurred, and so on.

An insurance adjuster will also want to inspect your property and take pictures of the damaged property, or otherwise note and record your loss for themselves. While this might seem intrusive, they do have the right to confirm your claim and assess your loss and property damage!

How Do Adjusters Determine Damage?

It’s vital for homeowners to note that an insurance adjuster doesn’t work for you and their job isn’t to get you full compensation for your loss or damages; they work for the insurance agency, and their job is to figure the lowest compensation possible! This doesn’t mean that adjusters lie or are in any way dishonest about their findings, but they will use any detail they can to lower your payout amount as much as possible.

As an example, if the contents of your closet were ruined in a house fire, the adjuster might argue that you should be compensated for the current value of your clothing items and not the cost of replacing them. So, they might offer $50 for an older coat, or what that coat would sell for today, rather than offering the $200 it would require to replace that coat with something new.

This approach varies from one adjuster to another and according to your claim, but understanding that an adjuster’s job is to figure the lowest compensation possible can help you better understand the process and what to expect. Knowing that an insurance doesn’t work for you can also help you know when it’s time to call a public adjuster, who can help negotiate higher compensation for your loss!

What Happens If I Don’t Agree With a Home Insurance Adjuster?

When your insurance agency presents you with a payout offer that you think is unfair or too low, you’re not without options. You can attempt to negotiate with your agent, but it’s vital you note how to do so effectively, as simply calling them on the phone and demanding more money is probably not going to work!

How to deal with a claims adjuster

When dealing with a claims adjuster or agent, first ensure you’ve reviewed your policy and know its limits and exclusions. In some cases, it’s required that you buy a separate policy for items such as fine art, expensive jewelry, and the like, and your policy might include a clause excluding those items from your general policy.

In other words, don’t assume that your agency must compensate you for overly expensive items or even every item damaged or lost in a fire, due to theft, and the like! Check your policy for any exclusions and provisions before contacting your adjuster or agent.

It’s also vital that you understand your policy limits, deductibles, and other such amounts. An insurance agency is not bound to pay out any amount past your policy limits, so if they’ve offered the maximum coverage on your policy, that might be all the money to which you’re entitled.

How to argue with an insurance adjuster

Appraisal is a common step in the claims adjusting and payout process. During the appraisal stage, both parties have an appraiser work to evaluate their claims; for a homeowner, their appraiser is typically a public adjuster, or an insurance adjuster who works for you and not the insurance agency!

A public adjuster cannot “force” your insurance carrier to offer a higher amount, but their work does offer you the best chance of securing a higher payout. Note how and why that is, and when it’s beneficial to hire a public adjuster:

  • Since public adjusters are very familiar with insurance policies, they can review your policy and its language and terminology, and note any coverage you’re overlooking.
  • Your adjuster can also note any paperwork or other information you might have neglected sharing with your agency, and which can hold up your claim or have them offer a lower amount. This might include receipts for certain services or products you needed because of that loss or damage, recent appraisals of certain property, and the like.
  • A public adjuster can review your loss notice or claim, and offer adjustments to property values, expenses you’ve overlooked, and anything else covered by your policy.
  • Your adjuster can negotiate with the agency’s adjuster when it comes to their valuation of your property. For example, an insurance adjuster might offer a lowball compensation amount for fire damage cleanup, and your adjuster might counter-argue with quotes from nearby contractors for that service.

If your property loss is significant and you believe that your insurance agency has not offered fair compensation, and are not successful in negotiating with them yourself, it’s time to call a public adjuster. Public adjusters are paid a percentage of the compensation they secure for you, so there is little to no risk involved in hiring them, and they are often your best chance at getting a fair payout for your losses.

Can a Homeowner Profit From an Insurance Claim?

Profiting from an insurance claim is a complicated business, as a homeowner should never lie about losses, intentionally inflate the value of certain items, or damaged items themselves in order to make a claim against their insurance! Depending on the circumstances, these actions can all be considered insurance fraud, which is a very serious crime.

However, a homeowner might be able to pocket some money they’ve received legally after filing a claim. For instance, if your agency compensates you $500 for clothes and furniture lost in a house fire, you aren’t necessarily obligated to spend all that money on new clothes and replacement furniture.

In some cases, an insurance policy will have provisions in place that prevent a homeowner from profiting from losses. For instance, your policy might stipulate that you use a licensed contractor for home repair, rather than performing the work yourself and pocketing money meant to hire a contractor. Some policies even stipulate that the money is not paid to the homeowner but directly to a contractor.

Before you do anything to profit from an insurance claim, speak to an attorney. He or she can review your policy details and local laws, and note if your actions might be deemed illegal or if they’re allowed under the law and your policy provisions. A homeowner should also note that their insurance policy might increase based on their claim, so it can be a long-term financial mistake to “pad” your current claim as much as possible, hoping to pocket those extra dollars!

How Long Does the Home Insurance Claim Process Take?

Most states have laws in place that require insurance companies to respond to claims within a “reasonable” amount of time; some states require insurers to acknowledge your claim within 10, 20, or 30 days, and to respond within 40 days.

These laws vary from state to state and of course, they can also change at any time! If you think your insurance company is taking far too long to respond to your claim and need to know the laws in your state, contact an attorney or insurance adjuster. He or she will be familiar with local regulations and how to address your insurance carrier as needed, to speed up the process and receive a timely response to your claim.

Should I Accept the First Offer From an Insurance Company?

Whether or not you should accept any offer from an insurance company is your decision, and that first offer your agency sends you isn’t always unfair! If your claim is somewhat simple and you’ve provided your agency with all needed paperwork, they might provide you with a fair offer for compensation.

You might also accept their first offer if you know it’s a bit lower than it should be, but not so low that it’s unfair or worth fighting. For example, if you’ve gone through a small house fire and your agency offers a hundred dollars less than you think your losses are worth, you might decide that it’s worth sacrificing that hundred dollars rather than waiting for your compensation or going through a mediation process.

However, it’s also important for homeowners to realize that they are not obligated to accept an offer from their agency without trying to negotiate for a higher payout! A policyholder can call their agent themselves and try to negotiate a higher offer or hire a public adjuster, as said, who can negotiate for them.

While hiring a public adjuster does prolong the process of receiving your final payout, it can be worth it if he or she can secure you a significantly higher settlement. They can also alleviate of the burden of having to negotiate with an insurer so you can get back to recovering after a fire, flood, or another such disaster, which can make that slight delay even more worthwhile!

Can an Insurance Company Deny a Claim?

If an insurer decides that your claim doesn’t fit your policy, they can deny it. A few common reasons for a carrier to deny a homeowners insurance claim include:

  • If you were negligent in maintaining your home or did something directly that resulted in a flood, fire, or other such disaster, the policy carrier might deny your claim. For example, if you ignored a leaking plumbing pipe which then eventually burst, your policy carrier might deny your claim based on you neglecting those needed repairs.
  • Along with negligence, a policy carrier might deny claims arising from poor-quality DIY repairs. If you attempted to fix your own water heater, as an example, and it then burst and flooded the home, your carrier might deny your claim for damages.
  • A non-covered peril refers to something not covered by your insurance policy, and your carrier will deny claims for any such damages. For instance, many homeowners policies don’t cover termite or carpenter ant damage, or damage caused by earthquakes.
  • An insurance company might also deny a claim if you wait too long to notify them and file your loss notice.

If you’re still curious about what happens after the home insurance adjuster comes out or have any questions about filing a claim and receiving fair compensation, contact a public adjuster at once! Their services are your best chance for receiving a prompt, fair settlement from your insurer.

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