– By Amy Bach, co-founder of United Policyholders and Robert Crown UP Volunteer and licensed PA.
QUESTIONS TO ASK AND THINGS TO KNOW
Background and Perspective
If your home or business property is damaged or destroyed and you file an insurance
claim, be prepared to spend time and energy on the claim process. Listing and describing
everything you lost and how much it will cost to repair/replace each item takes more
effort than most people realize. That’s called “documenting a claim.” But it must be done
or you won’t get paid the insurance dollars you’re entitled to. And, once that’s done, you
must negotiate with your insurance company or you are likely to get paid less than you
There are professionals you can hire to represent you in documenting and negotiating
your insurance claim. They are known in most states as “public adjusters”. Public
adjusters work only for policyholders, not insurers. There are two other types of
adjusters: Company, or “staff” adjusters who are employed by your insurance company,
and so-called “independent” adjusters who work only for insurance companies on a
contract hiring basis. Company/staff and independent adjusters are hired and paid by and
report only to insurance companies, not policyholders. They will be assigned by your
insurance company to work on your claim, but they are there as the insurance company’s
representative… not yours.
Your insurance company may assign one or many different adjusters to your claim over
the course of time. Each one may have a different approach and level of experience. One
may have very little experience and be difficult to communicate with, another may be
very friendly and have a lot of experience. Many people report to United Policyholders
that their first adjuster offered them a settlement sum, then left the company or was reassigned
and when a new adjuster came on, that new adjuster rescinded the offer or made
them start from scratch on the claim. We refer to that problem as “rotating adjusters.”
United Policyholders helped pass a law in California to protect consumers from being
victimized by rotating adjusters. (California Insurance Code section 2071)
When you file a claim, you may be fine on your own, or you may do better by hiring help
– it’s an individual decision you should make based on your own circumstances. A
licensed Public Adjuster can be your representative and advocate in the process of getting
your claim “adjusted” (processed) and “settled”, (paid). As with any professional, some
Public Adjusters are better than others. The last thing you need when you’ve suffered a
major loss is extra problems, so screen carefully before you hire. Resist high-pressure
sales pitches and don’t hire prematurely. The claim process involves leg work, paper
work, basic math, insurance lingo, and negotiation.
If you’re undecided on whether or not you need a public adjuster, visit the “Claim Tips”
section of our website at www.unitedpolicyholders.org .Click on “Hiring Professional
Help”. Start by reading the article titled; “Hiring a Public Adjuster – The Inside Scoop”.
If you’re leaning toward hiring professional help, this tip sheet will help you hire the
Claim adjusting is art, not science
Most people who file a claim rely completely on their insurance company to calculate the
amount of damage and what they’re owed. That’s not the way to go if you want to be
paid all you’re owed. The way to get paid all you’re owed is to do your own calculations
and research, provide complete documentation to your insurer, make a written demand
for payment and keep following up until you get paid. Particularly when it comes to a
large loss – you may need help from professionals to do the research and calculations
The insurance company sends out their own staff adjuster or “independent” adjuster, and
their handpicked contractor, whose job it is to identify the scope of work and to estimate
the costs to repair or rebuild your home. They measure the loss for the insurance
company, not for you. This matters because big dollars are at stake and your financial
goals and the insurers’ financial goals are not the same.
It is hard for you, the insured, to know whether you are getting all that is owed under
your insurance policy. Your policy may actually give you extended coverage beyond the
stated dollar limits on the policy. A qualified advocate on your side can be your voice in
the process and give you more input and negotiating leverage as to what you recover.
Documenting a catastrophic property loss is time-consuming and burdensome to even the
most sophisticated insured. Instead of relying on the insurance company to decide how
much you get to rebuild your home, hiring a good Public Adjuster can help you receive
the best possible settlement. Read United Policyholders’ Basic Tips, check your coverage
limitations and policy endorsements, (extras), and make sure to bring a copy of your
policy and review it with the Public Adjuster you are considering hiring before you
actually hire them.
Questions to Ask and Things You Should Know Before Hiring a Public Adjuster
1. Be sure you are hiring a licensed Public Adjuster. Ask to see their individual
Public Adjusters license for your state.(Some Public Adjusters work under the
license of another individual or firm, rather than becoming qualified and
2. Are you interviewing the individual(s) who will actually be adjusting the loss?
Or is the person simply a sales rep, who will hand off your claim?
3. Is the company signing up too large a volume of business to give you the best level of
care and attention? Your claim will be delayed if your public adjuster
is handling too many claims.
4. What skills, credentials and experience do they bring to the table? How many years
have they been licensed as a Public Adjuster, and how long have they been practicing
in your state?
5. Ask the Public Adjuster you are interviewing to give you a list of references
for claims he or she has personally handled in the past 3 years. (Some adjusters move
around among companies and have short-lived associations with the firm they
6. If the firm is located out of the area, how do they plan to service your claim? Make
sure you are clear on what you can expect from them over the long haul.
7. Is the adjuster handing the claim the right personality fit for you? You must
be confident and comfortable with their communications skills and level of personal
8. Before hiring a Public Adjuster, call and check at least three of their references. Ask
if the person you’re interviewing actually worked on their claim. Did the client feel
confident their Public Adjuster got the best possible result? Did their representative
answer all their questions throughout the adjustment and rebuilding process? Was the
Public Adjuster able to identify how much added value they brought to the final
settlement figures? Did the Public Adjuster assist with the additional living expense
and fair rental value portion of their claim? (Some Public Adjusters will waive their
fee on this portion of the claim.)
9. Don’t be rushed into making a decision before you are ready to. You have time to
make the right decision for you! Ask all the questions you need to ask so that you feel
confident in your selection of Public Adjusters. They will be part of your insurance
recovery process for as long as it takes to settle the claim and recover all the financial
benefits you are entitled to under the terms and conditions of your policy and the laws
in your state.
10. Most Public Adjusters work on contingency fees that range from 5% to 15% of the
monies the insurer pays on your claim.1 These fees are capped in some states and
negotiable in all states. The fee you agree to pay a Public Adjuster should take into
account the size and type of your loss and the status of your claim. Make sure you
agree up front on whether or not the Public Adjuster will get a percentage of monies
the insurer has already agreed in writing to pay but has not actually paid yet.
1 In some states Public Adjusters cannot charge contingent fees unless they are associated with an attorney
because it is considered the unauthorized practice of law. Many of the Gulf Coast states changed their laws
after the 2005 hurricane seasons to allow public adjusters to do business in their states.
11. If you get into a dispute with your public adjuster, do your best to resolve it
informally with them and with help from their trade association in your state. If there
is no Public Adjuster trade association in your state, contact the National Association
of Public Insurance Adjusters, (NAPIA) and seek their help resolving the dispute. If
that doesn’t help, file a complaint with your state regulator. Public adjusters are
regulated by state insurance regulators.
National Association of Public Insurance Adjusters (NAPIA): www.napia.com, 1(703) 433-9217.
National trade association of public insurance adjusters. Membership is voluntary and does not affect
license status. 21165 Whitfield Place, #105 – Potomac Falls, VA. 20165. Tel (703) 433-9217 Fax (703)
National Association of Insurance Commissioners (NAIC): www.naic.org All state insurance regulators
belong to this association. You can get contact and website information for every state insurance
department through the NAIC.
These tips are intended for educational purposes only. No legal advice should be inferred from these materials.
To learn more call 1-866-450-8520. Here at RHI Claims Specialist, Inc. our experienced staff are ready to assist you with any questions you may have regarding your policy or claim.