Trading claim stories with others in the insurance business sometimes feels like we’re talking about the Wild West. Everyone is kind of doing their own thing which results in vast differences from adjuster to adjuster and from company to company. It can certainly make you think that the insurance companies are all in cahoots and creating a bit of chaos.
With 2016 almost in the record books, we reflect back on all the severe weather and storms this year and the many questions surrounding whether or not damages were sustained as a result. The damages arising from a hail/wind claim can be vast and are often unknown to a residential or commercial property owner. For example, did you know that if your roof is damaged in a wind/hail storm and the materials are no longer available, the insurance company likely has to replace your entire roof rather than just the shingles that were damaged. This is just one of many examples that show the importance of hiring a qualified claim expert who works in the industry to ensure that your property looks and functions as great as it did before the storm.
When we refer to a “qualified claim expert,” we don’t mean those working for the insurance company who offer up a lick and a promise. We mean real claim help – someone who is on your side and has the knowledge, experience, and expertise to navigate and negotiate your claim on your behalf to full resolution.
This may also include hiring an attorney who specializes in property damage claims. Lots of folks are intimated by just the mention of hiring an attorney when a problem arises. But, a quick visit with a qualified first party claims attorney and your mind may be at ease immediately. These professionals usually work on a contingency fee basis and almost always their first consultation is free of charge. They are hardworking attorneys who have your back at the end of the day. They can quickly make the insurance company and its adjusters feel like a bunch of long-tailed cats in a room full of rocking chairs.
Don’t worry about biting off more than you can chew, your mouth is probably a whole lot bigger than you think. It doesn’t have to be a dicey experience. Hiring a claim professional right out of the gate does nothing but increase your chances of a timely and successful resolution of your claim.
It could just be your ace in the hole!
Let’s continue our discussion from earlier this week and cover who the frenemies are. You or your public adjuster will be dealing with an outside adjuster who reports to an inside adjuster. Here we will walk you through the differences and who is here to help you:
Outside Insurance Adjuster
The outside adjuster’s job is to determine the scope of loss, secure photos, and write an estimate for the administrator to review. Even though the administrator has the final say, the manner in which the adjuster documents the loss has a huge impact on how the claim is settled. The outside adjuster is the artist who paints the picture. Most adjusters have some limit of authority, which forces them to submit their findings to the administrator before the claim can be paid. A lot of times, the adjuster will either not commit to something until he runs it by the administrator or he approves something but it gets reviewed and changed or maybe even denied.
Inside Insurance Adjuster/Administrator
The inside adjuster/administrator is your inside person who has the authority to issue payments. Many times, the administrator will review and reduce the amount of an estimate and/or advise the outside adjuster to modify the report. Sometimes, this is the person who reaches a final settlement with the public adjuster. When push comes to shove, when the public adjuster is ready to advise the client to take the claim to the next level, the inside adjuster may be the only one that has the leverage to settle a claim.
Public Insurance Adjuster
A public adjuster is your claim representative. They monitor and track the progress of the claim while holding the insurance company accountable for what they owe. From a birds-eye view, you can see that a public adjuster documents each loss on its own merit based on what they see is a reasonable means of repair or replacement. The insurance adjuster’s approach is much more routine, restricted by time, and also controlled by company requirements with respect to documentation and estimate writing. Without a public adjuster, your claim is being documented and estimated by adjusters who work for the insurance company, not you. A public adjuster has the knowledge, training, and expertise necessary to advocate on your behalf and even the playing field with the insurance company.
While some insurance companies have the mindset of we are supposed to help “our” people, others do have a more fair approach. Either way, the most important thing you can do is protect your assets and this begins with hiring a public adjuster or other claim professional.
In the process of trying to make light of the relationship between adjusters in the insurance industry, the word frenemies pops into my mind. While some can be more friends than enemies, when the claim gets in the weeds the dastardly frenemies come out.
Comparable to Cinderella who had to deal with the two wicked stepsisters, public adjusters must deal with both an outside insurance adjuster who then reports to an inside insurance adjuster (who actually aren’t friends either). These “company adjusters” are usually overworked and some are good, some bad, and a lot just don’t have enough experience.
As Frenemies (an enemy disguised as a friend), these guys attempt to work together for a peaceful and fair resolution for the insured. But sometimes those attempts take a negative turn and the insured needs someone on their side. To steal a line from The Incredibles, the insured is left thinking man, I thought you (the insurance company) were supposed to help people. They do help people, they help “their” people.
The outside adjuster is responsible for the initial documentation of the claim for the insurance company. How they choose to paint the picture can be critical to the outcome of the claim. When the company adjusters stand by a messy canvas, then there are sure to be negative consequences to the insured. Sounds like someone should be in the dog house, but instead they leave this chaotic and uncontrollable mess to the insured to figure out.
A situation like this can cause lots of trouble for the insured if they don’t get a public adjuster or other claim professional involved at this point. It is only fair to level the playing field. Hire someone who also knows the ins and outs of the insurance business and how to reach a fair resolution of your claim and make sure you get what is owed.