Policyholder Question - Can my property insurance company take back claim settlement?

Policyholder Question - Can my property insurance company take back claim settlement?

Q. We had a dishwasher leak into my cabinets and on my engineered hardwood floors. A claim was filed. Independent adjuster came out. When I got my estimates done they came out higher. Insurance already sent a check to us for 45kand repairs are at 65k. Now they want to send out a staff adjuster. My question is can they take money back if their staff adjuster doesn't come out with the same figures when they've already sent payment and notice? We did well on our first adjustment but I am worried that the second adjuster might not be as much in my favor.

A. Thank you for your question, but I am not sure of your concerns  given what you wrote. As I understand it you were paid $45K but the repairs are estimated at $65K. Based on the numbers it would seem the staff adjuster would owe you more money provided you did the work and spent 65K for like kind and quality and the agreed scope of loss that was covered.

However your question is a good one in that other folks may find themselves in a position where they either did not do the work or spent less on the repairs than they were paid. It is not uncommon for insurance companies to send out staff adjusters or other types of re-inspectors to check to see if the first field adjuster is following claim procedures best practices.

Typically these folks are more concerned about coverage issues or to see if fraud or other misrepresentations may have been made. While a carrier can ask for money back if a loss was clearly overpaid , it would not be the norm. Remember there is generally no requirement that a policyholder has to make repairs but if it is a replacement cost form then only the actual cash value  or depreciated amount of the loss will be paid

If you have questions regarding disaster planning or any property insurance claim related issues please call 800.321.4488 or contact us to submit a question to one of our public adjuster insurance claim experts.

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