Many people might be surprised that having an adjuster look at your claim is only the beginning of the insurance claim process. Remember, the field adjuster that inspected your property may not be an employee of the insurance company. They are typically independent adjusters on contract and typically are paid a set fee or percentage for each claim they handle. This is especially true during disaster situations when there are so many claims to adjust. 

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As policyholders begin to hear back from their insurance company, many will learn that the amount offered by their respective insurer is not sufficient to pay for their complete loss and damages. Some may even learn part of their claim is denied. This is common when there is widespread damage to a geographic area and especially true with more complicated commercial claims to businesses, condominiums and hotels where methods to fix or replace damage can become complicated. There can be many reasons for this including overworked adjusters either documenting specific damages or inside claim adjusters denying certain parts of a claim. 
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Thank you to our Orlando Public Adjuster Brad Barrett for answering the following question:

Q. I had damage to my roof during a storm. Shingles blown off as well as some hail. Insurance told me to get 3 estimates which I did and then sent their adjuster out and he wrote me a check.  The 3 estimates said I had wind and hail damage and so did the check from carrier but the estimates said I needed the whole roof replaced and the carrier said I only needed the 1 corner repaired where shingles blew off. What should I do?

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Last week, I was interviewed by Deirdre Fernandes  who covers the insurance industry for the Boston Globe. Her story   Pricey car insurance policies test consumers     discussed how more policyholders were likely to shop around for both home and auto insurance after the brutal winter left many homeowners disillusioned with their claim settlements and the coverage increases the insurance firms are trying to push through. What’s amazing is how few homeowners shop for the best rates. We handled many winter storm claims in and around Boston and I can tell you many of our clients are now shopping for new policies due to the push back and negative experience they had with insurers some had been paying premiums to for many years. In many cases, these insurers failed their moment of truth. Instead of trying to make their policyholders whole, their adjusters instead looked for technical loopholes to minimize the payouts. The policyholder will have the last say in the matter when they walk away and look for a new carrier.

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As we continue to help our clients who experienced winter storm damage, settle their insurance claims, we are learning more and more about insurance company claim practices and procedures, some which is quite troubling. This winter in the northeast, we endured some grueling battles with insurance companies which I will detail below. No doubt, insurance is a for-profit business and no business likes to lose money.  We also understand that one can’t generalize one company’s behavior to all insurance companies as they all have their own standards of practice. And like other public adjusters in our industry, there are good apples and there are a few bad that can taint the entire profession. 
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While most folks are enjoying the spring weather and looking forward to summer vacations with outdoor time with the family, others are still working through the insurance claim adjustment process dealing with adjusters and contractors.  Yes, as hard as it may seem, a lot of folks are still struggling with losses over the last twelve months from winter storms in the Northeast, hail and tornados in the Southwest, and Caribbean wind losses from Hurricane Gonzalo.  It’s been a busy season for Public  Adjusters and with their help, many folks are just now entering into settlement discussions with their insurance companies. So now is the time to pay attention to the details in your insurance policy.  The news media seems to move on from storm to storm with little information offered or shared about the vital information you need to know about your property policy and its terms and conditions.
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Over the past few months, we have been helping businesses and homeowners try to settle their insurance claims from the extreme Winter Storm damage that has impacted enough property owners in Massachusetts and throughout the Northeast & New England area that this storm rivals the damage done by other major storms we have worked.  As we’ve seen with past major storms with widespread damage, it is very apparent that the insurance company’s are overwhelmed and they are desperately looking for assistance to service all their policyholders who have made claims for their property damage.  Similar to hurricanes, the carriers have enlisted the help of many independent adjusters who have made the trip from as far away as Arizona to help them make inspections, write repair estimates, and make field calls before turning their files in and heading back home.  The issue with this is that most of these independent adjusters are assigned so many claims that there are simply not enough hours in the day for these adjusters to conduct a thorough inspection of the damage and then spend adequate time behind the computer to write a detailed repair estimate.
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As we transition into Spring, hail storms will cause severe property damage to roofs, siding, screen enclosures and any other structure within its path. As public adjusters, we consistently see insurance company claim adjusters minimizing the damage and trying to do patch work. This can lead to real differences of opinion between the policyholder and their insurance carrier as this denied hailstorm insurance claim at a church seen in the video below. While every claim is different and must be taken on its own merits based on the policy, our advice is to always enlist contractors and public adjusters who know the nuances of these claims and can negotiate fair settlements. Hail damage can be easy to miss and come back to haunt you. 

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Let me explain with an example of a claim that came across my desk that should be instructive laying out the steps policyholders should take when the dreaded denial letter comes in the mail from your insurance company. First, don’t panic. You may be able to turn things around provided you have requested all the information you need to convince your insurance company of the errors of their ways. So let’s get started. It will require a little work on your part, but you can do it.

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Here is an insurance claim question that we recently were asked to weigh in on as a contributing member of insurance claim experts for United Policyholders who advocates for property owners. 

Q. My shower pan or the drain was leaking slowly. I had a piece of carpet over the carpet at the door of the shower and did not realize it. There is mold through to the sub floor under the pan and the carpeted area which we can see on the ceiling under the shower in the basement. I have Total Protect homeowners. They said it was not the plumbing so will not pay. My regular home insurance is with Allstate. Their representative told me they never pay for a pan leak even if it is the drain or pan itself. I pay for all of this insurance and then they refuse to accept responsibility. What do I do?


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