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Kevin is very knowledgeable, informative, responsive and a pleasure to work with. From my initial contact until reaching a favorable settlement for our property damage, Kevin instilled trust and confidence and demonstrated his commitment to be an effective advocate for us. Homeowner

Understanding the Claims Representation Process & How it Works

A loss to your commercial property or home creates an unfamiliar environment and poses excessive demands on your time. Decisions involving thousands and sometimes millions of dollars must be made and often made quickly with little margin for error. A decision must be made early on whether this process is to be undertaken by the policyholder or whether the professional expertise of a public adjuster should be brought in. Time and again it has been demonstrated that when dealing in an area that is unfamiliar, the end result can be a loss in valuable time and money.

Large or small, commercial or residential, properly handling a claim involves a structured process that when followed, will ensure it is processed properly and given the best chance of being honored and paid by your insurance carrier. The main services an adjuster will perform for you include:

  • Analyze your policy to get the maximum claim coverage.
  • Inspect the property damage and estimate all losses with our computerized system.
  • Notify the insurance company of your loss and ensure they have proper documentation.
  • Set all appointments with insurance company staff and provide them with preliminary estimates for building and contents damage and loss of business accounting figures.
  • Negotiate with insurance company for a fair and equitable settlement.
  • Prepare all documents in order to obtain payment.
  • Provide a list of trusted professionals for reconstruction if required.

The following explanation below is a more detailed explanation of the process used by Tutwiler & Associates and what to expect when dealing with a property damage insurance claim.

Stage 1: Initial Contact - Whether you contact us via phone 1.800.321.4488, email, or our free Claims Evaluation Form, we will respond to you as quickly as possible. The more information you can provide us the better we can answer your questions and concerns. Upon review of your information we will call you to answer any additional questions and then schedule a meeting to inspect your damage. For the initial inspection we should schedule a time when you can be present. During the meeting we will review your insurance policy to understand the coverage’s we have to work with. It’s of critical importance to have a plan in place based on the loss and the coverages. As an example: Are there enough limits available to hire a restoration company or are items and building components damaged to the extent that paying for the loss will use up your policy limits? There are a number of decisions that need to be made following a loss. These decisions will have a big impact on the outcome of your claim and your recovery. Our initial contact and the steps we recommend based on the facts of your loss and your policy coverage are going to be vital and critical to your recovery.

After the initial consultation, we hope you will realize the value of having a professional on your side. In order for us to be your representative and file your claim, you must appoint Tutwiler & Associates as your public adjuster. Thus we will ask you to sign an authorization form allowing us to notify the insurance company. Our professional fee structure will be worked out with you based on your needs and coverages and is generally based upon what we are able to negotiate for you. That means that we are highly motivated to do all we can to make sure you are fairly compensated in your insurance settlements with consideration to your coverage and insurance policy limits. Typically, fees run in the 5%-20% range and are highly dependent upon the type of claim, size of the claim and circumstances of the loss allowing us to gauge the amount of time a claim is likely to take. In Florida when a disaster is declared (such as in the aftermath of a Hurricane) Public Adjuster fees are capped at 10% per State law. One of the things we pride ourselves on is making sure fees and related expenses are understood upfront so there are no surprises.

Stage 2: Investigation – Once we become your authorized public adjuster, the first step is the analysis of your policy provisions and stipulations as they relate to your loss. This in-depth review is used to determine the coverage, limits, exclusions, and other forms that may apply to your particular loss. In investigating and planning for the loss and damages documentation and presentation, an understanding of recent court cases, decisions from the Insurance Commissioner's office, industry technical articles and opinions, and other factors that are likely to influence your standard insurance policy are all used to map a claims strategy. In many cases we have found the printed policy forms are contradictory to current practices and procedures of insurance adjusting in your area. Keep in mind that your insurance policy is a contract. While we do not dispense legal advice, given the nature of insurance disputes, we have seen instances where over the year’s court rulings may have an effect on the practice and procedures of adjusting property claims in your state. Thus what’s in a standard generic insurance policy may not be what the law of the land is where the loss occurred. We pride ourselves on staying current and in compliance with all issues that effect our profession through updated and current continuing education requirements required by the State regulators where we hold our professional licenses.

Stage 3: Documentation of the Claim – As the insured, you are required under the insurance policy to conform to the "Your Duties After A Loss" provision contained in your policy. This can be an involved and detailed process requiring time and expense to meet the requirements. As your claim representative, your Tutwiler public adjuster will create an exact profile of your property so it reflects its true value and conforms to your insurance policy language. This in-depth process includes: 1) detailed construction estimates with supporting engineering documents if necessary; 2) detailed and verified inventory and contents schedules with correct valuation and supporting documentation; 3) in-depth business interruption coverage analysis which includes projections and forecasts; and 4) the required technical and supporting documentation showing the current industry publications and authoritative papers supporting positions taken in the claim adjustment process.

Stage 4: Presentation of the Claim - After the full extent of the loss has been determined and documented a schedule of losses is prepared and undergoes a complete review by our staff. The claim is then segregated into the separate categories which conform to the various policy provisions that apply. A thorough review of the documents is made with the client and, with final approval the property insurance claim is submitted to the insurance carrier.

Stage 5: Negotiations and Settlement - Upon approval and submission, we initiate claims status follow-up on the insured’s behalf to expedite the processing of the claim. We also make ourselves available to answer any claim clarification requests posed by the insurance company which sometimes uses these as delay tactics. It is typical that there may be some negotiations regarding the claim, which many times boils down to justifying the value and legitimacy of the claim components. A well-defined position that is professionally documented should gain the respect of the insurance company representative. In addition Tutwiler & Associates expertise and qualifications in fielding any questions should lead to a fair settlement of your claim. It should be noted that no claim is settled without prior approval from the client who will be kept abreast of all negotiations as they proceed. We are also mindful of the negative financial impact of a loss to your property and we pledge to work diligently in resolving your claim in a timely manner. Our experience has been that perhaps one part of your claim can be settled faster than others and if this can be done we will certainly work to get you paid without jeopardizing the other parts of the claim.

FAQs About How Claim Representation Works

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Fees in the public adjusting profession are typically regulated by the State Insurance regulators. These regulations usually set a cap on fees but the actual fees can always be negotiated. Remember you always get what you pay for. The lowest bidder is a low bidder for a reason. Expect to pay a fair fee for the task at hand.

With Tutwiler & Associates, there is no upfront cost to utilizing our services. You pay nothing until we receive payment of your claim from the Insurance Company if we are working for you on a contingency basis. Our fees are generally 5 to 20% of the insurance claim recovery amount. The amount of our fee varies by the size of your loss, the complexity of your claim, and time estimated to manage the claim as each claim is uniquely different.

Because of our firms long history and reputation, we have at times been asked to serve as an expert in court cases and in those cases we work on an hourly basis. We have also been hired as consultants in pre-loss planning and preparation matters which is also billed on a hourly basis.

This is probably the most frequently asked question we receive. My answer has been that if you want a quick fast settlement, you do not want to hire us. Our experience has been that if you settle quickly without doing a thorough job, you most likely are leaving significant money on the table. Insurance companies know that the quicker they can settle a claim, the less it will cost them.  Taking the time to do the right job in adjusting a loss will benefit you in the end because you have thoroughly investigated, documented, presented, and negotiated a settlement that enables you to get all you are entitled to, based on your loss and the coverage you have purchased. Hiring Tutwiler and Associates will not delay your claim it will ensure your claim is paid in full. 

You can always have your claim reviewed and re-evaluated. The exception to this might be if the statue of limitation has run or if you have signed a full release. It is not unusual for policyholders’ to ask for a review as there can be many complex issues involved in a property loss adjustment process. Gives us a call we will be glad to review your claim and give you our best and honest opinion.

A claim denial is generally referred to as a coverage issue. Your claim has been denied because the insurance company says you have no coverage. There can be many reasons a claim is denied for lack of coverage. The important thing is to always request the basis for the denial to be sent to you in writing. Once you have a letter, let us take a look at it and allow us to visit with you at the loss site. Many claim denials have been overturned as it is not unusual for insurance companies to make decisions’ on faulty facts or lack of all the facts. If we cannot help you we will tell you and give you our suggestions on a course of action that may include appealing a denial to a senior manager in the claims department. You would be surprised at how effective it has been in the past to have a well detailed appeal letter sent to a home office official pointing out the errors in the claim investigation. If all else fails, we can recommended several competent lawyers that specialize in first party property insurance law. 

In most cases experts are not needed. But there are cases where experts such as structural engineers, roofing specialist, mold experts etc., are needed to substantiate your claim. In those cases we try and work first with the insurance company to agree on an expert who is fair and honest about what needs to be done to resolves any issues. There are always situations where there are differences that cannot be agreed upon. In some losses such as building claims, the insured will be required to have an expert submit plans and specifications in order to rebuild or repair. Since these cost and experts were used in the initial construction we can often include them in a claim as part of the cost to repair. The cost of an expert for a cause of loss opinion or to prove a claimed amount or item unless covered in the policy will have to paid out of pocket. Generally these costs have been minor versus the results.  We always consult with our clients on experts and it is the client’s right to pick and choose an expert in cases that requires this additional step.   

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Local Office

Charles R. Tutwiler & Associates Inc.
Licensed Public Insurance Adjusters & Loss Consultants
Offices: Tampa, Orlando, Hollywood, Palm City, Florida; Dallas, TX; Pittsburgh, PA

Executive Office
4300 W. Cypress St.
Suite 780
Tampa, FL 33607
Phone: 813.287.8090
Toll Free: 800.321.4488

Licensed in Florida # W840088 &
Texas #1399706 plus 16 other states
and the Virgin Islands