Every insurance company employs claims adjusters for the purposes of determining the validity of their client's insurance claims and calculating the amounts to be awarded when the claims are deemed to be covered by their policies. There are three different kinds of Insurance Claims Adjusters.
A public adjuster is an insurance claims expert who has a professional understanding of the language used in policies and can therefore discover where the limitations of each policy lie, as well as the benefits to the customer or policy holder. Most importantly, though, they work on behalf of the insured, unlike a claims adjuster that is employed by the insurance carrier. Every insurance claim is different and has its own unique set of circumstances based on the type of peril or event that triggered the loss and the subsequent type or scale of damage that occurred to the buildings, property or businesses that were affected by the catastrophe. Aside from understanding and interpreting the language of the policy there are several procedures that professional public adjusters usually follow when assisting a person with a claim.
There is an obvious conflict of interests when the insurance company sends either one of its own full time employees or someone they hired for the occasion to come to a fair and impartial judgement on how much they should award a client, when it is always a priority of the company to minimize these payments.
Once it is determined that the policy does indeed cover the damages and/or loss sustained the total cost of the entire claim must be calculated. In order to complete this step public adjusters employ the use of sophisticated software to help come up with the appropriate sum owed. In some cases there is even a need to calculate expenses incurred by the insured after the peril or loss occurred, such as money spent on gasoline, hotel rooms and food from restaurants as a result of not being able to live at home.
When a number is reached that satisfies the client and the adjuster, a report must be submitted to the carrier of the policy. In some cases there is either a desire or need for arbitration or dispute resolution services. Often the insurance company does not immediately agree with the findings of the public adjuster and that is when negotiations begin. Many people feel that this is the most important aspect of garnering an appropriate settlement and as such the most successful insurance adjusters are the best negotiators.
Often, in the process of putting together all of the details in a claim outside experts are consulted for their professional opinions. These experts may include professionals from the following fields:
According to the insurance laws of most jurisdictions it is not necessarily mandatory to work with a public adjuster for every aspect of the claims process. Depending on what phase of the process the file is in a client can request the assistance of anyone that they feel can do the job properly. Instead of using a public adjuster clients sometimes employ the services of lawyers, remediation/restoration consultants, contractors or engineers. In some jurisdictions, like Ontario, Canada, it is acceptable for one to represent themselves. Sometimes there are limitations on who could be used as a representative. This occurs most often when a claim has already been filed with the carrier and the amount is unsatisfactory to the claimant who has the right, at this point, to initiate an appraisal or alternative dispute resolution process.
The Appraisal or Alternative Dispute Resolution process follows the following steps:
Sometimes clients feel that hiring a licensed public adjuster is not as good an idea as hiring a lawyer to help them obtain a larger settlement. Some arguments for this idea are the thought that a lawyer brings the knowledge and power of their legal understanding to work on an insurance file. It is sometimes felt that a knowledge of case law, legal contracts and legal precedents puts the lawyer in a better position for negotiations with the insurance company. As well, lawyers usually charge their clients differently than public adjusters do. In the state of Alabama only lawyers are allowed to advocate on the behalf of claimants when disagreements arise between them and their insurance carriers. Many experts feel that this law will soon change, though.
Fire Damage, Smoke Damage, Property Damage, Wildfire, Replacement Cost, Actual Cash Value
Flood Damage, Overland Flood, Overland Water, Basement Flood Damage, Water Damage
Roof Leak Damage, Roof Damage, Roof Shingle Damage, Property Damage Claims
Water Damage, Burst Pipe, Plumbing and Service Line Damage, Sewer backup, Overflow, Accidental Discharge
Lightning Damage, Physical damage, Secondary Effect Damage, Electromagnetic Effect Damage, Changes in Ground Reference Potential
Landslide, Mudslide and Snow Slide (Avalanche) Damage, Erosion, Weather Damage, Earthquakes
Sinkhole Damage Claims, Natural Sinkholes, Man-Made Sinkholes, Water Main Break, Ground Collapse
Business Interruption, Loss of Income, Business Income Insurance, Business Insurance Claims
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