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Wednesday, December 28, 2022

Dealing with Insurance Adjusters

By Catherine Powell

Image courtesy of Pix4free
As they say, "Into every life a little rain must fall."  In my industry, falling rain is known to cause property damage and traffic accidents.  Should either of these befall you, it will likely trigger an insurance claim that will in turn require a property and casualty adjuster to resolve.  This kind of adjuster is tasked with investigating and settling homeowner and auto insurance claims.  The better you understand the process used by this type of adjuster, the better the result and the less stress you will go through while waiting for your claim to be processed.   Below are ten things you need to know to deal with insurance adjusters.

#1: Read your policy. - If you don't know what's covered in your policy, you may file a claim for something that isn't covered or expect to get paid more than the limits specified.  You also need to know who is covered by the policy and who or what is excluded, as well as the deductibles included in your policy.

#2: File your claim promptly. - Depending on the type of policy, you could have as little as 30-days to file a claim.  File a claim one day too late and you could wind up with nothing.

#3: Assessing a claim takes time. - While damage to your home or your automobile may block out the sun until either is made whole again, what you probably don't realize is that your claim is just one of 100-150 that a typical property and casualty adjuster has to deal with every month.  On top of that, adjusters not only have to take the time to investigate every legitimate claim, they also have to weed out fraudulent claims as well.  According to the FBI, the cost of non-medical-related insurance fraud is $40 billion per year.  Not only have some homeowners been known to file fraudulent claims, but unethical contractors, public adjusters, and attorneys have been known to get in on the act as well.  That's also why insurance adjusters must take the time to analyze damage and interview providers and witnesses to ascertain that the claim they are processing is legitimate.  They have to contact everyone related to the claim and occasionally consult with experts. Even without the threat of fraud, when mass casualty cases occur, such as after a natural disaster, the sheer number of claims can be so high that insurance companies can be flooded with requests.  This means you need to understand up front that resolving your claim may take more time than you realize.

#4: Document everything prior to meeting with the adjuster. - Instead of tapping your toes while awaiting the adjuster, take the time to shoot photos or a video to document the damage.  While you're at it, it wouldn't hurt to interview witnesses or neighbors to validate your claim.  If you're involved in a traffic accident, get the name, address, phone number, and insurance information of the other drivers, as well as the year, make, model and license plate of all vehicles involved. Pay attention to every little detail so you won't run the risk of not being reimbursed for anything left out of your claim.

#5: Help the adjuster help you. - If you want a fair and fast resolution of your claim, don't make the adjusters do all the heavy lifting.  Provide them with the evidence they need to substantiate your claim.   Do your part to have a couple of estimates on what it would cost to repair the damage.  Be polite and calm when dealing with the adjuster even if the damage has left you stressed out.  Ask an adjuster how to reach them and what time is best to call.  Don't barrage an adjuster with calls.  It can take anywhere from a few days to several months for an adjuster to sign off on an assessment.  Give the adjuster enough time to get the job donewith .

#6: Keep track of everything you say or send from the moment you file a claim. - Maintain a log that tracks the date and names of people you speak to so you'll know what you said or sent and who you spoke to.  This should include any conversations you have with the adjuster, insurance company representatives, doctors, police officers, contractors and anyone else with whom you deal until the day you cash the check from your insurance company.  Not only will this help you to eliminate any confusion, but it will keep you from having to dig through your records to answer questions related to your claim.

#7: Don't do anything that's likely to get your claim denied. - Make sure you file your claim promptly and completely.  Make sure your policy doesn't lapse.  Never tell an adjuster a lie or a half-truth.  Make sure you don't start repair work before the adjuster sees the full extent of the damage.  If emergency repairs are required to prevent further damage to your property, make sure you document the damage before you perform the repair.  Don't discard anything that helps you prove your case, even if it entails dragging debris to your driveway and covering it with a tarp.  If the adjuster requests additional documentation, make sure it arrives in a timely manner.  If you or someone else gets injured, make sure you or they seek immediate medical attention to prove that their injuries happened at the same time as the damage or accident.

#8: Don't volunteer anything that's likely to get your claim reduced or denied. - For instance, if you had a car accident and the adjuster asks how you feel, don't automatically say, "I'm fine."  Tell the adjuster, "I'll let you know after I've consulted my physician."  Symptoms of whiplash or other injuries have been known to display days after an accident has occurred.  Any premature admission you make can come to haunt you later, especially if you allowed the adjuster to record an earlier conversation. 

#9: What should you do if you're offered less than you expect? - If you feel the company's offer is less than you deserve, there's a process you can use to dispute the adjuster's recommendation.  First and foremost you can try talking to the adjuster to see if he or she will offer a higher amount based on your documentation. If that fails, you can contact the insurance company directly to file a dispute and request mediation.  If that still fails to up the ante, you can contact your state's Department of Insurance and file an appeal which will put the case in arbitration.  The arbitrator assigned doesn't work for the insurance company and is required by the court to consider both sides' information before rendering a decision.  Above all, if you disagree with the assessment, make sure you file promptly since many jurisdictions limit the time you have to appeal.

#10: What can you do if your claim is denied? - Just as with a lowball offer, the clock is ticking if your claim is denied outright.  Your insurer is required to mail you a letter explaining why the claim is being denied.  Before you appeal the decision, you first need to read the letter.  If the insurer has a legitimate reason to deny your claim, you will lose your appeal.  If they don't, this information will help you defend your position once you file an appeal.  The appeal process to follow is included in your homeowner's policy.  You also have the right to file on your own or hire a public adjuster to argue your case with your insurer.  Either way, you need to include as much documentation and evidence as possible to support the fact that your claim should be paid. 

Catherine Powell is the owner of A Plus All Florida Insurance in Orange Park, Florida. To find out more about saving money on all your insurance needs, check out her website at http://aplusallfloridainsuranceinc.com

1 comment:

  1. Dealing with an insurance adjuster can add to the stress of filing a claim. But it doesn't have to if you understand the process.

    ReplyDelete

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