What Is a Home Insurance Adjuster?
An insurance adjusterís job is to learn about your loss, determine whether your policy covers the loss, and calculate how much your insurer should pay you for your claim.

Article Courtesy of CREDIBLE

By Amy Fontinelle

Published September 21, 2022

 

A home insurance adjuster is the professional youíll work with if you file a claim under your homeowners policy. After you submit your claim online, by phone, or through your agent, your insurance carrier will assign an adjuster to your case. This person will be your contact for your claim.

What to expect from a home insurance claims adjuster

A home insurance claim adjusterís job is to assess your property damage, learn more about your loss, and determine whether your homeowners insurance policy covers the loss. Theyíll also calculate the amount your insurer should reimburse you for your claim.

Your insurance adjuster will take the following steps when evaluating your claim:

  • Closely inspect damage. Once you file your claim, the insurance carrier will schedule an adjuster to visit your home and assess the damage. Itís a good idea to prepare for this visit by noting all the damage you want to point out to them. The adjuster may also be looking for reasons to reduce or deny your claim.

  • Review the police report. Homeowners insurance claims donít always involve police reports, but if your cause of loss was theft, vandalism, or malicious mischief, this step will apply. The police report can help validate and provide more details about your claim.

  • Review additional evidence. For example, if you have a home inventory, photos, videos, or receipts showing the personal possessions you lost and their value, the adjuster will consider them.

  • Write a report. After reviewing all the information related to your claim, the adjuster will produce a report itemizing the damage to your home and the cost to make you whole.

How to deal with an adjuster

The adjuster you work with may be a staff adjuster who works only for your insurance carrier or an independent adjuster who works for several insurance providers. Either way, they donít represent you.
 

Tip: You can also hire a public adjuster to help settle your claim. Public adjusters charge a fee ó up to 15% of the settlement amount, according to the Insurance Information Institute ó but they donít work for an insurance carrier. This means theyíre more likely to look after your best interests.

Though your insurance contract and state law do require adjusters to treat you fairly, their incentive is to settle your claim quickly and minimize the insurerís costs. Knowing whatís covered and whatís not under your policy can help you navigate the process. So can knowing your rights and whatís considered an unfair claims practice.
Recognize unfair claims practices

Unfair claims practices committed by insurers include the following:

  • Lying to you about your coverage

  • Not communicating with you promptly about your claim

  • Not investigating or settling your claim promptly

  • Not acting in good faith to fairly settle your claim

  • Offering an unreasonably low settlement

  • Not providing a reasonable and accurate explanation for a claim denial

Become familiar with some of these key aspects of your policy:

  • Additional living expenses: Your policy may reimburse you for costs to live somewhere else while your home is being repaired. Costs your policy typically covers include hotel stays, reasonable food expenses, and storage.

  • Replacement cost coverage: If you have personal property damage, you should know whether your policy will reimburse you for the cost to buy each item new (replacement cost coverage) or only for the amount it was worth immediately before the loss (actual cash value coverage).

  • Building upgrade coverage: Building codes can become stricter over time, making rebuilding more expensive. Youíll want to know if your policy covers these increased costs.
    Know your options

If you arenít happy with the adjusterís assessment of your loss, you have several options:

  • Negotiate your claim yourself. If your claim isnít large or complex, or if the insurance providerís settlement offer isnít far off from what you want, present evidence to the adjuster ó such as damage they missed or a contractorís repair estimate ó explaining why the payment should be higher.

  • Speak with a claims manager. If you canít get anywhere with your adjuster, you can escalate your concerns to the insurance providerís claims manager.

  • Contact your stateís insurance department. They may be able to help you, and if nothing else, you can file a complaint.

  • Hire a public adjuster. This professional will represent you and provide a second opinion after doing their own assessment of the damage.

  • Try an appraisal or arbitration. These are processes that can help you reach an agreement with your insurer without going to court.

  • Hire an attorney. If nothing else works, you can speak with an attorney for legal advice. Some lawyers provide free consultations to see if you have a case. Youíll pay them a percentage of the settlement if they win your case.

What happens after?

After the adjuster submits their final report, the insurance providerís claims examiner will review it and approve it. The settlement amount should be based on the cost to rebuild, repair, and replace your damaged property.

It wonít be higher than your policy limit, and itíll be reduced by the amount of your deductible. You can find these amounts on your policyís declarations page.
 

Getting paid

If your carrier offers direct deposit and you donít have a mortgage, you can expect to receive your claim payment in your bank account within days of the examiner approving the claim.

You may receive multiple claim payments, especially for a large claim: an emergency advance followed by multiple payments for structural repairs, additional living expenses, and personal property. It may take 18 to 24 months to complete the process if you have to completely rebuild your home.

However, if you have a mortgage, the process can take longer. Your insurer will send you a check for the damage, which youíll then have to send to your mortgage servicer. Itíll endorse the check, then send it back to you if the claim amount is below a certain threshold. For larger claims, your servicer may put the money in an escrow account and disburse it as repairs are made.

Policy renewal

Finally, be prepared for a possible rate increase or policy nonrenewal. When your policy period ends, your insurer may charge a higher rate to renew your policy. In some cases, it may even decide not to renew your policy, which means youíll need to compare insurance quotes with different carriers.


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