Author Topic: The Initial Insurance Claim Inspection Process And What Happens To Your Hurrican  (Read 1005 times)

Monirul Islam

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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 Like Hurricane Irma when there are so many claims to adjust, there is a shortage of qualified adjusters and they are hard pressed to get to as many claims as possible. You should ask them what firm they are with when they come to inspect your property and note how thorough they are recording your damage and if they are “listening” to you.

Unlike the good old days when field adjusters had the ability and authority to make offers and settle claims quickly, most initial inspections are typically being done to gather enough basic claim information in order for the insurance company to set a reserve dollar amount of the claim the carrier expects to pay and determine what other resources are needed to adjust or investigate the loss. Pay close attention to what the adjuster has to say about your damages but be wary about making commitments or engaging in conversation about issues involving the cause of loss and damages as this should be completely investigated before commitments are made. We’ve seen too many policyholders unfamiliar with insurance speak talk about floods when they are really referring to water intrusion or agree to with a seemingly innocent comment about their loss only to have it come back to impact their claim after a thorough investigation.  People just need to be mindful of not getting into discussions of wind versus flood if both of these perils potentially impacted the property.  By all means cooperate fully with the company adjuster, (that is your contractual duty as the insured) just be careful. And if the adjuster or the contractor they are sending out on the initial inspection is telling you there is no need to hire your own public insurance adjuster, report them to the Florida Department of Financial Services.

We always encourage our clients to ask for an advance payment on the undisputed portion of their claim. Any advance should be paid under the content coverage so if there is a mortgage the bank or mortgage holders (bank) name is not on the advance check. If the mortgage holder is put on the advance check, this will delay the ability for ready cash to make repairs.

There is always an outside chance that some adjusters who work directly for your insurance carrier may have the authority and can settle a claim but people should never sign a release. If a “Proof of Loss” form is required from an adjuster to get an advance or partial payment, then the policyholder needs to write on the form “PARTIAL PAYMENT FULL LOSS AND DAMAGES TBD” (to be determined). This is an accepted practice and no adjuster from the carrier should balk at this.

Once your claim is submitted to your insurance carrier, it typically goes to an inside claims department for review. That’s right folks, a person who never saw your property is most likely the one who is making decisions on what you will actually be paid. If the field adjuster missed some damage the inside claims staff will never know and in some cases they may not always agree with the field adjuster’s conclusions. This is why many of our public adjusters who get involved in a claim after the initial inspection will request another inspection once they have documented the claim and then meet the adjuster onsite to review the details of the inspection to represent the best interests of our client.  If there is anything suspicious about your claim, information is missing, it is considered complicated or something seems out of the ordinary, the insurance company claims department might also decide to re-inspect the property, call in engineers or send it to an investigative unit that looks for insurance fraud.  This and the mountain of claims that get filed when there is a serious storm event like the wind and flood damage from Hurricane Irma is what can cause much of the delays that occur processing your claim.