Why would a business owner need help with a claim? Won’t the insurance
company cover the loss?
A professionally trained public insurance adjuster will act as your advocate and help
you navigate the maze of settling your claim for the full amount due under your policy. Your insurance
policy contains certain conditions that must be met: valuing your loss, presenting it to the insurer
and negotiating a settlement. Because insurance policies are complicated and conditional, full payment
on a loss is not automatic. A public adjuster can help determine coverages and causes of the loss so
you are able to evaluate the carrier’s offer or denial and are certain to maximize your settlement.
What is a Public Adjuster?
In California, there are three types of licensed Insurance Adjusters
According to CAPIA, the California Association of Professional Insurance Adjusters
Company Adjuster is employed by the Insurance Company to
represent the company in dealing with your loss and damages. The Company Adjuster's
main responsibility is to protect the interests of the Insurance Company.
An Independent Adjuster is hired by the Insurance Company to represent the company
in dealing with your loss and damages.
The Independent Adjuster’s main responsibility is also to protect the interests of
the Insurance Company.
A Public Adjuster is the only Adjuster specifically licensed by the
State of California to represent you, the Insured.
The Public Adjuster’s main responsibility is to protect you and your interests in
claims against a loss with the Insurance Company.
In addition to California, currently more than 43 other states and the District of
Columbia require an adjuster to hold this licensure in order to represent the insured.
According to NAPIA, the National Association of Public Insurance Adjusters, "Public
Adjusters are professionals who are employed exclusively by a policyholder who has
sustained an insured loss. They handle every detail of the claim, working closely
with the insured to provide the most equitable and prompt settlement possible. A
Public Adjuster inspects the loss site immediately, analyzes the damages, assembles
claim support data, reviews the insured's coverage, determines current replacement
costs and exclusively serves the client, not the insurance company."
What does that mean?
If you are overwhelmed by a process of determining what coverages you have and then
calculating the amount of your loss, you may consider speaking with a Public
Insurance Adjuster. Insurance policies can be very complex and difficult to
understand. Often coverage is excluded in one section of the policy and then
granted back to you in another section. It is also very important for the insured
to meet all of the policy conditions in order to be paid on their claim. If you
have ever had the unfortunate experience of suffering a loss and going through the
claim process, you will understand what a daunting ordeal it can become.
However, after a disaster, insurance companies often discourage claimants from
hiring a Public Adjuster.
According to United Policy Holders, a non-profit, tax-exempt organization dedicated
to educating the public on insurance issues and consumer rights, "This happens all
the time. Insurance companies don’t want the insured to be on an even playing field.
They want to control the situation and not deal with someone as or more knowledgeable
than they are. Insurers are predisposed to minimize claim payments. Public Adjusters
are predisposed to maximize claim payments."
Public Adjusters help you get your life back. Instead of using up all your waking
hours battling with the insurance company, your Public Adjuster does that for you.
A good Public Adjuster works with you to maximize your time so that you can get
our daily life, your family life, and your work life back in order while the Public
Adjuster and the Insurance Company negotiate to get your home and possessions as
close as possible to the state they were in before the disaster.
Experienced Public Adjusters are familiar with the local insurance companies, their
representatives and their regional adjusters. They may have worked together before
and may be able to effectively come up with a plan that will maximize the insured's
insurance claim payment without requiring a lot of heated discussion and argument.
It makes sense to let two professionals amicably settle your claim while you go
ahead and live your life.
The insurance company adjuster knows that the Public Adjuster is an expert with
the intricacies of insurance policies and negotiation, and therefore he or she
is much more likely to come up with a larger, more accurate and acceptable offer.
Like with most business negotiations, the easier and more professional the discussion
(i.e. no emotion), the more likely the settlement to be biased towards the policyholder.
One of the biggest challenges in coming to a solution that is acceptable to all
parties in a disaster insurance case is emotion and anger. For the homeowner who
has lost everything, this is a very emotional time. Your spouse may be devastated
and angry. Your children are devastated, lost and confused. Everything they know
is gone. You may have even lost your family pet in the disaster.
This emotional roller coaster can tear families apart. Now, add the stress of
compiling all necessary rebuilding costs and the strain of negotiating with the
insurance company and the insurance company's adjusters and you will find yourself
in a very difficult environment.
It is common to feel helpless and desperate after a fire destroys all of your
possessions. Having to then suffer through the indignity and endless questions
from a seemingly uncaring insurance claims representative is enough to send the
most sane and calm person over the edge.
By letting a qualified public adjuster work on your behalf, you will be saving
yourself a great deal of emotional turmoil.
Most insurance policy holders who have been through the process say this is the
biggest benefit of using a Public Adjuster. Yes, getting a big payout is good but
the fact they are once again able to live their lives while the adjustment and
negotiation is in process is often the most valuable part of the entire process.
Public Adjusters will keep you from signing documents that you shouldn't, and
they will make sure you keep the right documentation of your expenses. They will
also do their best to make sure you do not make any mistakes that will delay or
damage your claim.
Good Public Adjusters understand your tears, fears and anger. They won't cut you
off or walk away from your emotions. A good Public Adjuster will take the time to
listen; they will help make your life as livable as possible while the claim
adjustment is underway.
One of the most difficult and challenging aspects of filing a claim is creating
an inventory list of your possessions and assigning correct replacement values
to those items. A good Public Adjuster will show you how to do this - tips and
tricks that will help the property owner recall what was lost as well as the best
ways to figure out and calculate replacement costs. Many Public Adjusters can
actually do this work for you - researching the value of particular items you
lost and how much it will cost to replace them. Doing this kind of research can
consume many hours a day. For many disaster survivors it is much more efficient
and less heartbreaking to have their Public Adjuster do that for them.
Your Public Adjuster will work with you and various construction, restoration
and repair professionals who know LOCAL conditions, prices, and current building
codes in order to develop an accurate estimate of what it will take to truly
rebuild your property to its previous condition. This includes various improvements
and additions that you have made to the property, as well as upgrades that are now
required to meet local building codes – as long as you have the appropriate coverages.
Your Public Adjuster will also review the costs of rebuilding your outbuildings and
additional structures such as a garage, patio, pool house, etc. Public Adjusters
will also review and prepare estimates to restore your landscaping based upon your
specific coverage. Many people forget the many tens of thousands of dollars they
had spent on plants, materials and labor required to create a well-landscaped yard.
Your homeowners insurance policy should cover that restoration as well.
A good Public Insurance Adjuster understands a wide range of insurance policies.
They have seen plenty of insurance policies and have been trained to understand
the various policy language, endorsements, exclusions riders and schedules.
The language is often so convoluted that even the professionals may not agree on
what the policy is actually saying. This is when an experienced and educated public
adjuster can make all the difference.
According to NAPIA, "The typical fire policy contains hundreds of provisions and
stipulations - various forms and riders that are constantly changing and many
complex details about your requirements in case of loss. Most people do not know
or understand these policy provisions - and most do not realize that the burden of
proof is on them, the policyholder. Most insurance company representatives actually
prefer to work with an experienced accredited public insurance adjuster rather than
an inexperienced insured."
Unlike an insurance company adjuster, a good Public Adjuster will take the time to
go through ALL your policy documents to make sure you are getting ALL the money
that you are entitled to.
As a result of the wildfires that swept through Southern California in 2003 and 2007,
it became evident that many homeowners were not properly insured. Sometimes it was
their fault - they deliberately made a decision to not pay for the insurance they
needed. However, in many cases, as their homes had increased in value, as they added
improvements, and as overall repair and replacement costs skyrocketed, their policy
was not reviewed to see if it had appropriate amounts of coverage to meet the
replacement cost burden of the home.
A good Public Adjuster understands the impact and reality of under insurance and
in certain cases, can work with the insurance company to get you monies for coverage
that you should have had but were not offered or provided.
According to NAPIA, "The highly stressful period following a loss is a difficult
time for individuals and businesses. A Public Adjuster can take those major
headaches away and let you get back to your home or business. A typical fire or
flood policy contains hundreds of provisions and stipulations, constantly changing
forms and endorsements, and many complex details such as inventory appraisals and
real estate evaluations that are required in case of a loss. Most policyholders
do not know that the burden of proof is theirs. Public Adjusters know the insurance
business and are familiar with all procedures so they can work quickly to expedite
By using a good Public Adjuster, not only will you get properly compensated for
your insured losses, but you will also be able to avoid much of the conflict,
anger and helplessness that can sometimes arise when adjusting an insurance claim
on your own. Consider your family - your spouse and children. Consider your job.
Do you have the available time and energy necessary to deal with the insurance company?
A good Public Adjuster will get you what you are owed and may save both your career
and your family by not monopolizing your time.
No. Our team of experts will consult with you to determine if Quality Claims can
add value or if you can simply handle your claim on your own.
Quality Claims is licensed nationally and must comply with the regulations
of each state’s Department of Insurance. Public Adjusters typically charge a percentage of
the total claim amount. The fees that Quality Claims charges vary by state and comply with
fee limitations established in various states to protect the insured.
You should consider contacting a Pubic Adjuster as soon as you suffer a loss. The insured
has certain policy conditions that must be strictly adhered to. These conditions are detailed
in the policy and they will vary by the type of policy i.e. commercial versus residential
versus manuscript. You may start off at a disadvantage if you wait until your insurance
company has begun the adjusting process and you may discover you have not met certain policy
conditions or missed deadlines.
I believe it is the insured’s responsibility to determine the value of their claim and it
can be a cumbersome process gathering bids from various contractors while you are reading
your insurance policy and trying to understand what it means. Insurance policies are very
complex documents and are not very easy to understand, many of them have certain limits that
increase or decrease depending on the total amount of your losses – and each coverage area
can be different. Perhaps you simply do not have sufficient time to document and determine
the full value of your claim. Some people try to handle the adjustment process on their own,
and quickly learn there are not enough hours in the day to gather all information required
to prove your claim.
If you do experience a major disaster, it might be a good idea to immediately talk to a Public
Adjuster to get a general overview of what your options might be. Remember, a Public Adjuster
works for you, the policy holder, not the insurance company. A good Public Adjuster will help
you successfully work through the highly stressful period following a loss. This usually is a
difficult time for individuals and businesses, especially for someone who has never experienced
a disaster or had to file a claim with their insurance company. A Public Adjuster can take
those major headaches away and let you get back to your home life or running your business.
A typical fire insurance policy contains exclusions that must be fully comprehended by the
insured. Some policies also contain endorsements which provide additional coverages to the
policy. Knowing what the exclusions mean and understanding the additional coverage given to
the insured in their endorsements it is necessary to read, re-read and then be sure you completely
understand what your policy says.
Public Adjusters know the insurance business and are familiar with all procedures so they can
work quickly to expedite payments.
The best place to find a good public adjuster is through NAPIA (at www.napia.com). NAPIA can
provide referrals for every state that licenses Public Adjusters. A Public Insurance Adjuster
is the only type of adjuster qualified to represent the insured on a first party property claim.
Currently more than 44 states plus the District of Columbia require an adjuster to hold this
licensure in order to represent the insured.
A professionally trained Public Insurance Adjuster will act as your advocate and help you to
navigate the maze of settling the claim for the full amount due under the applicable policy.
Remember insurance policies contain certain conditions that must be met before you can get
paid: valuing the loss, presenting it to the insurer and negotiating a settlement. Because
insurance policies are complicated and contain certain conditions, full payment on a loss is
A Public Adjuster can help determine your coverages and cause of the loss in order to present
your claim and evaluate the carrier’s offer or denial. Determining the cause of the loss is a
critical step in verifying coverage.
After a disaster, fire victims often get besieged with inquires and offers from a plethora of
general contractors and Public Adjusters and others offering to assist them. This is normal.
Just because you are being solicited does not mean they are doing something wrong. However,
you need to be careful and do your due diligence before signing up for their services.
"It is not uncommon to meet up with a roving insurance adjuster following a disaster," said
Valerie Brown of RB United, a nonprofit community organization for San Diego area wildfire
victims. "Make sure they are licensed by calling the California Department of Insurance
Helpline at 1-800-927-HELP."
Valerie also recommended "You should not start any clean up or repair work until your insurance
company inspects your property. Take lots of photos of the damage to your property before any
work is done."
Here are a few danger signals:
- If they are not members of NAPIA, (National Association of Public Insurance Adjusters,)
or of their state association of public insurance adjusters watch out. Public Adjusters that
are members of professional associations are required to adhere to a professional Code of Conduct.
- They make BIG promises without any guarantees. If a Public Adjuster guarantees you they will
recover a certain percentage more than your insurer offers, beware. How can a Public Adjuster
guarantee anything unless they have read your policy, determined the value of your claim and
seen an offer from your insurer?
- Their fees are outrageous. Most legitimate Public Insurance Adjusters fees range between
5% to 15% with an average of around 10%. Some Public Adjusters may charge higher fees on smaller
claims or when hired midway through the claim process. If a Public Adjuster is hired to pursue
the last few dollars of a claim, they will likely seek a larger percentage since they have a
significant uphill battle to overcome.
- If you feel pressured to make a quick decision, run. Legitimate Public Adjusters recognize
that the decision to hire someone to represent you in order to get your home and life together
is a momentous one. This is not a decision that should be made in haste. This could one of the
most expensive decisions you make in your life. Take your time, ask for references and call the
references. Perform your own research to see what their backgrounds are.
- Check their web site and address. If they don’t have anything except a business card, be
very wary. If their address is only a PO box, this is a red flag.
- It is often better to hire someone who is local. Someone who knows the local building codes,
construction costs and has access to the resources of the community and how best to leverage
them. A locally-based Public Adjuster may also have prior experience working with representatives
of the major insurance companies in the area and may be able to cut through a lot of the red tape
and bureaucracy in order to make sure you get what is owed to you quicker.
Once again, make sure they are members of NAPIA and hold professional designations. Take your
time and do several in-person interviews and request at least five references for each. It may
be difficult and intimidating but you need to actually call the references and find out what
their situation was. Have your questions prepared before you call. Are they responsive to your
questions and seem genuinely concerned. If you hire a Public Adjuster, do so in writing and
understand their fees before signing.
Quality Claims Management Corporation provides a free consultation of your specific
situation. Quality Claims will hear your story, determine how big of a loss you
experienced, review your insurance policies and discuss your insurance coverage
Collect as many relevant documents as possible and bring them with you. This
includes your daily diaries, all receipts, estimates for repair, clean up and
rebuilding, etc. Bring all documents regarding conversations with the insurance
company. If possible, try to get a complete copy of your policy - including all
endorsements - from your insurance company. Even if you think you are not covered,
or just have partial coverage, we may be able to help you.
One of our trained professionals will sit down with you and get an overall picture
of your situation - how much have you lost, how you have been treated so far by your
insurance company, and what you may be entitled to. Is the insurance company's offer
good enough? Many times, insurance companies do the right thing and there is no need
to use a public adjuster.
If we think we can help you we will then propose several different plans and explain
our fees. Quality Claims Management, like most licensed and professional Public
Insurance Adjusting firms, work on a percentage fee basis of the total monies
recovered. If you decide to use our services, we will then notify the insurance
company and begin working for you.
Quality Claims will take over the handling of your claim allowing you to get back
to your normal life. We understand that handling your own claim can be time
consuming and burdensome. Many insureds have taken leaves from work just to
work on their claims with their carrier. We will gather and provide required
documentation and will take over the primary communication with the carrier.
We will strive to negotiate and settle your claim. Upon settling your claim
and after the damage is repaired, we will pursue any available depreciation so
that you receive the maximum amount allowed in your policy.
When Should Use a Public Adjuster and When Should You Use an Attorney? What to do after you
experience a disaster? Your home burns down, your home gets flooded. Who do you call?
By Janis Rasmussen, RB United Outreach Coordinator
What does a Public Adjuster do? Do you need a Public Adjuster? How to find a good Public
Adjuster? By Janis Rasmussen, RB United Outreach Coordinator
Why do you need a Public Adjuster after Your Home Burns Down?
What to Do After Your house Burns Down?
In 2007, this fire victim in Poway, California tells the heart-wrenching story of
what happened to her and her family, and why it is important to pick a good public
insurance adjuster firm like Quality Claims.
Why Did a 2007 Fire Victim Pick Quality Claim Management as their Public Adjuster
Quality Claims Management, San Diego, CA
National Association of Public Insurance Adjusters
Rancho Bernardo United
Contact us at Info@qualityclaims.com