Quality Claims Management Corporation Where Every Claim Counts
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Think you might need help with a claim? Email: claimsquestions@
qualityclaims.com

and a licensed Public Adjuster will respond to you shortly.

Frequently Asked Questions



Why would a homeowner 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 and What Do They Do?

In California, there are three types of licensed Insurance Adjusters

According to CAPIA, the California Association of Professional Insurance Adjusters (http://www.capiainc.com/) a 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.

How a Good Public Adjuster Can Help Save Your Family and Your Emotions

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.

Ok, lets talk about money.

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.

What if you are under insured?

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.

Why does a property owner need a Public Adjuster?

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 payments."

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.


Does every claim require the expertise of a professional public adjuster?

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.


What are the fees for the services of Quality Claims?

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.

When and why should a property owner contact a Public Adjuster?

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.

How to find a good Public Adjuster

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 not automatic.

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.

What to Watch Out For – The Six Danger Signals

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:

  1. 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.
  2. 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?
  3. 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.
  4. 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.
  5. 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.
  6. 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.

How to Make Sure You Hire the Right PA?

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 Services and Process

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 with you.

Step One

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.

Step Two

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.

Step Three

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.

Video Links

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 www.rbunited.com
http://www.youtube.com/watch?v=rVVTN8AjOc0

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 www.rbunited.com

Why do you need a Public Adjuster after Your Home Burns Down?
http://www.youtube.com/watch?v=d7AlCy3X-18

What to Do After Your house Burns Down?
http://www.youtube.com/watch?v=YWvKu04NQBE

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
http://www.youtube.com/watch?v=0nZRtSEBQDg

Resources & Links

Quality Claims Management, San Diego, CA
http://www.qualityclaims.com

National Association of Public Insurance Adjusters
http://www.napia.org

Rancho Bernardo United
http://www.rbunited.com

United PolicyHolders
http://www.unitedpolicyholders.org


Contact us at Info@qualityclaims.com.
Phone: 866-450-1183

 

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