Orlando Harmon
When your property is damaged, an insurance adjuster assesses the damage to determine the payout amount. They inspect the damage, review your policy, and estimate repair costs. Typically, a staff adjuster or third-party adjuster company is assigned by the insurance company to handle your claim. However, policyholders can choose to hire a public adjuster, who works on their behalf to assess damage, determine the scope of repairs, and negotiate a higher settlement. Public adjusters are compensated by receiving a percentage of the claim payout. While hiring a public adjuster may lead to a higher payout, it is an additional expense, and there is no guarantee that the insurance company will agree with their recommended payout.
| Characteristics | Values |
|---|---|
| Role | To investigate an insurance claim to determine if the insurer should pay for damage or injuries, and if so, how much they should pay |
| Type | Staff adjuster (employed by the insurance company), third-party adjuster (independent), public adjuster (hired by the policyholder) |
| Work | Inspect property, review insurance policy, estimate repair costs, make an initial settlement offer, write up a report, communicate with the insurance company on the policyholder's behalf, negotiate, help ensure no damage is overlooked |
| Payment | Staff and independent adjusters are paid by the insurance company. Public adjusters are paid by the policyholder, usually a percentage of the claim amount |
| Communication | The adjuster will call to let the policyholder know when they will visit the property. The policyholder can choose to be present. |
| Report | The adjuster will explain their findings and recommendations. They may have the authority to approve a claim on the spot, or they may have to submit everything to the insurance company for review. |
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What You'll Learn
The role of insurance adjusters
An insurance adjuster is a professional who evaluates insurance claims and decides whether an insurance company must pay a claim and, if so, how much. They are responsible for investigating, evaluating, and settling insurance claims, which can include inspecting property damage or personal injury claims. They determine whether the insurance policy covers the loss claimed and then decide on the appropriate payout amount.
There are different types of insurance adjusters, including staff adjusters, third-party adjusters, and public adjusters. Staff adjusters work directly for the insurance company and represent the company's interests. Third-party adjusters are independent contractors who work for an independent company that adjusts losses for multiple insurance companies. Public adjusters, on the other hand, work solely for the insured individual and are hired by claimants who prefer not to rely solely on the insurance company's adjuster. Public adjusters assist in preparing, presenting, and settling the claim, and they are paid a percentage of the claim payout.
When a claim is filed, an insurance adjuster will be assigned to the case and will often be the main point of contact for the claimant. The adjuster will review the claim details and the insurance policy to determine which coverages are applicable. They will then interview those involved, including the claimant, witnesses, and any relevant experts, to gather information and evidence. This can include photographs, police reports, and video footage. Adjusters will also inspect the property or vehicle to assess the damage and create an estimate for repairs.
After completing their investigation, the adjuster will communicate their findings and recommendations to the claimant. Some adjusters have the authority to approve a claim on the spot, while others will submit their report to the insurance company for final approval. The adjuster will then negotiate with the policyholder to settle the claim. If the claimant disagrees with the outcome, the adjuster will work with attorneys and expert witnesses to defend the insurer's position.
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Hiring a public insurance adjuster
When you file a home insurance claim, your insurance company will assign a claims adjuster to evaluate your property damage and determine a fair payout amount. However, you can also hire a public insurance adjuster to work on your behalf. Public adjusters are insurance claims adjusters who do not work for insurance companies. Instead, they work directly for the insured, assisting in the preparation, presentation, and settlement of the claim. They can be particularly useful if you think your claim was poorly handled, if your damage is severe, or if you simply want an insurance professional to navigate the claims process on your behalf.
Public adjusters typically work on a percentage basis, taking a portion of the money the insurance company pays for damages. These fees can range from 2% to 25% or more, depending on the public adjuster, the size of the loss, and other criteria. The fee is negotiable, and some states have laws capping the maximum fee. For example, fees in the state of Florida cannot exceed 20% of a reopened or supplemental claim limit. In California, a public adjuster must be licensed with the California Department of Insurance and must abide by the laws in the California Insurance Code.
There are several ways to find a public insurance adjuster. You can search online or use a directory like the one maintained by the National Association of Public Insurance Adjusters (NAPIA). The NAPIA Directory lists every public adjusting firm required to be licensed in their state of operation, allowing you to search for adjusters in your area. Another way is to get a recommendation from friends or family members, which can help ensure you find someone reputable and effective. Once you find a few options, it is important to check their references and read online customer reviews.
When you hire a public adjuster, they will handle the entire claim process. They will visit your home to survey the damage, do a comprehensive review of your claim, calculate their recommended payout, and coordinate with your insurance company to process your payout. They can also help you negotiate with contractors and insurers, saving you time and protecting you from potential pitfalls due to inexperience.
While hiring a public adjuster may lead to a higher payout, it is not guaranteed. Your insurance company will consider the public adjuster's findings, but they may not agree with their recommended payout. It is an individual decision that should be based on your specific circumstances and the size and type of your loss.
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How insurance adjusters calculate payouts
When a claim is filed with an insurance company, it is assigned a claim number and sent to an adjuster. There are three types of insurance adjusters: company or staff adjusters, independent adjusters, and public adjusters. Company or staff adjusters are employed by the insurance company and represent the company's interests. They do not charge a fee to the insured and are salaried employees. Independent adjusters are hired by the insurance company as independent contractors and must be licensed. They also represent the company's interests and are paid by the insurance company. Public adjusters, on the other hand, work solely for the insured and are compensated by charging a percentage of the claim payout. This rate typically ranges from 5% to 20% but can vary depending on factors such as the complexity of the claim and local regulations.
Once assigned, the adjuster will contact the claimant and schedule a visit to the property to assess the damage. The adjuster will check the exterior of the house, including the roof, and make notes and take photos of all damaged surfaces. This information is used to create a comprehensive report for the insurance company, which will form the basis of the estimate for repairs. The inspection process typically takes between one to two hours.
After the inspection, the adjuster will write up their report and may explain their findings and recommendations to the claimant. Some adjusters have the authority to approve a claim on the spot, while others will submit their report to the insurance company for review and approval. If the adjuster has the authority to approve the claim, they may provide the claimant with a check for the Actual Cash Value (ACV) amount. Otherwise, the claimant will receive the ACV check by mail or direct deposit.
It is important to note that claimants have the option to hire a public adjuster instead of using the insurance company's adjuster. Public adjusters can be useful in situations where the claim was poorly handled, the damage is severe, or the claimant wants a professional to navigate the claims process on their behalf. Public adjusters work on behalf of the claimant, assessing the damage, determining the scope of repairs, and estimating the replacement value. They can also negotiate with the insurance company to maximize the settlement for the policyholder. Studies have shown that homeowners who hired a public adjuster received higher payouts on average compared to those who did not.
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The insurance adjuster's visit
An insurance adjuster's visit can be a stressful experience for homeowners, but it doesn't have to be. The adjuster is simply there to assess the damage and determine a fair payout amount. Here are some things to expect and prepare for when an insurance adjuster visits your property:
Before the Visit
Before the adjuster arrives, it is important to take pictures of the damage and not to clean up or move any items. This ensures that the adjuster can see the full extent of the damage. Gather any relevant documentation, such as a home inventory, to help validate your claims. If there was an illegal act, such as theft, filing a police report is also important.
During the Visit
The adjuster will conduct a thorough inspection of your property, including the exterior, interior, and any other buildings or items on the property, such as fences, decks, and windows. They will take notes, photographs, and measurements to document the damage. The inspection process can take between 1 to 2 hours, depending on the scope of the damage and the size of the property. The adjuster may also ask you questions about the damage and if you have had it inspected by a contractor. It is helpful to be present during the visit so that you can make sure all the damage is assessed and included in the claim.
After the Visit
Once the inspection is complete, the adjuster will create a report for the insurance company, which will include an estimate for the cost of repairs. This estimate will take into account factors such as labor, materials, and equipment rentals. The adjuster may have the authority to approve the claim on the spot and provide you with a check for the Actual Cash Value amount. If not, they will submit their findings to the insurance company, which will make the final decision on whether to approve or deny the claim.
Working with a Public Adjuster
Homeowners also have the option to hire a public adjuster, who works on behalf of the policyholder instead of the insurance company. Public adjusters can be useful if you want an insurance professional to navigate the claims process, ensure no damage is overlooked, and potentially increase your payout amount. However, it is important to note that hiring a public adjuster will result in additional fees, typically a percentage of the claim payout.
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Adjusters and claim settlements
When a claim is filed with a homeowner's insurance provider, the insurance company will assign a claims adjuster to investigate the claim, come to a decision, and determine a payout amount if the claim is approved. The adjuster's job is to evaluate property damage and determine a fair payout amount based on the levels of coverage the claimant carries on their policy. Adjusters gather information, including photographs and statements, and put together a report for claims examiners to review.
There are two types of adjusters: staff adjusters (or company adjusters) and public adjusters. Staff adjusters are employed by the insurance company and represent the insurance company's interests. They do not charge the insured a fee and do not need to be individually licensed by the State of California. Public adjusters, on the other hand, work directly for the policyholder and are compensated by charging a percentage of the amount they recover from the insurance claim settlement. Their goal is to ensure the policyholder receives the full compensation they deserve.
After a homeowner files a claim, the insurance company will send an adjuster to visit the property and assess the damage. The adjuster will check the entire exterior of the house and any other buildings on the property, including the roofs, and will make notes and take photos of all damaged surfaces. This information is put into a report for the insurance company and will become part of the adjuster's estimate if the damage is covered by the policy. The inspection process typically takes between one and two hours, depending on the scope of the damage and the size of the property.
Once the adjuster has completed their inspection and report, they will negotiate with the policyholder and settle the claim. If the claimant contests the outcome of the claim or settlement, adjusters work with attorneys and expert witnesses to defend the insurer's position. It is important to note that adjusters working for insurance companies aim to minimize the payout, while public adjusters work to maximize the settlement for the policyholder.
Public adjusters typically work on a percentage basis, taking a portion of the money the insurance company pays for damages. These fees can range from 2% to 25% or more, depending on the adjuster, the size of the loss, and other criteria. The fee is negotiable, and it is important to carefully review the contract before hiring a public adjuster.
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Frequently asked questions
An insurance adjuster, also known as a claims adjuster, is a person who investigates an insurance claim to determine if the insurer should pay for damage or injuries, and if so, how much they should pay.
An insurance adjuster assesses the damage to your property, helps determine the scope of repairs, and estimates the replacement value for those repairs. They also review your insurance policy to see what's covered and what's not.
A public insurance adjuster is a person or business that can be hired by a policyholder to negotiate an insurance claim with the insurance company. They work for the policyholder and are compensated by charging a percentage of the claim settlement amount.
You can find a public insurance adjuster by searching the National Association of Public Insurance Adjusters (NAPIA) website or by getting a recommendation from friends or family members. In the US, public adjusters must be licensed by the relevant state authority, so you can also check their license status on the state insurance department's website.
