How The Public Adjuster Claims Process Works
Types Of Claims

Understanding the Claims Representation Process Works

Public Adjuster Claim Representation

What Are the Duties of a Public Insurance Adjuster?

A property insurance policyholder will typically hire a public adjuster to help get their claim expedited and to hopefully secure a higher settlement. A good public adjuster will be an indispensable advocate for the property owner during all steps of the property insurance claim process. Below is a summary of a public adjuster’s duties and responsibilities. We will respond to you as quickly as possible. The more information you can provide to us the better we can assist you. Upon review of your information we will call you to answer any additional questions and then schedule a meeting to inspect your damage. For the initial inspection we should schedule a time when you can be present. During the meeting we will review your insurance policy and declarations page in order to understand the coverage’s we have to work with.

Review and Evaluate Your Policy – Your public adjuster will examine your property insurance policy to determine what coverage will be applied to a particular claim. It is best to establish a relationship with public adjuster before any damage has occurred if possible. Once we become your public adjuster, the first step is the analysis of your policy provisions and stipulations as they relate to your loss. This in-depth review is used to determine the coverage, limits, exclusions, and other forms that may apply to your particular loss. In investigating and planning for the loss and damages documentation and presentation, an understanding of recent court cases, decisions from the Insurance Commissioner's office, industry technical articles and opinions, and other factors that are likely to influence your standard insurance policy are all used to map a claims strategy.

Inspect Property and Assess Damage – Our public adjuster will perform a detailed property inspection independent of the insurance company’s inspection. Part of their search will focus on hidden damage that may not be readily visible. Then the public adjuster will include all of the damage in their assessment and prepare your insurance claim.

Evaluate Additional Losses – If your damaged property is part of a business, and you are covered for it, your public adjuster can help you determine losses due to business interruption.

Prepare Documents – One of the public adjuster’s responsibilities is to prepare the claim to be filed with the insurance company and to insure that all pertinent documents are submitted as well.

Negotiations and Settlement -  Upon approval and submission, we initiate claims status follow-up on the insured’s behalf to expedite the processing of the claim. We also make ourselves available to answer any claim clarification requests posed by the insurance company which sometimes uses these as delay tactics. It is typical that there may be some negotiations regarding the claim, which many times boils down to justifying the value and legitimacy of the claim components. A well-defined position that is professionally documented should gain the respect of the insurance company representative. In addition Florida Public Adjusters expertise and qualifications in fielding any questions should lead to a fair settlement of your claim. It should be noted that no claim is settled without prior approval from the client who will be kept abreast of all negotiations as they proceed. We are also mindful of the negative financial impact of a loss to your property and we pledge to work diligently in resolving your claim in a timely manner. Our experience has been that perhaps one part of your claim can be settled faster than others and if this can be done we will certainly work to get you paid without jeopardizing the other parts of the claim.

Re-open Claims – If you have already accepted the insurance company’s settlement on your claim, it may still be possible to get more money. A public adjuster can help to re-open a previously settled claim if any discrepancy is found.

Documentation of the Claim - As the insured, you are required under the insurance policy to conform to the "Your Duties After A Loss" provision contained in your policy. This can be an involved and detailed process requiring time and expense to meet the requirements. As your claim representative, Florida Public Adjusters public adjuster will create an exact profile of your property so it reflects its true value and conforms to your insurance policy language. This in-depth process includes: 1) We will scope the loss and write a detailed construction estimates with supporting engineering documents if necessary; 2) Assist with preparing a detailed inventory and contents list with correct valuation and supporting documentation; 3) For business inturruption losses we will create an in-depth business interruption coverage analysis which includes projections and forecasts. Our public adjuster acts as a sort of buffer between the policy holder and the insurance company, reducing much of the stress of dealing with the insurance company after a loss. The public adjusters at Florida Public Adjusters are waiting to help you.

A loss to your property will create an unfamiliar situation and poses excessive demands on your time, most time beyond your ability. A decision must be made early on whether this process is to be undertaken by the policyholder or whether the professional expertise of a reputable public adjuster should be retained. Time and again it has been demonstrated that when dealing in an area that is unfamiliar, the end result can be a great loss in valuable time and money.

Large or small, commercial or residential, properly handling a claim involves a structured process that when followed, will ensure it is processed properly and given the best chance of being honored and paid correctly by your insurance carrier. The main services a Public Adjuster will include and are not limited to:

Analyze your insurance policy to get the maximum claim coverage.

Inspect the property damage and scope the loss and write a detailed estimate.

Notify the insurance company of your loss in a timely manner and ensure they have all the proper documentation.

Set all appointments with insurance company staff and provide them with preliminary estimates of damage and losses.

Negotiate with insurance company the best possible settlement.

The following explanation below is a more detailed explanation of the process used by Florida Public Adjusters and our affiliates as to what to expect when dealing with a property damage insurance claim.

Stage 1: Initial Contact -  Fill out the contact form and we will respond to you as quickly as possible. The more information you can provide to us the better we can assist you. Upon review of your information we will call you to answer any additional questions and then schedule a meeting to inspect your damage. For the initial inspection we should schedule a time when you can be present. During the meeting we will review your insurance policy and declarations page in order to understand the coverage’s we have to work with.

After the initial consultation, we hope you will realize the value of having a professional on your side. In order for us to be your representative and file your claim, you must retain our services as your public adjuster. Thus we will ask you to sign a retainer allowing us to notify the insurance company that you are being represented. Our public adjuster or insurance appraiser fee structure will be worked out with you based on your needs and coverages and is generally based upon what we are able to negotiate for you. That means that we are highly motivated to do all we can to make sure you are fairly compensated in your insurance settlements with consideration to your coverage and insurance policy limits. Typically, fees run upwards of 20% and is highly dependent upon the type of claim, size of the claim and circumstances of the loss allowing us to gauge the amount of time a claim is likely to take. One of the things we pride ourselves on is making sure fees and related expenses are understood upfront so there are no surprises at the end.

Stage 2: Investigation –   Once we become your authorized public adjuster, the first step is the analysis of your policy provisions and stipulations as they relate to your loss. This in-depth review is used to determine the coverage, limits, exclusions, and other forms that may apply to your particular loss. In investigating and planning for the loss and damages documentation and presentation, an understanding of recent court cases, decisions from the Insurance Commissioner's office, industry technical articles and opinions, and other factors that are likely to influence your standard insurance policy are all used to map a claims strategy. In many cases we have found the printed policy forms are contradictory to current practices and procedures of insurance adjusting in your area. Keep in mind that your insurance policy is a contract. While we do not dispense legal advice, given the nature of insurance disputes, we have seen instances where over the year’s court rulings may have an effect on the practice and procedures of adjusting property claims in your state. Thus what’s in a standard generic insurance policy may not be what the law of the land is where the loss occurred. We pride ourselves on staying current and in compliance with all issues that effect our profession through updated and current continuing education requirements required by the State regulators where we hold our professional licenses.

Stage 3: Documentation of the Claim –   As the insured, you are required under the insurance policy to conform to the "Your Duties After A Loss" provision contained in your policy. This can be an involved and detailed process requiring time and expense to meet the requirements. As your claim representative, your Florida Public Adjusters public adjuster will create an exact profile of your property so it reflects its true value and conforms to your insurance policy language. This in-depth process includes: 1) detailed construction estimates with supporting engineering documents if necessary; 2) detailed and verified inventory and contents schedules with correct valuation and supporting documentation; 3) in-depth business interruption coverage analysis which includes projections and forecasts; and 4) the required technical and supporting documentation showing the current industry publications and authoritative papers supporting positions taken in the claim adjustment process.

Stage 4: Presentation of the Claim -   After the full extent of the loss has been determined and documented a schedule of losses is prepared and undergoes a complete review by our staff. The claim is then segregated into the separate categories which conform to the various policy provisions that apply. A thorough review of the documents is made with the client and, with final approval the property insurance claim is submitted to the insurance carrier.

Stage 5: Negotiations and Settlement -  Upon approval and submission, we initiate claims status follow-up on the insured’s behalf to expedite the processing of the claim. We also make ourselves available to answer any claim clarification requests posed by the insurance company which sometimes uses these as delay tactics. It is typical that there may be some negotiations regarding the claim, which many times boils down to justifying the value and legitimacy of the claim components. A well-defined position that is professionally documented should gain the respect of the insurance company representative. In addition to Florida Public Adjusters expertise and qualifications in fielding any questions should lead to a fair settlement of your claim. It should be noted that no claim is settled without prior approval from the client who will be kept abreast of all negotiations as they proceed. We are also mindful of the negative financial impact of a loss to your property and we pledge to work diligently in resolving your claim in a timely manner. Our experience has been that perhaps one part of your claim can be settled faster than others and if this can be done we will certainly work to get you paid without jeopardizing the other parts of the claim.

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