Been Denied or given a partial repair?
Why use a Public Adjuster?:
The job of a public insurance adjuster requires a great deal of knowledge regarding insurance policies and principles; a thorough understanding of negotiation; the skill of insurance estimating; perfection in the analysis of damages; and most importantly, satisfying the needs of the property owner during one of the most difficult times that property owner will ever face. While you can attempt to navigate the claims process on your own, the average homeowner is simply overmatched trying to negotiate against some of the most powerful companies in the world. The claims process is intentionally setup by the insurance companies to be extremely confusing, frustrating, and downright unfair, all in hopes of getting the insured to throw up their hands and quit. This is why it’s in the insured’s best interest to hire a licensed Public Adjuster to navigate the difficult and complex task of earning a maximized award from the insurance carrier. Here’s why…
Insurance provides a great benefit to society, and in this day and age, it is extremely difficult to think about life without insurance. However, if an insurance company is to remain in existence, it must make a profit. In making profits, insurance companies are insuring businesses and properties with the hopes of earning an underwriting profit. The property insured is referred to as a risk, and if the expenses and claim payments do not exceed one hundred percent of the insurance premium, then the insurance carrier has earned an underwriting profit. In fact, many underwriters earn large yearly bonuses after the insurance company has determined that the policies they underwrote have earned an underwriting profit. Insured’s and public adjusters face a very difficult task, sometimes monumental, when filing an insurance claim in light of the insurance companies business motives and need for survival/profits.
In every property insurance policy, lack of maintenance is an exclusion to insurance coverage. Carriers are notorious for using lack of maintenance as a reason for denial. In fact, they train their field adjusters to look for and identify potential maintenance problems. If the field adjuster does not identify if the property has been maintained, then his supervisor will question his ability to properly determine a loss. If the issue of maintenance is addressed up front with the insurance company, then the issues of maintenance can quickly and easily be addressed during the first meeting with the field adjuster. This allows the field adjuster, and by extension his supervisor, to be satisfied that the duty to address maintenance has been satisfied.
Another key to claims adjusting is providing the field adjuster with true, accurate information regarding the loss scope, with an end goal of both simplifying their job and helping them to make recommendations for approval and payment. Accurate information saves energy and resolves the claim fast. As a licensed PA, we document the loss, submit a photo log of all damage found to the carrier, provide a detailed scope of repairs, meet with the field adjuster, negotiate the scope, and when necessary, work to get items paid that are not on the scope but incurred by the contractor during the restoration. This last step limits the homeowner from exposure to change orders from the contractor(s).
Real World Examples:
Simply fill out the “request a review” form below and we will email you a copy of “The Art of Adjusting First Party Property Claims & Why You Need Hagel Claims & SAL Construction” which contains actual insurance scopes on multiple claims worked by Hagel Claims & SAL Construction. In these pages, you will draw two parallel conclusions: (1) that it is so very important to use our services, and (2) it is extremely risky to have your insurance claim handled by anyone other than an expert. The benefit of hiring us to execute our proven system to negotiate scopes to an award is clear. Countless times we have been successful in overturning partial awards and straight denials to full approvals.
Looking for a Public Adjuster???
Has your insurance claim been denied or underpaid? Dealing with an unreasonable or unresponsive adjuster? You don't have to sit back and continue to let the insurance company dictate the outcome of your claim. We can help to guide your claim to a timely & equitable resolution. There is no up-front cost for our services as we only get paid when you get paid.
Therefore, No Recovery = No Fee.
Our team of public adjusters includes past insurance company adjusters, attorneys, and contractors with decades of experience and now exclusively representing policyholders like you.
Real Experience = Real Results
What is a Public Adjuster?
A Public Adjuster is a licensed and bonded insurance professional who assists policyholders with the complicated insurance claims process when they suffer an insured/covered loss. The Public Adjuster represents the public, rather than the insurance company. Although, many mistake the term “Private Adjuster” for a “Public Adjuster.” The Public Adjuster is generally compensated by a percentage of the amount paid to the policyholder or insured by the insurance company. The Public Adjuster is a fiduciary agent. The relationship requires maintenance of a high degree of fidelity and loyalty to the interests of the policyholder.
There are three types of claims adjusters:
Insurance Company Adjuster / Staff Adjuster – is employed by an insurance company to represent the insurance company in the handling and ultimate payment of your insurance claim. The insurance company claims adjuster’s main responsibility is to protect the interests of the insurance company (not the policyholder).
Independent Adjuster – is hired by insurance companies to represent the insurance company in dealing with you, your loss and damage. The independent claims adjuster’s main responsibility is to protect the interests of the insurance company. The independent claims adjuster investigates your claim by accessing your damage and reports his or her findings back to the insurance company. Generally, they do not make the decision on payment for your loss.
Public Adjuster – is the only claims adjuster specifically licensed by the State to represent you, the Insured. The Public Adjusters’ main responsibility is to protect you and your interests in claims against a loss with the Insurance Company.
Public Insurance Adjusters who belong to the National Association of Public Insurance Adjusters (NAPIA) adhere to a strict Code of Ethics. These claims adjusters can take advantage of the best quality, public adjuster specific, and continuing education in the country. Additionally, NAPIA members have a network of resources available to best assist policyholders in the handling of insurance claims.
Why Do I Need a Public Adjuster?
If you have just suffered an insured loss resulting from a pipe burst, a fire, hurricane or some other demanding event, it’s probably not the best time to take a crash course on how to properly present an insurance claim. You may be dealing with a multitude of other matters, such as finding housing or an alternate business location. Handling the emotional trauma of a loss or simply going about your daily responsibilities, like work and family is unnerving enough. God forbid you may also have to tend to injuries or the inconceivable in connection with any event.
Consider the following points: You, the policyholder, are responsible to prove the extent of your loss to the Insurance Company’s claims adjusters. The burden of proof is the responsibility of the insured to prove the value and cause of loss under the named peril policy. The insured is obligated to produce estimates of loss and to separate the damaged property from the undamaged property. Thus, it is highly recommended that the policyholder engages the services of a Public Adjuster who, by law, will determine the value of the loss and present the claim (or proof of loss) to the insurance company.
A typical insurance policy is dozens of pages long and contains numerous provisions and stipulations. The policy is written in technical and legal terms. Additionally, your insurance policy contains various forms and endorsements, which are constantly changing from year to year; and which add or exclude coverage from your policy. Most people have difficulty understanding what can appear to be a lot of legal verbiage. For example, did you know that for the insurance company to compensate you for your loss, there are certain conditions which YOU must satisfy? Did you know that your failure to satisfy these policy requirements could reduce your settlement amount or even cause your claim to be denied? Don’t feel bad. Most people don’t realize these aspects of their policy. A trained public insurance claims adjuster whom you trust can help to ensure you meet all the policy conditions, document your loss and get your claim paid.
No matter how organized you and your documentation is, filing and receiving payment on a claim is a time consuming and tedious process. If you do not sufficiently organize and document your damage, you may not realize the compensation you have paid premiums for and are entitled to receive.
A licensed, bonded and qualified Public Adjuster has the experience, knowledge and expertise to obtain your maximum entitlements under your policy. A Public Adjuster has, by law, the following responsibilities in the adjustment of a loss: Verify the effective date of coverage; verify coverage and proximate cause of loss, determine the named insured and who had insurable interest at time of loss; determine other entities that may have an insurable interest; determine if other insurance may apply to the particular loss; determine if the loss was caused by a third party or if subrogation may be pursued; verify if the insured has complied with their obligations within their policy and the law by also protecting property from further loss; assist the insured in mitigating the loss; determine if any special provisions apply and the deductibles; is the damage property subject to policy limitations as regards limits or peril coverage; is the property insured in compliance with a coinsurance clause; is the property covered on an actual cash basis, replacement cost basis or a valued or agreed amount basis; determine the extent of the salvage, if any and its value.
Remember, the insurance company claims adjuster is representing the insurance company. It is not uncommon for the insurance company to misinterpret their own insurance policy or forget to apply case law or statutes, which supersede their own policy. A public insurance adjuster is required to know current laws and how those laws affect insurance losses; enabling your public adjuster to best represent you. A public insurance adjuster has resources to help you through the maze of estimating, documenting, and filing your insurance claims. Your public adjuster will present your claim in the most advantageous manner to help you fully recover from your loss.
Why insurance companies don’t pay claims and what you can do about it:
Insurance works when the insurance company honors a simple promise: When a policyholder files a claim, the company will pay what it owes, no more but no less, and will do so promptly and fairly. Insurance doesn’t work when the company breaks its promise in order to increase its profits. Insurance doesn’t work when companies delay, deny, & defend. When they delay payment of claims to wear down claimants and to increase their investment income, flat-out deny some valid claims in whole or in part, and defend against valid claims in litigation to back up the delays and denials, they break their basic promise.
Compound the above assertion with the fact that many people have difficulty understanding the technical language of an insurance policy and the complicated procedures they must follow to comply with the policy’s terms. This problem is magnified when you have suffered a loss and are emotional about the situation. That is a perfect time to have an experienced professional on your side whose sole responsibility in the matter is to serve you, the insured. The insurance company certainly has experienced professionals working for them.
Basically, if the insurance company paid you the funds you need to fully recover from your loss, you would not have to hire a public adjuster. Public Adjusters would not exist if the insurance companies honored their contracts with the policyholders. Even the state recognizes the insurance industry has issues; thus, the state created an avenue for the licensed profession of Public Adjusters.
What should I consider when hiring a Public Adjuster?:
License & Appointment – Make sure their license and appointment are up-to-date with the State and make sure they are really a licensed Public Adjuster. Some people are misrepresented themselves as Public Adjusters. State Licensed Public Adjuster
Experience – Public Adjusters come from a wide range of backgrounds – Ask about experience and training and it’s always a good idea to ask for references. Make sure the person who you are considering has the right mix for you.
Professionalism – Do not sign blank contracts. A professional public insurance adjuster will explain the fee structure up-front so you understand why and what you’re are paying for.
Comfort Level – This intangible may be quite important if your claim is complex or extensive. This claims adjuster individual or company will be helping you through a very traumatic time and resolving the claim could take some time…find someone who fits your needs. Make sure they show you their license. – A public insurance adjuster who is a member of their state association of public insurance adjusters takes their profession seriously and subscribes to a strict code of ethics.