Ask An Expert

I certainly don’t agree with the terse response by the PA that said, “of course the adjuster can ignore this……….”

That kind of arrogance doesn’t win new clients either or necessarily change how the insurer elects to respond. Simply put, no the PA has no more legal standing than you do. However, knowing what to say, how to say it and when to say it may make all the difference in the insurer’s response. Insurance companies do have an obligation to pay what’s fair but they also have very bad habits and will do what they want to do, to both undervalue the claim or find a coverage term and condition that may limit their payout. For that reason, a knowledgeable PA may be a better resource for you than going it alone. As a PA, I am sometimes finding a need for plaintiff attorneys to also be involved, so the insurance company knows you mean business. Getting them to do what’s right is getting to be more challenging for sure. Robert C.

An insurance company adjuster cannot ignore an estimate from a builder if you provided it in support of your claim. The insurer is legally required to consider all information that supports your claim. An estimate from a real life builder is important evidence of the cost of replacing what you lost. The ideal is that the amount of the builder’s estimate is similar to what the insurance company adjuster estimates. But that often doesn’t happen – and that is often why many people end up hiring public adjusters–to convince the insurance company to pay the right amount for restoring your property to pre-loss condition if the insurance company adjuster is refusing to pay in full and fairly on what a builder says the work will cost. If you decide to hire a public adjuster, (and that is a fine decision) they are likely to obtain another estimate from someone they work with and trust as part of their approach to negotiating a settlement on your behalf. A licensed public adjuster who’s experienced in dealing with claims and company adjusters can be very helpful in maximizing and speeding up your recovery. BUT – they do not have more legal standing than you do with your insurance adjuster so if a public adjuster really told you that it is a a red flag as to their ethics. The insurer’s legal duty to behave in good faith (reasonably) goes directly to you – their customer from whom they accepted premiums and to whom they promised financial protection. They do have a duty to cooperate with the you and the public adjuster.

There is no one-size-fits-all formula for getting a fair insurance settlement. Your insurance company owes you good claim service and a fair settlement. Where that doesn’t happen, you can get free help from your state’s insurance regulator, or hire a public adjuster, or an attorney if you hit a wall with the insurer.

Be sure to vet and check references before hiring professional help on an insurance claim and read Making the Best Choice When Hiring a Public Adjuster and Questions to Ask Before Hiring a Public Adjuster. If you choose to document and negotiate your insurance claim on your own, United Policyholders offers lots of tips and free help in our Claim Help publications and workshops to help you navigate the process.