How To Deal With A Claims Adjuster When You Disagree On Price or Scope

A reader sent this question to us about a water damage claim she is dealing with that occurred in her home. I was a claims adjuster for three years, and I definitely know that adjusters and insurance companies love to pay the least amount possible for a claim, and they try to get away with as much as possible, hoping that the homeowner won’t push back or question their decisions. It’s the job of the insurance company and the claims adjuster to “indemnify” you, which means they have the responsibility to put you and your home back to its original condition. Here is the question from the reader:

My water heater busted and flooded my kitchen, living room, and den. I had a restoration company come out and remove the water and dry the area. The water only got 1 to 2 inches in the kitchen, but my cabinet warped a little due to the water. The insurance company only wants to repair the side of one cabinet and paint the bottom cabinet. They only want to replace carpet in the den and living room. I cannot match up my carpet with the correct carpet. The adjuster told me to get estimates, so I got several estimates. Later I contacted him and he stated that they were not the correct estimates and he could not understand them. Then he told me to call this Service Master and they gave me an estimate for $3,500. They stated that the cabinets did not need to be replaced however, I have had several contractors tell me that they do need to be replaced. My adjuster sent me a check for $2,500 and I got an estimate for $9,700. I was thinking about hiring an attorney or a public adjuster. Please help me. This is my first home, and I am a single 25 year old female. I think my adjuster is trying to take advantage of me.

This is a common situation, but it can easily be settled without the use of an attorney or a public adjuster. If you hire an attorney or a public adjuster, they will take anywhere from 20 to 40% of the claim settlement. Of course, they’ll guarantee that they get you so much money that it’ll pay for their commission, but they cannot really guarantee that, and it’s not ethical in the first place.

The insurance company sent you money, which is a great thing. This means that they agree with you that the claim is covered under the policy. So, the only difference you have is on price and scope. You disagree on how much the claim is worth, and you disagree with how and what should be replaced and repaired (scope of the loss). Scope and price can be negotiated with the claims adjuster, but you must put time and effort into it, and you must be persistent while maintaining a professional demeanor. As long as the claims adjuster didn’t get you to sign a release of liability form, then the check you received means nothing. All it means is that $3,500 is the “undisputed amount”, meaning that you and the adjuster both agree that the claim is worth AT LEAST $3,500. You can deposit that check without it being an admission of liability. But never sign anything saying that you agree that the $3,500 is the final settlement.

As far as the cabinets, you’ll probably need to concede thiis point. Cabinets can easily be repaired without requiring them to be fully replaced. Any good cabinet repairman can put your cabinets back to their original condition. Regarding the carpet, this is the area where you can negotiate with them. If the carpet runs continuous from the living room and den to other parts of the house without a break in the carpet, then the insurance company owes to replace all of the continuous areas. They cannot expect you to accept a “patch job” on carpet. Tell them that this isn’t indemnifying you. That word will get their attention that you know what you’re talking about.

The point is that you can negotiate the claim yoursef and continue to get competing bids. If they continue to be stubborn, then threaten to file a complaint with the state financial department. They will then give you the option of going to an “appraisal” which is a dispute of price and scope with a neutral mediator. This mediator often sides with the policy holder as long as you have legitimate reasons for your dispute.

I hope that answers your question! Anyone else want to weigh in on this?

  • FB @

    Wow, good to know for future reference, if I ever have a problem.

    My brother just had his basement flood.. and the claims adjusters actually didn’t put up a fight this time.

    They did the last time, and he did something similar to what you are outlining above.

    • Korn00

      Remember these simple Tips when negotiating with an adjuster: Always be friendly up front no matter if the adjuster is rude. Stay Calm, Do not Curse, Know your policy. The adjuster can make your claim a living hell if you are rude to him. Put your demand in writing in a formal letter along with copies of receipts, bids, or invoices documenting your demands. In most states the adjuster is required to respond within 30 days to a written demand. If negotiations totally breakdown, politely ask for another adjuster from your insurance company to reinspect and re scope your property. Last resort should be a public adjuster or attorney.

  • Financial Samurai

    Thanks for your thoughts. I’m just waiting for my own water heater to bust and flood my basement. That’s the downside to buying a historical house.

    Sounds like the best thing to do is have an open dialogue and just negotiate calmly.

    • Erik

      Yes, stay calm and negotiate calmly with the adjuster. You can avoid getting a third party involved, you just need to be stern, know your policy, and make rational demands.

  • Perfectiming!

    Erik your post is on perfect timing!

    My Brooklyn, New York home just experienced a (4-5 inche high) water flooding from a pipe burst (boilder) in my basement (800sq). The adjuster is extremely rude, inpatient & totally far from customer freindly. But i have maintained my professinalism and cool through out the process. Of course items that have been in my (fairly used) basement have no receipts or old checks i can prove purchase price. But the way he is sticking me for repair cost make me really think twice on how much he has appraised things. Even my wedding dress (23 yrs old) was in the basement and all he gave me for the repair of the water damaged dress was $120!

    Your experience and expertise is exactly what i need right now. PLEASE!

    Also, reading my policy and knowing what i should be entitled to has been more than what a 62yr old workingc (nurse), widowed woman can handle.
    please help i truly feel i am being taken for granted in my situation.

    • Erik Folgate

      I am really sorry that you have to go through this, and that your adjuster is not being professional. You have done everything right up to this point. Regarding your personal items, you should not need to provide receipts or proof of purchase for items that he can PHOTOGRAPH and document himself to research replacement cost value. Now, every state is different, and every standard homeowner’s insurance policy is different. In Florida, most standard forms include Replacement Cost Coverage which means that your personal items should be replaced at today’s current replacement value of something of like-kind and quality.

      Also, do you have children that could help you with the claims process? If you have a child that you trust will be more forceful and be able to negotiate with the adjuster better, you can type up a letter and sign it stating that you would like someone else to represent you for the claim. You MUST be proactive with the claim or they will try to get away with the bare minimum that they feel they owe. Don’t ever sign a release of liabiity form. As long as you never sign a form like that, you always have the right and ability to dispute the price and scope of a loss.

  • Alex Jones

    Reputable public adjusters
    like Adjusters International only charge about 10$ of the claim settlement.

    • Alex Jones

      Sorry about that. I meant 10% not 10$.

  • Bart

    I have a friend who has been living overseas for some time. Since then I have been watching his house and locating teneants and such. Recently several pipes broke due to a failure of the boiler while the tenants were out of town.

    When the tenants arrived they contacted me about flooding in the house. I immediately went over shut down the main. Took photos of everything to include the temperature of the house.The following day I spent from 8am to 8pm working with the plumber fixing pipes cutting holes in the wall etc. While doing so I documented each day. I also contacted a water mitigation company soon after the plumbers stopped the leaks and I was able to restore heat in the home. After stopping any further damage I then interviewed and got quotes to repair the damage (walls carpet etc). I was also in contact with the adjuster from day 2 (took time to get a hold of him). I submitted invoices for the different companies brought in to do repairs, I also submitted an invoice for the work I did cordinating and assisting in repairs of the house. I figured I lost 3 days of work to put all this together, do repairs along side the plumbers to include repairing the HRV etc.
    Any reason the adjuster shouldn’t accept my invoice? Just wanted an opinion since in my mind all the work I put in likely saved the insurance company by wuickly preventing further damage and there was no need for the company to hire a third party adjuster. What your thoughts. Should I get renumerated for my efforts?

  • Bruce


    I have had a similar experience with regards to some minor flooding in my kitchen due to the ice maker supply line leaking. One of the things that the adjuster wrote up that needed replacement was a 24″ base cabinet adjacent to the fridge that was damaged, beyond repair. The issue is that I have Thermofoil cabinetry and the new Thermofoil base cabinet doesn’t match, even though it’s ‘white’, to the rest of the older cabinets. There is a very obvious coloration difference and it’s impossible to find a Thermofoil color in a new cabinet that will match the older ones because unfortunately Thermofoil is known to yellow over time. The cabinet frames are fine, but I don’t know if I should press the adjuster to settle for replacing the cabinet doors so it all matches right. If they were wood or painted cabinets, it would be easy to match, but this Thermofoil product is not conducive to being replaced and having it match existing older Thermofoil.

    • nancy dominguez

      anyone who is having a dispute should hire an experienced and ethical public adjuster to review the claim. there are alot of good reasons not to represent yourself in a contract dispute – number one – it’s personal and you can’t help getting emotional about your own home.

      number two..and experienced PA is going to write an appropriate estimate that will take all of your damages and available coverage into consideration. They will also know how to steer you through the dispute resolution process. If you had to go to court.. you’d take an attorney.. if you had a health issue, you’d see a doctor. If you have an insurance claim you should counsel with a good PA..

      But don’t take my word for it… Florida’s Office of Program Policy and Government Analysis (kind of like the CBO) found that people who hired public adjusters generally received 547 higher settlements on regular claims – on catastrophic claims – a good PA can net you over 700% more.

      here’s the report

  • A M Dadabbo

    Hi Erik,
    I have an insurance claim I have a question about. My roof recently started leaking and there is damage to the soffit over one section of my kitchen cabinets. Contractor (who works with insurance companies often) had a cabinet company come out to get an estimate on replacement of all kitchen cabinets to submit along with estimate for entire claim. The insurance company is agreeing to replace the section of cabinets that are under the damaged soffit only. (My cabinets are original 1959 home) Is this standard practice? Not sure they will be able to accurrately match what is currently there since they are over 50 years old!!

  • David Ramsey

    I have recently had water damage in my kitchen and half of the lower cabinets, about 12 ft, had to be removed. The kitchen is 5 years old, and the claims adjuster is saying the industry standard is not to match or replace the upper cabinets, only the lower. Seems odd to me, so I ask, is this normal??

    • Ron erhard

      Hi, David my name is Ron I’m with Insurance Claims and Negotiations. It is standard for an Insurance adjuster to not give you enough money to fix your problem. I work with Insurance companies to help you get enough money to get your project fixed correctly. The insurance company does owe you enough money to restore your kitchen to the way that it was before the storm. Please call me too discuss further 913-481-0673

    • Paul

      David, One important thing to remember is each state has a time frame to appeal your claim, here in Texas it is 2 years and in some other states it is more. If you don’t know how to go about your appeal I would suggest talking with a Public Adjuster. They usually get a small percentage of the claim , usually about 10 percent. They will handle it all for you.


  • Luis_2622

    Hi I have recently filed a claim and received the claim check but the adjuster wants me to sign the check over to him. I though the adjuster endoresed the check to the client and info on proper procedure.

  • Jim

    Insurance Claim Not Paid Properly! We Can Help Free Consultation We Don’t Get Paid Until We Recover Money For You Please Contact Jim At Toll Free 855-PAYMYCLAIM 3 Sons Insurance Services

  • Hseda

    With regard to the lower cabinets. I have been a contractor for 30+ years, I am a disaster recovery consultant, and own a mitigation company, and I will tell you that cabinets sufficiently damaged by water may require replacement. What will determine this is: 1) the amount of water, 2) whether or not the water was contaminated, 3) how long the cabinets sat in water, and 4) the quality of the cabinets.

  • Worried

    Hi, I have had a very large tree crash through my roof recently during a bad wind storm. 3 sides of my roof are punctured from branches etc. My insurance company has said that they will only re-shingle the damaged areas leaving my with 1/4 of the roof 10 yrs older than the rest. This effects my re-sale value.
    Also I initially requested a structural engineer to be called in due to the fact that the chimney in the centre of the house has moved and actually separated. There are numerous small cracks throughout the house and the stucco. The restoration contractor Suggested by my insurance company says the house has “vibrated” but not moved and therefore I don’t require a structural engineer.
    I am not comfortable with this. My adjuster says I need to discuss this with the contractor again.
    I feel like they are spinning me in circles.
    Any advice would be appreciated.

    • Paul

      Find yourself a good General Contractor and or a Public Adjuster to help you sort this out. With 30 years in construction it sounds like you may have many issues.If you need some advice give me a call at 210-296-9136.

      Remember, the Restoration companies are often in bed with the insurance companies.

  • Marthamary55

    My hot water heater of 5 years burst; when water was discovered in basement/family room, I called the plumber who called a local co. to extract the water—and many other “non approved,
    or estimated” actions…..5 days of fans and dehumidifiers….30% increase on everything for (sat. hours). Immediately I called my ins. co for my homeowners policy; they arrived 2 days later, Mon., and the clothes to be cleaned were taken away. At that meeting I did ask him what resp.
    the condo assoc. had…he wasn’t sure. I got the declarations pg. from management co., and my ins. rep. said it was an “all in” policy, and should cover repairs and losses to one chest of drawers, and a bunch of hanging clothes. The management co. now is playing opponent, asking why I didn’t call their emerg. people (wasn’t informed they had any)….I acted as fast as one could, got the water turned off. It looks like now a showdown between my ins. co. and the condo association’s to juggle the numbers. Don’t try to reason with property managers….they are paid by us and pistol whip anyone they can to assert their sense of power. Anyone know if hiring my own adjuster at this point will help me? No one wants to pay but they sure are happy to collect all those premiums year after year..what a disaster. The homeowner is NEVER represented in these scenarios….if anyone has used an adjuster please let me know. The water remediation co. hasn’t been paid because my ins. co and condo’s think the final estimate is too high. Bottom line….never SIGN ANYTHING if you call a water or fire remediation co (like franchises), who do business with the big ins cos., one or the other gets paid from my claim and the franchise makes you sign a paper stating the ins co for claimant will pay water remediation co. the deductible
    directly!! What suckers we become to try to insure our property and fight with these goliaths.
    I think it bears hiring a lawyer, no matter what the cost. The home owner is treated as insignificant and powerless. Any suggestions?

  • Paul

    Always, always get a second opinion on damage to property. The last one I appealed for the homeowner got him an additional $35,000 on a hail storm . Most Public Adjuster will give you a free inspection to let you know if you may have further damages to your property.

  • Riley

    Help! In July, our hot water heater burst and flooded basement. A water removal co. was
    called. They charged up 30% FOR AFTER HOURS. So, my homeowner’s policy paid 1700. on property loss and 583.00 on personal property (clothes cleaned and some furniture). My policy should have been written for a much higher am’t on the building loss, but I was advised it was OK, because we had an ins. co. through the condo association.
    Now the property manager is insinuating I don’t want to use my check to restore the flooring! I need to understand if I the homeowner is under legal obligation to share this info. with them, because of course they will adjust their estimate. Also, is this common
    practice to involve the homeowner? I’m not allowed to communicate with the commercial ins. co., why should I divulge financial info to them. Anyone had the same issue?

  • qtur4me

    my home recently flooded and I have renters insurance, they told me to call a remediation company or they would find one for me. well it seems weird the remediation company recieved a check for over $15,000 dollars before I got a dime and then I only recieved $8000 for all of my loss. I have pictures reciepts etc everything in order then i seen they paid out another $5000 or so to the remediation company and I’m going on 2 months still waiting to be riembursed for reciepts or recieve some kinda compensation for items that were a complete loss that i have documented and submitted. if the remediation company gets much more money there will be nothing left of my coverage to cover my loss. My coverage was only for 35,000 in personal property. Doesn’t seem right the remediation company gets 21,000 or soi of it?

  • Jace Carlson

    My sewer backed up and flooded our basement. I called Servicemaster and my insurance agent, and they both showed up within an hour of each other. Servicemaster took three days to finish the work, and billed me $4000. A week later, I got a letter (and a check) from the insurance adjuster for $900 ($1400 minus a $500 deposit). This is a $3000 discrepancy that I cannot afford to “eat”. What should I do?

  • Amy Costello

    Hi, My beach house in Lavallette, NJ flooded with 2-3 feet of water during Hurricane Sandy and because there was so much damage to the area, they’ve enacted Martial Law and are blocking all access to the barrier island. They’ve posted pictures of each house and mine and my neighbor’s all show a high water line of at least 4 feet. The water took days to recede. Thousands of people are in either worse or the same condition. My concern is that even if the water has drained by now (I don’t actually know if it has), mold has started growing and is getting worse daily. The township says it’ll be up to two months before we can get enough access to begin any repairs. A nor’easter is happening right now, which can only worsen the situation. I’m convinced that I’ll have to tear down my house and toss everything in it if we let the mold take hold for 2 months. What is your opinion on this. I’ve filed an insurance claim but can’t get an adjuster out there until the island is reopened. Except for the water line the exterior of the house shows little damage. The house is 60+ years old.

    • Sol

      Hi, im writing this as an professional in the restoration field, most likely ive been to homes (farockaway long island) after sandy where the water had been sitting for 2 or more days in the basements and there is one choice and that is to demolition and it cant wait, because once the ocean water starts spreading then there is going to be a higher water mark which ultimatly means more damage, if you need any help please call 347-930-9335 ill send you my company info we are brooklyn based.

  • andi in ortley

    am worried as well. our homes have been sitting for 2 weeks with water damage inside. How does one get a fair settlement? how does one even get a contractor to come when so many homes have been damaged.

  • Paula

    Hi I recently had a fire in my kitchen and smoke damage through out my house, I had new carpet installed in my house 1 year before the fire… My insurance adjuster had the restoration company remove my carpet and store it in a warehouse for 3 months while the repairs were being done on my house….. Then the carpet was put back in my house and cleaned…. My carpet does not look the same it has a grey tint to it… I have been arguing with the adjuster for over a month now The restoration company says there is nothing more they can do.. And I also have bad seems in my carpet where the carpet was unable to be stretched anymore to repair these seems… What should I do?

  • Desk210

    I am located in Manchester, NJ and on 11-21-2012 my hot water heater located in my basement broke and flooded the basement and soaked all of my personal property down there, I called my insurance carrier who I thought was Geice and was told that they are only the agent that I need to call the Ins carrier that wrote the police, I called the number they gave me and was told to throw away all of my personal property and take pictures of it??? I was also given the number to a restoration company who I was told I would have to pay for any “may” be paid back by my insurance company. I called the restoration company and it is a answering serivce I am told that I am not priority because I am not a hurricane victim. I dragged all my things out of the basement and they are sitting in the back yard and I called the insurance company again who is again telling me to throw everything away? There was alot of property damaged they refuse to provide me with a telephone number to a adjuster and only give me a email I have now sent 4 emails to the adjuster and to the general claims department. It has now been 6 days and nobody has contacted me. If anybody can help me please call me 732-737-4820 thank you Matt

  • Orlando roofer

    Your website came up in my search and I’m taken by what you have composed on this topic. I am presently diversifying my research and thus cannot contribute further, even so. Just Now love it and thanks for granting my remark. Great job.

  • ny1980

    i had a fire in my home and my insurance adjuster’s estimate has noted for each line line to Replace, but not to Remove. The adj. is stating that he included these costs in the ‘general demo’ line item at the end of his estimate.

    Is this a normal practice, or should the adjuster have Remove and Replace per line item??? There is approx. $50k difference between Ins comp est and my contractor.

    We are not making any improvements to the home, as it was just renovated 1 year before our loss.

    • LFeltz99

      If your dispute is still on-going, please feel free to send me a copy of both the insurance company’s estimate and your contractor’s estimate. As a general contractor, mediator and an insurance company’s premier provider, I can accurately and JUSTIFIABLE evaluate your claim and successfully argue my stance with your adjuster.

  • GBerry

    Good article, with a couple of items that were incorrect. As a former adjuster and current attorney this is how it works. If you hire an attorney to help you with a claim against your insurance company they do not take a fee out of your settlement. This is called a 1st party claim. With 1st party claims, the insurance company will have to pay the attorneys fees and costs once the attorney wins your case. So, an attorney will help you get more out of your claim and you will not have to pay the attorney’s fees and costs out of pocket.

    • LFeltz

      What if the attorney doesn’t win the case? Do they still charge you for their service?

  • VA….

    my house was broken into and I had almost 30,000.00 dollars of items stole…they want receipts and I can’t produce because I didn’t keep they dont want to pay. I’ve had this policy for 15 years never had a claim…what can I do.

    • golfguy65

      We had the same thing happen. We lost lover $100K of my wifes’ designer clothing, jewelry, purses. The high end stuff was covered under a separate policy and we got that back very quickly. For the remainder, we ended up buying some new items and giving the insurance company the new receipts and they paid most of the new cost. You need to have some cash in order to go this approach.

  • Caroline

    I have a question about a recent adjuster. He looked at my 4 damaged Andersen Casement vinyl clad Windows. I received 1600. to replace them. I didn’t notice until just a few weeks ago that in his description he described the windows as “Aluminum Casement Windows.” Is the amount given worthy of aluminum and or were my vinyl worth more. Also, how can he make a mistake like that. I would appreciate any opinion on what could or should be done if anything now. Thank you for anything you can share. Caroline

  • dmd

    I had smoke damage to my home from a faulty installed water heater which burned through the floor and caused smoke damage. My insurance company initially denied the claim and their sponge came up clean during inspection. My public adjuster encouraged me to appeal and get a lawyer as well. I won based on a technicality (the insurance adjuster messed up in his denial letter). The amount awarded was for far less than what was being asked and really wouldn’t have helped to get any repairs done. I heard nothing from my lawyer, public adjuster or insurance company in regards to this case after payment. Neighbor ended up having a fire 2 years later and there was some smoke in our home. According to my insurance company, I do not have current coverage for smoke damage because I didn’t hire a contractor to professionally clean my home of soot from previous claim. This is news to me as I was never advised to get this done and nothing in my written policy has changed. They wouldn’t even pay the remediation company for air scrubbers even though the adjuster said himself it doesn’t count as cleaning. I am unable to get a hold of the lawyer who handled my case and do not know what to do. If I had known I was required to hire a contractor, I definitely would have done so. Any suggestions? Thank you!

  • Sabrina

    My insurance company is trying to treat a doorway as a break in the wood which allows for transition but our whole condo has the same wood running through out. Any suggestions?

  • PropertyGuy

    Sabrina. If you do not have any transition strips the flooring should be paid for. With that said, if it is true hardwood then the entire floor may not be replaced, but all will be sanded and refinished. If the flooring is laminate or engineered wood then age and direction the flooring is ran affects repair possibilities. If the flooring seam runs parallel with doorway and flooring is less than 3 years old or so your insurance can argue repair. I can tell you that with the insurance company I work for we would replace all flooring if no transition because even the same type of flooring can have a different lot number and can appear different. I would suggest you fight for what you think is fair. Remember, the insurance is not there for you to make a profit, but instead to get you back to a pre-state loss.

  • Frustrated_homeowner

    I recently had water damage to my home. The reverse osmosis system cracked and ran all night long. My kitchen living room and basement were damaged by the water. I finally got the insurance adjustor to agree to remove the portion of the hardwood that was wet on the 12th day because I was scared of mold growing and my child has asthma. When they removed it all the flooring wad still wet including the subfloor and it DID have mold starting to form. The insurance adjustor has tild me that they will only replace what boards were removed and that MO is a non matching state so he doesn’t have to match the rest of my floor, just like my kitchen cabinets. The took a saw and sawed through the floor to remove a large portion. How can they put my floor back the way it was before after sawing through it and how could they leave me with a mismatched hardwood floor? This doesn’t seem right to me. Need some advice. My adjustor is rude and has had me crying I’m at a loss and need some advice.

    • William Cook

      Florida matching statute should make them replace floor.
      williwm s cook
      public adjuster

  • Scott Michelle Foster

    Hello, boy o boy we sure could use some help about now. We had a small water damage & mold, we were covered for this, restoration people came and ripped out 3/4 of my kitchen cabinets, half the floor, to the subfloor I can see dirt underneath my home.and my whole countertop 18′ ,cracked my tile backsplash,and a few holes in the ceiling from their tape job. My home with built in 1956 with original cabinets and hardware,they don’t make them like they used to, my kitchen was in perfect shape nothing wrong not a stain on my counter not a mark on the floor and I have before pictures. Insurance company sent out their contractor with an unbelievably low bid, We’ve had two AAA aproved contractors come over, they sent their estimates in to the insurance company,One came back and they had the contractor take out what he had written “all cabinets must be replace, they cannot be matched”to all cabinets will be sanded all the way down and refinish,. and a few other things, like new money for the tile backsplash etc. so his bid was cut almost in half,I know this because of the email sent back-and-forth I was privy to. and the other the contractor would not take out the things they wanted. He also stated the same thing” all cabinets must come out they cannot be matched”he asked if they would please send a adjuster to the home so he could go over his estimate with the adjuster. This started in May! it is now December !I have asked them many many times to send an adjuster, they say they don’t have one in our area, we live in the San Francisco Bay area it’s huge! I wrote a complaint into the California insurance board they looked into it and stated they can’t really do anything about prices and they suggested that we use the (aphrasal provision) in our policy, or seek out the lawyer.since then the insurance company send a registered letter of a timeline of things done! stating we did not respond, so the sent us a check for the amount of their contractors estimate,they also stated we did not want to use the contractor that asked for an appraiser to come to our home, which is an absolute lie, he would be the one I would’ve chosen out of all three.I have the emails that shows we did reply,and their replys,so this timeline is wrong and the emails to prove it, This is just dragging on I don’t want to give in because there is no way we can replace our kitchen for the amount they are saying I am thinking the only thing I can do right now is keep getting estimates for the counter, the floor, cabinets,and tile, The appraisal provision they just now 12/18/14 sent me a copy and it says something like this-that we hire our appraisal they hire an appraiser and then there is a mediator I don’t have the money for an appraiser. FYI all three estimates including the aaa insurance contractors started off all in the same ballpark within $2000 of each other,which shows you that,they all really knew how much it cost to replace our kitchen two of the contractors caved in to AAA and the third asked for an adjuster to come to our home which really should have been done to begin with, and never did. What should I do next? tno kitchen no running water no counters I know we have a “loss of use”which they said they would only pay up till December 5,they explain the cost amount over which a family of four would spend on food for a month.i thought we had good insurance, we have Guaranteed Replacement Cost,with No Depreciation,Building code Upgrade Coverage.and really need some help thank you Michelle and Scott Foster

  • Adjuster in Iowa

    I disagree with the opening paragraph, at least in the area where I work, that all adjusters are out to get you and pay the least possible. First off, adjusters do not have quotas to meet, which is a popular myth. That is illegal. Adjusters do not get a bonus or profit share from paying as little as possible. Also illegal. Laws vary state to state with insurance but I believe those two areas are across the USA illegal. While it is certainly possible and has occurred that some adjusters are not working with the highest of ethical standards (as is the case with some attorneys, teachers, etc.), a majority are just people like you that what to be good at their jobs. The insurance policy is a contract of indemnification, that is true. To indemnify is to put you in the exact position you were in prior to the loss, no better, no worse. The way a contractor writes an estimate can be vastly different than the way an adjuster can write an estimate because of this. The contractor is in business to make as much money as possible, which is fine, that’s how they make their living. The adjuster is writing an estimate to try and pay you the exact amount to put you in the same position you were in. The best way to think about it is if you didn’t have insurance at all and you were paying out of pocket how would you proceed. Repair or completely replace? The insurance company is looking for the most cost-effective way to fulfill their promise in the contract of the policy. The contractor is looking to make a profit and sell their services. That doesn’t mean the adjuster or the contractor is shady. It’s a balancing act and it always has been. A good adjuster will work with the contractor and a good contractor will work with the adjuster and both will understand where the other is coming from. The best way to move forward working with an adjuster is as politely and professionally as possible from the start. The adjuster should be doing the same. Too many claims get off to a bad start when the adjuster just arrives on the property and they’re already being yelled at and they haven’t said a word. The bottom line is that disagreements are common during insurance claims, the adjuster should be able to explain and justify what they are paying. It doesn’t mean you’ll agree with it but if they aren’t able to explain it then there might be a need for concern. Here in Iowa maybe 5% of property claims involve an attorney and there are no public adjusters, which is an expense that aids in increasing insurance premiums. (Fraud is one of the biggest factors that raises premiums which we also have a very low rate of here.) I truly believe the reason why is because all parties are treated with respect and the insurance dept responds swiftly and fairly to all complaints. In turn we have some of the lowest premiums in the country.

    • Contractor in AZ

      Adjuster In Iowa,
      As a general contractor certified in WTR, Asbestos, Lead, Trauma, Smoke, Odor, Contents etc… I agree with you about 90%. It is ALWAYS better if the contractor is open to some “give and take” with an adjuster but the biggest problem we run into is that we do not deal with adjusters that are certified in any of the above referenced areas. How can a field adjuster write a water scope if they are not certified in WTR or have any experience in drying down a structure? How can a field adjuster write or except an asbestos estimate from a certified asbestos contractor if they are not certified in this field of work? How can any adjuster write an accurate or somewhat plausible scope of repairs if they have never worked in any of the trades they are adjusting? This is far too common in this industry and just because an adjuster went through a “12” week school, does NOT qualify them to write any scope whatsoever…They only understand what the policy will cover in the claim. I fully understand that “insurance” is a business and all insurance companies have to make money, but having adjusters that do not understand construction as a whole is only doing your client and mine a disservice.

      Professional Contractor in AZ

      • sexyandiknowit

        Your biggest problem is that it is illegal for you to ‘deal’ with the adjusters. Any insurance claim should be referred to a public adjuster, who will get the proper settlement and then you can give the property owner a quote on what they want repaired. It doesn’t matter if the company adjuster doesn’t understand ‘construction’. The public adjuster does. Step aside and let the professionals argue the scope. Then come back in and give an estimate to do the repairs that the adjusters negotiated.

  • Henry Margossian

    The tips that the writer has provided in regards to “dealing with a claims adjuster when you disagree” are helpful but mostly incorrect when it comes to the attorneys and public adjusters. I am a licensed/bonded public adjuster in the State of California, and I can assure you if insurance adjusters did their jobs correctly, I would be out of business in 1 week.

    First and foremost, accusing all public adjusters to be working unethically is not exactly helping others with their claim issues. Nor using a public adjuster is going to cause your premiums to go higher. Your premium will go higher when the underwriter reviews your file and decides that you are a high risk therefore increasing your premiums based on how many claims you have filed.

    There are unethical public adjusters just like there are unethical doctors and contractors….you get the picture.

    A public adjusters fee depends on the complexity of the case, if it is a new claim or one that an undisputed amount has been paid. Obviously, a new claim will be at a lower fee, and one that a payment has been made will be at a higher fee. I can’t speak for all PA’s, but my fees start at 8% and go up to 20%.

    In response to the answers that the homeowner has to concede the cabinets is completely incorrect and misguided. The insurance company’s job is to put you back to your pre-loss condition. If the homeowner has a replacement cost coverage endorsement, then the insurance company is obligated to replace the cabinets. The fact that you did not even know what material the cabinets are made of or how old they were tells me that you do not know construction, or policy language to truly give the policyholder what they are entitled to.

    It’s funny that your advice on the carpet was not to accept a patch job, which is probably the only time I will let the insurance adjuster take a point on this. Most insurance company’s out there will stop at the doorways. There are no one piece carpets, all carpets are cut at the doorways, in addition a 10×12 bedroom with carpet will cost no more than $700 to replace.

    We get all hardwood floors, laminate floors, and engineered wood floors replaced for the policyholder. The manner in which they were installed and what they are installed on are all important factors. One blogger mentioned they only sand and polish the remaining and replace what is actually damaged, I would love to give my answer on that, but that is giving too much trade secret away.

    I don’t have to guarantee an amount, or promise them I will get them more money. In fact, I make it a point not to answer the question when asked, because 99.9% of homeowners that call in for claim assistant, their 3rd or 4th question is usually how much can you get me. My response is, I will know when I start scoping your property and documenting all the damages.

    Here is a case example that I recently had that I talked about in another forum.

    Allstate adjuster walks into a water damaged 2 story home, scopes the
    damage, and tells insured here is a check for $7291 to repair damages.
    Frustrated, insured calls our office, and I meet with the
    homeowner, at the property, spend about 4 hours sketching and
    scoping the damage, called adjuster back, set up a time to meet with
    adjuster, and submit my $87,534 estimate to the Allstate adjuster and
    after 3 weeks of conference calls and supervisor involvement, I hand the
    customer a check for $87,534, in addition to that amount insured
    received $9500 for additional living expense for 2 months, that Allstate
    adjuster failed to offer insured.
    $87534 – $7291 = 80,243 x 10% = $8,024.30
    Net amount to insured = $ 72,218.70 for build back
    + $9500 for additional living expense.
    to recap, insured only had $7291, but it cost him $8024.30 to receive
    additional $72,218.70 not including additional living expense of $9500
    that was never offered, (potential for bad faith lawsuit) but I won’t go
    into that now).
    Which part of this math problem does not make sense?
    Who is being unethical here, the insurance adjuster that was trying to save
    the company 80k, or my services that cost $8024?

    At the end of the day, we provide a service that is in demand, otherwise we would not be needed. The manner in which a public adjuster provides that service is entirely up to them ethical or otherwise, but please do not not include everyone in the same boat.

    I worked for Farmers Insurance for 10 years as an adjuster. Insurance companies are in the business of making money, and each claim is treated as such, a business transaction. Claim centers are not profit centers, but if they can get away by paying $20k on a $60k claim, they have just saved the company $40k (profit not earned, rather not paid). When you get a chance to read your policy, which hardly anyone does, it clearly states “the burden of proof is on you/the policyholder.

    On the other hand, a claim for a homeowner is very personal and tragic, most homeowners I deal with are very fragile and want to give up very easily. They get emotional, and making decisions in that state will not have a positive outcome.

    • mikey7777

      henry I am in the middle of a cluster you know what with allstate at the moment ,how do I look up a public adjuster…They are giving my contractor the run around and me as well and I am getting no where near what i think and my contractor quoted at.

  • Antonio Genovese

    The comments by the editor is misleading. There is NO public adjuster that takes as much as 40% of a settlement in Florida. Most take between 15 and 20 percent. Florida law dictates that. And if it is a declared emergency such as a hurricane or some other disaster, Citizens Insurance can only be 10% of the settlement. Also, a public adjuster and lawyer can get up to 300% more than a homeowner doing this on their own. Don’t try dealing with the insurance company alone. You will not come out ahead. You will be underpaid and/or denied.

  • Antonio Genovese

    Erik Folgate states the following, “…Cabinets can easily be repaired without requiring them to be fully replaced. ” WRONG. That is the typical response you get when dealing with an adjuster who works for the insurance company. If the cabinets were damaged, the homeowner is entitled to new cabinets and more if their policy is a replacement policy. That kind of talk by Mr. Folgate reflects the insurance company argument. However, insurance companies are not your friends. They are there to make money just like any other business.

  • RNS Claims

    The insurance companies are likely to diminish your claim. I have been working on the claims side of insurance companies for approximately 17 years and moved over to the Public Adjusting side. The “cabinets” in question have to be brought back to pre existing condition. The insurance company has to indemnify you and be brought back to alike. So if only one cabinet got ruined they all have to be replaced NOT just one cabinet that will look different from all others and depreciate value if any to the residence. The same goes with your tiles, wooden floors, marble, etc.

    As far as New York State the average percentage for a PUBLIC ADJUSTER is 10%.

  • Anne M

    We live in Colorado and recently had a house fire with significant damage to several rooms; unfortunately asbestos was detected throughout the house and all of our carpeting was removed during abatement. Because we can’t provide a sample of carpet to analyze for quality our insurance adjuster informed us that they will cover the cost of standard grade carpet. An associate at the carpet store (that works with our construction company recommended by insurance adjuster) said that they don’t have carpeting that is within the claim’s budget; the lowest price carpeting they offer is used for low-cost rental apartments and is available only in shades of tan-brown. The carpet is 10 years old and I don’t have the receipt (burned in the fire) and the carpet store is no longer in business. Any suggestions? Thank you