Common Public Insurance Adjuster Questions and Answers

What Is a Public Adjuster?

Public Adjuster (PA) Definition

A Public Adjuster is an insurance claims adjuster who advocates for the policyholder in appraising and negotiating a claimant’s insurance claim. Aside from attorneys and the broker of records, public adjusters licensed by state departments of insurance are the only type of claims adjuster that can legally represent the rights of an insured during an insurance claim process.

There are three classes of insurance claims adjusters: staff adjusters (employed by an insurance company or self-insured entity), independent adjusters (independent contractors hired by the insurance company) and public adjusters (employed by the policyholder). “Company” or “independent” adjusters can only legally represent the rights of an insurance company. Knowing which one they are, tells us how to negotiate your claim.

Public Adjuster (PA) Duties
The public adjuster’s main responsibilities are to:

  • Evaluate existing insurance policies to determine what coverage may be applicable to a claim.
  • Research, detail, and substantiate damage to buildings and contents and any additional expenses
  • Evaluate business interruption losses and extra expense claims for businesses
  • Determine values for settling covered damages
  • Prepare, document and support the claim on behalf of the insured
  • Negotiate a settlement with the insurance company on behalf of an insured
  • Re-open a claim and negotiate for more money if a discrepancy is found after the claim has been settled
Public Adjuster (PA) Advantages

Typically, a policyholder hires a public adjuster to document and expedite their claims, obtain a more satisfactory claim recovery, more quickly, and completely restore their residence or business operations, and insulate themselves from the stress of engaging in an adversarial role with a large corporation. Policy holders who are not properly indemnified by their insurance carriers may be left with little choice but to hire professional assistance to recover the claim payment to which they are entitled.

In the past, you have hired an attorney for legal issues, an accountant for financial issues, a real estate broker for property issues, and now, you can hire a highly trained public adjuster for all your insurance claim issues!

FAQ’s

What should I look for in a Public Adjuster?
You should look for the same qualities you would look for in any other professional, which includes experience and proven performance. Your Public Adjuster must be licensed and bonded. Your chosen Public Adjuster should also utilize its own staff of adjusters, appraisers and other professionals to assist him or her in maximizing the benefits you are entitled to receive after a claim. The Public Adjuster you choose should be aware of your needs and responsive to your concerns.
Who uses the services of Public Adjusters?
Individuals, businesses and professionals including banks, churches, restaurants, accountants, attorneys and even insurance adjusters and agents on their own losses utilize Public Adjusters.
Do I have to pay up front?
No. We are not paid until money is collected from the insurance company. In fact, we use our own resources and time documenting and resolving the claim before we are compensated.
Am I assured a higher settlement if I use your services?
Generally, the more thorough and complete the claim investigation and evaluation, the higher the settlement will be. We meticulously inspect the loss site and document the damages. On severe losses where all or most of the contents are destroyed by fire, stolen or blown away, we will go over a variety of checklists with you to help recap, on a room by room basis, what was in or on the property at the time of the loss. Having a professional who is looking out for your best interests and who understands the “tricks of the trade” is invaluable. The insurance company representative is usually instructed to reduce the value of the claim and ignore portions of your claim unless you know how to present the claim in the way the insurance company will concede to or cannot challenge.
Will my loss be settled faster with the services of a Public Adjuster?
An experienced Public Adjuster knows exactly what to provide to the insurance company to expedite the settlement of your claim. Having our professional Public Adjusters handle your loss can save a great deal of your time and result in a faster presentation of your claim. With your cooperation, we will quickly have your claim filed and the settlement process underway.
Will I be cancelled or will my Rates go up if I use a Public Adjuster?
An experienced Public Adjuster knows exactly what to provide to the insurance company to expedite the settlement of your claim. Having our professional Public Adjusters handle your loss can save a great deal of your time and result in a faster presentation of your claim. With your cooperation, we will quickly have your claim filed and the settlement process underway.
Why can't my insurance agent or broker handle my claim?
While most insurance company adjusters would like to be fair, not too many people can serve two masters. It is very easy and very common for even the most honest adjusters to underpay a claim. The reasons for this can be poor training, too heavy of a workload, and a bureaucracy that is motivated by profit.
What Happens Now?
I would first like to thank you for the opportunity to work with you on your insurance claim to make sure you get every penny you deserve. This process will take approximately 6-8 weeks to complete. So please be patient and remember…

1. DO NOT SPEAK TO ANYONE FROM YOUR INSURANCE COMPANY WITHOUT US PRESENT OTHER THAN TO VERIFY THAT WE ARE REPRESENTING YOU AND TO GIVE THEM OUR CONTACT INFORMATION AND REQUEST THAT THEY CALL US.

2. DO NOT ALLOW THEM TO SCHEDULE AN APPOINTMENT/INSPECT PROPERTY WITHOUT CALLING US FIRST. NO ONE SHOULD BE THERE WITHOUT US PRESENT.

What is ClaimsMate's workflow?
  • We meet with you and pre qualify your business or home, your insurance and your claim.
  • If we believe that you have a valid claim and you request our assistance, we will collect:
  1. A copy of your policy with endorsements, a declarations page, any past estimates or correspondence if your claim has been underpaid/denied.
  2. We will attempt to collect this information from your insurance company if you don’t have it.
  • We will then…
  1. Do a complete inspection of your property with photos for all peril related damages. Please note that if the damage is from different perils, there will be multiple deductibles.
  2. Let you know if you need to get any repair estimates for specialty items such as AC units, swimming pools, electrical items, plumbing items and assist you in finding someone to provide that estimate.
  3. Open your claim for you, if it hasn’t been opened already, by phone, fax and email and provide our contact information to your insurance company and request that they correspond through us to limit the traps that they often set for you in recorded conversations.
  4. Review your policy for negative policy wording that might hurt your claim so that we know what is/isn’t covered and how to win a negotiation of your policy coverage for full indemnification.
  5. Request an inspection or re-inspection date with your insurance company’s adjuster and meet them at the property to point out damages and argue policy coverages for you. We will be prepared with industry specific tools and data to back up our position and your claim. THIS INSPECTION COULD TAKE UP TO TWO WEEKS TO HAPPEN AS WE ARE SUBJECT TO THEIR ADJUSTER’S SCHEDULE.
  • Once we receive the approval or decline, we will negotiate with your insurance company to properly indemnify your claim…meaning we will fight for every last dollar for you!
  • After we think that they have covered all damages, we will explain to you what was/wasn’t covered, why and for how much. We will turn in any additional estimates to back up our estimate amount. We will always ask if you approve of the settlement before accepting any final offers for you and will not close the claim until you give us permission to.
  • We will work with your insurance company to get new proceeds distributed to you in a timely fashion.
  • We will also assist you in finding qualified contractors that have successfully worked with our clients in your area and provide references if needed for them.
  • We will discuss other options with you and your insurance company if the claim is denied or underpaid and how to remedy those in the State of Texas.

How Does ClaimsMate Get Paid?

We Handle Your Claim From Start to Finish
10% of the gross settlement when you retain our services from the beginning of the claim until the end of the claim.
We Handle Your Claim Once You Have Already Been Denied or Underpaid
25% of the net settlement of new money secured for you when you file your claim and work the process until they have underpaid you or denied you. This is a more difficult process for us as you have already made statements and had an initial inspection by your insurance company’s adjuster. We must go back at this point and find out what has been said and done up to this point. Again, if we recover no new monies for you at this point, then you owe us nothing. If we are successful in winning a large award for you (which often happens), we revert back to the 10% of the total amount of the claim. Please request an explanation if this is confusing.
Do I Need To Pay a Sales Tax?
State of Texas law requires us to charge an 8.25% as a service related sales tax on the amount you pay us.

This money goes directly to the State of Texas.

Do I Need To Pay If ClaimsMate is Unsuccessful in Getting Me More Money?
Absolutely Not!

We are not paid until you receive your insurance settlement.

No Settlement = No Charge

No Recovery = No Fee