CONTENTS
CONTENTS .......................................................................................................... 1
THE FIRST STEPS ............................................................................................ 2
WHAT HOME INSURANCE COVERS AND DOES NOT COVER .............................................. 3
READING YOUR DECLARATIONS PAGE ................................................................................... 4
ESTIMATING DAMAGE ................................................................................... 5
FIRE DAMAGE RESTORATION COSTS ........................................................................................ 6
HOUSE FIRE CLASSES & CATEGORIES .................................................................................... 6
SMOKE AND SOOT DAMAGE RESTORATION COSTS ............................................................. 7
WATER DAMAGE RESTORATION COSTS ...................................................................................8
WIND DAMAGE RESTORATION COSTS ......................................................................................8
REPAIRING VERSUS REBUILDING YOUR HOME................................... 9
WHO DECIDES? ............................................................................................................................... 10
REPAIRING VERSUS REBUILDING: PROS AND CONS ......................................................... 11
REPLACEMENT COST VS. ACTUAL CASH VALUE POLICIES ............................................. 12
HOW TO DEAL WITH YOUR INSURANCE COMPANY’S ADJUSTER . 13
WHAT TO DO AND WHAT NOT TO DO ........................................................................................ 14
INSURANCE CLAIM ROADBLOCKS ......................................................... 15
WHY INSURERS DENY CLAIMS .................................................................................................. 16
HOW INSURERS JUSTIFY LOWER PAYOUTS .......................................................................... 17
STEPS TO TAKE AFTER CLAIM DENIAL................................................................................... 18
HIRING PROFESSIONAL INSURANCE CLAIMS HELP ........................ 19
PUBLIC ADJUSTERS VERSUS ATTORNEYS .......................................................................... 20
HOW PUBLIC ADJUSTERS HELP .............................................................. 21
TOP 3 THINGS PUBLIC ADJUSTERS DO ................................................................................. 22
FAQS ................................................................................................................. 23
FREQUENTLY ASKED QUESTIONS ........................................................................................... 23
SOURCES......................................................................................................................................... 23
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THE FIRST STEPS
Major insurance claims are frustrating and complicated. To make
things worse, most homeowners aren’t experts.
The average homeowner deals with one major home insurance claim
in their life.
Unfortunately, insurers take advantage of your inexperience.
We can help you get the payout you paid for.
1)
2)
3)
4)
5)
Secure the Scene
Contact emergency services if necessary. Protect yourself
and loved ones from immediate danger.
Call your Insurer
Your insurer explains the next steps. The sooner you contact
your insurer, the sooner the claim process begins.
Contact a Restoration Contractor
Emergency contractors work 24/7. Contractors secure your
property and prevent further damage.
Take Photos and Document the Damage
Your insurer needs proof of the loss. Take photos and videos
of damaged property.
Wait for the Restoration Contractor to Complete the Project
The contractor restores your property to pre-loss condition.
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1
* Flood and earthquake insurance are available through FEMA in some areas.
COVERED
NOT COVERED
Fire ✓
Floods*
Smoke ✓
Earthquakes*
1
Wind ✓
Nuclear Accidents
Theft / Vandalism ✓
Termites, insects, rats, mice, and pests
Tree damage ✓
Wear and tear
WHAT HOME INSURANCE COVERS AND
DOES NOT COVER
You assume home insurance will be there when you need
it most. Unfortunately, that’s not always the case.
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READING YOUR DECLARATIONS PAGE
Your declarations page
explains your coverage
and how it works
It also lists certain
risks and features of
your home.
This is the total amount
you owe your insurer
over the policy term.
Discover coverage
limits included in your
policy, as well as any
endorsements
(additional coverages).
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ESTIMATING DAMAGE
Your insurance company’s adjuster estimates damages:
• The adjuster surveys your property to assess damage
• You must cooperate with the adjuster during the survey
• The adjuster creates a report based on the survey
Based on the adjuster’s report, you could receive 10% to 100%
of the payout you deserve.
Insurance adjusters use the cheapest cost estimates. They want
to pay you as little for your claim as legally possible.
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2
(US Department of Labor, 1996)
3
(Angi, 2021)
Fire Class
2
Class A
Class B
Class C
Class D
Class K
National Average
Cost
3
$5,000 to $70,000
Water Damage
Cleanup (After Fire)
$1,000 to $4,000
Soot Removal and
Cleanup
$2,000 to $6,000
Removal of Damaged
Items
$50 to $100 per pound
Duct Cleaning
$200 to $500
Deodorizing Costs
$200 to $1,000
Restoring fire damage can cost
anywhere from $1,000 to $100,000. If you
need to rebuild your home, it could cost
over $100,000.
The average policyholder pays around
$22,000 to restore fire damage.
Restoration companies rate fires based on
Class.
The cost of fire damage restoration varies
based on water damage, soot removal,
smoke cleanup, and miscellaneous cleanup
costs.
Types of fire damage by class.
Average cost of fire damage
restoration
FIRE DAMAGE RESTORATION COSTS
HOUSE FIRE CLASSES & CATEGORIES
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4
(Home Advisor, 2021)
National Average Cost
4
$2,000 to $6,000
Smoke Restoration Costs
$200 to $1,000
Furniture and Texture
Deodorizing Costs
$200 to $1,000
Thermal Fogging
$200 to $600
Ozone Smoke Removal
$200 to $400
Homeowners know the destructive power of
fire. Smoke and soot, however, can be more
devastating.
Smoke and soot spread throughout your
home during the fire.
Remediating smoke and soot damage adds
thousands to an insurance claim.
Average cost of smoke and soot
damage restoration.
SMOKE AND SOOT DAMAGE
RESTORATION COSTS
DID YOU KNOW?
Public adjusters force your insurance company to pay
the full amount for your fire, smoke, and soot damage.
Public adjusters:
• Analyze damages ✓
• Negotiate with your insurer for higher payouts ✓
• Oversee restoration ✓
A good public adjuster can increase your insurance
settlement by 700% or more.
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5
(Home Advisor, 2021)
6
(HomeAdvisor, 2021)
National Average
Cost
5
Cost by Area
Category 1 (Clean
Water)
Category 2 (Grey
Water)
Category 3 (Black
Water)
Mold Restoration and
Removal
National Average Cost
6
Full Asphalt Shingle
Roof Replacement
Siding Repair
Broken Window s
Water can cause visible and invisible
damage to your home.
Some water damage is obvious. Other damage
is hidden behind your walls or underneath your
floors.
Windstorm damage is unpredictable. Some
windstorms cause extensive losses.
Your insurance covers roof repair, tree
removal, water extraction, and structure
repairs after a windstorm.
WIND DAMAGE RESTORATION COSTS
Average cost of water damage
restoration in the United States
WATER DAMAGE RESTORATION COSTS
Average cost of wind damage
restoration in the United States
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REPAIRING VERSUS REBUILDING YOUR HOME
Deciding whether to repair or rebuild your home is a life-
changing decision.
Your policy impacts your decision: you may have a
replacement cost policy or an actual cash value (ACV)
policy.
Your insurer always pushes for the cheapest option, which
may not be the best option. Prepare to negotiate.
Who Decides?Deciding whether to repair or rebuild your home
is a life-changing decision.
In some cases, your insurer forces you to repair or rebuild your
home. In other cases, it’s up to you and your public adjuster to
make the best decision for you.
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WHO DECIDES?
Your insurer wants the cheapest option. You want the best option. Who
decides?
• Traditionally, you had to rebuild a house of the same kind and
quality at the original location to receive payment from your
insurer.
• Things have changed. More than 20 states have passed laws
allowing you to receive the same compensation for
rebuilding or repairing your home at its original location or
elsewhere.
• In most cases, you rebuild your home if the cost of repairing
damage is greater than half the value of the house itself.
• In some areas, your local building inspector decides whether
to repair or rebuild – say, for flood-damaged homes in low-lying
areas.
• If you have a mortgage, your lender has a say.
The decision is complicated, and multiple parties are involved.
PARTIES INVOLVED IN THE DECISION
INSURER
Pushes for the cheapest option
HOMEOWNER
Pushes for the best option
LENDER
Pushes for the safest option
LOCAL
INSPECTOR
Has final say in certain claims (like flood-damaged homes and
homes in low-lying areas)
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REPAIRING VERSUS REBUILDING: PROS AND CONS
Choosing to repair or rebuild is a big decision. Both approaches have
advantages and disadvantages.
REPAIRING: PROS & CONS
PROS
CONS
Save money (cheaper option)
May find additional damage during repairs
(or leave certain damage unfixed)
May be able to occupy the home during
repairs
May be leaving money on the table if you
have a replacement cost policy
Ideal for smaller insurance claims
REBUILDING: PROS & CONS
PROS
CONS
Ideal if you plan to stay in your home for a
long time (reset all wear and tear in your
home)
Costs can quickly exceed expectations, and
insurance only covers a specific amount
Remove all traces of damage from your
home after a major insurance claim
All or nothing (once you start demolishing
your home, you can’t change your mind)
Ideal for homeowners with replacement
cost policies
May need alternative accommodations for
months
You get a new home
Insurance does not pay to rebuild the home
to its original condition if you have an
actual cash value (ACV) policy (unless you
paid for an inflation clause)
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REPLACEMENT COST VS. ACTUAL CASH VALUE POLICIES
When buying home insurance, you choose a replacement cost or actual
cash value (ACV) policy.
Both policies cover damage to your home and its possessions. However,
they cover damage in different ways.
REPLACEMENT COST
Replacement cost policies pay to repair or replace damaged property
without deducting depreciation.
A replacement cost policy:
• Covers the cost of rebuilding your home to pre-loss condition
• Pays out based on the square footage of your home and
construction costs in your area
• Is more expensive than actual cash value policies
ACTUAL CASH VALUE
Actual cash value policies cover the cost of damaged property after
deducting depreciation costs.
An ACV policy:
• Does not rebuild your home to pre-loss condition
• Pays out based on the value of your home and possessions
before the loss
• Is cheaper than replacement cost policies
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HOW TO DEAL WITH YOUR INSURANCE COMPANY’S
ADJUSTER
You interact with your insurance company’s adjuster
throughout the claim.
By law, you must respond to your insurance company’s adjuster
honestly and promptly.
A good relationship with your insurance adjuster makes a claim
easier. However, it’s important to not let the adjuster push
you around or take advantage of your inexperience.
The adjuster may be friendly, but the adjuster is not your
friend. They want to protect their employer’s bottom line.
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WHAT TO DO AND WHAT NOT TO DO
Your insurance company’s adjuster is doing their job. However, you have
a responsibility to protect your financial future.
When dealing with your insurance adjuster, there are things you should
do to optimize your insurance claim.
For a smooth claim, follow the tips below.
WHAT TO DO
To ensure a good relationship, practice the following strategies:
• Respond promptly to the insurance adjuster’s requests. ✓
• Be honest about your loss. ✓
• Submit documents, evidence, and photographs within the time
specified by your insurance policy. ✓
• Document interactions and phone conversations, including dates,
times, and topics discussed. ✓
WHAT NOT TO DO
Certain actions could jeopardize your claim. Avoid problems with the
following tips:
• Do not give the insurance adjuster more details than
requested ×
• Don’t be intimidated by your insurance adjuster. Most
insurance adjusters are normal people doing their jobs. ×
• Do not sign anything or provide a recorded statement. ×
• Do not accept the first offer. ×
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INSURANCE CLAIM ROADBLOCKS
Major insurance claims are complex. There’s a lot of money at
stake, and insurers may challenge certain damages.
If the damage came from a legitimate covered loss, you have
nothing to worry about: the insurer is legally obligated to cover
your claim.
However, there may be roadblocks. Prepare for roadblocks
today to avoid insurance headaches in the future.
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WHY INSURERS DENY CLAIMS
Insurers deny claims when they have a legitimate reason to deny a
claim. However, insurers wrongfully deny roughly 10% of all insurance
claims.
7
Reasons to deny a claim include:
Lack of coverage / exclusion clauses
Your insurance policy does not cover everything. Your insurer
may deny your claims based on exclusions and insufficient
coverage.
Missing the filing deadline
Typically, homeowners have 30 days to 1 year to file a claim. If
you miss the filing deadline, the insurer might deny your claim.
Non-payment of premiums
You need to pay premiums on time. Insurers may deny claims
because you did not pay your premiums.
False statements
Insurers lose billions to fraud every year. If you lied about your
claim, or if the insurer suspects fraud, the insurer can deny your
claim.
Insufficient documentation
The insurer may require receipts, estimates, photos, videos, and
other documents proving the loss.
Wear and tear / poor maintenance
Insurance covers sudden and unexpected damages. If you did
not maintain your property, then your insurer can deny your claim.
7
(Insurance Information Institute, 2021)
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HOW INSURERS JUSTIFY LOWER PAYOUTS
40% of homeowners report receiving a lower-than-expected payout
from their insurer.
8
The insurer may decide to cover certain damages but not others, for
example.
Or, the insurer could use the lowest possible value for your
possessions, lowering your claim by thousands.
Insurers use several excuses to justify lower payouts. Some are
legitimate. Others are negotiation tactics to convince you to accept a
lower offer.
REASON
EXPLANATION
Wind-driven rain
If strong winds caused water to enter your home, then
insurance may not cover damages. Insurance covers windstorm
and water damage, but it does not cover wind-driven rain.
Cheap product
replacements
When replacing your possessions, insurers use the cheapest
possible replacement products they can find.
Flood damage
Insurers may decide that flooding caused certain damages.
Windstorm damage is insured, but flood damage is not.
Lack of maintenance
You must maintain your home. If you failed to maintain your
property and it leads to a loss, insurers may lower payout.
Failure to limit
damage
You must take steps to limit damage after an accident. If you did
not place a tarp over the hole in your roof after a windstorm, for
example, your insurer might deny your claim.
Other reasons
Insurers use dozens of reasons to deny claims and justify lower
payouts. Ask for a written explanation from your insurer.
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ClaimsMate.com
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STEPS TO TAKE AFTER CLAIM DENIAL
If an insurer denies your claim, it’s not the end of the road.
You have legal rights to challenge the claim. Insurers allow you to
respond with evidence proving the claim is justified.
Alternatively, many policyholders hire professional help – like a lawyer or
public adjuster. If your insurer denied your claim, follow the steps below.
1) Say no
You don’t need to accept the first offer from your insurance
company. Insurers wrongfully deny thousands of claims each year.
2) Ask for a written explanation
Few insurers provide a written explanation of the claim denial
unless you ask for it. However, you may need this letter when
formally challenging your claim.
3) Check your policy
Look at your home insurance policy. Does the insurance company
have a legitimate reason to deny your claim based on the written
explanation?
4) Get professional help
Insurance companies aren’t charities. They’re for-profit businesses
that want to maximize profit. But they shouldn’t do it at your
expense. If the insurer has wrongfully denied your claim, then
consider getting professional help:
• Hire a public adjuster
• Hire an insurance attorney
• Contact your state’s Department of Insurance
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HIRING PROFESSIONAL INSURANCE CLAIMS HELP
You’re not an insurance expert – and that’s okay.
When you need an insurance expert, you have two
options:
• Hire an attorney
• Hire a public adjuster
Both professionals play a similar role. In fact, many
public adjusters are attorneys and vice versa.
However, depending on the stage of your insurance
claim, you may want to hire one or the other.
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PUBLIC ADJUSTERS VERSUS ATTORNEYS
Public adjusters and attorneys play similar roles. They help policyholders
overturn denied claims and receive higher payouts.
PUBLIC ADJUSTERS
ATTORNEYS
Provide expert assistance for claims
Provide expert assistance for claims
Have a legal and/or insurance background
Have a legal background
Can manage your claim from start to end
Help with denied claims issues late in the
process
Negotiate and obtain higher payouts
Negotiate and obtain higher payouts
Work on a contingency basis
Charge hourly or on contingency
HOW MUCH DO PUBLIC ADJUSTERS COST?
You don’t pay until you accept your insurer’s final settlement. This is
called a contingency fee agreement.
Public adjusters:
• Charge a pre-arranged fee of 10% to 15% of the final payout
• Depending on your agreement, could charge on the total
claim or only the additional amount awarded
• Are motivated to obtain highest possible payout from insurer
to receive higher commissions
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HOW PUBLIC ADJUSTERS HELP
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9
ClaimsMate.com
Public adjusters lend their expertise to your insurance claim.
This expertise can put more money in your pocket when you
need it most.
Public adjusters can:
• Increase final payout by 700%
• Solve tricky insurance disputes
• Overturn denied claims
• Walk you through every step of the claim process
When you hire a public adjuster, you get a certified insurance
claim expert on your side.
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TOP 3 THINGS PUBLIC ADJUSTERS DO
No two insurance claims are alike. Public adjusters approach each case
differently and optimize your insurance claim via several roles.
1) Assess your claim to determine fair compensation
A public adjuster works on your behalf. A public adjuster uses their
decades of insurance industry experience to assess your claim and
determine fair compensation.
2) Negotiate with your insurer
Public adjusters negotiate the insurer to obtain the optimal payout.
They use their experience and industry knowledge to force insurers
to pay you the money you are rightfully owed.
3) Guide your insurance claim from start to finish
Policyholders feel relieved after hiring a public adjuster. The public
adjuster performs countless tasks while expertly guiding your
complex insurance claim from start to finish.
BENEFITS OF HIRING A PUBLIC ADJUSTER
Hiring a public adjuster comes with little risk. You benefit because
you:
• Get a second opinion on your insurance claim
• May get an increased payout by up to 700%, overturn denied
claims, and get the payout you paid for
• Pay nothing until you accept your insurer’s final payment offer
• Get a free consultation with zero risk
As a policyholder, you have little to lose by hiring a public adjuster.
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FAQS
FREQUENTLY ASKED QUESTIONS
Question
Answer
What is a public
adjuster?
A public adjuster is a licensed and certified
insurance industry professional who manages
your claim, negotiates with your insurer for a
higher settlement, and solves insurance claim
disputes.
What do public
adjusters do?
Public adjusters analyze your insurance claim
and negotiate with your insurer for a higher
payout.
How much do
public adjusters
cost?
Public adjusters set different prices based on
their experience. The average public adjuster
charges a fee of 7.5% to 15%.
SOURCES
Angi. (2021, November 5).
How Much Does Fire Damage Restoration Cost.
Retrieved November 11, 2021, from Angi: https://www.angi.com/articles/how-
much-does-fire-damage-restoration-cost.htm
Home Advisor. (2021, November).
2021 Water Damage Repair & Restore Costs.
Retrieved from HomeAdvisor Powered by Angi:
https://www.homeadvisor.com/cost/disaster-recovery/repair-water-damage/)
Home Advisor. (2021, November).
How Much Does It Cost to Repair Fire & Smoke Damage?
Retrieved from Home Advisor:
https://www.homeadvisor.com/cost/disaster-recovery/repair-fire-and-smoke-damage/
HomeAdvisor. (2021, November).
How Much Does It Cost To Repair Hail, Wind, Or Storm Damage?
Retrieved from HomeAdvisor:
https://www.homeadvisor.com/cost/disaster-recovery/repair-storm-or-wind-damage/
Insurance Information Institute. (2021, November).
Facts + Statistics: Homeowners and renters insurance.
Retrieved from Insurance Information Institute:
https://www.iii.org/fact-statistic/facts-statistics-homeowners-and-renters-insurance
US Department of Labor. (1996, May).
Classification of Portable Fire Extinguishers.
Retrieved from Occupational Safety & Health Administration:
https://web.archive.org/web/20080401035246/http://www.osha.gov/doc/outreachtraining/htmlfiles/extmark.html
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