What Insurance Adjusters Don’t Want You to Know
The average homeowner only experiences one or two major claims in their lifetime.
The average insurance adjuster, however, handles hundreds – if not thousands – of claims over their career.
There are certain things insurance adjusters may not want you to know – from fine-print exclusions to when to push back against a lowball offer.
Here are some of the things insurance adjusters may not want you to know about your homeowners insurance claim.
Insurance Company Adjusters vs. Public Adjusters
First, it’s important to distinguish between the two main types of adjusters, insurance company adjusters and public adjusters:
- Insurance company adjusters are salaried employees of your insurance company. For example, State Farm or Allstate send an adjuster to your property after you file a claim. These company adjusters analyze claims, apply coverage, and work with property owners. Their goal is to close claims quickly and limit payout to protect the company’s bottom line.
- Public adjusters represent homeowners and business owners. They’re licensed insurance professionals – like ClaimsMate. As a policyholder, you can hire a public adjuster to represent your side of the claim. Many choose to do so, especially if the claim is complicated or expensive.
For the purpose of this article, we’re referring to insurance company adjusters. These are the secrets your insurance company and its adjusters may not want you to know.
Some Use Outdated Cost Tables to Reduce Payout
Cost tables are a cornerstone of the insurance evaluation process.
Insurance company adjusters use cost tables to estimate the cost of repairing damaged property. They’re supposed to be updated regularly and reflect real-world prices for construction, labor, and materials in each region.
However, some insurers may use outdated cost tables to reduce your payout.
During periods of high inflation – like the past few years – these tables can vary significantly. It may have cost $11,000 to replace a roof in 2020, but today it could cost $18,000.
If your insurer uses old numbers, you could receive thousands less than you’re owed.
Others Use Software with Company-Set Price Caps
Many insurers use estimation software like Xactimate, which includes cost tables and repair estimates for areas across the United States.
However, some insurers set internal price caps in the software, significantly underestimating real-world repair costs.
Some even claim tools like Xactimate are “rigged” in favor of insurers. Others argue the software is effectively “owned by the insurance industry.”
As a homeowner, you might not notice small differences in price per square foot. But over the course of an entire roof or kitchen repair, those differences add up fast.
Company Adjusters Are Pressured to Close Claims Quickly & Cheaply
Insurers aren’t running a charity. Their goal is to close your claim:
- As quickly as possible to reduce the chance of finding extra damages
- As cheaply as possible to protect profit margins
Insurance company adjusters are employees of the insurer. Their priority is their employer’s bottom line, not your best interest.
They May Ignore Secondary Damage
Experienced adjusters know what storm, water, or fire damage looks like – and where to look for secondary issues.
But that doesn’t mean they’ll tell you.
Some insurance company adjusters deliberately miss or downplay damage. Others avoid checking for hidden problems entirely.
These damages can include:
- Water
- Mold
- Smoke and soot
Insurers don’t like covering these hidden damages because they add thousands to a claim. By leaving off these damages, insurers can save money – at the expense of homeowners like you.
They Love Using “Wear & Tear” to Deny Claims
Insurance doesn’t cover routine wear and tear or homeowner negligence.
However, some insurers may stretch this exclusion to deny claims.
They might argue you failed to fix a leaky pipe or ignored your roof after a hurricane years ago, for example. By shifting the blame onto you, they put you on the defensive, keeping them in control – and reducing your payout significantly.
A good public adjuster can help distinguish new damage from old, potentially recovering a much larger payout.
Some Discourage You from Hiring Help
As a policyholder, you can:
- Use your own contractor
- Hire a lawyer
- Work with a public adjuster
However, some company adjusters may discourage this. They might suggest it could slow down your claim, for example. Or, they may argue it’s completely unnecessary.
In reality, outside professionals hold insurers accountable. Your contractor might estimate $25,000 in repair costs while your insurer offers $16,000, for example. Without hiring an outside professional, you could be leaving thousands on the table. Third party professionals – from public adjusters to independent contractors – help bridge that gap.
Remember: you have the right to use your own contractor for estimates and repairs. You have the right to hire a public adjuster or attorney. Don’t let your insurance company’s adjuster trick you into feeling otherwise.
Why Many Homeowners Settle for Less
Insurance claims are complicated and stacked against homeowners like you.
Unless you work in the industry, you probably have little insurance experience. Most homeowners don’t file more than one or two major claims in their lives.
Insurance company adjusters use this to their advantage. They position themselves as a figure of authority, and some may use that authority to bully policyholders into accepting a smaller settlement.
Some of the reasons homeowners settle for less include:
- Lack of claims experience. Most homeowners only file one or two big claims in their life. An average insurance company adjuster, meanwhile, will handle hundreds or thousands of claims over their career. Most people don’t understand how claims work. Adjusters might use this to their advantage.
- Trusting the adjuster’s word as final. Your insurance company adjuster may advise against hiring a third-party contractor or public adjuster. They sound official and authoritative, so homeowners trust them. But they represent the insurance company – not your best interests.
- Confusing policy language. Insurance contracts are confusing and filled with exclusions, legal jargon, and fine print. Insurers might use this confusion to their advantage. Many homeowners don’t know about an exclusion until it’s too late.
- Fear of legal action or claim delays. If your home has been damaged in a fire, you want it repaired ASAP. You need to move back in. Some homeowners accept a lower settlement because they want to close the claim quickly. Others fear legal repercussions.
A good public adjuster can help you navigate these worries and ensure you don’t settle for less.
Final Word: Public Adjusters Know These Tactics – and How to Counter Them
You pay your premium and expect to be protected. But when it’s time to file a claim, the insurance process feels stacked against you.
Public adjusters help fight back against insurers and company adjusters. They know the strategies used by insurers – and how to counter them.
Public adjusters help by:
- Analyzing damages – including hidden damages
- Applying policy coverage to ensure fair coverage
- Organizing documentation to maximize payout and speed up settlement
- Negotiating with the insurer on your behalf
- Fighting for a higher settlement while reducing claim stress
- Helping you avoid being lowballed or ignored
To discover how a public adjuster could help with your insurance claim, schedule a no-cost consultation with ClaimsMate today.
Stephanie is a property insurance claim expert with over 20 years of experience working as an insurance adjuster, expert witness, appraiser and umpire. She is passionate about sharing her expertise, knowledge, tips and training to help both property owners and Public Adjusters in their pursuit of effectively managing claims and recovering the claim settlement they deserve after a loss.
