Insurance Claims

Shh! Confessions from an Insurance Adjuster

Basically, when you file an insurance claim, an insurance adjuster is assigned to complete an investigation to determine coverage. During that timeframe, they encounter a few roadblocks with you, the insured. Here are a few insider secrets for you. Let’s be honest, you will now have the upper hand! Here are the confessions straight from an insurance adjuster.

See my disclaimer here.

Ask any insurance adjuster, and they will tell you all the frustrations they commonly encounter during a claim. From the initial phone call to settlement, there are many things insurance adjusters wish they could say to you but must keep it professional.

Luckily, I’m here to give you the insider’s scoop on what insurance adjusters want you to know! 


Don’t lie because you think something is not covered.

I cannot tell you how many times someone has lied to me to try and cover up what really happened all because they thought it wasn’t covered. This is seriously not cool. You are wasting your insurance adjuster’s time. If it’s purely accidental, lying about it makes it appear intentional. You definitely do not want your claim to be denied because of misinformation.

Here are two possibilities:

  1. Chances are it’s covered, and you lied for nothing. You just held up precious time to close your claim.  
  2. It’s not covered, and the insurance adjuster will most likely find out. Again, you just held up precious time and resources.

If you think something is not covered, speak with your agent first and get a better understanding of what is covered.

I’m telling you that lying is never the answer. If you do not want to provide information, you may need to complete an examination under oath. You would have to go speak with the insurance company on the record and provide whatever details or information they request. It’s not fun, so I suggest you always tell the truth!

Personally, I’ve had a handful of situations where the insured has lied about what caused a fire. I hate to break it to you, but (great) adjusters know when you are lying. For total fire losses, a fire investigator is usually hired to determine the cause of loss. I would keep that in mind 😊.

We are on strict timelines.

Typically, an insurance adjuster must contact you within 24 hours of receiving the claim assignment from your insurance company. 

We must inspect your property within 48 hours and have our report to the insurance company that same day or within 72 hours of the assignment.  

All insurance companies vary; however, they are all on tight timelines.  

If you wait a week for your inspection, the insurance adjuster still has to write a report on it. Along with updating their notes, and then following up with you again to make sure you are still on for the inspection. This all takes up valuable time. 

Try your hardest to allow the adjuster to inspect as soon as they can. 

Please don’t argue with the insurance adjuster… just yet.

I have shown up to so many inspections with the homeowners (insureds) already defensive and ready to fight. After I introduce myself and start speaking with them about details of the claim and previous losses, they begin to confess that they had a bad prior experience. This is the ah-ha breakthrough moment. Most homeowners admit that they encountered an adjuster that just wasn’t up to par. Seriously, just because you had a prior bad experience does not mean the next one will be the same. Give the insurance adjuster a chance.

Remember this:

  • Be communicative, not defensive. 
  • Allow us to perform our full inspection and ask questions. 

Having a defensive attitude puts your adjuster in a bad mood and they may unintentionally not perform at their highest level.

Think about if the roles were reversed. Would you want someone coming to your job immediately with an attitude whom you never met?

I’m sure the answer is NO.

Be prepared for your inspection.

Again, another scenario that could have been avoided. I’ve shown up to people’s houses in absolute despair. Not from their claim, just because that’s how messy they are.

Property adjusters are there to take pictures of your property!

I’ve had so many homeowners tell me that I could not access or take pictures of a room because they were embarrassed. Here’s an insider exclusive: the insurance company frowns down on adjusters when we do not entirely document the claim. The moral of the story is to please have your house presentable (of course, not total losses or severely damaged homes!).

If you know something is damage, speak up now and show us what you have found. Download the property insurance claim packet here. Fill this out when you have a claim and submit to the insurance adjuster.

A great, thorough adjuster does not need you to show them what is damaged; however, not all adjusters are made alike. By providing a list of what you found to be damaged will make sure you are both on the same page. It does not hurt to be prepared for the inspection!

Send all documents together

Sometimes an adjuster will request additional documentation after an inspection. Or they may ask you to retain all invoices, receipts until a specific event expires or whatnot.

PUBLIC SERVICE ANNOUNCEMENT: Please, for the love of all things, keep all your documents together. So they do not become lost and submit them at ONE TIME.

Sending documents one by one over days or even weeks holds up the claim & causes the adjuster to continuously update their notes and the official file. Not to mention the reports the adjuster will have to write to update the insurance company on their progress. All when they could have just done it at once.

If you are having trouble keeping your documents together and in order, ask the adjuster how they would like for you to submit them.

Whenever in doubt, just ask the insurance adjuster. 

Call us during regular hours

This confession is pretty apparent, yet it still needs to be addressed. If your adjuster does not set clear communication expectations during the initial phone call, then simply ask them.

Based on my experience, I would call your adjuster between the hours of 9am-5pm. 

Don’t throw anything away

Pictures are helpful, but if something can be repaired or cleaned, we must have the opportunity to inspect it ourselves.

Yes, we want you to take your own photos. BUT it does not mean that once those photos are taken that you can discard everything. 

I can’t tell you how many times I’ve encountered this problem. Unfortunately, the insurance company has every right to deny your request for specific items that were discarded before the inspection. 

You must notify us if you have an attorney upfront.

HERE’S THE DEAL:

  1. We are not allowed to speak with you if you are represented.
  2. We must have a letter of representation from your attorney.

That’s it. Easy. Please follow those two rules.

Have your contractor present

Do you have a contractor chosen before the adjuster being assigned? Be respectful and tell your adjuster.

There is nothing more irritating than you already having a contractor and not having them present during the inspection. Because if they discover additional damage, then we may have to complete another inspection. You probably have a million questions after that… Okay, let me explain. Some contractors want to be present during the inspection because they can be fully knowledgeable about what is covered and what work they will be paid to do. If something is not covered and YOU cannot pay for it, the contractor probably does not want to do it.

Another example would be a roofing contractor that tells you that your roof is totally damaged by hail and must be replaced. Well, when the adjuster gets there, guess what, the roofer exaggerated. The roofer was not there during the inspection and is now upset that the adjuster denied the roof. Well, here goes another inspection! Always have your roofer present. It’ll save time and will let them hash it out. 

Full roofer disclosure: I’ve met a TON of roofers. Half was great, half not so great. I have nothing against the great roofers. 😊

Here’s what to remember:

  1. Having the contractor there just allows the claim to advance.
  2. Adjusters are on a timeline that we must adhere to!      

Independent Adjusters are not trying to save the insurance company money.

Oh, the holy grail of confessions. The moment you have been waiting for! The answer to your burning question. The conspiracy theorists are gathering up with their popcorn and lounging back in victory.

Not so fast. Here’s the real deal truth.

  • The adjuster can ONLY pay for what is covered. PERIOD. Nothing more, nothing less.
  • HOWEVER, I hear it repeatedly that adjusters are somehow in cahoots with the insurance company to save them money. That is simply not true.
  • Adjusters are responsible for our estimates. 
  • If we go to court, it’s the adjuster explaining why they paid for something or didn’t.
  • Despite what anyone believes, independent adjusters can get paid on a fee schedule. This means the more that’s included in your estimate, aka what we pay for, the more money we get paid. It’s based on the logic that the longer it takes to write an estimate, the more that’s damaged, the more work is typically done, etc.
  • AGAIN, IT MUST BE COVERED UNDER YOUR POLICY FOR US TO INCLUDE IN OUR ESTIMATE.

I hope my explanation clears that misconception! However, I can’t speak for staff adjusters as I’ve never been one.


The Curious Confidential: Do you have a burning question for an insurance adjuster? Shoot me a message! It may just be featured in this article.  


Shh! Confessions from an Insurance Adjuster via @The_Insurance_Confidential
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