Claims adjusters are professionals in the insurance industry who investigate damages in order to determine the appropriate claim amount that should be paid to the insured. In some cases, the claims adjuster may even determine that the damage isn’t covered by an insurance policy or that repairing the damage wouldn’t meet the insured’s deductible, resulting in claim denial.

A claims adjuster’s investigation usually involves:

• Physically inspecting the damage or analyzing photographs of the damage
• Reviewing any associated paperwork, such as repair estimates written up by contractors
• Discussing the damage with the property owner or any witnesses
• Determining liability

If Your Home Was Damaged in a Hurricane, Why Would a Claims Adjuster’s Job Include Assigning Blame?

Insurance policies are written to save the company as much money as possible, which is why they put in language that puts maintenance and repair requirements on the homeowners. If you have preventable water damage from a months old roof leak that you, as the homeowner, should have taken steps to fix, the insurance adjuster may recommend denying your claim.

Most of those policy rules boil down to whether you could have taken action to prevent the damage. The problem is those recommendations are often subjective in nature.

If a leak under a sink in a bathroom no one ever uses goes unnoticed for weeks and causes mold growth, is it fair for the insurance company to claim you should have fixed the leak before mold started growing? Some people may say yes. It was your house and just because no one in your home uses that sink regularly you should have known it was there. Others will be more reasonable and empathize with your unique situation. In those scenarios, it really depends on the insurance company and their adjuster.

Types of Claims Adjusters

There are two primary types of claims adjusters – those who work for the insurance company and those who are independent.

In many cases, insurance company claims adjusters are honest people who are well intentioned, but they still have a professional interest in saving the company they work for money by underpaying or denying claims.

During most claim investigations, you’re relying on the claims adjuster to perform an honest assessment and recommend a claim payment that will allow you to make all the necessary repairs to your home after a fire, hurricane or hail storm.

Even the most honest insurance claims adjusters can still make mistakes. Under normal circumstances a good claims adjuster probably has no problem accurately and fairly analyzing damage and making estimates. Hurricanes are anything but normal circumstances for insurance companies.

After a hurricane, a claims adjuster’s normal case load can grow exponentially. They’re having to deal with a huge volume of claims in the same amount of time they had dealing with the occasional plumbing leak and house fire. These professionals understandably get overwhelmed and are in a rush to get distraught homeowners the money they need to rebuild and get life back to normal.

Mistakes inevitably get made and homeowners receive claim offers that are far less than what they need to repair – or their claim gets denied altogether.

This is where independent claims adjusters come into the picture. As a homeowner you are entitled to get your own claims adjuster who isn’t working for the insurance company. These professionals do the same job but don’t have any motivation to minimize their damage estimate.

Having an unbiased set of experienced eyes may result in a claim report that’s more favorable to you and will more closely align with your contractor’s repair estimates. An independent claims adjuster’s recommendation can be a vital piece of evidence in negotiations with the insurance company, and, if necessary, during legal proceedings.

When Should You Get an Independent Claims Adjuster Involved?

There are clear situations where you don’t need an independent claims adjuster. If you’ve gotten a bid from a contractor for repairs and your insurance company agrees to pay the repair costs requested, you probably don’t need to contest the claim.

There are also obvious situations where you should consider consulting with an independent claims adjuster:

• You’ve read your policy and believe the insurance company is misrepresenting or underestimating your damage or unfairly denying your claim
• The insurance company isn’t willing to negotiate  
• The contractors you’ve consulted with are adamant that it will cost far more to repair your home than the claim amount recommended by the insurance adjuster handling your claim
• The insurance company is saying your hurricane damage was caused by an excluded peril, such as natural flood water, and you’re convinced it was caused by a covered peril, such as wind-driven rain
• The damage wasn’t discovered right away, and the insurance company is giving you a hard time about filing a claim months or years after the storm

The most important thing for your family after a hurricane is getting life and home back to normal. If the insurance company isn’t treating your claim fairly and preventing you from making the repairs that are required to make your home livable, it may be time to seek assistance from an independent claims adjuster or even a hurricane damage attorney.