The Book On Roofing

How to Work With Your Claims Adjuster to Get Everything You’re Entitled To

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You’ve suffered through a severe wind, rain or hail storm. Now, your roof is damaged and needs expensive repairs. You might have gutter or siding damage, too, which can be even more costly. Thankfully, you’re covered by insurance.

However, even insurance can be a daunting process to endure. This is especially true if you’re not familiar with making insurance claims for roof damage and you don’t know how to work with your claims adjuster.

Insurance claims for roof damage have a fairly straightforward approach. The details matter. They determine if your claim will be fully compensated, partially paid out or entirely denied. Knowing what to expect puts you in a much better position when requesting a claims adjustment following storm damage.

It pays to be a step ahead — and that involves understanding the elements of your home insurance policy and knowing how insurance adjusters operate. Here’s a crash course.

First Steps When Filing Roof Insurance Claims

Exterior insurance claims are a bit like a chess match. You have to make the first move and file a claim.

Then, it’s your insurance company’s turn. They’ll respond by assigning a claim number and a representative to investigate the extent of the damage. That includes calculating or adjusting the amount to be paid for covering repairs. The adjuster also determines if your claim is even valid within the terms of your policy.

You can put yourself in the best position by anticipating these moves and making moves of your own.

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Your first priority is to assess your damage and do everything you can to mitigate further damage. Failing to do this may put you in a bad position when it comes to having incidental damage covered. This usually includes water ingress resulting from missing shingles or flashings. Your adjuster will take into account whether you’ve acted in good faith and protected your property rather than allowed more liability to be incurred by the insurance company.

If you have the potential for continuing damage, make sure you contact a reputable and professional roofing company to assess your damage. Make intermediate repairs to minimize further expenses that may be part of your insurance claim. This approach will put you in a much better position on the insurance chess board when it’s time to deal directly with your adjuster.

Doing these two things will help keep you in control of the settlement game.

Insurance Claim Terminology

Once you’ve protected your property from further damage and yourself from unnecessary payments, take some time to prepare yourself for the insurance adjustment process. Your next move is to open your insurance policy and go through the fine print. Determine exactly what’s covered and what isn’t. Knowing your ground and your entitlements will make the process easier and more efficient when you first meet with your adjuster.

Consider these four insurance terms and conditions:

1. Coverage

Coverage is what the insurance company is responsible for paying. Watch for an “Act of God” clause, which is how most wind, rain and hail storms are classified. You may or may not be covered for natural disasters. Your insurance company will immediately check on this upon receiving your claim, and your eventual adjuster will surely be aware of what pieces are covered and what needs to be removed.

2. Deductible

The deductible is the amount of money that’s discounted from your claim at payout. Almost all insurance policies carry a deductible clause. It can vary from a few hundred dollars to a thousand or more, depending on the terms you agreed to when you purchased your policy.

You may find that your deductible amount exceeds the total damage costs. If so, there’s no point in filing a claim. It wastes your time, the insurance company’s time and the adjuster’s limited and valuable time.

3. Depreciation

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Depreciation can be another obstacle on the settlement board. Many insurance companies have a depreciative clause written into policies that deduct for older and already-failing materials. This is common with roofing materials. Insurers might ask the claims adjuster to calculate the age of your roof, the condition prior to the storm damage as well as the type of materials and how you’ve maintained them.

Your adjuster may be required to conclude that your roof was already close to the end of its natural lifecycle and to adjust your claim accordingly. Combined with your policy’s deductible amount, you may find yourself without coverage.

4. Incidental Clauses

Incidental clauses are other issues that crop up during the insurance settlement game. If your damage is so severe that you’re required to move out during repairs, you may be entitled to incidental payments for interim lodging and meal expenses.

Make sure you’re aware whether you’re covered before absorbing incidental coverage. If you incur them without prior approval from your insurance examiner or adjuster, you may find yourself denied compensation even though you may be contractually entitled to it.

Working With Your Claims Adjuster

Now that you know your boundaries and exactly what you're entitled to, it's time to move on to filing for a claims adjustment for your home repair. This will place you on good footing in having your claim properly and fairly adjusted. You want to make this a cooperative process — not an adversarial one. Preparing yourself will help keep your relationship with your adjuster positive and clear.

Remember that most claims adjusters are primarily responsible to the insurance company — not to you as the homeowner. Being prepared for this dynamic is the key to working with your claims adjuster. Here are some additional suggestions for being prepared for the insurance adjustment process and meeting with your adjuster:

1. Photographs

Photographs are enormously helpful to insurance adjusters. In all likelihood, they’ll take their own independent photos when they visit your site, but you can certainly make their job easier by giving them a head start with a preview of the damage.

Digital photos can be emailed directly to support your insurance claim. They can also be duplicated and shared without cost.

2. Video Footage

Videos are another great way to supply information. All smartphones have video capability and have instantaneous internet sharing capacity.

Videos can show more than still photos. You may also have been at home and in a position to record the storm itself while it was in progress. This is positive proof of the cause of damage and will save an adjuster the effort involved with verifying your story against weather records. You might even catch shingles falling off or a tree coming down.

3. Before and After Pictures

Before and after pictures can be very useful for proving that claimable damage occurred. Many homeowners protect themselves by taking periodic photos of their property as their own insurance against having to fight a weather-related claim.

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If you have photographic evidence of your roof's condition before the storm, this will assist your claims adjuster greatly. It will establish that your damage is coverable and not just due to wear and tear. Recording the date of “before” photos is helpful. This reduces doubt about whether a natural event is at fault.

4. Written Documentation

Written documentation is highly useful to an insurance adjuster. They rely on documents as well as photographs in adjusting a claim and concluding what constitutes a fair settlement.

You might have recently replaced your roof. Or, if your home is newer, your builder may have provided warranty information that includes your roofing products. Establishing the brand and quality of your roofing materials is an immense help to an adjuster so they can calculate the true cost of replacement with equivalent materials. You should also have receipts for any emergency or temporary repairs.

Steps in the Insurance Adjustment Process

Before meeting with your insurance adjuster, it’s important to know what the steps in the process are. Insurance claims are done all the time, which means there’s a routine to the business.

If you’ve suffered storm damage, you can expect that others in your area have, too. That’s going to place a high workload on insurance adjusters. Being patient with the process is important and will result in starting a good relationship with your adjuster.

Here’s what to expect in the steps:

Step 1: Filing a Claim

Normally, this is done with a phone call to your insurance provider during business hours. You can also file by email or however your insurance provider directs.

Make sure you do this as quickly as possible once you’ve prepared yourself. Some insurance companies have a specific time limit to report damage after it occurs. You don’t want your coverage denied due to procrastination on your part. Also, make sure you have your policy in hand to provide the number and other details if requested.

Step 2: Assigning a Claim Number

Your adjuster will likely assign a claim number right away. They use this number to track all information pertaining to your claim. Record the number and have it ready for whenever you need to contact your insurance company or adjuster.

They have many claims active at the same time. Referring to the number makes retrieving your claim quick and easy. It shows preparedness on your part, which will go a long way toward having your damage claim adjusted smoothly.

Step 3: Arranging an Adjuster Appointment

An insurance claim examiner will first process your claim. That’s a different person from your insurance claim adjuster. Examiners are office people who have the primary control over your claim and work in a supervisory role. You’ll likely have little or nothing to do with your claim examiner.

Instead, you’ll be assigned an adjuster, who acts as a field investigator. Your adjuster will almost always make a personal visit to your home and see the damage firsthand. You should make every attempt to be at home and meet your adjuster in-person.

Making an appointment is an important step. Make sure you’re flexible and can work within the adjuster’s schedule. Respect their time and workload.

Step 4: Supporting Your Claim

Once your adjuster is satisfied your claim is valid and can be adjusted, they’re going to start assessing the extent of damage and what the costs of repair are. This is where it’s extremely helpful for you to have already contacted a reputable roofing company and had them make an inspection.

Professional roofing companies are used to working with insurance claims. They’ll know exactly what an adjuster needs and will have supporting documents and photos ready. It’s wise to ask your insurer about getting an independent inspection done during your initial claim contact. They may have company policies or preferred contractors they work with.

Step 5: Working With Your Insurance Adjuster

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Do everything you can to help your adjuster process your claim. Being honest and transparent is vital in building and maintaining rapport. They’re people like you and they appreciate others who act responsibly and in good faith.

Try to do everything to make their job easier. Stay within your squares on the board and don’t commit to any outside parties until you’ve got permission from your adjuster to incur reimbursable expenses. That includes signing a contract with a roofing company or any repair service. Unauthorized expenses put your adjuster in a bad position and may leave you without payment.

Step 6: Settling Your Claim

Roof repairs resulting from storm damage usually settle quickly and without much hassle. Your adjuster will consider factors like deductibles, depreciation and incidentals as well as what the reasonable repair expenses are before making you a settlement offer. If you’ve been reasonable, they likely will be, too.

Your adjuster should be transparent about how they arrived at the settlement figure and why certain claim expenses may be denied. You’re entitled to negotiate, provided you do it fairly and respectfully. If you can’t reach a settlement, you’re entitled to appeal the decision of the insurance examiner.

If all negotiations fail, you have the option of contacting an attorney and pursuing legal action.

Step 7: Authorizing Repair Work

You won’t be in a position to authorize repair work until your adjuster gives approval. Who you authorize work to may depend on your insurance company’s policy and, possibly, approval by the adjuster.

Time is of the essence in roofing repairs and your adjuster knows this. An experienced adjuster may immediately ask you who you’d be comfortable hiring. They also know roofing companies need lead time, particularly after a storm and roofers are in high demand. This should be a team approach. You may even have a company in mind already.

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It’s good practice to have your roofing company’s representative meet with your adjuster and yourself. This will make the adjustment process even smoother.

Step 8: Receiving Payment

This is the final step.

Different insurance companies will have slightly different payout methods. Ask your adjuster early in your discussions how payments are disbursed. Two payments are generally used in insurance payments. The first covers incidental, out-of-pocket expenses and provides a down payment to the repair company. The second payment clears up the entirety of the amount due.

Insurance companies are responsible to mortgage companies. They may include your mortgage lender in the adjustment process and require the financial agency to endorse your insurance payments. Your adjuster will know this and can offer advice. The main thing is to know the payment process so you won’t be caught short.

Understanding Your Insurance Adjuster’s Role and Qualifications

Your claims adjuster is a specialized professional who is trained to assess damage and repair costs and then arrive at a settlement figure that’s fair to both the insurance company and you as the homeowner. Your adjuster has to work within the law and the terms and conditions of your written policy. Sometimes that can be a tough job for what might seem like a simple process.

Let’s do a quick review of your adjuster’s role before examining their qualifications. Knowing both will make it easier to work with your claims adjuster and get everything you’re entitled to in claims adjustment following storm damage. Here are your claims adjuster’s tasks:

1. Examine your damaged property

2. Gather all information about the cause

3. Take photos and document evidence

4. Assemble a report containing all details

5. Present the report to an insurance examiner

6. Obtain a settlement decision and present it to you

7. Remain available until the damage is repaired

8. Close the claim once everything is complete

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To appreciate what an insurance claims adjuster does and to work cooperatively with them, keep in mind these professionals adjust more than roof claims. They have to be generalists rather than specialists.

Insurance claims are generally divided into two categories. One is property damage and the other is personal liability. On any given day, your claims adjuster may have dozens of open files requiring their attention.

There are also different types of insurance claims adjusters. Your insurance company will usually assign you an adjuster to go along with your claim. On a rare occasion, you may be allowed to select your own adjuster, but you always have the option to hire a personal adjuster for a second opinion. The different types of adjusters include:

-Staff adjusters: These are employed directly by insurance companies and are retained on staff. They’re common in large companies and centers where the volume of work and geographic locations makes this role cost-effective.

-Independent adjusters: They belong to a company that specializes in adjustments. They provide contract-based adjustment services to insurance companies. They’re often found in more remote locations and used in mass claim situations after natural events. Independent adjusters can also be self-employed, private contractors.

-Public adjusters: These are adjusters who are openly available for hire by both insurance agencies and the public. They’re usually employed by the government and self-insured organizations. Often, public adjusters are attorneys or people with advanced legal training.temp-post-image

Adjusting insurance claims requires a high skillset. It can take years to become proficient and efficient. Many insurance adjusters start out in a different field and then branch into adjusting after they acquire knowledge in business management, legal services and industries that require estimators. There are few specialized schools that provide degrees or diplomas in insurance adjusting. Many adjusters learn on the job while understudying with experienced adjusters.

Claims adjusters require more than good estimating skills. They’re rounded individuals who are flexible and look forward to challenges. No two cases are alike in the claims adjustment business and they have to be ready for them.

Consider these traits and skills that make up a professional insurance claims adjuster:

-Good academic standards: Adjusters need to be conversant with the complex wording contained in insurance policies. They must know exactly what their legal parameters are when offering an opinion as to a fair claims settlement.

-Stellar communication and interpersonal abilities: Adjusters often deal with policyholders at the worst moments of their lives. Emotions can be a big factor in negotiating claims. It’s vital for an adjuster to clearly communicate with clients so there is no doubt about how the settlement process unfolds.

-Excellent organizational traits: Adjusters have to be organized and ensure claims are dealt with quickly and efficiently. They’re often involved in situations affecting peoples’ lives and financial futures. Getting claims organized quickly so decisions can be made is crucial.

-Proficient in analysis and math: Insurance adjustments are always about analyzing facts and calculating costs. A good claims adjuster requires an analytical mind and a good grasp on figures.

-Able to withstand stress and fatigue: Insurance claim adjustments aren’t a 9-5 job. Adjusters have to respond at all hours and days of the week. Some claims require long hours in inclement weather or long travel distances. Stamina is important and burnout can be high.

Working With Your Claims Adjuster Requires Cooperation

When you work with your claims adjuster, the most important thing to do is cooperate. There’s a myth or a stereotype in the insurance business world that companies are all about selling policies and doing what they can to prevent claims payouts. That myth carries on to labeling adjusters as one-sided players who represent the kings in the corporate chess game.

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The truth is, claims adjusters are supposed to be impartial and to work toward a mutual settlement that’s fair for all parties and based on the contract’s terms.

But adjusters do have some limitations when processing your claim. This depends on the adjuster’s experience and proven abilities. Their level of financial authority varies depending on their position with the insurance company. Some senior adjusters have a high degree of flexibility when it comes to disbursing funds without approval. Newer adjusters have limited responsibility and have to be overseen by superiors before they can make any onsite decisions.

This is important to know. Your adjuster should make every effort to further your claim without delay and arrive at a decent conclusion within a reasonable time. That depends a lot on your cooperation.

When making an insurance claim for a storm-damaged roof, part of your cooperation is finding a professional roofing company to provide your adjuster with a reliable estimate for the cost of your repairs. Your adjuster needs confidence that your roofing contractor will perform properly and be a team player. This will help process your claim like no other move.

TEC is your reliable roofing professional. We’re experts in repairing storm damaged roofs and have years of experience in working with claim adjusters. We help make sure you get everything you’re entitled to. Contact TEC today for your home and roof repair needs.

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