Frequently asked
questions

Dealing with a property insurance claim and not sure where to start?
Get clear answers and support to navigate the complexity and know when to hire a public adjuster.
  • business owners & property managers
  • contractors

It’s best to contact a professional to validate damages BEFORE you notify your insurance company in order to avoid a frivolous claim. There are no hard and fast rules on what warrants damage. For example, even one-inch hail and 60mph gusts can cause damage depending on the surface it impacts. Watch this video for more information.

If you have an active claim and you have a large dispute between the amount paid by insurance and what your contractor is stating, it’s a good idea to contact a public adjuster. Our trained and licensed public adjusters can give you a thorough and unbiased estimate of damages and negotiate your claim with the insurance company on your behalf.

On a large, complex claim, hire a public adjuster immediately after the loss occurs! On average, we settle claims 38% faster when we are involved before the claim is filed. (See how we expedite the claims process.) If the claim has already been filed and you are facing a denial, that is the time to consider an attorney or public adjuster. Plaintiff attorneys charge anywhere from 30-40% of the settlement. Most public adjusters charge anywhere from 10-25%. The claim fact pattern and venue can dictate which route to go. Get a free claim review from C3 Group today.

Each policy has a wide range of deductible options. Generally speaking, the lower the deductible, the higher premium you will pay. Make sure you check to see if there are different deductibles for each peril. For example, hail, wind, and hurricane deductibles can be upwards of $500,000 per loss. (See how percentage deductibles work.)

Repair versus replacement is a huge contention point with insurance companies and each case is different. For commercial flat roofs, you must consider substrate damages as well as the membrane. For sloped shingle or tiles, you must consider the age, availability, and other repair factors that drive costs. If a warranty exists on the roof, consider if the repairs recommended by the insurance company void that warranty.

Typically an “act of god” claim will not increase your premium. However, even if you don’t submit a claim or are not affected by a large catastrophic storm, you may see a rate increase as many other people submit claims.

A public adjuster is a claims adjuster who represents the interests of an insured in a property loss. Public adjusters negotiate settlement of such claims with the insurer’s claim representative. Public adjusters are compensated with a percentage of the payable loss that they are able to secure for their clients.

You should consider a public adjuster if you have a large, complex insurance loss which requires expertise and is unbiased. If insurance companies are underpaying or denying a claim without valid reasoning. Red flags are exhibited that show the insurance company is posturing to low ball or deny the claim.

It depends! Most of the time you can accept a payment without waiving your rights to collect more later. It is best to verify in writing this is not a full and final payment. Do not sign anything stating you waive your right to collect more on the claim. Supplements are a natural part of the construction process, and unless you are 100% positive you will not have any supplements, it’s best to have a public adjuster or attorney review settlement terms to verify the payment isn’t final.

Public adjusters carry state specific licenses that require testing, continuing education and training to represent policyholders. Once a contract is signed, they act as a fiduciary for the insured and become the de facto insured.

An independent adjuster is a claims adjuster who provides services on a contract basis to insurance companies, self-insured firms, and governmental entities. Depending on the nature of the claim being handled, billing can be on a time-and-expense basis, flat fee-per-claim basis, or flat annual fee for all claims.

A public adjuster is a claims adjuster who represents the interests of an insured in a property loss. Public adjusters negotiate settlement of such claims with the insurer’s claim representative. Public adjusters are compensated with a percentage of the payable loss that they are able to secure for their clients.

It’s best to have an independent, unbiased claims professional review the claim to verify the settlement is what you are entitled to. On average, C3 Group sees over a 200% increase in the claims we handle.

Insurance companies use Xactimate to help estimate the amount of damage and then apply coverage from the policy to know what items are covered.

In terms of insurance, bad faith can be ill fulfillment of contractual obligations to the policyholder. Administering misleading information and breaching basic industry standards are just some examples of an insurance company displaying bad faith.

If you have a claim denial or a partially denied claim, it is a good idea to have a licensed public adjuster or attorney review the file to provide a secondary coverage opinion. Our team can review your claim for free.

A qualified restoration contractor can provide an estimate and guide you through the residential claims process. However, if you own or manage a commercial property, policies become more complex and require more detailed reviews of coverage. Oftentimes, insurance companies will require detailed estimates written in a software program, Xactimate. And unfortunately, the vast majority of commercial property claims are underpaid. Our team is certified in Xactimate and includes one of only 48 Xactimate Certified Trainers in the nation. We also have the insurance knowledge and industry expertise you need to ensure your claim is filed accurately, negotiated professionally, and paid fairly.

NO. Your insurer owes to restore your property to its pre-loss condition subject to the dollar limits of your coverage. The appearance of your property after repairs have been made is legally supposed to be “uniform and consistent”. United Policyholders has gotten reports that insurance companies’ accountants are telling them they can save money by not paying to match vinyl siding, roofing and carpeting. United Policyholders has gotten reports that adjusters were told in Mississippi and Louisiana “we do not match siding, bricks, paint or carpet in this state”. That is absurd and unfair. Don’t stand for it.

This is a common problem with some insurance companies and it’s unfair and – in some states – illegal. Overhead and profit, (“O & P”) is a known expense that all contractors charge, usually at a rate of 10% and 10%. An insurer that holds back O & P until repairs are completed puts the property owner in an impossible financial position. It is wrong for your insurance company to hold back O & P until your property is completely repaired. If you have a flood insurance policy, check the NFIP bullet is for specific items that are covered.

Get a second opinion before rebuilding on an existing slab/foundation. Concrete can “fail” due to damage that an untrained eye won’t see. Most insurance adjusters have no training in concrete science.

No. There are insurance claims that do go smoothly. We are in this business to ensure that happens more.

Frustrating delays, rotating adjusters, wrong information about what’s covered and what’s not, “lowball”/unfair repair estimates and settlement offers, and what many people describe as a “second nightmare” of being treated badly by the company they trusted for many years.

YES. Take the time to read the wording of the specific exclusion the adjuster is relying on. Make sure to read the whole policy and whatever brochures or sales materials you can get your hands on. You may find words that show they promised or owe more benefits than they’re offering. Insurance policies are contracts written by insurance company lawyers. Doesn’t it make sense to get legal advice for yourself before taking the insurance company’s word that you’re not covered? You can use legal advice and arguments to convince your insurance company to change its position without getting involved in a lawsuit. Get together with others in your situation. Find videos taken of the storm that show the wind that came first. Pool your money and hire a “forensics” engineer who’s experienced in evaluating hurricane damage. If the engineer concludes that wind or another covered “peril” was a triggering cause in your area, present the information to your insurance company and don’t take no for an answer. Follow United Policyholders claim tips by keeping a claim diary, staying organized, writing to higher-ups in the company, and getting help from your state Insurance Commissioner’s office. Don’t take “no” for an answer until you’ve run out of options and that won’t be for a long, long time. Although you may feel discouraged and in no mood for fighting, it doesn’t make economic sense to take “no” for an answer from your insurance company this soon in the process. Before you give up or agree to take less than you need to repair/rebuild, it can’t hurt to get advice from a licensed PA or attorney. Just make sure it’s an attorney who has already had experience representing property owners on insurance matters.

Insurance companies are profit-making businesses and their employees are not social workers. Their goal is to close your claim quickly and without paying a dime more than necessary. Your adjuster may be friendly but he or she is not your friend. Insurance companies are naturally trying to control their payouts after a devastating disaster. There is a lot of confusing wording and legalese in insurance contracts and there are laws to protect you from getting taken advantage of. Many insurance companies are reading their policies with a bias that is too much in their own favor and against their policyholders. Your property is your biggest asset. Don’t accept an insurance company’s rejection of your claim without getting other opinions on the causes of the damage and the wording of the exclusion. You paid good money for insurance protection. There are laws that protect you against unfair treatment.

A public adjuster can help with scaling your company by taking out the everyday minutia of writing an estimate, corresponding with stakeholders and insurance company reps and navigating policy intricacies. We also have the training and expertise to handle claim red flags on behalf of you and your customer, including when/if to engage an engineer, policy coverage, delays, unwarranted denials or underpayment. Furthermore, there are legal limits to what a contractor can do when dealing with insurance claims. Contractors working with policyholders should check the public adjuster statutes in their jurisdiction to ensure they are not acting as unlicensed public adjuster when assisting in claims.

Labor and material costs always go up after disasters due to supply, demand and greed. Your insurance company owes you for what it will cost in real life, not on paper (up to your policy limits). Guideline pricing is something insurance companies use to predict how much materials and labor should cost. This system is often a problem because reality demands flexibility. No one can accurately predict how much prices will change after a disaster – especially one that is big. Take plywood for example – its price fluctuates wildly and can vary from $12 per sheet up to $25 per sheet in a post-disaster scenario. That doesn’t make it right, but it’s not fair or legal to make you wait until things stabilize to start repairing/rebuilding your property. Roofs are a highly contested item. If the insurance company’s pricing is $150 per square foot but the market price is $240, keep all receipts and demand the difference along with all amounts the insurance company “held back” due to ACV rules. (See United Policyholders tips for details.) The National Flood Insurance Program also has pricing lists of what they’ll pay pre-repair. If your pricing increases you can go back with a supplemental claim and they should pay the adjusted price.

Some insurance companies have the reputation of being fairer and more prompt in handling claims than others, but it’s hard to predict what’s going to happen in an unprecedented situation. Working together with professionals and fellow policyholders, following United Policyholders claim tips and using the materials in your three-ring binder will really increase your chances of getting treated well.

No. There are insurance claims that do go smoothly. We are in this business to ensure that happens more.

Frustrating delays, rotating adjusters, wrong information about what’s covered and what’s not, “lowball”/unfair repair estimates and settlement offers, and what many people describe as a “second nightmare” of being treated badly by the company they trusted for many years.

Insurance companies use Xactimate to help estimate the amount of damage and then apply coverage from the policy to know what items are covered.

In terms of insurance, bad faith can be ill fulfillment of contractual obligations to the policyholder. Administering misleading information and breaching basic industry standards are just some examples of an insurance company displaying bad faith.

Public adjusters carry state specific licenses that require testing, continuing education and training to represent policyholders. Once a contract is signed, they act as a fiduciary for the insured and become the de facto insured.

An independent adjuster is a claims adjuster who provides services on a contract basis to insurance companies, self-insured firms, and governmental entities. Depending on the nature of the claim being handled, billing can be on a time-and-expense basis, flat fee-per-claim basis, or flat annual fee for all claims.

A public adjuster is a claims adjuster who represents the interests of an insured in a property loss. Public adjusters negotiate settlement of such claims with the insurer’s claim representative. Public adjusters are compensated with a percentage of the payable loss that they are able to secure for their clients.

Have other questions?

Talk to one of our licensed public adjusters today.