The 411 on Insurance Claim Adjusters-

Dealing with an insurance claim after wildfire can be a stressful experience. There is significant evidence (look up McKinsey and Allstate) that indicates that frustration might just part of the design at some companies.

As policyholders, we expect our insurance claim adjusters to guide us through the process, provide fair compensation, and alleviate the burden of the situation. That might happen. However, if it did, you wouldn’t be reading this. Often, the process can be convoluted, frustrating, and Kafka-esque.

Tips to help with insurance claims-

Let’s explore some of the common sources of frustration and how to navigate them for a smoother claims process.

1) Communication Challenges: One of the primary sources of frustration with insurance claim adjusters is communication breakdown. Delayed responses, unanswered calls, and vague explanations can leave policyholders feeling unheard and uncertain about their claims.

Solution: Begin a journal for your claim. Keep written records of all correspondence, including emails, phone calls, and even notes from in-person meetings. If communication is lagging, politely request updates and set expectations for timely responses. Always put “reply by” date and time at the end of an email.

2) Lowball Offers: Many policyholders find themselves disappointed with the initial settlement offer from their insurance company. Adjusters often undervalue damages or repairs, leaving individuals feeling shortchanged.

Solution: Research and gather evidence to support your claim. Obtain multiple repair estimates from reputable sources to present a well-rounded view of the costs involved. If the initial offer is inadequate, negotiate respectfully and provide your evidence to back up your counteroffer. This is NOT a reason to hire a public adjuster. The PA has never built a home and is no better at estimating the cost than you are. Hire a builder who will take the time to do what is called a Scope of Loss Report.

3) Unclear Policies and Procedures: We find it interesting that insurance policies can be so specifically worded throughout except for one section, how to file a claim. This is designed ambiguity by the insurance company. leaving policyholders confused about what is covered and what is not. Adjusters might use ambiguous language that makes it difficult to determine the scope of coverage.

Solution: Begin at United Policyholders. Their website contains a full library of information you want. Carefully review your insurance policy to understand your coverage limits and exclusions. If something is unclear, don’t hesitate to ask your adjuster for clarification in writing. Keep a copy of your policy handy for reference during conversations.

4) Delays in Processing: Lengthy delays in the claims process can compound stress for policyholders who are waiting for compensation to repair their property or cover medical expenses. For some companies, this is another part of the attempts to frustrate you. They want you so upset and worn out so you give up. Don’t give them that satisfaction or unfair profit!

Solution: Request a clear timeline for the claims process from your adjuster. Regularly follow up on the status of your claim to ensure it is progressing. If there are unexplained delays, politely ask for explanations and advocate for a resolution.

5) Lack of Empathy: Some policyholders feel that adjusters treat their claims as mere numbers on a spreadsheet, lacking empathy for the emotional and financial toll of the incident.

Solution: For you, this is a disaster. For them, it is just another claim, just another disaster. Their coldness is not personal. Approach interactions with professionalism while also expressing your concerns and emotions. Sometimes, reminding the adjuster of the human aspect of the situation can help foster a more compassionate approach. If you understand going in this person is not there to help you, they are there to help the company, you can be less upset when they treat you inhumanely.

6) Inconsistent Information: In some cases, policyholders receive conflicting information from different representatives of the insurance company, leading to confusion and frustration. Often times, the claims department of an insurance company is staffed by their very worst employees that cannot yet be legally fired. That is the type of person you’re forced to deal with. Be persistent, calm, and write it all down.

Solution: Whenever possible, communicate with a single point of contact within the insurance company. If you encounter conflicting information, politely request clarification and refer to the records of your previous conversations. “Which page and section of my policy are you referring to, please?”

7) Multiple Adjusters: A lack of transparency in the claims process, such as the evaluation of damages or the calculation of compensation, can leave policyholders feeling in the dark about how decisions are made. But one of the most frustrating aspects of claims is when a company swaps out your adjuster for a new one. Companies have their reasons, none of them they will describe to you, but this relates back to our first tip – keep a journal. We have seen the companies (like the one whose ads claims they are a good neighbor) change adjusters up to seven times on people. It’s a frustration and delay tactic in our opinion. Keep good records.

Solution: Request detailed explanations for any assessments made by the adjuster. Be sure any new adjuster has the case notes. Note anytime they ask you for information already provided. If they have you repeat yourself, they are giving you evidence for bad faith dealings.

In conclusion, while frustrations with insurance claim adjusters can be disheartening, there are effective ways to navigate these challenges. Open communication, thorough documentation, research, and persistence are key elements in ensuring a smoother claims process. Remember that your insurance policy is a contract, and you have rights as a policyholder. By advocating for yourself with professionalism and patience, you can increase the likelihood of achieving a fair and satisfactory resolution to your insurance claim.