What Happens If You Disagree with Your Insurance Adjuster?
Resolving Your Property Damage Disputes with Your Insurance Company
When homeowners or business owners suffer property damage from a disaster such as a hurricane, tornado, or a hail storm, they may disagree with their insurance companies about how much damage occurred as a result of the disaster. What should a property owner do when the insurance company thinks that the disaster caused $20,000 worth of damage and the homeowner thinks that the disaster caused $50,000 worth of damage? What should the homeowner do if the insurance adjuster states that you need 10 roofing squares to repair your roof and you believe that it will take 25 or even 30 squares to repair the damaged roof? Or that you think the roof should be replaced and the insurance claims adjuster thinks that the roof can be repaired? In these instances, it is fair to say that the property owner has a dispute with the insurance company? What are your options?
Why Do Damage Estimates of Claims Adjusters Sometimes Differ from Yours?
First, it is important to understand why the dispute arose? Perhaps the insurance claims adjuster does not understand the full extent of your damages. Or the claims adjuster may have performed a quick assessment without considering all of your damages. Or you may have discovered additional damages after the insurance adjuster’s first assessment of your damages.
It is important to understand that a property owner can disagree with their insurance adjuster. It happens. People see things differently. After all, you are concerned with getting the maximum recovery possible for your property damages. And the insurance adjuster may have interests that are different from yours. Remember, the insurance claims adjuster is employed by the insurance company, and thus, will work to further the insurance company’s best interests, not yours.
What are the Property Owner’s Options When They Disagree with the Insurance Claims Adjuster?
After the insurance claims adjuster has inspected your property, they will usually send you a report of their assessment of damages including the deductible and amount payable to you for the loss. Consider this information a first offer, because it is just that. This report may also contain various adjustments based on the type of policy or the type of coverage that you purchased from the insurance company. If you agree with the assessment of damage and coverage after reviewing the report, you might wish to
accept the offer, get the damages repaired, and move on with your life.
On the other hand, if you disagree with the estimates contained in the report, you might consider contacting an experience lawyer who handles these types of cases if you do not feel comfortable negotiating with the insurance adjuster.
How the Appraisal Process in Insurance Contracts Works
When the insurance company and the property owner disagree over the amount of damages or the scope of damages, you or the insurance company can invoke the appraisal clause in the insurance contract. The appraisal process simply means that you and the insurance company will be getting a neutral third party who will render a professional opinion on the value of the loss. Your lawyer will work with the insurance company in choosing another person who has no interest in the matter to determine
the value of the loss. This process works outside of the courtroom. A lawsuit is not necessary in order to invoke the appraisal process.
A typical appraisal clause in insurance looks like the following clause:
Appraisal - In case we and you shall fail to agree as to the actual cash value or the amount of loss, then, on the written demand of either, each shall select a competent and disinterested appraiser and notify the other of the appraiser selected within twenty days of such demand. The appraisers shall first select a competent and disinterested umpire; and failing for fifteen days to agree upon such umpire, then on request of you or us such umpire shall be selected by a judge of a court of record in the state in which the property covered is located. The appraisers shall then appraise the loss, stating separately actual cash value and loss to each item, and failing to agree, shall submit their differences, only, to the umpire. An award in writing, so itemized, of any two when filed with us shall determine the amount of actual cash value and loss.
This clause basically states that the property owner and the insurance company will each choose a person to act as their representative in the appraisal process. These chosen representatives are called appraisers. Then the two appraisers will together choose a truly neutral party called the Umpire. The umpire and the two appraisers will then work together to assess the value of the loss. The homeowner will pay the costs of their appraiser and the insurance company will pay the costs of their appraiser. And
together, the parties will split the costs of the Umpire.
To determine the amount of the damages or loss, it is customary for the two appraisers and the Umpire to visit the site of the loss to inspect the damages. They will usually take numerous photos or videos of the damages. Then the three will usually meet later in order to determine the amount of damages. Some Umpires like to serve as a mediator to get all parties to agree on the amount and scope of damages. Other Umpires like to simply write an Award after the site visit which will be adopted by appraiser for one of the parties.
Using the appraisal clause in your insurance contract could be the best option for you to ensure that you receive a fair settlement after a loss. The lawyers at Gaynell Williams LLC Attorney at Law have substantial experience handling insurance claims .
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Gaynell Williams LLC Attorney at Law offers a free initial consultation to discuss your case. The first consultation can be in person or it can be virtual, on the Internet. Call Gaynell Williams today at (504) 302-2462 for a free consultation as soon as possible. We will work around your schedule. New Orleans lawyers Gaynell Williams LLC Attorney at Law have offices in Gretna and Downtown New Orleans by appointment only.
This information has been provided for informational purposes only and is not intended and should not be construed to constitute legal advice. Please consult your attorney in connection with any specific situation under federal and/or Louisiana law and the applicable state or local laws that may impose additional obligations on you and/or your business.