What to Know About Home Insurance Adjusters and How They Work

When you file a homeowners insurance claim, your insurance provider will send a home insurance adjuster to evaluate the extent of the damage to your home. The adjuster’s assessment will determine how much your insurance company will pay to repair or rebuild your home.^[1]

You have some recourse if you disagree with your home insurance adjuster’s estimate. You can dispute the assessment directly with your insurance company, hire a public adjuster, or file a complaint with your state regulators.^[2]

What is a home insurance adjuster?

Insurance companies employ home insurance adjusters to evaluate claims and collect evidence to determine the financial loss incurred by the homeowner and whether the policy covers it.^[3] Adjusters typically work with larger claims. For example, suppose you have water damage from a burst pipe or fire damage in your home. In that case, your insurance company will likely send an adjuster to collect cost estimates.

Read More: How Much Homeowners Insurance Do You Need?

What do home insurance adjusters do?

Home insurance adjusters fulfill several duties for insurance companies, including:

• Asking you questions about your claim by phone

• Visiting your house to evaluate the scope of damage

• Speaking with witnesses, doctors, or employers for more information

• Looking at official police reports or documents related to the claim

• Consulting with legal counsel on complicated claims

A home insurance adjuster’s investigation allows them to achieve several objectives:

• Deciding whether a policy covers a loss

• Determining a fair payout

• Investigating any potential insurance fraud

• Settling the claim

• Authorizing payments to the mortgage company or homeowners^[4]

How much does a home adjuster cost?

Insurance companies typically employ home insurance adjusters, who provide their services at no cost to the homeowner. However, some homeowners prefer to hire a public adjuster to investigate claims. If you choose this route, you should vet public adjusters by checking qualifications and references.

While a public adjuster may have your best interests in mind, they can only get you the amount you’re entitled to under your insurance policy. Hiring a public adjuster could provide a smoother claims process and more confidence in the settlement amount. However, public adjusters may charge up to 15% of the settlement amount for their services.^[5]

Should you hire a public adjuster?

The Insurance Information Institute recommends that you be wary of public insurance adjusters who show up at your door after a natural disaster and that you should avoid working with anyone who pressures you. But you may want to get a second opinion from an independent adjuster in some instances.

If you want someone on your side who can explain the claims process, or if you’re worried the insurance company’s settlement offer is too low, hiring a public adjuster might make sense.

However, you should thoroughly research your options and ensure you understand the fees before hiring a public adjuster. Public adjusters will take a portion of your settlement amount, so you may get less money than you need to repair your home.

How to prepare for a visit from a home insurance adjuster

Here are some things you can do to prepare for an insurance adjuster’s visit:

1. Review your homeowners policy’s declarations page. Your declarations page shows your insurance coverage limits, home insurance deductibles, any endorsements you added to your policy, and settlement provisions. It’ll give you an idea of what’s covered and what to expect from a settlement.^[6]

2. Determine if the cause of your claim falls under your policy’s covered perils. Next, read the full policy to identify any exclusions or processes. Read the policy carefully to determine if the loss is covered.

3. Review the policy’s steps for settling a dispute between you and the insurer. Get a sense of the formal process of a dispute so you know what to expect if you disagree with your claims adjuster.

4. Determine if your insurance company will pay the actual cash value or replacement cost. Some home insurance policies only pay the depreciated value of a damaged or stolen item, while others cover the cost of buying a new similar item. Even if you have a replacement cost policy, you may receive the actual cash value first and the additional costs as a reimbursement once you replace your items.^[7]

5. Document the condition of your home and create a home inventory. Collect photographic evidence of the damage to your home and create an inventory of damaged, destroyed, or stolen items to present to the home insurance company adjuster for review.

6. Gather pre-disaster photos of your home for comparison. If you have pictures from your home before the loss, you can include them with your post-disaster photos and present them to the claims adjuster.

7. Complete a proof of loss form. Include as much detail and evidence as possible in your proof of loss form, as this is your formal statement to your insurance provider, which your claims adjuster will review when determining your claim payout.^[3]

8. Be there when the adjuster visits. You’ll need to walk through your home with the adjuster and point out evidence of the loss.

Learn More: Why Do Home Insurance Companies Deny Claims?

What to do after a home adjuster’s visit

Follow up with the home insurance adjuster. Provide additional documentation or photographs as needed and ask how the payment process will work. If you have a mortgage, your mortgage lender may release your payment for some coverages over time, as your contractor completes the necessary repairs. However, your additional living expenses reimbursement will be paid directly to you.^[7]

How to dispute an adjuster’s decision

You may disagree with your insurance company’s adjuster on whether the loss is covered or what amount will fairly cover the scope of the damage. If that’s the case, appealing your home insurance adjuster’s initial settlement is always an option. Your policy should list the steps necessary to file a dispute, but you’ll generally start with the following:

1. Understand your rights. Know your state’s laws regarding claims processing. Contact your state’s insurance department if you believe your insurer is engaging in unfair practices.

2. Get the settlement in writing. Ask for an itemized explanation of the damages and review the settlement offer to determine what additional evidence you can provide.

3. Provide more evidence. Collect photographs, witness statements, and other documentation of the property damage or loss, and submit these to your claims adjuster.

4. Get help from your insurance agent or broker. Your insurance agent or broker is accustomed to working with your insurance company and may be able to advocate for you. You can also speak with someone from the policyholder service department and explain your concerns.

5. Get legal help. If all else fails, hiring an attorney might be a good idea. Give your lawyer a copy of your insurance policy and the settlement. You may be able to enter into arbitration or mediation, depending on the stipulations of your contract.^[3]

Check Out: Can I Cancel a Home Insurance Claim?

Home insurance adjuster FAQs