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General Claims Process

The average claims adjusting process will go through several steps:

Reporting a claim with insurance company – Policy holder will need to notify the insurance company about the sustained loss in order for claims process to start.  Once the claim is received by the insurance company, a claim number will be assigned.  Next, a claims adjuster will be assigned to evaluate and adjusting the claim on behalf of the insurance company.  The insurance company may utilize a staff/company adjuster or an independent adjuster.  A staff adjuster is employed by the insurance company.  They represent the insurance company and are paid by the insurance company.  A staff adjuster will not charge a fee to the policy holder.  The staff adjusters are not individually licensed or tested by the State of California.  The independent adjuster may be hired on contract basis by the insurance company to represent the company in the settlement of the claim.  Independent adjusters are paid by the insurance company. 

Before moving forward with any payments, the insurance company will conduct its evaluation of the reported claim to determine coverage.   

A knowledgeable licensed Public Adjuster who is working for the policy holder may assist the policy holder to properly document and present the claim related facts to insurance company.   At the same time, the Public Adjuster may evaluate the insurance policy contract and inform the policy holder about their options.   

Mitigation – The policy holder will need to protect the property from any additional damage.  For example, in case of a water leak, the policy holder may need to call a plumber for the leak repairs and call a restoration company to start the drying process.

Housing/ALE (Additional Living Expenses); Loss of Use – Depending on the extent of damage, the policy holder may be entitled for a temporary housing or loss of use compensation and other relevant expenses.   In case of a commercial/ business property, the policy holder may be entitled for loss of business income or business interruption.  A knowledgeable licensed Public Adjuster may assist the policy holder to properly document and present the temporary housing needs, loss of use or any other relevant costs as needed.

Evaluation of Claim Related Damage – The insurance company staff adjuster or independent adjuster will prepare structural estimate and or contents estimate (if needed) and pay based on these estimates.    

A knowledgeable licensed Public Adjuster who is working for the policy holder may assist the policy holder to properly document and present the claim related structural and or contents damage to insurance company.   Public Adjusters utilize similar estimating systems to prepare the competitive estimates.  Additionally, Public Adjusters may utilize industry experts to properly evaluate the claim related damage. 

Documentation and negotiation of claim settlement may be a lengthy and complicated process.  A knowledgeable Public Adjuster will make sure that policy holder receives a maximum and reasonable settlement without sacrificing its own time away from work and family.

There are many other circumstances that may arise during the claims adjusting process where knowledgeable Public Adjuster’s expertise may make a difference and change the balance towards in policy holder’s favor. 

Call Now to Schedule a Free Consultation if your property or business sustained damage and you need assistance with your insurance claim.