Avoiding Home Insurance Claim Adjuster Secret Tactics

Insurance adjusters use various strategies to achieve their objectives. These tactics can range from requests for additional documentation to outright denials of a legitimate insurance claim. Recognizing these tactics is the first step in effectively countering them.

1. Requesting Repeated Documentation

   One common tactic adjusters use is to repeatedly request documentation. They might ask for the same information multiple times. Also, they may request additional and often unnecessary documents. This strategy aims to frustrate the policyholder. Essentially, it leads to delays and causes them to give up on their insurance claim.

   You can avoid falling for this by staying organized. Keep all your claim-related documents in one place and maintain copies of everything you submit. Also, ensure that you respond to documentation requests quickly. Ensure you keep a record of all communications. Lastly, don’t be afraid to speak out and seek clarification. If an adjuster’s request seems excessive or repetitive, ask for clarification on why they need the information.

2. Delayed Responses

   Adjusters may also delay responding to your inquiries or processing your claim. This tactic can lead to a prolonged claims process. Also, it makes policyholders anxious or desperate. Therefore, they are more likely to accept a lower settlement offer.

   When faced with a scenario like this, keep detailed records of all your communications. This record should include dates, times, and the names of the people you speak with. You should also politely but firmly request timelines for responses. Make sure you follow up if these timelines are not met. If delays persist, escalate the matter to a supervisor. You can also file a complaint with the insurance company’s consumer affairs division or your state’s insurance department.

3. Undervaluing Damages

   Insurance adjusters might try to undervalue the damage to your property. They could claim that certain damages are pre-existing or not as severe as reported. This tactic aims to reduce the payout by questioning the extent of the loss.

   Adjusters can identify the smallest discrepancies or inconsistencies in your insurance claim. They might suggest that wear and tear caused the damage rather than a covered peril. Additionally, they might attempt to downplay the severity of the damage. They might also bring in contractors who underestimate repair costs, further minimizing the payout.

   This is why you need to get independent estimates. Hire your own contractors or appraisers to assess the damage and provide written estimates. You should also have evidence of the damage such as comprehensive photos and videos and repair receipts. You can then present your independent estimates and request a reevaluation.

4. Applying Depreciation Aggressively

   Insurance companies often apply depreciation to reduce the value of your claim, paying you less for older items. Adjusters may use overly aggressive depreciation schedules to minimize payouts.

   For example, if your policy covers Actual Cash Value, the adjuster might depreciate the value of your belongings based on age and condition. This leads to a significantly lower payout than you might expect. Even with Replacement Cost Value policies, some adjusters might calculate the ACV to delay the full payout.

   To avoid falling for this, you need to know your policy better than anyone else. Know whether your policy covers actual cash value or replacement cost value. RCV policies typically provide higher payouts because they don’t factor in depreciation. If the adjuster applies depreciation, negotiate with them. Provide evidence of the item’s current value and condition. Lastly, if you believe the depreciation is unfair, request a reassessment or consult with a public adjuster.

5. Denying Certain Damages

   Adjusters may deny parts of your claim by arguing that your policy does not cover certain damages. They might claim that issues such as wear and tear, poor maintenance, or excluded perils caused the damage.

   This tactic often involves the adjuster interpreting your policy in the narrowest possible terms to deny coverage. For example, if you experience water damage from a burst pipe, the adjuster might argue that it was due to a maintenance issue rather than an unexpected event. They might also claim that the damage falls under exclusions like mold or gradual water damage. These issues are not covered by standard policies.

   You should take out time to review and read through your policy to understand the covered perils and exclusions. You should also offer detailed evidence linking the damage to a covered peril, such as weather reports or expert opinions. Furthermore, keep records of regular maintenance and repair. These can help counter claims of negligence.

6. Misinterpreting Policy Language

   Adjusters might intentionally misinterpret or misrepresent policy language to deny or reduce your claim. They might use vague or confusing terms to their advantage.

   For instance, an adjuster might claim that your policy does not cover certain types of water damage. They may also argue that specific exclusions apply when, in reality, your policy covers the damage. These misinterpretations can significantly reduce your payout if not challenged.

   To avoid this, you should constantly familiarize yourself with your policy’s terms, conditions, and coverages. If an adjuster’s interpretation seems incorrect, ask a professional for a detailed explanation. They will point you to specific policy language that supports your insurance claim.

7. Initial Low Offers

   Another common tactic is offering a low initial settlement, hoping that the policyholder will accept it out of desperation or lack of knowledge.

   Lowball offers are designed to save the insurance company money. They rely on the fact that many policyholders are either unaware of the full extent of their coverage. Additionally, policyholders are often too eager to settle quickly. These offers often come with a sense of urgency, suggesting that they are the best you will get. They may also emphasize that delays could jeopardize your claim.

   Never accept the first offer without thoroughly evaluating it. Instead, obtain independent estimates to compare with the adjuster’s offer. You should also consider negotiating for a higher settlement based on your documentation and evidence.

8. Using Settlement Pressure

   Adjusters might pressure you to settle quickly by suggesting that you won’t get a better offer.

   This pressure can be subtle or direct, with adjusters indicating that the process will become more complicated. Also, they might say that you risk receiving nothing if you don’t settle promptly. They may also suggest that you sign a release that prevents you from pursuing additional claims for the same incident.

   Try as much as possible to stay calm and don’t let pressure tactics force you into a quick decision. If you feel pressured, consult a public adjuster or an attorney to review the offer. They can also negotiate on your behalf. Ensure you fully understand the extent of your damages and your policy before agreeing to any settlement.

9. Advising Against Public Adjusters or Attorneys

   Insurance adjusters might discourage you from hiring a public adjuster or attorney. They may claim that it will complicate the process or reduce your payout.

   Adjusters know that public adjusters and attorneys have the expertise to challenge low offers and denials. They might tell you that professional help will slow down the process, hoping to dissuade you from seeking expert advice.

   You should remember that you have the right to seek professional assistance if you feel it’s necessary. This is especially true when your insurance claim is complex or the insurer is uncooperative. Hiring a public adjuster or attorney can be beneficial. When making the decision, opt for reputable professionals with experience in handling insurance claims. This ensures you get the best representation.

10. Questioning Professional Fees

    Adjusters might argue that the fees for public adjusters or attorneys will make your settlement less worthwhile. Public adjusters and attorneys typically take a percentage of the settlement as their fee. However, their involvement often leads to significantly higher payouts. Furthermore, the industry standard is between 10% to 15% of your settlement and never more. 

    Weigh the potential increase in your settlement against the fees. Often, professional help can significantly boost your payout. Furthermore, many public adjusters and attorneys work on a contingency basis, meaning they only get paid if you do. This can align their interests with yours.

11. Ambiguous Statements

    Adjusters may use vague or ambiguous statements to create confusion or mislead you about the status of your claim. For example, they might say that certain damages are “under review” without specifying what that means. These kinds of ambiguous statements can lead to misunderstandings and delay the claims process.

    Do not hesitate to ask for specific explanations in writing if anything is unclear to you. You should also document all conversations between you and the adjuster and save all written communications. Also, follow up on verbal agreements or understandings with written confirmations.