One of the most important steps in filing a property insurance claim is having the damage appraised. In a perfect world, this would be simple. An unbiased professional would come to your location, review the damage, and give you an objective and accurate appraisal of the costs of the necessary repairs. Unfortunately for homeowners, that isn’t always what happens.
The problem is that most insurance adjusters – the people responsible for assessing the damage to a property – are hired and paid by insurers. Whether they are independent or work full-time for an insurer, they are likely to feel loyalty or obligation towards their employer. In that situation, even the best adjuster can become biased.
In too many cases, adjuster behavior goes beyond bias and becomes unethical. It is invaluable to have an insurance attorney on your side when you need to file a claim to prevent this widespread problem from impacting your claim.
Why Insurance Adjusters May Act Unethically
It should be obvious that insurance adjusters have ethical responsibilities. Their job is to determine whether property is damaged and deliver a fair account of the necessary repairs and associated costs. If they do their job poorly, property owners may not receive the money they’re due under their insurance policy to repair damage, which can be financially devastating.
However, the pressure adjusters face from insurance companies can be significant. The CEO of one Florida firm stated this outright at the 2022 Property & Liability Resource Bureau conference during a presentation on ethics. According to her, “any duty to report will create a conflict with the adjuster’s perceived duty to the insurer, which may not be interested in dealing with an even larger potential claim […] How many times do we ask our engineers not to put that in the report?” she asked the audience. “Lots of times, right?”
Yes, it was stated at a conference that it’s common to encourage adjusters to leave information out of a report, during a presentation on ethical behavior. This demonstrates the pervasive pressure to act unethically in the field.
Of course, many adjusters are trustworthy. However, in situations where there is such a strong incentive to act dishonestly, it is in your best interest to prepare for the worst. If an adjuster is biased towards their employer, it can significantly impact your claim and finances.
How Insurance Adjuster Fraud Hurts Property Owners
When adjusters do not uphold standards of honesty and accuracy in their reports, it can seriously harm property owners. Relying on an insurance company’s adjuster can leave you struggling to get your home or business repaired or footing the bill yourself. Critical risks include:
- Inaccurate adjuster reports: This is both a problem and the cause of many other insurance problems. Insurance companies use their adjusters’ reports to determine everything from whether a claim is covered to the extent of the damage to the costs associated with repairs. If they leave out information in their reports, the insurer has little reason or evidence supporting your request for payment. Furthermore, inaccurate reports can make it difficult to dispute denials and underpayments by forcing you to rely on reports made later, after time has passed, evidence has been lost, and some repairs have potentially already been made.
- Denied payments: An incomplete or inaccurate report an easily lead your insurance provider to deny your claim outright. In that case, you’ll be stuck with a damaged property or forced to cover repairs out of pocket.
- Underpayments: A more subtle problem occurs if if a report inaccurately lists certain damage as pre-existing or underreports the scope of damage. In these cases, the insurer may pay some, but not all of the claimed amount. This can be worse than a denied claim because property owners are less likely to realize they have not received the full amount for which they are actually eligible and may not file a dispute.
- Delayed payments: Even if you do dispute an underpaid or denied claim, it can take months for the matter to be fully resolved. In the meantime, you may not receive the funds you need to cover your costs and you’ll be left with debt or unrepaired structures.
The Importance of Working With an Expert Insurance Attorney
You don’t have to accept the report of the adjuster sent by your insurer. In fact, if your home or business is significantly damaged, you shouldn’t. Instead, you should work with a property and home insurance lawyer from the beginning.
Why work with an insurance attorney? Think of it as leveling the playing field. Insurers have teams of adjusters and in-house legal counsel specifically to help them pay as little to consumers as possible while following their contracts. Simply accepting what the professionals employed by your insurance company say about your claim is an excellent way to miss out on the full benefits of your policy.
Consulting with a proven property insurance lawyer lets you approach the negotiation table on equal terms. The benefits of insurance lawyers on your side include:
- Accurate adjuster reports: Insurance attorneys may also act as adjusters in states like Florida, allowing them to produce accurate reports that can be compared to the insurer’s, reducing the risk of bias.
- Knowledgeable legal counsel: Your lawyer will explain to you what your policy covers and guide you through the process of holding your insurer accountable to it.
- Experience with negotiation and litigation: Whether you choose to negotiate or litigate your claim, your attorney will help you pursue the best possible outcome.
At The Professional Law Group, we are dedicated to helping our clients with all of the above issues. Whether you have just experienced a disaster or you need to dispute a denial or underpayment, we are available to help you enforce your insurance policy contract. Schedule your consultation today to learn how we fight insurance adjuster fraud and pursue fair compensation for our clients.
