The relationship between an adjuster, restoration contractor and policyholders is tricky.

Insurance adjusters work for insurance companies and determine whether the insurance company is responsible for paying out a restoration claim. They inspect the property to see the extent of damage, compile that with other documentation and information that the policyholder and contractor provides, and then use that to determine if the loss is covered.

Of course, adjusters want the settlement to be as low as possible and sometimes they will try to turn the policyholder against restoration contractors in an attempt to pressure the contractor into a lower settlement.

Restoration contractors, of course, are not adjusters – and many states have laws expressly prohibiting restoration contractors from acting as an adjuster. Because of this, it’s crucial that while you help guide your customers, you never try to step in and fill this role. However, you can be aware of the tactics that adjusters like to use, so you can educate your customers.

In this blog, we’ll walk you through some of the tactics adjusters use against policyholders, and what you can do to keep your customers as your advocates.

1. Questioning the Extent of the Damage

Above all else, an adjuster serves the insurance company. Their main goal is to save the insurance company money – and one way they can do this is by questioning the extent of the damage. 

An adjuster may claim that some damage existed before the event for which the claim was filed, or question whether certain items destroyed in the event were worth as much as the policyholder claims. This may lead them to ask for more and more documentation. 

As a restoration contractor, you need to make sure your customer knows you are on their side. Assure them you will document every part of the restoration process, including photos before, during and after the work has been done. Once the damage is fixed, the evidence is gone. You want to go above and beyond documenting the entire process, because it will be needed later.

There are several technology tools that can help streamline documentation and job management for restoration contractors.

2. Undervaluing the Claim

In addition to questioning the extent of the damage, sometimes adjusters will undervalue the damage on a restoration claim. They might tell the homeowner the amount of work performed was unnecessary or extensive.

If an adjuster comes back with a lowball offer, make sure the homeowners know that they have a right to refuse that first offer. Using the documentation that you provide, the homeowner can request more and substantiate their counteroffer with photos and notes that you provide.

You can also let the homeowner know that they can opt to hire a loss assessor or public adjuster. Loss assessors are hired by the policyholders to handle a claim – they work for the owners in assessing the damage, rather than serving the insurance companies. The policyholders of course will be responsible for paying this person, but if the offer is seriously under what was expected, this can be a good option.

3. Employing Policy Loopholes

Insurance policies are long, tedious and arduous to read – and that’s in part by design. If policyholders don’t read the entire thing, they may not realize the loopholes or gaps that exist in their coverage. Adjusters can use these to justify lower offers in the case of a loss claim. 

Remind homeowners to review their insurance policy in full before entering into a negotiation with their insurance company. This can help them fully understand what they’re entitled to, and could even help guide the documentation that you know you’ll need to provide them with to substantiate their claim.

4. Getting the Policyholder to Admit Fault

This is a common tactic used in all insurance sectors, and restoration claims are no different. If a policyholder admits fault – or even partial fault – a claim will be worth significantly less. For damage claims, adjusters may try to get the homeowners to say they failed to mitigate the damage, or that the damage occurred before the claim event.  Adjusters will use phrasing like “there is a chance that this may have been going on for a long time correct?”

For example, they could say homeowners failed to shut their windows during a storm, which then allowed rain in, which turned into mold. They may claim certain appliances were broken or damaged before the disaster occurred. 

Here, you can help your customers again by having meticulous documentation. Help them record details at the start that they may forget later – for example, if the windows were indeed shut at the time of the loss. Photograph everything, and take diligent notes about everything you find before starting to repair the damage.

5. Delaying the Claims Process

When a claims process is dragged out, the insurance companies are often banking on tiring out you and your customers, to the point that you’ll settle or give up on a claim just to have the process be over. This is why it’s so important to make sure the claims process is kept moving along as quickly as possible. Make sure you’re always available to answer any questions from the adjuster. If you’re not, your claim is going to the bottom of their stack.

At One Claim Solution, we’re here to help with that in particular. We go to bat with the insurance companies on your behalf, keeping claims moving, following-up with requests for additional documentation as needed and answering questions from adjusters, so that these delay tactics are rendered ineffective. With our team of attorneys and appraisers, we have plenty of options to make sure you get paid quickly and fairly and your customers’ lives can go back to normal. When you work with us, you can assure your customers that you’ve got the claims process handled from your end of things.

A Final Word

The restoration claims process can be daunting and insurance adjusters can be tricky. As a restoration contractor, the best thing you can do is build trust with your customers and help them understand that you are the one who works for them and has their best interests at heart – unlike the adjuster. Hopefully this blog helps you understand some ways you can build and keep the trust of your customers.

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