When the unexpected happens, we rely on our insurance to provide us with the support we need to overcome, rebuild, and thrive again. From the time we initially invest in any property, our first instinct is to find the proper policy that fits our specific needs. We seek out peace of mind. Assurance that should something happen, normalcy can be restored. Unfortunately, this isn’t always the case.
First and foremost, insurance companies are businesses. Their goal is to make a profit from policies so they can continue to run their business. They must ensure they’re not giving out more money to claims than taken in with premiums or they face the risk of bankruptcy. As a result, insurance companies will do whatever they can to avoid paying a claim. Essentially, if an insurance company believes they CAN avoid paying one of their policyholders, they won’t.
Claim Filing Process
When you file a claim with your insurer, a process goes into motion where both you and the insurer have something you must prove — for the policyholder, establishing proof of the existence and severity of damage so they can obtain a payout that solves most if not all of their problems related to an insured incident. For the insurer, they must analyze the gathered evidence to determine what, if any, money should be given out to their policyholder remains their primary goal.
Ideally, both the policyholder and the insurance company will come to an amicable agreement about the amount of money required to repair the damage. The insurance company will send out one of their insurance adjusters—or an independent hire—to assess the damage and determine a proper amount of money required. However, there are times when the insured will disagree with the conclusion of the adjuster and the insurer. In other cases, the insurer will dispute or outright reject the claim altogether. What can you do then?
Public Adjuster or Insurance Attorney?
Many would say to hire a public adjuster. What is a public adjuster? A public adjuster is a licensed professional who analyzes damage claims similar to that of an insurance adjuster but is hired by the policyholder rather than the insurance company.
For example, say you’ve received significant damage to the siding of your home after a combination storm (wind, hail, rain, lightning, etc.) and the insurance company hires an adjuster to analyze the claim. When the adjuster issues their verdict, you believe the amount is too low, or that the insurance company is not providing you with the extent of coverage you are entitled to.
If this is true, then the insurance company would be in breach of your policy. Hiring a public adjuster to produce a more accurate analysis of the situation might be the right decision, but there is an important caveat. Public adjusters are not empowered legally, and insurance companies are not legally obligated to follow what their report says.
Although public adjusters may be able to sort out a problem and clear up any dispute between the insured and the insurer, they are not in a position of authority over the insurance company. On top of that, the public adjuster will take a percentage of the final insurance offer regardless if the insurance company accepts their report or not.
Hiring a public adjuster may make sense depending on the situation, but often the best way to pursue the payout you are entitled to is to hire a competent insurance attorney. By obtaining legal representation, you take the power that regularly rests solely with the insurance company and place it into the court.
Getting What You Are Owed
Insurance lawyers and public adjusters often work in tandem; they can utilize shared evidence as a means to make a stronger case. However, when push comes to shove an insurance attorney can advocate for you inside and outside of court, whereas a public adjuster can merely dispute the claims of another insurance adjuster.
If you are facing an insurance dispute based on the insurance company’s unfulfilled obligation to provide coverage for an incident, the best course of action is to hire an experienced insurance attorney. Disputing the case in court may be a much more effective route to obtaining what your policy entitles you to. If you win the lawsuit, you may even get compensation for any damages you’ve received from your insurance company’s bad faith actions. Some of these damages include mental anguish, loss of consortium and pain and suffering.