Q: The heavy rains this winter severely damaged the roof and interior of my house and although I have insurance coverage, how can I be sure that I recover all of the benefits I am entitled to under my insurance?
A: After a claim is reported to an insurance company, it will conduct an investigation to determine whether the claim is covered under the policy, and the nature and extent of benefits the policy holder is entitled to receive. But the person assigned to investigate or adjust the claim is hired by the insurance company and is required to follow the company’s policies in handling the claim, even if they limit the ultimate recovery by the insured.
A public adjuster is a specialist on loss adjustment that the policy holder can retain, at the policy holder’s expense, to perform an investigation of the loss from the policy holder’s point of view, and then negotiate with the insurance company’s adjuster to obtain the best result possible for the policy holder. Typically, the public adjuster charges a percentage of the insurance company’s settlement.
In assisting the policy holder, the public adjuster will determine the extent of the loss and damage by listing the inventory and equipment by category, and specify a fair market value for replacement of the damaged items. Included in the public adjuster’s evaluation will be the cost of removal, installation, hook-up, debris removal, and securing the property. The public adjuster will handle all of the necessary details for compiling and filing the claim as required by the terms of the particular insurance policy that covers the property. Often, numerous steps are required to properly document and present the claim.
The typical property policy contains hundreds of provisions and stipulations, complex and specialized terms, and various forms and riders that are constantly changing as the various companies revise their policies from year to year. The burden of proof regarding the value of the claim is on the policy holder, and many insurance companies prefer to work with an experienced accredited public adjuster rather than an inexperienced insured.
The goal of the public adjuster is to re-create the situation as it was prior to the occurrence of the loss, and then prepare a comprehensive inventory and scope of damage to the structure and interior items. Because of their experience and familiarity with the various insurance companies and their adjusters, a public adjuster can often help the policy holder obtain a larger settlement from the insurance company than would otherwise have been obtained. Many insurance policies may provide more coverage than the amount shown on the policy’s declaration page depending upon how the claim is presented and documented.
Public insurance adjusters in California are licensed by California’s Department of Insurance. They may also be members of the National Association of Public Insurance Adjusters (NAPIA) based in Washington, D.C. A Certified Professional Public Insurance Adjuster (CPPA) must have a minimum of five years experience and pass an examination to earn certification. A Senior Professional Public Adjuster (SPPA) must have a minimum of ten years experience and also pass a rigid examination. Both a CPPA and SPPA must continue their professional education to keep up with changes in the insurance industry.
According to a local public adjuster, Michael Rubin, past President and current member of NAPIA, and holder of the SPPA certification, most insurance property claims are beyond the experience and knowledge of an insured, and they are grateful for the timely and professional help his company, Michael Rubin & Associates, is able to provide.
Upon experiencing a loss, the policy holder should promptly notify the insurance agent or company that has the policy on the property, and then contact a certified public adjuster to follow through on completion of the claim. The types of losses for which a public adjuster can help the insured include claims due to water, wind, fire, vandalism, earthquake, and compensable losses such as business interruption, loss of rental income, damage to improvements, lost commissions and profit, and other expenses of the loss.
A public adjuster can help the policy holder during the stressful and frustrating experience of handling an insurance claim that involves a multitude of insurance issues that can be daunting for a policy holder to understand. Although an expense for the policy holder, the cost of a public adjuster is often worth the assistance provided in preparing and filing the claim, and obtaining a prompt and fair settlement.
The opinions expressed in this article are those of the author and not the Daily News. Individual circumstances may vary and professional advice is recommended before making decisions.
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