When do you need a Public Adjuster

No matter what stage in the claims process you are in, even if you have received your settlement check, it is still not too late. Considering your insurance company has engaged experts to represent their interest, shouldn't you consider having professional assistance in what is likely the largest single loss situation you shall ever experience?

New Claims Process

South Wind Public Adjusters will provide you with the peace of mind that comes from knowing that you have an expert team of licensed adjusters, association of engineers, construction and financial consultants supporting your claim. We will conduct a complete evaluation of your damage, and then document the full extent of your loss by reconstructing bills and invoices, compiling photographic evidence, and using outside experts to support your claim as needed.

Be honest, have you ever read your policy from front to back and know how to apply your specific coverage to your property damage, all while determining the current fair market value of that loss? Would you buy a house without a real estate agent? Would you represent yourself in a legal dispute without an attorney? Then why would you consider negotiating a claim without a Public Adjuster? When the insurance company makes their initial inspection and evaluation of a claim, it will determine what path the claim will take to payment or denial. Having a SWPA associate representing you at the beginning can help the insurance companies representative see your claim in a more favorable and liberal view when accessing the damages, ultimately affect the life span of the claim (read below) and the amount it settles for. In addition to obtaining higher settlements, you will sleep better at night knowing we handle the entire process from start to finish, so you can concentrate on what is important to you. To get started, we would need to speak with you about the loss and review:

  • The declarations page of the insurance policy that was in effect on the date of loss.
  • Any emergency or temporary repair invoices you have already paid in regards to your claim.

Pending, Underpaid & Denied Claims Process

Generally, most states allow at least two years from the date of denial or partial payment to dispute your insurance offer or settlement. We have had great success reopening these claims and finding discrepancies which benefitted our clients tremendously even if you have already been paid or have received an offer for settlement.
If however, we believe that the insurance company was correct in their original determination, we will advise you of that and discuss the basis we believe they have right to deny your claim.
In order to make an accurate determination of your claim, we need to gather and assess some basic information and documentation. Having this ready for your SWPA associate will expedite the claim review process. If you do not have the items listed below we can recover them from the insurance company by written request from the policyholder.

  • The declarations page of the insurance policy that was enforced on the date of loss.
  • Any estimate(s) provided by the insurance company
  • Any denial letter(s) or other claim communications in writing from the insurance company.
  • Any photographs that you have taken of the damaged property.
  • All repair Invoices you have paid in regards to your loss.
  • Any estimates or contracts you have from repair contractors.

After we review the documentation about the claim, we will make a determination of the facts and possibly schedule an inspection of your property to have a new estimate produced by a 3rd party we hire. If new discrepancies are discovered, they will be sent to your insurance company.

Usually within 30 days of submitting the discrepancies to the insurance company, a re-inspection of the property will occur, with the insurance company and a SWPA representative. After this re-inspection, one of three things will usually happen within a 2-3 week timeframe.

  1. A full settlement is reached with insurance company and a check is issued.
  2. A partial payment is determined by your insurance company and a check is issued.
  3. Or a roadblock in negotiations with the insurance company occurs.

If an obstruction for a full and final settlement still exists after re-inspection and/or negotiations have been exhausted between SWPA and your insurance company, we will then advise you of the two options you have remaining for completing a full settlement for your claim.

1. Appraisal

  • The policyholder and insurance company must hire at their expense, an independent, competent appraiser to represent them during the appraisal process.
  • Both appraiser’s must agree on an umpire and bear his expense equally. If the two appraisers cannot agree on an umpire, a judge will decide who the umpire is.
  • When 2 out of the 3 parties agree on the damages, the claim is generally closed and final award issued.

This avenue for closing a claim is often very risky and a great deal is already determined once the umpire selection has been made. It would always be in your best interest to consult an attorney that specializes in insurance claim disputes before ever approving to go through the appraisal process with your insurance company regarding a claim.

2. Consult an Attorney

In many states, there are very strong laws in place to protect the policyholder from the insurance company’s power, greed and unscrupulous actions. These laws and statues punish the insurance companies monetarily in addition to the property loss. Your state may allow additional awards for the insurance company acting in bad faith, intentionally deceiving or an unreasonable delay in payment.

  1. Attorney and Public Adjuster Fees
  2. Interest on settlement
  3. Triple damages

We highly recommend that if this need arises, that you speak to a licensed attorney that specializes in property claim disputes and that has the background and proven track record to get the most value for your insurance claim.