Filing your claim – The key to your claim often starts with how you present your claim to your insurance carrier. Your carrier will ask you specifically as to what the damage is, when and how you discovered it and to what steps you are now taking to mitigate your loss. This is a concern especially if you have a leaking pipe that may have been just recently discovered. In California, you have 14 days to file your claim from the date of discovery. This is easy when it comes to fire, smoke, vandalism and many types of water damage. However, there are exclusions for long term leaking pipes. Most policies have a clause after the exclusion for long term leaks that allows for you to successfully file a claim based up the date of discovery. An example of this type of loss are pipes under sinks, air conditioners, or behind dishwashers, refrigerators or washing machines. Often times these are not discovered until you move those appliances out of their current position or water is discovered coming from in or around that sink, appliance or piece of equipment. It is imperative that you immediately notify your carrier upon discovery in order to give yourself the best opportunity for a successful claim. Often times, carriers or their adjusters will look for ways in which to deny leaking pipes based only on the long term leakage or seepage clause, and in turn they overlook the date of discovery and the time in which you submitted or notified the carrier based upon that date.
Types of adjusters – There are basically four types of adjusters. The first is the most common and that is the new adjuster or relatively inexperienced adjuster. Insurance adjusters that work directly for the company are referred to as staff adjusters and that position can often times be a transient employment stop. The training is usually good by major carriers except that it is fairly limited due to the overall depth required to truly understand all aspects of what goes into a restoration process along with how that ties into the insurance policy itself. The second type of adjuster is someone that has been with the company for a long period of time and has been through the wars, so to speak, with many claims. Usually this individual will work to get the claim off their desk and onto the next claim. This can be good or bad depending on how you work with the adjuster and follow through the claim to uncover all aspects of what you are entitled to receive. On the other hand if this adjuster feels they can close the claim with the least amount of effort, than you may be exposed to limited or under-evaluated claim. The third type of adjuster is the competitive type that wants to guard the company vault as if the money was coming directly out of their own pocket. This adjuster will work to minimize the claim purely based upon the need to exercise what they may believe to be their expertise in construction and claims knowledge. The last type of adjuster is an Independent Adjuster or IA, which is hired as a consultant by the carrier to facilitate the claim’s handling. This adjuster usually has more experience and construction knowledge than that of the staff adjuster. However, they are heavily monitored by an in-house staff adjuster and they require lots of documentation to prove the loss. As is the case with all these adjusters, you should have someone from your side that understands how to present the loss and negotiate through-out the entire claim’s process.
The insurance carrier’s contractors – Often times the carrier will present you with a list of preferred contractors that they have from an in-house vendor program. This is your option to use the contractors or to select your own. At no time are you obligated to use the carrier’s contractors and many times that is not necessarily the best approach. Although many of these contractors provide good work product, they are working based upon their relationship with the carrier and may not be working in your best interest, which can result in their being swayed be pressure from an adjuster who may not want to pay for an item that you believe should be covered. Examples of this often occurs with expensive items such as cabinetry, tile, marble and the complete repair or replacement of a particular items.