Dealing with insurance companies can be a daunting task, especially when it comes to minor or major damage to your property. Whether it’s your first or second time going through this process, it can be overwhelming to navigate the complex world of insurance claims. That’s where our team of expert public adjusters at Bulldog Adjusters comes in. We understand the ins and outs of the insurance claim process and are here to guide you every step of the way.
In this blog, we’ll take you through the process of working with a public adjuster like Bulldog Adjusters and what you can expect from our team. We’ll discuss the role of a public adjuster and how they can help you navigate the often-confusing world of insurance claims.
The insurance claim process
First, as part of the process of filing a claim, we begin by coordinating an inspection with your insurance company and our representative to show them the damage.
The insurance company’s adjuster will have asked for the following information:
- The date of loss – This is the date that the damage/loss occurred and it’s necessary so they can confirm that the policy was in effect when the damage occurred.
- What caused the loss – this information is used to determine coverage within your policy
- What action you took to stop further damage – your insurance company will need to know that you took steps to protect your home from further damage as that is one of the main duties following a loss (i.e., tarping, dry out, etc.).
Our adjusters and in-house estimation team will prepare a written estimate which includes a detailed line-by-line item scope and damage report for the sole purpose of repairs. Once the estimate is completed, we’ll present it to you for approval and then submit it to the insurance company.
Additional documents from the insurance company
Your insurance company may also request additional documentation – which we will prepare for you – to further investigate your claim; this includes but is not limited to the following:
Proof of Loss statement
A Proof of Loss is a legal document that states how much we are claiming under a policy for a loss. Clients must execute this document with a notary. Below is the list of states that REQUIRE a proof of loss to be sent in and the timeframe. In some states, when a POL is submitted to the carrier, the carrier now has a set timeframe to complete their coverage determination.
Colorado: 60 days to submit; carrier has 60 days after submission to respond
Florida: 60 days
Idaho: 30 days; carrier has a reasonable amount of time to respond
Illinois: 30 days; carrier has a reasonable amount of time to respond
Maryland: 60 days; carrier has a reasonable amount of time to respond
New Jersey: 30 days to submit; carrier has 30 days after submission to respond
New Mexico: 30 days to submit; carrier has a reasonable amount of time to respond
New York: 30 days (NY is very strict on this deadline)
Ohio: 60 days
Oklahoma: 60 days (OK is very strict on this deadline); carrier has 60 days after submission to respond and we can sue if there are 90 days without correspondence
Pennsylvania: 60 days; carrier has 15 days after submission to respond
Rhode Island: 60 days; carrier has 21 days after submission to respond
Tennessee: 60 days; carrier has a reasonable amount of time to respond
Utah: 30 days (Bear River Mutual and NC Farm Bureau always send their own POL, this must be executed to continue with the claim); carrier has a reasonable amount of time to respond
Receipts, invoices, and bills that pertain to your claim
Receipts are important because they provide proof of purchase for the items that you are claiming. This is important because it helps to establish the value of the items that were lost or damaged. Invoices, on the other hand, are important because they provide proof of the cost of the items that were lost or damaged. This is important because it helps to establish the value of the items that were lost or damaged.
Bills, meanwhile, are important because they provide proof of the services that were provided in relation to the claim. This is important because it helps to establish the cost of the services that were provided, and it also helps to establish the extent of the damage that was done.
To ensure accuracy and fairness in the claims process, insurance carriers often request recorded statements from clients. These statements can be scheduled by the Claim Specialist, who will facilitate a three-way call between the client, the desk adjuster, and themselves to gather all necessary information.
Contractor or Repair Proposals
A contractor or repair proposal is essentially a document that outlines the scope of work that will be required to repair or rebuild any damage caused to your property. This can include everything from the cost of materials and labor to the timeline for the completion of the project.
After the initial inspection
After the initial inspection, your insurance company may request to send out a contractor and/or an engineer for any further property inspections. Our adjusters will make sure that this inspection is scheduled according to YOUR schedule.
After their inspections are completed, your insurance company will review their adjuster’s report and documents. This is one of the parts of this process that may be considered “lengthy” as your insurance company may take a while to go over the documentation that we provide in order to try and deny or lowball your claim.
Please be aware that insurance carriers have 90 days to make their decision on an initial file. We closely monitor this time frame throughout all the required steps making sure that your insurance company doesn’t blow past its deadlines. During this time, our team at Bulldog Adjusters will diligently pursue your claim settlement and reach out regularly in order to get updates on your behalf.
Finally, once your insurance company makes a coverage determination on your claim, we will review their response and determine the best approach for settlement.
The insurance process after the inspection
After the initial inspection and all the proper documentation above have been collected, we will submit an estimate to your insurance carrier for the loss amount. Once this email is sent, we can begin looking forward to the fair and equitable settlement that you deserve. This estimate includes the date of loss, the cause of loss, what was damaged, and the claimed estimate. Once the insurance company responds, we will have a coverage determination to work with and can continue moving forward with the claim.
What are the different coverage determinations?
An undisputed payment in an insurance claim is a payment made by the insurance company to the policyholder without any disputes or disagreements about the validity of the claim. This means that the insurance company has accepted the claim and is willing to pay out the agreed-upon amount to the policyholder.
A below deductible determination is a decision made by the insurance company when assessing the damage or loss incurred in a claim. It refers to the point at which the cost of the damage or loss is less than the deductible or the amount the policyholder is responsible for paying before the insurance company covers the remaining costs.
A partial denial in an insurance claim refers to a situation where an insurance company only approves a portion of the claim, rather than the full amount requested. This can happen for a variety of reasons, such as if the insurance company believes that the claim is not covered under the policy or if the claim exceeds the policy limits.
A denial in an insurance claim is a decision made by the insurance company stating that they will not cover the costs associated with the claim. This can happen for a variety of reasons, such as if the claim is determined to be outside of the scope of the policy, if the policyholder is found to have engaged in fraudulent activity, or if the policyholder fails to provide the necessary documentation to support their claim.
It is important to note that an insurance claim denial does not necessarily mean that the policyholder is not entitled to any coverage. In many cases, the denial may be the result of a misunderstanding or a lack of information and can be resolved through further communication with the insurance company.
Negotiating Your Claim
After we’ve received a coverage determination, we start our negotiations. This could be anything from speaking to the insurance company to recommending some kind of alternative dispute resolution.
Alternative dispute resolution (ADR)
If we cannot come to a settlement agreement with the insurance company and are unable to settle the claim, we can begin moving toward an alternative dispute resolution (ADR). The three courses of ADR available are Mediation, Appraisal, and Litigation.
Always available in FL. Available in a few other states only after Declared Emergencies (hurricanes or other natural disasters). Mediation involves the carrier and our adjuster meeting with a mediator to attempt to settle the file. Mediations are free and non-binding.
Available in all states. The carrier and the PA each choose an Appraiser to represent them. The Appraisers review the file and inspect the property. They must come to a settlement. In the odd case that they cannot come to a settlement, an Umpire will resolve the dispute. Appraisals are binding and have costs associated with them.
Available in all states. An attorney will take over the case and sue the carrier to settle the claim. This ADR is most common with denied claims. Attorneys fees will be a percentage of the settlement. Attorneys may decline to take a file if they feel the file is too small or feel it will be unsuccessful.
In the more likely case that your insurance company offers a lowballed settlement or denies your claim, that’s when Bulldog Adjusters’ expert negotiators can work their magic to ensure you get the results that you deserve.
After much negotiation and determinations about the best way to go about your came, we come to the final settlement.
Even if your claim is denied or low-balled, our team will keep fighting to obtain the settlement you deserve and that will help you bring your home back to pre-loss conditions. Bulldog Adjusters knows how to handle tough situations. As disaster experts, we stay on top of the latest in property insurance laws so YOU don’t have to worry. Whether you’re dealing with a five-alarm fire, a pipe break, or damage from a natural disaster such as a hurricane, trust Bulldog to have your back!
When you file a property damage claim with us, you’ll always get our full attention to ensure that you’ll get the largest possible settlement in the end!