Dealing with property damage and navigating insurance claims can be overwhelming, especially for homeowners who often have never dealt with a property damage insurance claim. When your home is damaged, understanding who does what in the claims process can make things a lot easier. This article will explain the roles of adjusters, engineers, and building consultants – three key professionals who might be involved in your insurance claim.
When you file a claim, different experts work together to assess the damage, estimate repair costs, and ensure that your home is restored properly. Knowing the specific roles of these professionals can help you understand how your claim is handled and what to expect along the way. Let’s break down who these experts are and how they contribute to resolving your claim.
The Role of Adjusters
Who They Are:
There are two types of adjusters: insurance adjusters and public adjusters. Insurance adjusters work for your insurance company, while public adjusters can be hired by homeowners and work for policyholders. This article focuses on insurance adjusters – the professionals hired by your insurance company to evaluate and adjust your claim.
What They Do:
- Inspect Your Property: Adjusters visit your home to assess the damage. They look at what’s been damaged and try to determine what caused it.
- Estimate Costs: They calculate how much it will cost to repair or replace the damaged parts of your home.
- Review Your Policy: Adjusters check your insurance policy to see what is covered and to what extent. They make sure the damage falls within your policy’s coverage.
Why They Matter:
Adjusters are crucial because they handle the financial aspect of your claim. They visit the property and ensure that the insurance company has all the information needed to make a decision about your payout. However, they might not have the technical expertise to fully understand structural issues, so they often collaborate with other experts.
In addition, as they are hired by the insurance company, they may have a biased view and be more likely to minimize the damage they see on the report to minimize payouts and maintain a relationship with the company by showing that they are effective at limiting what the insurer pays out for claims.
Limitations:
Adjusters are not trained to perform detailed structural analyses. They rely on engineers and building consultants for a thorough assessment. For high value or complex loss situations they will often hire an Engineer to support the carrier’s position.
Engineers
Who They Are:
Engineers, especially structural or civil engineers, are experts brought in to assess high value or complex loss situations, particularly if it involves structural elements or higher value roofing systems.
What They Do:
- Evaluate Structural Integrity: Engineers assess the safety and stability of your building. They check whether the damage has affected the overall structure.
- Identify Extent of Damage: They determine how severe the damage is and what repairs are needed to restore your home.
- Recommend Repairs: Engineers provide detailed recommendations for repairs or reconstruction, ensuring that your home can be safely and effectively restored. Keep in mind that these recommendations may not be in line with the terms of the policy such as upgraded overages or other required work to bring your home back to pre loss condition.
Importance of Licensure:
Many engineers hold a Professional Engineer (PE) designation, which signifies their high level of expertise and adherence to strict ethical standards. It is crucial to verify that any engineer you hire holds this certification to ensure that their evaluations are reliable and authoritative.
Challenges:
There have been many instances of fraudulent engineering reports that work against policy holders to save the insurer money on the scope of repairs or coverage. These incidents underscore the need for vigilance to ensure that the engineers involved are providing unbiased and accurate assessments.
Building Consultants
Who They Are:
Building consultants are specialists in construction and repairs. They bring additional expertise to help the carrier evaluate the construction aspects of the claim.
What They Do:
- Second Opinion: Building consultants can offer a second opinion on the adjuster’s estimates, providing an additional layer of scrutiny.
- Suggest Repair Strategies: They recommend cost-effective repair or reconstruction strategies, typically to reduce the cost to the insurer.
- Prepare Scope of Work: Building consultants can help prepare detailed plans for the repair process, outlining what needs to be done and how.
Qualifications:
Building consultants often have backgrounds in architecture, construction management, or engineering. Certifications such as Certified Construction Manager (CCM) or Registered Roof Consultant (RRC) are important to check for to validate their expertise and ensure they are well-qualified.
Limitations:
While building consultants are knowledgeable about construction, they may not have the technical expertise for detailed structural evaluations. Therefore, they often collaborate with engineers to ensure a comprehensive assessment of the damage. Additionally, they may not include policy required upgrades or scopes of repair.
Real-World Example:
In a recent large loss claim, we set up a call between my loss consultant, the adjuster, and his engineer and building consultant. Knowing the roles and limitations of the players became critically important. The insurer hired the engineer to support its position that patchwork or partial repairs would be sufficient to restore the property to pre-loss condition.
Our position was that a building with 20 band aids is not the same as a building restored to pre-loss condition. When the engineer started discussing coverage, I was able to call him out for bias in his investigation. Insurance coverage and policy interpretation are not the roles an engineer plays in evaluating a property damage claim.
By knowing and acting on this information, I was able to point out and check the engineer’s bias, refocus the discussion on the lack of repairability factors, and keep the discussion moving in a productive direction.
Collaboration is Key
Effective collaboration among adjusters, engineers, and building consultants is crucial for navigating complex insurance claims. Each professional brings unique skills and expertise, contributing to a comprehensive evaluation and fair resolution of your claim.
For example, an adjuster might identify and estimate the damage, but an engineer’s detailed structural assessment is necessary to ensure safety and integrity. Similarly, a building consultant’s construction expertise helps to develop a practical and cost-effective repair plan. By working together, these professionals ensure that all aspects of the damage are addressed, leading to a more accurate and fair settlement.
Tips for Homeowners
Be Informed:
Understanding the roles of each professional can help you feel more in control during the claims process. Don’t hesitate to ask questions and seek clarification on any part of the assessment or repair plan.
Be Vigilant:
Watch out for any signs of bias or fraudulent activity. Ensure that all professionals involved are providing honest and accurate information. If something doesn’t seem right, consider getting a second opinion.
Document Everything:
Keep detailed records of all communications, assessments, and recommendations. This documentation can be crucial if there are any disputes or issues with your claim.
Seek Support:
If the process feels overwhelming, consider hiring a public adjuster or a loss consultant who can advocate for your interests and help navigate the complexities of the claim.
Final Thoughts
Navigating an insurance claim can be daunting, but understanding the roles of adjusters, engineers, and building consultants can make it more manageable. Each of these professionals brings important expertise to the table, working together to ensure your home is properly assessed and restored. By staying informed and involved, you can help ensure a fair and thorough resolution to your claim.