Why is the public adjuster asking so many questions?
Calling a public adjuster to discuss your insurance claim can be the first step toward full payment, however somewhere in the first fifteen minutes of nearly every call I take, the tone shifts. I have asked something the caller did not expect — something that sounds less like sympathy and more like cross-examination — and I can hear the question forming on the other end of the line even when it is never spoken aloud: I called you for help. Why does it feel like you are taking their side?
It is an entirely fair reaction, and policyholders deserve a straight answer to it rather than a reassuring one. This is that answer.
Two different conversations, and only one of them is representation
When I represent a claim, I represent the insured. Not partly, not with reservations, and not with an eye toward what would be convenient for the insurance company. That is the entire function of a public adjuster, and it is the only side of the file I work.
But the conversation in which a policyholder is deciding whether to engage me, and I am deciding whether the claim can genuinely be helped, is not representation. It is evaluation — and evaluation has a different loyalty. In that conversation I am on the side of the facts, wherever they happen to lead, including when they lead somewhere the caller does not want to go.
Those two postures look like a contradiction from the outside. They are not. They are a sequence, and the order is not optional. What I can do for a policyholder once I am retained depends entirely on how honest we were with each other before I was.
Why my practice makes those questions unavoidable
It is worth explaining what kind of practice this is, because it shapes every intake conversation I have.
I am not a door knocker. I do not follow weather systems across Missouri and canvass the subdivisions that took the worst of it, and I do not appear in a driveway three days after a hailstorm with a clipboard and a roof-inspection pitch. I have nothing to sell to a homeowner whose claim is being handled properly, and there are a great many claims that are handled properly.
My practice starts later, and it starts narrowly. I take claims that have already been denied outright, or paid at a number that will not put the property back — commercial losses at essentially any size, and residential losses of substantial magnitude. That is the whole of it.
The consequence of that intake limitation is the thing most callers have not thought about. Every file that reaches me has already been argued, and every one of them has already gone badly. No one calls me the morning after the storm. They call after the inspection, after the estimate, after the denial or the disappointing check, and usually after several rounds of letters and phone calls that produced nothing. By then the story has been told a dozen times, to a dozen people, and it has hardened into a fixed shape.
And the caller, understandably, is not looking for a second opinion. He is looking for reinforcement.
Reinforcement is exactly what will not help him.
An argument that lost does not win by being repeated
This is the principle underneath everything else I am describing, so I will put it plainly.
An argument that failed with the claims department does not improve because it is delivered a second time at greater volume by someone with a license and letterhead. If a carrier held its position against a particular argument once, having considered it, it will hold that position again. Nothing about my involvement makes a weak point strong. What moves a stalled claim is a different argument — a fact that was never developed, a report that was never examined, a component of the loss that was never presented, an inspection whose limits were never exposed.
Finding that different argument requires dismantling the one the caller arrived with. There is no gentler route to it. If I simply adopt the framing I am handed, I will spend a policyholder’s money losing his argument for him — more expensively and more slowly than he already lost it himself.
So I ask the questions that sting. Here are the ones that come up most.
The questions I ask, and why each one matters
One. Where was the storm — exactly? Not the storm that led the news that week. The storm over this address, on this date. Hail is spectacularly local; a severe core can sit over one township and leave the next one alone. If the significant hail fell twelve miles up the road, that is not a difference of opinion about scope or pricing. That is a problem of causation, and it does not yield to insistence. It is also the first thing the carrier’s weather report will address, so it is far better discovered by me, now, than discovered by the policyholder, later.
Two. Is the property still in the condition the carrier examined? This one is the most quietly decisive question in the whole conversation, and callers almost never anticipate it. If the roof came off and was replaced out of pocket eight months ago because the leaks could not wait and the family had exhausted its patience, then the insurance company’s adjuster examined the evidence — and no one on the insured’s side of the table ever will. That asymmetry is permanent. No expert I retain can inspect what is no longer there. It cannot be argued around, and nobody is served by my pretending otherwise.
Three. What does the policy actually say? Not what was understood at the kitchen table when the coverage was sold, and not what a neighbor’s policy says. The governing document is the specific policy in force on the date of loss, with its specific edition, its declarations, and its endorsements — including the ones added quietly at a renewal. A surprising number of disputes turn out to be arguments about a provision no one involved has read in its current form.
Four. What is already in the record? What was said in the recorded statement. What was written on the first estimate. What the contractor put in writing, and whether it stated facts and reasons or simply announced a conclusion. What the prior claims history looks like on this same property. None of these are things I can wish away, and all of them are already sitting in a file the caller has never seen.
Five. What is the estimate actually establishing? A contractor’s estimate is a price. It is not, by itself, proof that a given item of damage was caused by the covered event, and it will not be treated as such. A large number from a reputable builder feels like leverage and is frequently mistaken for it. The work of establishing what happened to the building is a separate task, and skipping it is one of the most common reasons a well-documented claim still goes nowhere.
The subject I never raise
There is one thing I do not ask about, and it arrives on its own in very nearly every call: the neighbors.
A policy insures one address. The claim rests on damage to that address and on nothing else. What some other company paid on some other roof — different age, different slope and exposure, different contract, different inspector — establishes nothing whatever about this building, and no amount of documenting the rest of the block will change that.
I raise it here because of where it usually sits in the conversation. The neighbor comparison is very often among the arguments the caller already made to the adjuster, and very often the one he considered his strongest. It was turned aside then, and it will be turned aside again, because it was never capable of carrying weight to begin with. It reads as injustice and functions as nothing. Every hour spent on it is an hour not spent developing the facts about the insured’s own property, which are the only facts the claim can be built on.
These are not expressions of disbelief. They are rehearsal.
Every question above has already been asked — inside the insurance company’s file, by people the policyholder will never speak to, in a document he has never read. That work has been done. It was simply done by the other side, in private, and without anyone present to answer it.
The intake conversation is very often the first and only occasion on which those questions get put to the insured while there is still time to respond to them. Treating that conversation as an inconvenience to be smoothed over would be a disservice dressed up as courtesy.
The most valuable thing the challenge produces
Here is what I have found matters most, and it is the reason I will not simply defer to the caller’s account of his own claim.
The reason a claim was underpaid is very often not the reason the insured believes it was.
He has spent four months arguing about shingle pricing when the real failure in the file is an engineering report whose methodology was never examined. Or an inspection that never reached the elevation where the damage actually is. Or a coverage that was purchased and never claimed. Or a scope that quietly omitted an entire building system. The stated theory and the operative problem are frequently different things, and testing the stated theory is how the operative one surfaces.
That is what the difficult part of the conversation is for. It is not skepticism about the policyholder. It is a search for the argument that will actually work — which cannot begin until the argument that did not work is set down.
What changes the moment the answers hold up
When the facts survive that examination, the posture reverses entirely and immediately.
Every ounce of doubt turns around and goes where it belongs — to the carrier’s estimate, to its report, to the inspection that produced them, to the language it is relying on, and to the conclusions it reached before it had finished looking. That is the work. It is adversarial, it is documented, and I do not do it halfway. A policyholder who has been through a hard intake conversation with me knows something valuable by the end of it: that when I tell his insurance company his claim is right, I am not saying it because he is paying me. I am saying it because I checked.
And when the answers do not hold up
Then I say so, directly, and I tell the caller how to proceed without me — what his own documents show, which way they cut, what the governing language says, and what event ought to send him to an attorney rather than to a public adjuster. I take no fee for that, and I do not use the conversation as an opening to sell an engagement the facts do not support.
That is not the conversation failing. That is the conversation working. A policyholder who leaves that call with an accurate picture of where he stands has received something genuinely useful, even when it is not what he hoped to hear — and certainly more useful than a signed contract and an invoice for repeating an argument that was never going to succeed.
The point
If it seems strange that the person you are asking to fight for your claim begins by pressing on its weakest points, consider the alternative. The insurance company has already found those points. It found them weeks ago, at leisure, and it has built its position on them.
The carrier will test your claim. It already has. The only real question is whether anyone on your side tested it first.
James H. Bushart, PA, SCLA Licensed Missouri Public Adjuster · MO License #8207067 James H. Bushart, Public Adjuster LLC P.O. Box 742, Cassville, MO 65625 · 314-803-2167 jbushart@mo-public-adjuster.com
This article is general information about how claims are evaluated. It is not legal advice, and it is not an opinion about any particular claim. Every policy and every loss is different, and no outcome is promised or implied.
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