The following questions are the most frequently asked about a public adjuster, but your specific question, which is not found or answered on this page, is important to me.  If you don’t see the answer to your question on this page, send it to me at jim.bushart@pm.me or submit your query here:  http://missouripublicadjuster.org/send-me-your-questionscomments/ 

What is a Public Adjuster?

There are three distinct types of insurance adjusters.

First, there is the “insurance company adjuster,” who is employed by the insurance company and who is required by law to protect the rights and interests of the insurance company.

Second is the “independent adjuster,” contracted by the insurance company and is required by contract and law to protect the rights and interests of the insurance company.

The third is the “licensed public adjuster” contracted by the policyholder to protect the policyholder’s interests and negotiate a fair and reasonable settlement for an insured loss.

A licensed Public Insurance Adjuster is an expert on loss adjustment and the recovery process and is employed by the policyholder — not the insurance company.

The Public Adjuster assists you, the policyholder, with his intimate knowledge of insurance policies and negotiation techniques in preparing, filing, and managing the payment of insurance claims regarding property loss.

He works on your behalf and does NOT work for the insurance company.

 

Do You Have Additional Training and Abide by a Specific Ethical Standard in Addition to Your License Requirements?

Yes.  I am a Senior Claim Law Associate and a member of the National Association of Public Insurance Adjusters (NAPIA). 

All public adjusters licensed to represent claims in Missouri must know and comply with Missouri insurance laws. Still, it takes more than passive compliance to overturn improper denials from insurance companies and turn their underpayments into fair settlements. 

For those reasons, I have added special formal education to my training and experience and have achieved the designation of Senior Claim Law Associate (SCLA) to enhance my skills and ability to serve my clients. 

As a member of the National Association of Public Insurance Adjusters (NAPIA), I am held to the highest standards of professional conduct and ethics, ensuring that my clients receive the best possible service. NAPIA is the oldest and most esteemed organization in the public adjusting profession.

 

Will a Public Adjuster help me profit from my insurance claim?

The short answer is “No.” Insurance claims are not intended to provide profit to the party filing the claim but only to restore them to their financial condition before the loss.  No policyholder or public adjuster has the right to demand more than that from their claim with an insurance company.

It is often true that a policyholder will receive more money from their insurance provider when represented by a public adjuster than when handling their claim, but their share will not enrich them but fully restore them to their condition before their loss.  

Insurance carriers are corporations with a fiduciary duty to protect their shareholders’ financial interests and a contractual obligation to fulfill their promises to their policyholders. They will often find this conflict of interest resulting in their wrongful actions of grossly underpaying or wrongfully denying their policyholders’ claims. 

I specialize in turning improper denials and underpayments into cash for my clients.  I don’t do this by “estimating” but by dealing with actual costs.   As a result, my clients are restored to the financial conditions they enjoyed before their covered losses that were wrongfully denied or underpaid.  The intent is to restore them to where they were before their loss, not to enrich them.

My insurance company paid an engineer to look at my damage, and based on his report, they denied my claim.  Can a public adjuster assist me under these circumstances?

I can.  I have often used the same engineering report to reverse denials that the insurance company used to base their denials.  In several cases for commercial and private dwellings, the insurance company used engineer’s reports to deny claims; I used those reports to obtain settlements for my clients ranging from $80,000.00 to $925,000.00. 

Sometimes, insurance company adjusters (through bias or negligence) will incorrectly interpret these reports or overlook information that supports your claim or, in some instances, they may manipulate ambiguous language to favor a denial rather than a payment.  Reversing improper claim denials resulting from engineer reports is my specialty.

For more examples, visit THIS PAGE of my blog.

 

The insurance company adjuster inspected the damage to my property and provided me with a computer-generated estimate that represents less than what I believe is fair and necessary.  Is this all that I am entitled to recover from my claim?

No, but the adjuster won’t tell you that. 

The computer-generated estimate he provided is his opinion of what you might be entitled to based on his industry’s computer software program.  It does not necessarily represent all it will take to restore your property to its pre-loss condition, nor all you are entitled to recover from your claim.  Your insurance policy promises to be paid what it costs to restore you to where you were before your loss.  It does NOT limit you to what anyone “estimates” that cost.

 

I didn’t know better and allowed my contractor to negotiate his work directly with my insurance company.  They have reached an impasse, and my claim is undergoing an “appraisal” process. I have been instructed to find an appraiser to represent me.  Will you act as my appraiser?

No.  I work on a contingency basis, meaning I am paid a percentage of what I collect from your insurance company on your behalf.  Your policy demands that your appraiser be independent and non-biased … with no direct interest in the outcome of your claim … which certainly is NOT me.  When I work for a policyholder, I work only toward what is in their best interest.  Accordingly, I am not the one to act as an appraiser if you have strayed to that point in processing your claim.

The appraisal process was added to your insurance policy by your insurance company.  It was their idea.  This should be enough to tell you who the appraisal process is designed to favor.

How much time will it take to settle my claim?  If I hire a public claims adjuster, will this cause more time delay?

Hiring a public adjuster does not cause a delay in settling your claim.  Your licensed public adjuster will monitor to ensure that your insurance company complies with all Missouri regulations and statutes that govern the insurance company’s requirements for timely responses to pertinent communications.

Sometimes, insurance companies will attempt to settle the claim “quickly” at the expense of a thorough investigation, considering all the recoveries you are entitled to.  Other times, they will try to add unnecessary delay to exasperate you so that you walk away and leave your money on the table.

Taking the right amount of time to adjust a loss will ensure that you have thoroughly investigated, documented, presented, and negotiated a fair settlement that enables you to have all you are entitled to based on your loss and coverage.

Hiring me will not delay your claim but will increase the likelihood that your claim will be paid in full.

 

Do I still need a Public Adjuster when I already have an Independent Adjuster working on my claim?

Many consumers get confused about these two types of adjusters. The word “independent” means an adjuster is licensed to represent multiple insurance companies. But he does represent those companies and not the policyholder.

The independent adjuster’s income/commissions are paid by the insurance carrier he represents, whose financial interest is his only priority. 

On the other hand, a Public Adjuster (such as me) is licensed to represent an individual or business who has purchased a policy from an insurance company.  It is your claim that you hire a Public Adjuster to assist ONLY you in reaching a fair settlement with the insurance company for your loss or damage.

 

How much should I expect to pay a public adjuster for his work?

When you hire me to prepare and negotiate your claim, there is no upfront cost to utilize my services.

You pay nothing until you receive payment of your claim from the insurance company.  My fee is generally 12.5 to 15 percent of the insurance claim recovery.  The amount of this fee varies by the size of your loss and the complexity of your claim, as each claim is uniquely different. 

Can you help me with my automobile or mobile home claim?

No.  I assist policyholders with claims for private or commercial real property damage. 

Suppose your insurance carrier has agreed to cover the damage to your vehicle, but you do not want to accept their settlement offer. In that case, you should consider invoking your right to appraisal.  The process for doing this is explained in your automobile insurance policy.  While the appraisal process is grossly insufficient in addressing damage to real property, it is possible to arrange an agreeable settlement for your automobile or truck through this process.  

 

Can I hire you as my appraiser or umpire if I decide to invoke my right to appraisal under my home or business insurance claim policy?

No.  There are public adjusters and building contractors who will act as appraisers and umpires; however, I do not.  The focus of my practice is directed toward successfully negotiating full indemnification for my clients.  I do not believe the appraisal process is intended or equipped to perform that service.

Must I have a large insurance claim to get assistance from a public adjuster?

To the untrained eye, large claims can appear to be small.  The roofing contractor who tells you about the hail damage to your roofing materials is not always trained to identify the additional hail damage to your window frames, siding, doors, and other exterior areas and contents.  While the small fire in the kitchen may have been contained to the top of the stove, smoke from that fire may have damaged the walls, carpet, draperies, clothing, furniture, and other contents.  Water damage from broken plumbing might be invisible to the naked eye while seen with infrared devices.  

While small claims can and should be handled by policyholders, they will often be underpaid because they may not include the entire scope of the loss.  

Call and speak to a public adjuster for advice on when he can or cannot assist you in being fully indemnified.  The call is free.

Are all insurance companies “evil” with the intent to cheat their policyholders out of money?

No.  

Most insurance companies operate in good faith and attempt to hire adjusters who do.  When an insured client who has been regularly paying money to the insurance company wants to collect money from the insurance company, the insurer’s response to his client’s claim can sometimes become adversarial.  

The burden of proof falls upon the party filing the claim to demonstrate his or her entitlement to be paid, which is often an unexpected and misunderstood process.  Some adjusters have been known to work harder to deny a claim than spend it, which is an improper claims practice. Sometimes, however, innocent mistakes are made, and usually, they are made in favor of the insurance company, and most policyholders miss them.

 Some public adjusters contact insured homeowners with offers of representation when they incur damage. Will you contact me after my loss to see if you can help me?

No. 

I only represent Missouri home and business owners referred to me by others I have worked with or who contact me independently.

I do not solicit claims directly from policyholders or pay national public adjusting ‘lead harvesters’ (from the 1-800 numbers) for local referrals.  Nor do I solicit or encourage policyholders to file claims with an assurance of recovery.  Deciding whether you should file a claim with your insurance company is a decision only you should make, and since not all claims will require the assistance of a public adjuster, that call should also be yours. 

I am a building contractor and would like to hire a public adjuster to assist me in recovering more money from the insurance company for the work I am doing for my customers with insurance claims.  Can I hire you to help me or my company with these insurance claims?

No.  I work only for the policyholder.  I provide consultation services to contractors, but I do not represent them.

While many contractors refer their customers to me for assistance, I represent only the policyholders and their interests.  I am not involved with what they decide to do with the money I recover for them or who they hire to work on their home. 

Missouri law forbids licensed public adjusters from performing restoration or repair work for the policyholders they represent with a claim. Being hired by and working for a contractor to negotiate his customer’s insurance claim would be a conflict of interest and fall under that same prohibition.    

Suppose you are a contractor with a customer you believe is not treated fairly by their insurance company. In that case, you should suggest to them that they contact a licensed public adjuster – directly – for assistance.

I decided to process and settle my claim independently, and I am not sure I have received a fair settlement.  What should I do?

You can always have your claim reviewed and re-evaluated.  There is no charge for this process if you contact me to provide this service.  It is not unusual for policyholders to ask for a review as many complex issues can be involved in a property loss adjustment process.

Call me, and I will gladly review your claim and give you my opinion.

I have already accepted payment on my claim, but I am entitled to more than the insurance company paid me.  Can a Public Adjuster help me in such a case?

Possibly. 

In a case in which you believe you have been fairly and fully indemnified by your insurance company and are seeking a way to profit from your insurance claim, I cannot help you; however, if the insurance company’s estimated payments are insufficient to meet the actual costs of restoration or replacement for your loss, I probably can.

 It will cost you nothing to contact me and allow me to review your claim to see if additional steps are available.

Can the residential contractor working on my home negotiate my claim with the insurance company?

Not in Missouri. (Click here for an explanation from the Mo Dept of Insurance)  If your contractor is a licensed public adjuster, he is prohibited from contracting to provide repair or remodeling services for the damages associated with the claim. 

Suppose he is not a licensed public adjuster. In that case, he may be prohibited by law from negotiating your claim on your behalf with the insurance company, depending upon the nature of the work.  Residential contractors are prohibited from representing their customers to their insurance companies.  

No matter how you look at it, your contractor should not be negotiating your claim on your behalf.  Any “negotiating” that he may be doing is limited to his work, which, frankly, is something that he should be negotiating with YOU … not your insurance company.

Another consideration is that a contractor negotiating his fee with your insurance company is likely to limit his negotiations to only those that will directly result in his compensation … while you may very well be entitled to much more under your policy.

Can I speak with a public adjuster BEFORE I have a significant problem to understand better what my insurance policy does and does not cover?

Absolutely … and you should. 

Once you understand how your policy works, you may need to meet with your insurance agent to arrange to fill in some gaps or improve your coverage to better address your expectations.  You will also learn what essential steps you need to take to protect your rights under your policy when disaster strikes.

Will you come to my home or business to look at the damage and tell me how much you can recover for me before I file a claim?

The short answer is, “No, I will not.”  

I have heard that some public adjusters will do this for you, but I will not. The laws and regulations that govern my license and moral and professional ethics forbid me from making any guarantees concerning your recovery from your insurance company.  

A public adjuster cannot take an initial look at your damage and commit to you what your insurance company will agree to pay to restore it.  Without a full investigation and review of your policy, he can only guess if (a) you are entitled to any recovery, (b) how much of the damage, if any, is covered, and (c) he can only roughly estimate what he might be able to present to the insurance company as a cost to restore the damage.  

I do NOT make promises to enrich my client by manipulating facts to achieve payments beyond what he is entitled to under his insurance policy. That would be fraudulent.  Instead, I thoroughly investigate a claim and prepare the evidence to compel the insurance company to honor their agreement to fully indemnify my client and provide him with every cent that he is entitled to under his contract to restore his property to its condition before his loss.  This happens after I have fully investigated and prepared a claim.