insurance claims adjuster

5 ways to trick an Insurance Claims Adjuster

Let me show you how to gain an advantage on the insurance claims adjuster and the insurance company.  I know all their tricks so its time we turn the tables on them.

Insurance companies will deny your homeowners claim for a variety of reasons which sometimes really doesn’t make sense.  Their whole goal is to frustrate you, make you go away, and hope you don’t fight them when your homeowners claim is denied.

Let’s take a look at some common ways that insurance claim adjusters deny your homeowners claim

-They will use policy language to deny your claim even if the language doesn’t apply to your property damage claim.

Let me give you example, you have a water damage claim, you report it to the insurance company, they come out do an inspection then a couple weeks later your water damage claim was denied.  Why?  They state because they saw mold and the leak appeared to be long term.  Normally per the homeowners insurance policy you will find this type of language, we do not insure for “repeated or constant leakage or seepage”  Now, what if you leak happened a week before you reported it.  Does that mean this leak is repeated?  Constant?  Long term?  Of course not, it’s the insurance company simply creating ways to deny your insurance claim.

  • Another common way they deny homeowners claims is by stating you reported your claim late
  • They will say that you failed to provide a proof of loss form within 60 days
  • They will use terms like wear and tear when you file a roof damage claim

All these are examples of “tricks” the insurance company uses again people who file claims.

 

BUT NOW I SHARE 5 WAYS ON HOW TO TRICK THE INSURANCE CLAIM ADJUSTER

 

 

#1  What do you do when the insurance company underpaid your claim or wrote a lowball estimate as they frequently do?

This is a very common scenario the insurance company adjuster works for the insurance company not you.  Their job is NOT to pay your claim to maximum dollar amount you deserve, rather, their job is to make sure they don’t pay your claim to its full value.   How do you then fight back against the insurance company without them knowing and surprise them?  In Florida, you can file a mediation request with the State of Florida.  Any policyholder who had a property damage claim that has been denied or underpaid has the right to file for mediation to get the money that is deserved.

Here are 2 links to help get you started:

https://www.myfloridacfo.com/division/consumers/understandingcoverage/guides/documents/MediationProperty.pdf

https://myfloridacfo.com/Division/Consumers/Mediation/default.htm

 

#2 The insurance claims adjuster wants to come to your house for an inspection of the damages

The insurance adjuster a few days after the claim will call you to set an appointment to inspect the damages.  Now, most insurance companies have independent adjusters, otherwise known as the “field adjuster” to inspect your property and even ask you questions about the claim and the damages.   So, when the independent adjuster comes to your house you video everything from when he steps into the house.  You then walk with him/her point to all the damages, then ask the adjuster on video while pointing to the damage “Mr. or Ms. Claim Adjuster see this wall that has water damage, is it damaged?  yes or no?  Try to get them on video to commit to acknowledging the damage that is visible.  But remember, some damages also could NOT be visible such as water damage behind a wall or in the ceiling.  In that case, you need to ask the claims adjuster on video, could there be damage in the wall, ceiling, floors that’s not visible?

#3 When they come for the inspection, make a list of everything that is damaged and have them sign it

When the claims adjuster comes for the inspection, make a list of everything that is damaged then before leaving you ask them to review the list and sign it.  Will they sign it ?  Probably not, but then what you do is send an email to the desk adjuster handling the claim stating “Dear Mr. or Ms. Claims Adjuster,  During the inspection I created a list of areas and items that were damaged and tried to discuss this with the field adjuster, however, he would not sign the list acknowledging the damages I sustained in my homeowners insurance claim.  As such, I am forwarding this list to you so that you have a full understand of the damages I have suffered in this property damage claim.”

You can also be more specific like “the damages I have suffered in this”  Roof Damage Claim, Fire Damage Claim, Water Damage Claim, Hail Damage Claim, Storm Damage Claim, Hurricane Claim, Water Leak Claim, Roof Leak Claim, etc…

#4  If they ask you for a recorded statement keep everything simple, don’t talk too much, and use “I don’t know exactly”

Insurance companies and Insurance company adjusters will always try to get you to say things so that they can find a way to deny your homeowners claim.

Let me share the most common types of questions asked by claim adjusters and how you should answer them.  Remember “I don’t know exactly” are the most powerful 4 words you can use

*When was your roof damaged?      YOU:  “I don’t know exactly”

* How long did you have this water leak  YOU “I don’t know exactly but it was very recent”

  • For water damage claims you always want to say it just happened, was recent, happened abruptly

*What was damaged in your home  YOU “I don’t know exactly but there are many rooms in my home”

*What caused the water leak   YOU  ” I don’t know exactly”    Note:  if you had a leak and a plumber fixed the issue then it’s ok to tell the insurance company what happened.

Here are a few more tips for a recorded statement:

a.  keep your answers short, let me repeat this, keep your answers short DO NOT RAMBLE

b.  Listen to the question

c.  Use “yes” “no” “I don’t know exactly” often

d.  Keep calm

#5 Don’t be there during the inspection, yes that’s right, DO NOT be present during the inspection

Mike, why shouldn’t I be there during the inspection?  Here is the reason.  When the claim adjuster comes to your home, they will ask you questions trying to set you up to deny your homeowners insurance claim.    A question like “How long was the leak there?”  and you respond, “It’s been there a long time”.   Well guess what, you just hurt your claim and they will deny your claim.  What I advise my clients to do is have a neighbor, friend, relative, anybody you can trust let the claim adjuster into the home.    This way, if the adjuster asks any questions that person simply says “I don’t know anything about the claim, I’m here only to let you in”

 

There you have 5 ways to trick an insurance claims adjuster.  Hope you found this helpful.

 

Mike Keeler

The Claim Squad Public Adjusters

754-252-5438

Email:  TheClaimSquad@gmail.com