Insurance Claims 101: Don’t Self-Adjust Your Insurance Claim

Don’t adjust your Insurance Claim.  What does that mean?  A layperson, in other words: a person not familiar with insurance industry, may not even know what the word “adjust” means when used in the context of an insurance claim.  What does it mean to “adjust” an insurance claim?

The website www.dictionary.com lists the following definitions of the word “adjust.”

verb (used with object)

1. to change (something) so that it fits, corresponds, or conforms; adapt; accommodate: to adjust expenses to income.
2. to put in good working order; regulate; bring to a proper state or position: to adjust an instrument.
3. to settle or bring to a satisfactory state, so that parties are agreed in the result: to adjust our differences.
4. Insurance. to determine the amount to be paid in settlement of (a claim).

So, to “adjust an insurance claim” simply means “to determine the amount to be paid in settlement of a claim.”  In order to do this, your insurance company employs claims adjusters.  An insurance claims adjuster, simply put, is one who adjusts an insurance claim.

Claims adjusters review your claim to determine a fair amount for settlement.  They interview you and inspect the property to determine the extent of the damage, and the costs of repairing the property. The claims adjuster then reports his findings along with a recommendation for the amount of the claim.  Inherent in a claims adjuster’s duties is a determination as to whether an insurance policy provides coverage for a loss.

So, to get back on task.  When damage occurs to your home, car, boat or business do not “self-adjust” your insurance claim.  Do not investigate the cause of the damage and then make a determination as whether you think your insurance policy covers it.  Most people have never read their homeowner’s insurance policy and have no idea what the policy actually covers.

I often speak to people about damage that occurred to their property months after the damage happened.  When asked why they didn’t report it to their insurance company, the reply is some version of “I didn’t think it would be covered.”  Don’t decide whether your insurance covers the damage:  That is what claims adjusters are for

Side Note:  Most insurance policies require that you provide prompt notice of a loss, with some requiring notice with twenty-four hours.  Your failure to timely report the loss can result in the denial of a loss that may otherwise have been covered.

Lastly, your insurance company will send a claims adjuster to your home to “adjust” your claim.  These individuals are either employees of the insurance company or someone that receives a lot of business from the insurance company.  These adjusters are not there to help you.  They are there to find a reason to deny insurance coverage for your claim.  By law, you are permitted to have your own representative, either a licensed public adjuster or an attorney, adjust the insurance claim on your behalf.  It is important to have someone that is on your side during what can be a lengthy, tedious, frustrating and confusing process.