Should I Hire A Public Adjuster?

Role of a Public Adjuster

  • Licensed by the Department of Insurance to represent property owners in claims against insurance companies.
  • Helps ensure that policyholders receive the full amount they are entitled to, particularly in wildfire damage cases.
  • Negotiates with insurers, prepares professional damage assessments, and provides documentation to substantiate claims.

Payment Structure

  • Public adjusters work on a contingency basis, charging a small percentage of the recovered insurance payout.
  • No upfront cost; only paid when additional funds are secured beyond what the insurance company initially offers.

Claims Process for Wildfire Damage

  1. Partial Damage (Smoke or Fire Damage)
    • Insurers may not pay the full policy limit immediately.
    • Adjusters should be present during the inspection to ensure appropriate loss reserves.
    • Insurance companies often prioritize total loss claims, making a public adjuster valuable in getting fair compensation.
  2. Total Loss Claims
    • The Department of Insurance mandates certain upfront payments for total loss victims (e.g., four months of loss-of-use payments).
    • Homeowners should verify that they have received the mandated payments.
    • Once the insurer issues an initial advance, a public adjuster can analyze the policy to determine what additional funds may be recovered.

Common Homeowner Mistakes in Negotiating Claims

  • Failing to use insurance-approved estimating software (e.g., Xactimate, Symbility).
  • Getting contractor bids instead of structured insurance estimates, leading to insurance disputes.
  • Not recognizing smoke and fire-related damage (e.g., soot in ventilation, insulation damage).
  • Not hiring professionals (e.g., environmental hygienists) when needed.

Public Adjuster vs. Lawyer

  • Lawyers acting as public adjusters typically charge significantly higher fees (25-35% vs. 5-10%).
  • If litigation is required (e.g., suing a utility company for liability), lawyers become essential.
  • If a dispute is solely about insurance policy limits, a public adjuster is often sufficient.

Specialist Testing & Additional Costs

  • Environmental testing may be covered under some policies, but not all.
  • Insurance companies prefer deducting costs for engineers, testers, and consultants from policy limits, which public adjusters often contest.
  • Homeowners generally hire and approve testers, though insurers may offer their own.

Insurance Payouts & Mortgage Companies

  • If there is a mortgage on the property, insurance payments may be held by the mortgage company in escrow and released in stages.
  • Homeowners should coordinate with the mortgage company’s “Lost Draft Department” for check endorsements and disbursement.

Temporary Housing & Additional Living Expenses (ALE)

  • Policyholders can claim temporary housing costs, including rent, increased food expenses, and utilities.
  • If staying with family, homeowners should create a lease agreement to claim reimbursement.
  • The California Department of Insurance has mandated insurers extend ALE coverage from 12 to 24 months, with additional 6-month extensions.

Mitigation & Reconstruction

  • Smoke remediation costs range from $40,000 to $100,000.
  • Insurance covers necessary repairs after remediation, but homeowners may need to ensure that the work is fully funded.
  • Some remediation companies do not handle reconstruction, requiring additional contractors.

Code Upgrade Coverage

  • Policies often cover the incremental cost of bringing a structure up to modern building codes but may have limits (typically 10% of policy).

Handling Underinsurance

  • If policy limits are insufficient for rebuilding, homeowners may need to reallocate funds from other coverage areas (e.g., personal property).
  • In such cases, legal action may be the only way to secure additional compensation.

California FAIR Plan (Last-Resort Insurance)

  • Provides minimal wildfire insurance coverage.
  • Known for being difficult to work with and offering limited benefits.
  • Some policies exclude smoke damage, which public adjusters argue is unlawful.

Public Adjuster’s Role in Personal Property Claims

  • Helps homeowners create a detailed inventory of lost items.
  • Ensures all items are priced before submission to avoid insurer undervaluation.

Final Takeaways

  • Public adjusters help maximize insurance claims without upfront costs.
  • They ensure fair compensation for wildfire-related property damage, whether partial or total loss.
  • Working with an adjuster from the beginning can prevent low-ball insurance settlements.