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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
- 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.
- 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.