The Crux of Adjusting

Disputes in insurance claims fall broadly into several categories: coverage disputes, damage disputes and causation disputes. This message addresses damage disputes.

The insurance adjuster’s job is to ascertain what the insurance company’s minimum contract responsibility is under the terms and conditions of the insurance policy. In so doing they look for the open and obvious damage and damages that can be documented using a camera and a tape measure. Sometimes these open and obvious damages actually reflect the full extent of the loss, however many times they do not. The crux of adjusting then becomes how you resolve that difference.

You’ve heard the old adage “The Right Tool For The Right Job”. This applies to insurance adjusting as well. Sometimes the right tool might be an ice pick to show charring in wood framing and at other times a golf ball to demonstrate hollow spots in tile flooring. When choosing a tool, ask yourself two simple questions: what am I trying to demonstrate? And how is this best demonstrated?

Let me give you an example. I had a client whose sliding glass door was damaged in a hurricane. Following the hurricane the wind whistled through the door whereas prior to the storm it did not. Taking a picture of the door was ineffective. The loss was proven two ways. First, I set up audio equipment to capture the whistle as it was actually occurring. Second, I videoed the door capturing the rattle of the door as it was shaken back and forth using only my pinky finger and thumb as leverage. The insurance company agreed to replace the door. Had they not agreed to pay for the door, additional more expensive proof would have been required: proof the insurance company would have been on the hook for.