Navigating the world of insurance claims can often be a labyrinthine affair. Frustrations can run high, especially when you've been met with a denied or underpaid claim. The complexities piling on top of your already stressful situation can make it unclear who to turn to for assistance. Should you consult an insurance claim lawyer, a public adjuster, or an insurance adjuster? In this article, we’ll demystify the roles of these professionals and guide you in understanding how they can assist you in your battle against your insurance company.
The Basic Definitions
What is an Insurance Adjuster?
An insurance adjuster, often referred to simply as an "adjuster," is a professional hired by your insurance company (or sometimes by a third party) to investigate and evaluate your claim. They are responsible for assessing damages, establishing the value of your claim, and determining whether a payout should be made.
Adjusters can be categorized into two main types:
1. Company Adjusters - Also known as staff adjusters, these professionals are employees of the insurance company and manage the claims that come in.
2. Independent Adjusters - These adjusters work as freelancers or are employed by third-party firms. They are hired by insurance companies to assess claims on their behalf.
What Is A Public Adjuster?
Unlike their counterparts, public adjusters represent the policyholder (you), rather than the insurance company. They can perform all of the same functions as an insurance adjuster, but they work and advocate for you in your claim process, ensuring that you receive a fair settlement from your insurance provider.
What is an Insurance Claim Lawyer?
An insurance claim lawyer, or attorney, specializes in handling disputes with insurance companies. Their primary role is to provide legal representation to clients whose claims have been denied or undervalued. An insurance claim lawyer is knowledgeable about the intricacies of policies and laws governing insurance claims, allowing them to advocate effectively on behalf of their clients.
Key Differences Between Adjusters and Lawyers
Primary Function
Insurance Adjusters focus on claim investigation and assessment; they gather evidence, analyze damages, and recommend a payout to the insurance company, while balancing the interest of the company they represent. Remember that the insurance company pays their salary and provides all of their training. They do what is best for their employer - the insurance company.
Public Adjusters focus on advocating solely for the policyholder. Their primary role is to assess damages independently from the insurance company, ensuring a thorough and accurate evaluation of the loss. They work directly with policyholders to prepare, document, and negotiate the claim, with the goal of maximizing the payout based on the policyholder's interests, not the insurance company’s. Public adjusters handle the entire claims process on your behalf, making sure nothing is overlooked or undervalued.
Attorneys focus on legal representation; they advocate for the policyholder's rights, often preparing for litigation if necessary. This approach can be essential when claims are denied or when there are significant disputes over the payout. When an attorney is involved, the process often takes much longer, but they payouts can be better.
Pay Structure
Insurance Adjusters are typically compensated by the insurance company, which can sometimes lead to a conflict of interest. Their goal is to keep costs down for the insurer, which may not align with the policyholder's best interest.
Public Adjusters work on behalf of the policyholder and are typically paid a percentage of the final settlement amount, often referred to as a contingency fee, typically 10%. Because their payment is tied directly to the amount they recover for you, public adjusters have a vested interest in maximizing your settlement. This structure ensures that their goals are aligned with the policyholder's best interest, not the insurance company’s.
Insurance Attorneys usually charge fees based on a contingency model, typically ranging from 25% to 35%, meaning they take a percentage of any settlement amount they recover for you. This structure gives them a strong incentive to achieve the best possible outcome.
Scope of Engagement
Insurance adjusters often work quickly to settle claims, usually within a short timeframe. This fast-paced nature can sometimes result in subpar evaluations of claims, especially from a policyholder’s perspective.
Public adjusters offer a more thorough and detailed approach to the claims process compared to insurance company adjusters. Because there will be disagreement between the insurance adjuster and the public adjuster in terms of damages, the process will take longer but will typically result in a much higher payout to the insurance holder.
Insurance claim lawyers may take longer to negotiate with insurance companies but bring a comprehensive understanding of legal nuances, which could result in a better outcome for complex cases or large claims.
When to Call an Adjuster vs. When to Call a Lawyer
Working with an Insurance Adjuster
If you have a straightforward claim for minor damages, and you feel comfortable communicating directly with your insurance company, an insurance adjuster may suffice. In these clear-cut situations, working with an insurance adjuster can expedite the process and resolve your claim more efficiently.
However, if you encounter any of the following, it’s time to consider escalating your situation:
Claim Denied: Your claim has been denied for any reason.
Low Settlement Offer: You feel the adjuster’s offer does not adequately reflect your damages.
Complex Cases: Intricate policies, large claims, or multiple parties.
Hire A Public Adjuster
If your claim has been denied, underpaid, contains complex issues, or you simply want an advocate working solely on your behalf, a public adjuster is the right choice. They handle everything from assessing damages and documenting losses to negotiating directly with the insurance company. Because a public adjuster doesn't work for the insurance company, there is no conflict of interest and they can work to maximize your claim settlement.
Hiring an Insurance Attorney
If your claim has been denied, or you are facing difficult negotiations, contacting an insurance claim lawyer should be your next step. They bring a wealth of experience in negotiating with insurance companies and understanding policy language. If the case starts heading toward litigation, having an attorney will ensure that you are adequately represented in court.
Common Misconceptions About Adjusters and Lawyers
All Insurance Adjusters Are the Same: Many policyholders believe that all insurance adjusters work with the same aim. Company adjusters, who are employed by the insurance company, are fundamentally focused on protecting their employer’s financial interests. Their goal is often to minimize the payout on your claim.
In contrast, public adjusters work exclusively for you, the policyholder, and are dedicated to maximizing your settlement. Understanding this distinction is crucial for securing the compensation you deserve.
Hiring a Public Adjuster Will Slow Down the Claims Process: Some policyholders believe that hiring a public adjuster will delay the resolution of their claim. In reality, public adjusters often expedite the process by streamlining communication with the insurance company, ensuring all necessary documentation is provided, and negotiating on your behalf. Their involvement can prevent costly delays and help you avoid the back-and-forth with the insurer that can drag out a claim.
It’s Cheaper to Handle the Claim Yourself: Many people assume they’ll save money by not hiring a public adjuster or attorney. However, this can often result in underpaid claims, leaving you with out-of-pocket expenses. Public adjusters typically earn a percentage of the settlement they help recover, and their expertise in maximizing claims can far outweigh the cost. Similarly, hiring a lawyer for complex or denied claims can prevent costly mistakes and ensure your rights are protected.
Lawyers Are Only Needed for Lawsuits: Another common misconception is that you only need to hire a lawyer if you’re planning to file a lawsuit. In reality, lawyers can assist in navigating complex insurance claims and can provide valuable legal advice even before litigation becomes necessary. They can help you understand your rights, negotiate with the insurer, and ensure your claim is handled fairly. While public adjusters handle the technical aspects of claims, a lawyer can provide additional legal backing if things escalate.
At Best Adjusters, we take a collaborative approach to ensure our clients receive the maximum payout they deserve. We work closely with both insurance adjusters and attorneys whenever necessary to navigate the complexities of the claims process.
Our public adjusters handle the detailed evaluation of damages, documentation, and negotiation with the insurance company’s adjusters to ensure a fair assessment. If disputes arise or the claim becomes more complex, we seamlessly collaborate with experienced lawyers to provide legal backing, ensuring every aspect of your claim is covered. By uniting technical expertise with legal support, we maximize your claim’s potential, giving you the best possible outcome with the largest payout possible.