The relationship between an adjuster, restoration contractor and policyholders is tricky.
Insurance adjusters work for insurance companies and determine whether the insurance company is responsible for paying out a restoration claim. They inspect the property to see the extent of damage, compile that with other documentation and information that the policyholder and contractor provides, and then use that to determine if the loss is covered.
Of course, adjusters want the settlement to be as low as possible and sometimes they will try to turn the policyholder against restoration contractors in an attempt to pressure the contractor into a lower settlement.
Restoration contractors, of course, are not adjusters – and many states have laws expressly prohibiting restoration contractors from acting as an adjuster. Because of this, it’s crucial that while you help guide your customers, you never try to step in and fill this role. However, you can be aware of the tactics that adjusters like to use, so you can educate your customers.
In this blog, we’ll walk you through some of the tactics adjusters use against policyholders, and what you can do to keep your customers as your advocates.
1. Questioning the Extent of the Damage
Above all else, an adjuster serves the insurance company. Their main goal is to save the insurance company money – and one way they can do this is by questioning the extent of the damage.
An adjuster may claim that some damage existed before the event for which the claim was filed, or question whether certain items destroyed in the event were worth as much as the policyholder claims. This may lead them to ask for more and more documentation.
As a restoration contractor, you need to make sure your customer knows you are on their side. Assure them you will document every part of the restoration process, including photos before, during and after the work has been done. Once the damage is fixed, the evidence is gone. You want to go above and beyond documenting the entire process, because it will be needed later.
There are several technology tools that can help streamline documentation and job management for restoration contractors.
2. Undervaluing the Claim
In addition to questioning the extent of the damage, sometimes adjusters will undervalue the damage on a restoration claim. They might tell the homeowner the amount of work performed was unnecessary or extensive.
If an adjuster comes back with a lowball offer, make sure the homeowners know that they have a right to refuse that first offer. Using the documentation that you provide, the homeowner can request more and substantiate their counteroffer with photos and notes that you provide.
You can also let the homeowner know that they can opt to hire a loss assessor or public adjuster. Loss assessors are hired by the policyholders to handle a claim – they work for the owners in assessing the damage, rather than serving the insurance companies. The policyholders of course will be responsible for paying this person, but if the offer is seriously under what was expected, this can be a good option.
3. Employing Policy Loopholes
Insurance policies are long, tedious and arduous to read – and that’s in part by design. If policyholders don’t read the entire thing, they may not realize the loopholes or gaps that exist in their coverage. Adjusters can use these to justify lower offers in the case of a loss claim.
Remind homeowners to review their insurance policy in full before entering into a negotiation with their insurance company. This can help them fully understand what they’re entitled to, and could even help guide the documentation that you know you’ll need to provide them with to substantiate their claim.
4. Getting the Policyholder to Admit Fault
This is a common tactic used in all insurance sectors, and restoration claims are no different. If a policyholder admits fault – or even partial fault – a claim will be worth significantly less. For damage claims, adjusters may try to get the homeowners to say they failed to mitigate the damage, or that the damage occurred before the claim event. Adjusters will use phrasing like “there is a chance that this may have been going on for a long time correct?”
For example, they could say homeowners failed to shut their windows during a storm, which then allowed rain in, which turned into mold. They may claim certain appliances were broken or damaged before the disaster occurred.
Here, you can help your customers again by having meticulous documentation. Help them record details at the start that they may forget later – for example, if the windows were indeed shut at the time of the loss. Photograph everything, and take diligent notes about everything you find before starting to repair the damage.
5. Delaying the Claims Process
When a claims process is dragged out, the insurance companies are often banking on tiring out you and your customers, to the point that you’ll settle or give up on a claim just to have the process be over. This is why it’s so important to make sure the claims process is kept moving along as quickly as possible. Make sure you’re always available to answer any questions from the adjuster. If you’re not, your claim is going to the bottom of their stack.
At One Claim Solution, we’re here to help with that in particular. We go to bat with the insurance companies on your behalf, keeping claims moving, following-up with requests for additional documentation as needed and answering questions from adjusters, so that these delay tactics are rendered ineffective. With our team of attorneys and appraisers, we have plenty of options to make sure you get paid quickly and fairly and your customers’ lives can go back to normal. When you work with us, you can assure your customers that you’ve got the claims process handled from your end of things.
A Final Word
The restoration claims process can be daunting and insurance adjusters can be tricky. As a restoration contractor, the best thing you can do is build trust with your customers and help them understand that you are the one who works for them and has their best interests at heart – unlike the adjuster. Hopefully this blog helps you understand some ways you can build and keep the trust of your customers.
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Hello! I’m Nicole, and I’m here to champion for our employees, recruit for new talent, and impact culture at One Claim Solution. I find satisfaction in supporting a memorable employee experience and bring innovation, problem solving, and strategic view to the process. Nothing is more important than our people, and a healthy culture is my top priority! I have had the pleasure of building my career in various sectors, specializing in small to medium size firms focused on high-growth. My experience is centered around driving and implementing change, leading high-performing teams, and driving process improvements. I am excited to make an impact at One Claim. Outside of work, my family and I enjoy getting outdoors as much as possible to explore beautiful Colorado!
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Welcome! I’m Alisha, and I’m here to champion your success as the Director of Customer Success at One Claim. With a passion for helping customers thrive, I bring a wealth of experience in onboarding, customer service, and account management to ensure your journey with us is nothing short of exceptional.
Prior to joining One Claim, I had the privilege of scaling SMB and Enterprise Customer Success teams at fast-growing SaaS startups. With over six years of experience at companies like Mavenlink, Teamwork, and ServiceTitan, I honed my expertise in building high-performing teams and fostering proactive, consultative customer relationships. This background has equipped me with a deep understanding of the challenges faced by businesses like yours, and I’m dedicated to helping you overcome them.
Hi there, my name is Eric! I am the Chief Technology Officer here at OCS, spearheading our technical strategy. I have a background in computer science, graduating cum laude from BYU-Idaho with a Bachelor’s degree in Computer Information Technology.
Before coming to One Claim, I served as the Director of Engineering at Slingshot Technology, Inc., a company later acquired by WorkWave in 2021. My professional journey has spanned both emerging startups and established corporations, with a steadfast focus on cultivating high-trust, low bureaucracy teams and innovating technology using agile methodologies.
In my free time, you can find me flying drones, enjoying the outdoors, and spending time with my family.
Hello, my name is Cam, I’m the COO of One Claim Solution! I come from a management consulting background (Bain & Company) and hold an MBA from the University of Michigan. I have worked at a wide variety of organizations, from Fortune 500 to small-cap, in an equally wide variety of industries. I have over 15 years of experience in operations and strategic growth, and I have spent much of my career focused on developing high-performing tech-enabled service organizations through early stage and high growth phases.
Outside of work, my wife Brittny and I have four kids, ages 13 to 6. As residents of Mesa, Arizona, we love to ski and explore the national parks of the southwest!
Hello, my name is Dan, and I am the CEO of One Claim Solution. I am super excited by everything we are doing at OCS to be the market leading insurance billing specialist that advocates on behalf of our restoration contractors.
My professional experiences are predominantly corporate in nature. My career started at General Electric in finance and accounting. Immediately prior to joining OCS, I spent time as an investor at Bondcliff Partners and management consultant with Bain & Company. I also hold an MBA from the Kellogg School of Management at Northwestern University and got my BS in finance and accounting from Northeastern University.
Outside of the office, I enjoy spending time with my wife, two young children, and our family dog, Whiskey. We live in Charleston, SC and take advantage of the beautiful weather by spending as much time as possible outside at the beach or adventuring around town
Hi, I’m Josh! In 2016, I co-founded One Claim Solution with my partner Jeremy Traasdahl, and I serve as General Counsel of One Claim Solution. Working in the restoration industry, Jeremy and I saw contractors struggling to get paid quickly and fairly and we knew there was a need for change. We founded One Claim Solution to be this change and it’s been my privilege to see our company grow and to advocate for our clients as general counsel.
Outside of my passion for helping the restoration industry, I enjoy spending time outdoors, fly-fishing, hunting, skiing, and coaching my kids’ baseball teams. I’ve been married to my amazing wife for 20 years and we have a beautiful family of 5 children.
Hey, I’m Jeremy! In 2016, I co-founded One Claim Solution with my partner Josh Ehmke. Working in the restoration industry, Josh and I saw contractors struggling to get paid quickly and fairly and we knew there was a need for change. We founded One Claim Solution to be this change and it’s been my privilege to lead our amazing team.
Prior to One Claim Solution, I started my career as an inside sales rep for Avnet, then moved to Pepsico as a district sales manager. Outside of work, I love spending time with my wife and four children, two boys and two girls!