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If you work in restoration long enough, you will run into a claim that hits a wall. You have solid documentation, photos, and clearly justified line items, but the carrier will not budge. At that point, you may consider invoking the restoration claim appraisal process. Appraisal is one of the few industry tools available to help settle a dispute over the value of a loss without going straight into a lawsuit.
In theory, appraisal should be a simple, neutral, and fair system. However, as restoration insurance billing becomes more aggressive and as claims payments are squeezed tighter, many carriers are pushing back on the process itself. In a recent C&R Magazine webinar, One Claim Solution Co-Founder and General Counsel Josh Ehmke explained how insurance carriers often interfere with the appraisal process, what contractors should be watching for, and how to protect the fairness of the process. Here is what you need to know.
Appraisal is a form of alternative dispute resolution included in most homeowner insurance policies. When the contractor or policyholder and the carrier cannot agree on the value of a loss, either party can trigger appraisal. Once that happens, each side selects an independent appraiser, and those two appraisers select a neutral umpire. When two of the three agree on a value, that becomes the legally binding figure.
The idea is simple. Get independent industry experts together to determine a fair value without a lawsuit, court dates, or years of back and forth. When used properly, appraisal brings accountability, reasonableness, and faster resolution to a claim.
Josh explains, “Appraisals are meant to be an independent valuation process. It is meant to determine a fair market value for a claimed payment.” Unfortunately, the reality is not always that smooth.
Many insurance carriers do not like the restoration claim appraisal process because it limits their control and forces a neutral party to assess the loss. There are several common ways carriers try to weaken the process or influence the outcome.
One of the most frequent issues is carriers selecting appraisers who depend heavily on carrier referrals. When someone’s livelihood depends on staying in the carrier’s good graces, they are less likely to rule in favor of the restoration contractor or policyholder. That defeats the purpose of a neutral review.
Even if a contractor selects a good and independent appraiser, the process often still depends on the umpire. The umpire can make or break the outcome. Some carriers may try to control this stage as well by:
If the umpire is not neutral, the entire process becomes skewed.
Another strategy carriers use is simply trying to shut down the appraisal request altogether. They may claim:
However, in most cases, scope is part of value. You cannot determine the true value of a loss without determining the amount of work required. Carriers sometimes use these arguments to confuse or intimidate restoration contractors into giving up. Even in states where the ability for restoration contractors to use assignments of benefits is limited or not allowed, the homeowners themselves almost always have the right to the appraisal process under their insurance policy. In trickier states, getting the homeowner involved can be a good solution for moving forward with the appraisal process.
Insurance carriers may sometimes use tactics to delay or complicate the restoration claim appraisal process in the hopes that the restoration contractor will simply give up. The carrier may bet that the contractor does not understand the process, the policyholder will be scared off, or that the cost of appraisal will deter the contractor. Appraisals are not free. Each side pays their own appraiser and splits the cost of the umpire. Carriers know that cost alone can discourage contractors, especially on smaller claims.
Contractors cannot stop carriers from pushing back, but they can protect themselves and improve their chances of a fair restoration claim appraisal outcome.
Appraisal decisions are based heavily on the contractor’s documentation. If your photos, moisture readings, scope notes, change orders, and justification are clear and detailed, the appraisers have a strong foundation. If the job is not well documented, it becomes much easier for a carrier to poke holes in your work.
Restoration contractors should look at the numbers before pulling the trigger and moving forward with the restoration claim appraisal process. If an appraisal will cost $1,000 to $3,000 between experts and filings, there needs to be enough financial difference to justify moving forward. Appraisal is a powerful tool, but it is not always the right tool for smaller balances.
Neutrality matters. When possible, work with professionals who understand restoration, are not financially tied to carriers, and have a strong record of independence. If the carrier is pushing for a biased umpire, do not accept the pick. If the two appraisers cannot agree, courts can appoint one.
In some states, particularly ones where contractors are unable to use assignments of benefits, the policyholder must demand appraisal. If that is the case, contractors should educate homeowners about the option without crossing the line into giving legal advice. Many policyholders do not know appraisal exists and are grateful for guidance. As Josh put it, restoration contractors can tell customers, “We are willing to stand behind our work and go through the appraisal process,” which often earns trust and confidence.
Appraisal is not perfect. Carriers will continue to exert influence where they can. But even with its challenges, appraisal is still one of the strongest tools contractors have to keep the claims process fair. It allows you to avoid the cost and delay of lawsuits while still seeking a neutral result that is enforceable. When restoration contractors understand the process, document their work, and protect the neutrality of the experts involved, restoration claim appraisals can level the playing field.
To learn more about appraisals, watch the C&R Webinar recording or reach out to OCS.
Hi there! I’m Connor, the Account Executive for One Claim. My goal is to guide our contractors through the sales process, ensuring you’re equipped with all the information you need to make your decision and hit the ground running once aboard. We view ourselves as an extension of your business and I strive to make the process an enlightening and consultative one.
My career has primarily been focused in software sales over a few different industries but the last few years were spent helping general contractors solve similar problems to what we’re doing here at OCS! Outside of work, I love spending time with my family, cooking and boating during the summer months.
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!
Great to meet you! I’m Elizabeth, and I’m the one behind all the emails and advertisements you’ve been seeing. As the Demand Generation Manager at One Claim Solution, my mission is to connect with contractors like you who need our services. I’m passionate about having an impact on others and I bring a wealth of experience in demand generation and marketing strategy to create moments of delight, curiosity, and education for you.
Prior to One Claim Solution, I had the privilege of building marketing departments from the ground up at companies in a variety of industries, including IT consulting, first protection, and healthcare. Personally, I love being outdoors, playing Dungeons and Dragons and board games, singing, and traveling.
Welcome! I’m Alisha, and I’m here to champion your success as the Director of Contractor Success at One Claim. With a passion for helping contractors 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 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!