You just hired a public adjuster and they told you not to talk to the insurance company anymore. Why could that be? Doesn’t it help if you give them information on your loss? Shouldn’t you call them if you want to know what is going on with your claim? Isn’t it rude not to answer if they call you?
The answer to all of these questions is a resounding “No!” I’ll say it louder for the people in the back, “NO!!!”
You hired a public adjuster to represent you because you are smart enough to know that your insurance company does not have your best interests at heart. No matter how buddy-buddy you may be with your insurance agent, the adjuster for your insurance company has a fiduciary duty to protect the insurance company’s bottom line. Just like an opposing attorney in a court case, their job is to get the absolute most favorable outcome for their client that they can, and you are most certainly not their client.
You are, however, our client and our legal fiduciary duty is to you. We have a legal and ethical obligation to protect your financial interest in your property, and we are going to use every tool we have to do just that. Like your attorney is your representative counsel in a court case, we are your representative counsel on your insurance claim, and the insurance company is legally obligated to channel all communication, requests, and settlement offers through us.
Why is who talks to who such a big deal? The simple answer is to protect you. Communication in the insurance industry is full of secret codes and buzzwords that trigger different actions and coverage decisions. For example, if your toilet overflows and covers your bathroom floor with water, you might explain the situation saying, “My toilet overflowed and flooded my bathroom! I was away for the weekend when it happened and now there is mold everywhere!” While that is a completely logical explanation and gives a very vivid and accurate picture of the situation when talking to your friend, if you say that to your insurance adjuster you’ve just put your claim in deeper s*** than your bathroom. Both “flood” and “mold” are common exclusions in a standard insurance policy, and you just inadvertently gave your insurance company exactly what they need to deny your claim. You know what isn’t excluded in most policies? Water Damage. Or as we say in the biz, “a sudden and accidental discharge of Category 3 water.” (Unless you meant to flood your bathroom with toilet water, in which case you are on your own kid!)
“But doesn’t claiming water damage just force them to dry everything up and call it a day? That was disgusting, and a couple of fans isn’t going to fix my fungus issues!” you say to me. First of all, stop saying fungus. It’s a gross word in real life and, more importantly, it’s another potty word when it comes to your insurance claim payout. Second, now is when your fearless public adjuster can explain to you (and the insurance company’s adjuster) that not all water is created equal. The water that covered your floor is not potable, drinkable, liquid-of-life category 1 water, or even “grey”, mildly contaminated category 2 water. It is harmful, bacteria-laden, “black” category 3 water that is detrimental to humans and the indoor environment. You know what category 3 water damage requires? Full remediation. Kinda takes care of that mold problem, don’t you think? Just because the mold is there and needs to be taken care of, the complex doctrine of concurrent causation allows you to be compensated for the covered peril that conveniently requires the same restoration work as the excluded peril. Good thing you had a public adjuster who know her stuff to have your back on that one!
“But, Keri, I just read your blog post and now I know not to say flood or mold, so should I talk to my insurance company now?” Again, the answer is a resounding, “No!” Like I said before, the insurance claim process is full of those buzzwords and loopholes and one blog post cannot possibly cover all of them. The good news is that you don’t need a blog post because you hired us. Of course, I would love for your insurance company’s adjuster to behave ethically and not try to trap you into coverage limitations or a denial, but I cannot guarantee that. What I CAN guarantee is that they cannot trap you if they cannot talk to you.
I have often used the concept of a court case to explain what we do to clients unfamiliar with the role of a public adjuster. If you imagine filing an insurance claim like going to court, hiring a pubic adjuster is like hiring an attorney to represent you rather than representing yourself. While there are some people who are secretly legal savants despite never having attended law school, the average person will most definitely benefit from having representative counsel. In fact, even someone who is a legal savant (like, say, a lawyer) often knows better than to represent themselves on personal matters, because when it concerns your own wellbeing, you are compromised. Likewise with an insurance claim. While a very rare person may know their policy, insurance law, and restoration/construction like the back of their hand, the average person only stands to gain by hiring a public adjuster. Even if you do know all that stuff backwards and forwards, the emotional toll that claims take is significant. Take it from someone who watched my own husband (and business partner) turn from policyholder advocate extraordinaire to the equivalent of the crazy uncle on the hill who never quite made it back from the war writing angry emails to the insurance carrier at 4 am because they changed their coverage decision halfway through demolition day on our house while I was 6 months pregnant. While he ultimately settled the claim (because consider the source!), take it from someone who knows, hiring someone else to represent you is worth it—even if only to maintain your sanity!
Carrying that analogy further, if you were party to a lawsuit, would you talk to opposing counsel without your attorney present? No way! Not only would you avoid those conversations like the plague, you would likely contact the Bar Association to report that attorney for malicious practices. The ONLY ethical way for opposing counsel to contact you is through your legal representation, whether in court or in an insurance claim. We don’t tell you not to talk to the insurance company to keep you out of the loop, but rather to protect you from malicious claim handling practices.
So now the question is what to do with all your free time now that you’re not having to field the litany of phone calls, emails, and document requests from your insurance adjuster? My suggestion? Leave it to me and get back to living your life. I’ll take it from here.