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The Real Deal When Claiming for Property Insurance Coverage

Throughout the years that I’ve been practicing law in Miami, I have seen the ups and downs of many cases. I’ve seen the personal struggles of people in trying to defend their case; and I’ve seen a series of victories and defeat in the process. Perhaps one of the most interesting is in line with real estate property owners and their ordeal when claiming for insurance coverage. 

There are many times when I find myself in disbelief on how insurance companies treat and serve their policy holders when they are claiming for insurance coverage. Things can get really messy and ugly that oftentimes, policy holders come to me to seek for professional and legal advice. Emotions can get really high especially when a property owner comes to me asking how to recover following an insurance claim denial or after being presented with an unreasonable insurance settlement. In the midst of a badly damaged property or business loss, what advice can I possibly give to a discouraged client in order to provide comfort and relief?

The Truth Behind Insurance Companies

Insurance companies have their own language and interpretation of insurance policies. It is quite difficult to understand their processes but they have their own ways of validating their assessments and investigations when dealing with insurance claims. From a professional standpoint, a game of “tug of war” is the best way to describe the process of claiming for insurance coverage. Two sides are both exerting efforts to pull at opposite ends of a rope until one successfully drags the other towards and across the central line. One side of the rope represents the insurance company and the other end represents the policyholder. Each side attempts to pull the rope towards them in order to beat the other. 

What are their odds of winning the game? To understand this better, let’s uncover the ways they can gain an advantage over the other.

  • Claims Handler and Independent Adjusters

Claims Handlers are in-house employees of an insurance company. They are tasked to assess and investigate an insurance claim. They are the ones who inspect the property damages and interview the property owner to determine entitlement to insurance coverage.

An Independent Adjuster is someone who is hired or outsourced by the insurance company to conduct an assessment and investigation relative to an insurance claim. An Independent Adjuster is usually contacted when a major calamity hits a certain area and there’s massive number of insurance claims to be handled. 

Basically, a Claims Handler and an Independent Adjuster work for the insurance company. They represent the interest of the insurance provider and it just makes sense that their assessment and investigation are also geared in favour of the company they are representing. 

  • Public Adjusters

Public Adjusters are hired by insurance policy holders to represent them and their best interests when claiming for insurance coverage. They also perform assessment of damages and investigation to facilitate the process. The duties of Public Adjusters are state-regulated thus giving them legal rights to represent policy holders and to negotiate on their behalf.

Apparently, it is now very easy to picture out the game of “tug of war”. Each one can rely on their allies to power up their game. Insurance companies can rely on Claims Handlers or Independent Adjusters to come up with an investigation that will enable them to validate a resolution that is on their favour. On the other hand, policy holders can rely on their Public Adjusters to maximize their insurance claims and to negotiate for a fair settlement. Each side tugs on opposite ends of the rope trying to gain an advantage over the other. 

From a Legal Perspective

The process of claiming for insurance coverage should not be an ugly and dirty process. Let’s face the reality that policy holders pay for their insurance premium in the hope that they can depend on it in the future. Thus, they should be entitled to insurance coverage come claiming time. Furthermore, insurance policies should provide peace of mind – that’s the reason why consumers pay their premium in the first place. 

In a perfect world, your insurance provider should be your ally when the need arises. You should be on the same side and not on the opposite ends of the rope. However, we don’t live in a perfect world where there are no complications and inconsistencies. This is Miami and just like in any other cities, insurance claiming can be a laborious process. And as an insurance policyholder, you should be aware of your options and rights. In this case, it’s clear enough that you can always hire a Public Adjuster Miami to represent you. This can somehow unload the heavy burden of you having to fight on your own. Having a Public Adjuster can give you a good head-start in managing your claim if you know little about the process. 

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