This is Part 3 of a 4-part series of posts addressing homeowner insurance policies. Click for Part 1 (introduction) and Part 2 (discussing terms and conditions that are frequently in dispute). The legal and other issues described in these posts apply generally to Connecticut and New York, but elsewhere as well subject to state law.
Third-party adjusters or “public adjusters” are commonly involved with the claims adjustment process following the loss or destruction of an insured’s policy and resulting insurance coverage claim. Public adjusters are stated licensed, and most states including Connecticut have enacted consumer protection statutes aimed to safeguard again unscrupulous adjusters.
Public adjusters can play an important role for insureds dealing with a property loss; just as insurers have lawyers on their side (meaning that, insureds often should, too), insurers are staffed with individuals who are educated, trained, and very experienced in dealing with property losses and valuation and coverage issues that can arise in this context. Because these individuals are tasked with looking out for the insurer’s interests, there is no question that public adjusters can help even this playing field and help enhance an insured’s recovery.
An insured’s public adjuster is most often compensated on a contingent basis, based on their insured client’s total claim. In some situations, adjusters may require that the insured pay for the retention of an expert consultant or additional compensation in the context of unique, problematic, or unusually time-consuming claims. Any such additional costs should be discussed with a public adjuster before entering any contract.
The public adjuster should have a technical background appropriate for the claim at issue, (e.g., a background in construction in the context of a fire loss), should be familiar with insurance policies in the jurisdiction, and should discuss with the insured client the policy, policy limits, and potential recovery. He or she should also be exceptionally knowledgeable about the claims process and the proper way to document and support a claimed valuation and owes a duty to the insured claim evaluate, document, and submit and insured loss and advocated to obtain the best possible result.
We are often asked by insureds whether it makes sense for an insured to retain counsel even where a public adjuster is involved. It often does make sense. Public adjusters cannot assert legal arguments about the application of policy language to a particular claim, and various legal issues can arise.
Disputes between insureds and third-party adjusters can arise, as well. For example, there may be questions about the amount or portion of a loss the adjuster helped to obtain or maximize (and thus disputes about compensation). Occasionally, an insured will become unhappy with the adjuster’s work, before the adjustment process is complete, can likewise create disputes about the adjuster’s compensation.
This content is provided as background and does not constitute legal advice. The attorneys at our firm have many years of experience with insurance coverage issues in Connecticut, New York and elsewhere. For more information or to schedule a free consultation, contact us at info@lalorattorneys.com / 646.818.9870.
Recent Comments