How an Insurance Attorney Can Help a Public Adjuster

Anyone who has lived through a major disaster like a fire, flood, windstorm or a worse case scenario like Hurricane Katrina, knows how traumatic and stressful it can be to recover both your tangible belongings and emotional well being.  After several days of trying to keep your family safe, cope with finding new living quarters or attempting to keep a business running, it becomes quickly apparent to the insured that they may benefit from some professional help to pick up some of the slack.  It is in this type of situation that a public adjuster and/or an attorney could be of tremendous assistance.  Each can play a valuable role to the insured during these times and often work hand in hand with a mutual client.

Public Adjuster’s Role

The public adjuster’s job is to appraise the extent of the loss, decide how to best present the claim and prepare estimates.  They inventory, then negotiate the settlement with the insurance company on behalf of the insured.  Their main role is to negotiate the fairest settlement so the insured can make full recovery and get back to a normal living environment again.  The level of expertise and detail that a public adjuster invests in a claim is usually something most policyholders either don’t know how to do, don’t have time to do or would prefer not to do.  Policyholders often underestimate the process until they are in the middle of it.  When they understand how tedious the process can be and see how special knowledge in this field comes into play when applied, they start to appreciate the help.  The majority of the time the amount of effort a public adjuster puts into the claim turns out to be in direct proportion to the result of the settlement which could end up to be three or four times the amount that an insured would receive if negotiated on their own.  If an insured decides to go with a public adjuster over an attorney to start, the adjuster can be a lot faster and less expensive than an attorney’s services.  However, some cases reach a standstill in which case in order to move forward, an attorney’s expertise is needed for litigation.

Attorney’s Role

An attorney is either brought in when the negotiation process has stalled or when the legal rights of the policyholder has been threatened.  They will focus on the legal aspects of the claim including liability and subrogation.  Their main responsibility is to make sure that the insured’s interests and rights are protected at all times.  Attorneys will often call on a public adjuster to help them develop and document claims that are not necessarily first party claims.  They are also asked to review claim procedure and claim handling.  An attorney is extremely helpful if a public adjuster is involved and cannot resolve the claim to the satisfaction of the client.  An attorney will review the case to see if it’s viable to pursue for litigation and call on the public adjuster to present their case on behalf of the client if necessary.

Attorney’s can also be helpful in seeing that consequences are imposed on any insurance company that denies a claim in bad faith.  This is when an insurance company fails to act in a fair and honest manner towards a policyholder.  If the company refuses to pay or unreasonably delays paying your legitimate claim you may have the right to pursue an insurance bad faith lawsuit with your attorney.  They will help you prove that the insurance company failed to honor the policy and had no reasonable cause not to pay what was due.

Other ways an insurance can commit bad faith are:

Failing to promptly and thoroughly investigate a claim

Withholding benefits without cause

Unreasonably delaying payment

Unreasonably denying benefits to a claimant

Underpaying or undervaluing claims

Using unreasonable interpretations in translating policy language

Unfairly refusing to settle and/or reimburse claims

Unfair cancellation of an insurance policy

Unfair claims handling is another issue that can affect a policyholder’s ability to receive the benefits to which he or she is entitled.  Unfair claims handling occurs when insurance companies try to avoid paying valid claims or reduce the payment to the policyholder.  Unfair claims handling involves the conscious doing of some wrong on the part of the insurance company which can include fraud, misleading or deceiving a policyholder or neglecting or refusing to fulfill a duty or contractual obligation.  An insurance dispute attorney can help you to determine if your company is engaging in bad faith practices or unfair claims handling and ensure your rights are protected.

When to Hire Both A Public Adjuster And An Attorney

Both a public adjuster and an attorney are usually hired if there are legal issues that are beyond the expertise of a public adjuster like in the case of “bad faith practice.”  Also, in a case where there is property damage and injuries and the adjuster may be needed to document the damage while the attorney is needed to resolve a dispute not clearly addressed in the policy language of the insured’s contract with the carrier.

Attorneys refer clients to public adjusters when they feel it is in the client’s best interest.  Public adjusters recommend the services of an attorney  when it becomes apparent that legal advice would be helpful to the client.  The attorney and the adjuster both work to make sure that the best interests of the client are paramount and that nothing is done to jeopardize the client’s rights under the insurance  contract.  Each works within the framework of their expertise to provide services for the client. Some public adjusters are also attorneys and vice versa but since both fields are extensive and continually changing, you may prefer to work with an attorney and public adjuster separately with specific expertise in each of their fields.