Denied or underpaid roof insurance claims

Finding a licensed public adjuster, and checking they are one

A public adjuster represents you rather than the carrier, and the role is licensed by the state. The license check takes minutes and is the single most useful thing an owner can do before signing anything.

A public adjuster works for the policyholder. That single fact is the whole reason the role exists, and it is what distinguishes a public adjuster from the adjuster an insurer sends out, who may be entirely professional and is nonetheless working for the carrier.

The role is licensed, in almost every state, by the department of insurance. Which means the most useful thing an owner can do before engaging anybody is also the easiest: look the person up on the state register and confirm they are who they say they are. It takes minutes, it costs nothing, and it eliminates the category of problem that causes the most harm after a storm.

We are not public adjusters and we do not file, negotiate or settle claims. What follows is how to find and check one, written for owners who have decided they may need representation.

The three kinds of adjuster

Who Employed by Duty to
Staff adjuster The insurance carrier The carrier
Independent adjuster Contracted by the carrier The carrier
Public adjuster Engaged by you You

All three may handle a file competently and courteously. Only the third has an obligation to the policyholder, and that is what an owner is paying for.

How to verify a license, step by step

  1. Find your state’s department of insurance. Every state has one, and almost all of them publish a searchable licensee register online.
  2. Search by name and by license number. Both, because a name alone can match more than one record.
  3. Check the status. Current, not lapsed or suspended.
  4. Check the state. A license in a neighboring state does not authorize work on your property.
  5. Look for disciplinary history. Where the register shows it, read it.

Do all of this before signing anything. Unlicensed operators appear in storm affected areas within days of an event, and an agreement signed with somebody who is not licensed to do the work may be unenforceable in ways that do not help you.

Finding candidates in the first place

Three sources, in rough order of reliability.

Professional associations. National and state associations of public insurance adjusters maintain member directories, and membership means somebody has at least met an entry requirement.

Your state register itself. Several state registers allow searching by location, which gives you a list of licensed people near the property without any marketing attached.

Referrals from professionals who are not involved in the claim. An attorney, an accountant, a property manager or a building consultant with no interest in the outcome. The key qualifier is that they are not also hoping to do the repair.

The source to treat with caution is the one that arrives at your door the week after a storm. That is not a reason to dismiss somebody, but it is a reason to run the license check before any conversation about contracts.

Fees, and the one question to ask precisely

Public adjusters are usually paid a percentage of the recovery, agreed in writing before work starts. Several states cap that percentage by statute, and some apply a different cap after a declared catastrophe.

The question worth asking exactly is what the percentage applies to. A fee calculated on the entire settlement is a very different proposition from a fee calculated on the increase achieved above the carrier’s original offer, especially where the carrier has already offered a substantial sum. Both arrangements exist. The contract should say which.

Then ask what is owed if nothing is recovered, and get the answer in the contract rather than in conversation.

When representation is worth the fee

It is a commercial calculation and worth doing on paper.

Engaging somebody makes sense when the gap between the carrier’s position and the real cost of the work is large, when the claim is complex enough that documenting it properly is beyond what you can manage, when a claim has been declined on a basis you believe is wrong, or when you simply do not have the time the process demands.

It makes less sense on a small claim that the carrier has handled reasonably, where a percentage fee can consume most of the improvement achieved. What to do about an underpaid estimate covers the steps available to an owner without representation, and several of them are effective.

The warning signs, plainly

  • Pressure to sign on the day. Nothing about a claim improves because a contract was signed before you read it.
  • No license produced, or a license from another state. End the conversation.
  • A document that assigns your claim proceeds. Read every form presented as an inspection authorization. Some do considerably more than authorize an inspection.
  • A guaranteed settlement figure. Nobody can promise an outcome before the loss is documented and the policy read.
  • An offer to cover or waive your deductible. Unlawful in many states, and a clear statement of how that person operates.

Roof claim scams and how to spot them sets these out in more detail, because the patterns repeat after every major storm.

What helps whether or not you engage anybody

Documentation, and it is worth doing on day one regardless.

Dated photographs taken before any repair or cleanup. The weather record for the loss date. Your policy declarations page. And an independent inspection report that locates each finding, photographs it, quantifies it and separates damage caused by the event from the roof’s pre existing condition.

That last document is the one that carries weight with a carrier, and it is useful to a public adjuster too, because it gives them a factual record to work from rather than a reconstruction. It is also the part we do.

What to agree before work starts

Five things, in the contract, not in an email.

Scope. Which claim, which property, which loss date. A contract drafted broadly can cover claims you did not intend to include.

Fee basis. The percentage, what it applies to, and the statutory cap if your state has one.

Term and termination. How long the agreement runs and how either side ends it. Some agreements run for the life of the claim with no exit, which is worth knowing in advance.

Communication. Who speaks to the carrier, who speaks to contractors, and whether you remain copied on correspondence. You should.

Settlement authority. Whether the adjuster can accept an offer on your behalf or whether every offer comes to you for a decision. The second is the normal and sensible arrangement.

A professional will have no difficulty with any of that and will usually have answers ready. Reluctance on any of the five is itself informative.

A reasonable sequence for an owner

If you are weighing this up, the order below keeps the options open and costs little.

Read your own policy first, particularly the valuation basis and the deductible. Many owners discover the real constraint is the policy rather than the carrier’s attitude.

Then document the roof independently, because that record is useful whichever route you take and cannot be recreated later.

Then read the carrier’s estimate line by line against a contractor’s scope, and identify what is missing. A number of claims close satisfactorily at this point without representation at all.

Only then decide whether the remaining gap justifies a percentage fee. By that stage you know the size of the gap, which is the one number the decision depends on, and you are negotiating from a documented position rather than an impression.

Where to go next

If you have not yet established what your policy covers, reading the coverage first is the sensible order, since the policy sets the boundaries of any claim. If the claim has been declined rather than underpaid, a declined claim is the page that deals with what follows.

Common questions

What does a public adjuster do?

A public adjuster is licensed to represent the policyholder in an insurance claim. They assess the loss, prepare and document the claim, and negotiate with the carrier on your behalf. They work for you rather than for the insurer, which is what distinguishes them from the adjuster the carrier sends.

  • Licensed by the state to represent policyholders
  • Assesses and documents the loss independently
  • Prepares the claim and supporting evidence
  • Negotiates with the carrier on your behalf
  • Paid by you, usually from the recovery

There are three kinds of adjuster and the distinction matters. A staff adjuster is employed by the carrier. An independent adjuster is contracted by the carrier. A public adjuster is engaged by you. All three may be perfectly professional, and only the third has a duty to the policyholder, which is the difference an owner is buying. Ask plainly which kind you are speaking to, because the answer is not always volunteered.

How do I check that a public adjuster is licensed?

Through your state's department of insurance. Every state that licenses public adjusters maintains a searchable register, and you can confirm the name, the license number and whether it is current and in good standing in a few minutes at no cost.

  • Search your state department of insurance register
  • Confirm the name matches the person in front of you
  • Check the license is current, not lapsed
  • Check the license covers your state, not a neighboring one
  • Note any disciplinary history shown on the record

Do this before signing anything rather than afterwards. Unlicensed operators appear in storm affected areas within days, and a contract signed with somebody who is not licensed to do the work may be unenforceable in ways that do not help you. Checking the state your property is in matters too, since a license in one state does not authorize the work in another, and after a large storm people travel.

Can my roofing contractor act as my public adjuster?

No. Representing a policyholder in a claim is licensed work, and in most states a contractor who negotiates your claim without a public adjuster license is acting unlawfully. It is also a conflict of interest, since the same party would be setting the scope and then being paid to perform it.

  • Claim representation is licensed separately from roofing
  • Many states prohibit contractors from adjusting claims
  • One party scoping and selling the work is a conflict
  • A contractor may document damage and price the repair
  • Ask who holds which license, and verify both

A contractor can legitimately inspect the roof, record what they find and produce a priced scope, and that evidence is genuinely useful to a claim. What they cannot do is negotiate the settlement for you. Where a contractor offers to handle the claim, ask to see a public adjuster license for your state, and if there is not one, keep the roles apart: one party documents and builds, another represents you.

When is a public adjuster worth engaging?

Generally when the amount in dispute is large enough to justify the fee, or when the claim is complex enough that documenting it properly is beyond what you can do yourself. A small, straightforward claim that the carrier has handled reasonably rarely needs one.

  • Large losses where the gap is substantial
  • Complex commercial claims with business interruption
  • Claims already declined or substantially underpaid
  • Situations where you lack time to manage the process
  • Not usually worthwhile on a small, fairly handled claim

Run the arithmetic before engaging anybody. If the gap between the carrier's position and the real cost of the work is modest, a percentage fee can consume most of the improvement. If the gap is large, or the claim has been declined on a basis you believe is wrong, the calculation looks very different. Either way it is a commercial decision rather than a technical one, and worth treating as such before anybody is engaged.

What are the warning signs?

Pressure to sign on the day, a refusal to show a license, a contract that assigns your claim proceeds to a contractor, promises of a specific settlement figure, and anybody offering to cover your deductible. The last of those is unlawful in many states.

  • Pressure to sign immediately, before you have read it
  • No license shown, or a license from another state
  • A document that assigns claim proceeds to a contractor
  • A guaranteed outcome or a promised figure
  • An offer to absorb or waive your deductible

The deductible offer is the clearest signal to walk away, because in many states it is illegal and anybody making it is telling you how they operate. Guarantees are the second clearest. No honest professional can promise a settlement figure before the loss has been documented and the policy read, and anybody who does is selling something other than representation. Treat urgency itself as the warning, since nothing about a claim improves by being signed on the doorstep.

Book an independent inspection

Three things and we will call you back. No obligation.

Or call (646) 643-3790