By William S. Cook

WHAT IS A PUBLIC ADJUSTER?
A public adjuster is educated and trained in the policy issues that effect the entitlements of a named policyholder on first party property damage claims. Public adjusters work exclusively to enhance the benefits of a policyholder. Public adjusters also known as PA's, in many states, are required to pass stringent certification examinations and attain a surety bond before the Department of Insurance will grant a license. Attorneys and public adjusters are the only parties that are allowed by law to represent and pursue another party's interest on an insurance claim.

WHY IS A PUBLIC ADJUSTER DIFFERENT FROM ADJUSTER SENT FROM THE INSURANCE COMPANY?
A public adjuster is employed and paid by the policyholder and his/her fiduciary responsibility and duty must be to the policyholder. The adjuster employed by the insurance company works for the best interest of the insurance company, accordingly their responsibility and duty must be to their paymaster. It is impossible for any insurance adjuster to protect and maximize the policyholders interests while their paychecks, bonuses, instructions and future business must come from the insurance company.

WHY SHOULD I RETAIN A PUBLIC ADJUSTER TO BE PAID WHAT I AM OWED UNDER MY POLICY?
You may consider retaining a public adjuster if the claim has derailed or you suspect that you will not receive all of the coverage benefits for which you paid a premium. If the insurance company representative attempts low-ball tactics by using an insurance industry preferred contractor or wrongly denies your claim, you may find yourself in the uncomfortable position representing your interest against an army of experts. They often try to make you prove that loss coverage exists and the amounts sought for repairs are justified. The preparation and presentation of the facts can be complicated, burdensome and time consuming.

The policy requires that the policyholder substantiate and document their damage. To allow the company's adjuster to compute your damages seems like a good idea in the early stages. Rest assured his loyalty is to his paymaster, but he will help as long as he determines how much and what you will get paid for. This procedure allows the basis of any dispute or arguments to be from the insurer's perspective. Many details and variables can be easily overlooked. There is overwhelming evidence that a majority of policyholders do not receive a proper settlement without professional assistance. Public adjusters will almost always obtain much greater settlements than individuals representing themselves or depending on the representative sent by the insurance company. Most policyholders lack the education and the skills for evaluating, estimating, and appraising covered damage. More importantly, they lack the knowledge to deal with the "ins and outs" of the insurance industry experts. As is true in any profession, the more experience and training one has acquired the better the results.

Now with all that being said, if the claim is simple, and gets adjusted and paid in a proper manner and does not severely impact your financial or physical well-being, the services of a public adjuster are not required.

WILL I GET A HIGHER SETTLEMENT IF I USE THE SERVICES OF A PUBLIC ADJUSTER?
Almost always. With a thorough and complete evaluation by a professional of the applicable coverages that may apply to the individual circumstances of your claim, the results usually equal higher settlements. The meticulously attention to the details of the loss are where most public adjusters are worth their weight in gold. Most public adjusters have computer programs that allow maximizing the details of the loss and the ensuing increase in the settlement amount. Having a professional public adjuster, whose compensation is directly linked to achieving your best settlement, assures a mutual interest of achieving the full entitlements under the policy.

DO I HAVE TO PAY A RETAINER OR UP FRONT FEES?
Public adjusters usually work on contingency fees ranging from 10 - 15% for a normal uncomplicated claim. Fees are not paid until the payment is collected from the insurance company. The fee structure may encompass all aspects of your coverages or you may elect to pursue portions of your claim on your won such as personal property or additional living expenses, get an agreement in writing to avoid future misunderstandings.

As a general rule the fees charged by an attorney are much greater than the fees charged by a public adjuster and in nearly all cases, litigation expenses are enormous and paid by the insured.. Should you elect have an attorney become involved, the information and services provided by the public adjuster will always enhance the objectives of the attorney if they are able to work together..

However, you must understand that if an attorney does get involved after a public adjuster has not successfully brought a claim to its conclusion, the public adjuster, unless otherwise negotiated, will have to be compensated. Simply put, be sure to negotiate a written "Plan B" with your public adjuster if their efforts fail and you are forced to seek legal remedies against your insurance company.

WHO USES THE SERVICES OF PUBLIC ADJUSTERS?
Public adjusters are used wherever a first party property claim may arise. All types of businesses and professions, including banks, accountants, attorneys, and even insurance adjusters and agents consider using a public adjuster for their personal losses. Once an insured has experienced the benefits of a claims expert's services, they will rarely attempt to settle a claim without the consulting effects of a PA. However, as with attorneys, you need to interview several potential public adjusters before deciding on one.

IF I HAVE A MOLD CLAIM, SHOULD THE PUBLIC ADJUSTER HAVE AN EXPERTISE IN MOLD ISSUES?
Few public adjusters have seen the necessity of seeking training and expertise to address the complex issues of mold related losses. Many insurers are now creating mold teams to respond to the complex issues found in the recent avalanche of mold related claims. Attorneys for claimants and insurers are being invited to seminars and classes to become better-informed processors of mold related losses. Restoration companies are clamoring for certification as "Mold Remediators". Industrial hygienist and professional engineers are attending classes to be better informed about the hazards of mold. It only makes sense to enter the battlefield with the most knowledgeable representatives working for your best interest. Finding a public adjuster with the background specialty or enhanced knowledge of mold is rare. Interview several and select the one that you feel the most comfortable with, that has an available track record for your review.

WHAT IF MY CLAIM HAS BEEN DENIED IN PART OR IN TOTAL?
Errors in the application of the policy terms to the circumstances of your loss can cost you thousands of un-collectable dollars. The insurance company representative could be misinformed as to the conditions of coverage afforded by your policy or may wish to be a hero adjuster. An unfavorable answer provided by a representative from insurers is often considered by policyholders to be the final authority of an insurance company response to a reported loss. A public adjuster provides an excellent source to verify the correctness of questionable coverage calls. Many professional PA's will review a policy and your circumstances for as little as a one time fee of $250.00. That policy review could save you from losing thousands of dollars.

Agent are licensed to sell insurance and they are not licensed in most states to investigate or deny a reported claim. Lack of knowledge, lack of a full investigation, lack of time or an unannounced quota agenda may influence an agent's decisions on your coverage. An agent may be a long time friend or a new business associate; but he is not he best person to determine your claim agenda.

CAN A CLAIM THAT HAS BEEN CLOSED BY THE INSURANCE COMPANY BE REOPENED?
There are some public adjusters that specialize in revisiting claims that have been concluded. (for up to five years in some states) Absent the involvement of a public adjuster many of those claims will remain dormant forever in the warehouse of the insurance company and the policyholder will never gain benefit of the coverage for which he or she paid a premium. Legislative rules change as do court decisions on a daily basis, and you can rest assured that insurers will not be digging through their closed files to find the cases that might warrant a second look.

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William S Cook resides in Orlando Florida and has been licensed by departments of insurance in seven states and the Caribbean to work for insureds. He currently consults on water intrusion/mold losses on a national basis. He has worked for and against insurers for over thirty years. He has been involved with environmental issues since 1990. He is the vice president of the Florida Association of Public Insurance Adjusters and a member of the American IAQ Council. His hobbies include researching court cases involving insurance claims and their resolutions.

Policyholders of America ("POA") rarely recommends public adjusters. There are a few, however, who have proven to be knowledgeable and reputable. POA will provide names of those public adjusters to members who request such information.

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