Dealing with the insurance adjuster: what to say, what not to say

Who is the adjuster, and who do they work for?

The adjuster inspects the damage, measures it and writes the estimate the insurer uses to decide what to pay. Three kinds of adjusters may touch your claim, and only one works for you.

“Independent” does not mean neutral. Florida DFS says independent adjusters are typically hired by the insurance company. For flood claims, the NFIP policy form says the insurer has not authorized its adjuster “to approve or disapprove claims or to tell you whether we will approve your claim.” The adjuster gathers facts; the insurer decides.

Florida DFS says all three types must be licensed by the Department of Financial Services, and you can check a license at licenseesearch.fldfs.com. Our public adjuster guide explains fees and when hiring one makes sense. The insurance claims hub covers the rest.

What does the adjuster’s inspection look like?

Florida DFS describes the usual sequence. A field adjuster visits to document the full scope of the damage through measurements, photographs, video and sometimes interviews of people who were present. That report goes to a desk adjuster, who enters it into estimating software that prices the materials and labor to return the house to its pre-loss condition. DFS says it is the desk adjuster, or their manager, who decides whether the policy provides coverage and for which parts of the damage.

The field adjuster may not climb the roof. DFS notes insurers are allowed to use drones and satellite photos for roof inspections, and Fla. Stat. 627.70131 permits electronic inspection by photos, video, video conference or drone, while still allowing a physical inspection. In Florida the adjuster who inspects must hand you a printed or electronic document with their name and state license number, and every later communication must include the name and license number of the adjuster handling it.

The first visit is sometimes incomplete. The California Department of Insurance says an adjuster pressed for time may “scope the loss,” a brief inspection followed by a second visit. Triple-I says to set up a second appointment if the first evaluation misses damage. For NFIP flood claims, FloodSmart says the adjuster should contact you within 48 hours of your report, and you can ask to see their Flood Control Number card and photo ID.

How do you prepare for the adjuster?

The adjuster’s estimate is built from what they can see and measure on the day. Your job is to make sure nothing is missed. The NAIC says to make a list of all your damaged property and take photos and videos before the meeting. Triple-I says the inventory should give each item’s description, approximate purchase date and the cost to replace or repair it, with receipts attached when you have them, and to work from memory if records were destroyed. Our guide to documenting your claim has the full method.

Be there. The Texas Department of Insurance says to try to be home when the insurer inspects, and to leave a note on how to reach you if you cannot stay. United Policyholders suggests walking the property with the adjuster so nothing is missed, and bringing your contractor if that helps. Triple-I says to get written bids from licensed contractors that itemize materials and prices, and to show them to the adjuster.

Bring copies, not originals. Florida DFS says never to give original documents or photos to anyone. Keep receipts for emergency repairs and for any hotel, meal or mileage costs; the sample HO-3 lists receipts for additional living expenses among the records you may need to provide.

What should you say to the adjuster?

Say what you know firsthand. The date you found the damage, what you saw, where the water or wind came in, what you did to stop it, and what you have spent so far. The California Department of Insurance puts it simply: the more information you provide about your loss, the sooner your claim can be settled.

Be organized and businesslike. United Policyholders describes the claim as a business negotiation and sums up its advice as “Be Polite, Be Prompt, Be Persistent.” It also says to be proactive: give the insurer proof of your losses and ask for the dollar amounts you believe are owed, rather than waiting for the insurer to name a figure.

Point out everything, including damage you think is minor. Florida DFS says hidden damage is very common once repairs begin. Ask questions. FloodSmart’s checklist suggests asking about the process, coverage and next steps, and the California Department of Insurance lists questions such as how long the claim will take and whether you need repair estimates.

Put important points in writing afterward. United Policyholders says that after any promise made in person or by phone, a short follow-up email or letter creates a paper trail. Florida DFS says to use email as much as possible and to keep a log of every call: date, time, who you spoke with and what was said.

What should you not say to the adjuster?

Do not guess. United Policyholders says not to “exaggerate, speculate or guess about the loss or value of any particular piece of property,” and to say when you are estimating or unsure. It warns that minor inconsistencies between statements can later be labeled material misrepresentations. The sample HO-3 policy’s Concealment or Fraud condition voids coverage if an insured intentionally conceals or misrepresents a material fact or makes false statements relating to the insurance.

Guessing at cause is the common trap. If you do not know how long a pipe leaked or when a shingle lifted, say you do not know. The HO-3 excludes wear and tear, deterioration and neglect, so a casual remark that something “has been like that for a while” describes your damage as maintenance when you may simply be unsure. Describe what you observed and when.

Do not minimize either; under-describing damage leaves it out of the estimate. Do not vent. United Policyholders says not to use the insurer as an outlet for frustration about the loss, to assume everything you say or write is recorded, and to avoid anything that makes you look uncooperative or like the cause of delay. And, in its words, do not mistake a friendly adjuster for a friend.

Recorded statements deserve care. United Policyholders says not to give recorded or sworn statements about your property or coverage until you understand your rights, and that you can record your own copy. If the insurer requests an examination under oath, it suggests consulting an attorney first.

What does your duty to cooperate require?

Your policy sets the rules for the relationship. The sample HO-3’s Duties After Loss condition says the insurer has no duty to provide coverage if your failure to comply “is prejudicial to us.” The duties include giving prompt notice, protecting the property from further damage and keeping records of repair costs, cooperating in the investigation, preparing an inventory of damaged personal property, and, as often as the insurer reasonably requires, showing the damaged property, providing requested records, and submitting to examination under oath. A signed, sworn proof of loss is due within 60 days after the insurer requests it.

Cooperation is not the same as agreement. You must give access, documents and honest answers. You do not have to accept the first figure. United Policyholders says you should not have to sign a release to settle an undisputed claim, and the California Department of Insurance warns to be wary of initial offers presented as full settlements that require a release of further liability. It also notes the first check is often an advance, not a final payment.

Florida adds a cooperation rule on timing. Under Fla. Stat. 627.70131, the insurer’s deadlines pause if you fail to provide material claim information within 10 days after a request. Respond to document requests promptly and in writing, and keep a copy of what you send.

How do you disagree with the adjuster’s estimate?

Start with the paper. Ask for the detailed estimate in writing; in Florida the insurer must send you any detailed estimate within 7 days after its adjuster generates it (Fla. Stat. 627.70131). Florida also requires a preliminary or partial estimate to carry a notice that it “MAY BE REVISED” as the insurer continues to evaluate the claim. United Policyholders suggests asking the adjuster for a scope of work that defines the repairs they believe are needed.

Compare line by line with a licensed contractor’s written bid. Look for missing items, quantities and prices. Send the insurer what it missed and ask for a revised estimate. United Policyholders says to write to the adjuster, copy the supervisor, request a reply within a set time and send time-sensitive letters by certified mail. The California Department of Insurance lists the same ladder: talk to the claims manager, contact the state insurance department, consult an attorney.

If the dispute is about the amount, the sample HO-3’s appraisal clause lets either side demand an appraisal: each picks an appraiser, the two pick an umpire, and a decision by any two sets the amount. Florida policyholders can also request free DFS mediation before appraisal or a lawsuit; the insurer bears the cost of the mediation conference (Fla. Stat. 627.7015). A state complaint, a licensed public adjuster or an attorney are the other routes. Our guide to a denied or underpaid claim walks through each one.

What are Florida’s rules for adjusters and claim deadlines?

Florida sets the clock in statute. The table shows the current numbers in Fla. Stat. 627.70131 and the Homeowner Claims Bill of Rights in 627.7142. Deadlines can pause during mediation or when you have not answered an information request, and the Office of Insurance Regulation can extend them by up to 30 days after a declared emergency.

Late payments bear interest from the date the insurer received notice. The insurer must keep a log of every adjuster who communicates with you and give you the list on request (627.70131). The Bill of Rights also lists free DFS mediation and the Insurance Consumer Helpline, 1-877-693-5236. We explain the process; for your own claim, ask your insurer, your state insurance department, a licensed public adjuster or an attorney.