Fire Damage and The Insurance Claims Process

The Basics of Handling Fire Damage Insurance Claims

By Dan Chavez – President of Chavez Restoration & Cleaning

Restoration Advocate

After a lifetime of working fire damage restoration projects:

First as a technician, then as a crew leader, and eventually as a supervisor, I have a wide array of experiences with hundreds of adjusters. As well as experience with thousands of claims. As a company, we have become to be known as “Your Restoration Advocate” in fire and water damage restoration services.  I am sharing this valuable information to assist anyone that may have suffered a fire & smoke damage loss. This information may help others to become their own advocate throughout the claims process.

These basic fire damage survival tips are at the core of some of the issues that I see repeated during the restoration process.

1: Be your own advocate

Fire Damage Restoration

Realize that you have the most to lose if the repairs are incomplete. Your insurance company’s representatives inherently may make you feel guilty for spending your policy dollars. They are looking to repair or replace in the most cost-effective way possible, even if it is to your detriment.

A: Understand the entire scope of damage and the recommended remedies; do they make sense to you?

B: It’s important to know the parameters of your policy coverage and your options for repair or replacement.

C: Try to determine time frames for repair, and how it will impact you.

D: Your insurance company’s costs should be secondary to your time and your hassles.

E: From the first day to the last day, ask questions and consider the answers. Don’t be afraid to ask; “Why?”

F: Never let a contractor begin work until they have answered two simple questions; “How soon can you start? How long will it take you to finish the repairs?”

Key Point: Be clear, be firm and stand strong

2: Many insurance companies try to force you into their “preferred vendor” program for the repairs of your property.

Whatever way the concept is sold to you; the bottom line is that the vendor programs are designed to save your insurance company money. Your insurance carrier will promote it as easier for the policyholder; they take care of everything with the “one call does it all” approach.

What your insurance carrier may not tell you is that once you sign on with their “preferred vendor”, you have will have little to no control of the restoration process from that point on. You will no longer have control over who comes into your property to complete the repairs. Many times, the policyholder will be left out of the complete details of the repairs. These details may include what gets repaired, the estimated time frames, as well as the final cost of repairs.

After fire damages your property, who completes restoration is completely up to you as the property owner.  You should not feel forced to choose one restoration company over another. However, your insurance representative will try hard to push their “preferred vendor” onto you. This may be only to save your insurance carrier money. By cutting corners to save costs, these preferred vendors may not completely return your property to pre-loss condition.

When choosing a restoration company and a “preferred vendor” is suggested by your insurance carrier, ask yourself:

A: Was the insurance company’s vendor suggested to you because the quality of their work? Or were they hand-picked because they are a savings tool for your insurance company?

B: From a vendor’s perspective, will you be the client? Or will the insurance company be their client, and you just a job?

C: If the insurance carrier is the vendor’s direct client, will the “preferred vendor” have your best interests in mind? Or will it be the interests of their client… the insurance carrier?

D: Whether it was explained to you or not, it is your choice who does the repairs in your home.

E: Your insurance company’s effort to save money shouldn’t be your burden or your hassle. This can result in lasting detriment for you if repairs are not full and complete.

Key Point: Do not assume that your insurance company’s “preferred” vendor would be your preference as a contractor. Their vetting process will be different that yours. Sometimes thriftiness can be a good thing, but as the policyholder, you should be the one making that call!

3: The curse of the third-party claims management:

Some insurance companies have outsourced their claims adjusting process to 3rd party independent claims management companies. Outsourcing keeps their staffing costs down, and distances them from negative feelings from the adjusting side of their business. They won’t be the one telling you no. They will say “It’s out of their hands”. Third party claims companies make their living by cost cutting; unfortunately, the quality of the work from repair vendors, preferred or not, usually goes down as well.

What to look out for with 3rd party independent claims management companies:

A: If dealing with a 3rd party claims management, address any quality concerns directly with your adjuster. Fundamentally, you will be better served by your insurance company’s adjuster; they have more to lose if you are unsatisfied.

B: Third-party claims personal will adjust “over the phone”. Most times, without a site visit, or a complete understanding of your loss, which can and will complicate your claim.

C: Restoration companies, contractors, and sub-contractors may get “squeezed” in the cost-cutting efforts. Many times, they are forced to choose between making a profit or doing a quality job for you.

D: Your insurance company’s phone adjuster or manager will have the ability to override decisions made by the third-party claims handler if you are unhappy. Unfortunately, they will not tell you about this!

E: Strict enforcement of their payment guidelines may reduce the scope or quality of your restoration service.

Key Point: If you are getting the run around from a third-party claims company, go to your insurance agent first. Ask for your company’s claims manager to report your problem! When discussing your claim with your insurance carrier or a 3rd party claims manager, there are three points to remember. Be clear, be firm and stand strong!

4: Understand that your homeowner’s policy is a legal and binding contract:

Your insurance policy is like all legal contracts, they are designed to leave little wiggle room. Please keep in mind:

Stove Fire

A: Insurance companies are not doing you a favor when they “cover” your loss.
If it’s written into their policy/contract, the insurance carrier is obligated to provide the necessary coverage . The common insurance policy/contract is to return your property to pre-loss condition and make all necessary payments to do so.

B: Despite the “feel good” marketing your insurance company employs, they will follow their policy to the letter. Words and phrases like; “just because”, “to be fair”, “nice guy”, etc. will not be in your contract.

C: Whether storing or borrowing the property of others. The policy will not commonly cover damaged items that are not your personal property, unless noted otherwise within the contract.

D: You have two individual policies within a typical homeowner’s policy heading. One extends coverage for your structure and the other covers your personal property, each with separate limits.

E: If there are questions of policy, coverage limitations, exclusions, Etc., ask your representative to “email” you the written documentation. If their information is correct, they shouldn’t have an issue sending the documentation.

Key Point: Friendly smiles, handshakes, and feel good jingles are the sales side of your insurance company. The claims side of the business will have different goals, and they will live by the letter of the contract!

5: Working with an adjuster:

Close the file, and satisfy your needs, if possible. These are the goals of your insurance adjuster. They will sometimes negotiate between you as the policyholder and their boss or underwriter to find a final settlement. Like a car salesman, they would prefer you pay more for less. Your insurance carrier may prefer you settle for less than more.

A: Adjusters are not the insurance company’s concierges. Their chief goal is not to make sure you have everything you need. Or to ensure that you are comfortable and happy for the duration of your claim.

B: Be yourself when working with an adjuster. Being adversarial or trying to make friends will seldom help or hurt the situation.

C: Your adjuster notices that your house is in disrepair or has other obvious liabilities. As a result, you may expect to be non-renewed or hit with a rate increase letter later; insurance companies are always looking to limit their liabilities.

D: Some adjusters may have preconceived notions when deciding how much they are willing to spend based on your neighborhood. Other Considerations may be the diminished value or condition your home or contents.

Key Point: Adjusters are just people, so some will be friendly, and others will not. Some will be confrontational, and others will not. Be yourself and don’t be afraid to stand up for yourself, if you don’t, no one else will!

6: If your home suffered significant damage and were unlivable, ask about policy provisions like “additional living expenses” (A.L.E.)

This is a common component of most property owner’s insurance policies. Costs related to being temporarily displaced are usually paid for by the A.L.E.. If you are going to be out of your home for an extended period of time, pay close attention to what is available. Ask for what you are entitled to, as a part of your policy coverage. When addressing your A.L.E. benefits with your adjuster, be sure to remember:

A: Ask about additional payments to cover hotel, apartment or house rental.

B: This coverage will reimburse you for the extra food expenses above and beyond your average weekly or monthly spending.

C: Ask about mileage or gasoline cost above and beyond typical usage.

Key Point: This is what an insurance commercial may sound like. “My adjuster will explain everything that I am entitled to in great detail. Then they will follow-up to make sure I have everything I need”. It may work that way in TV commercials. However, in the real world, you usually only get what you ask for… or demand. Ask detailed questions and be the advocate for yourself and your family.

7: The squeaky wheel gets the grease.

Unfortunately, this is not the way the process is supposed to work. Nothing will change f you are unhappy and do not address these issues with your insurance carrier. It may be counter to your personality, but it’s the vocal minority that will get what they seek.

A: Your goal is to return your property to pre-loss condition. If you are willing to settle for less than you are entitled to, the insurance carrier will gladly accommodate. Speak up when you are unsure or dissatisfied.

B: Be clear if you have a complaint or complaints.

C: Keep a list of questions to ask and document the answers. Log what was said and when it is said. Logging all of the events throughout the restoration and claims process may benefit you more in the end.

D: Get names, numbers, email addresses, etc. of every person you come in contact with throughout the process.

E: If something doesn’t make sense, seems wrong, creates a bigger hassle for you, etc., don’t mince words. Explain the problem and demand a solution.

Key Point: Be pleasant and be clear, but be prepared to be strong if you have a problem during the claims process!

Final observation:

If you’ve had a fire, it can be a troubling and traumatic experience, even on a small scale. Don’t expect your insurance company’s personnel to be compassionate, supportive or even reasonable! The insurance claims process can be challenging even with their best people and best intentions. It can be downright devastating without their willingness to help you restore your home. We will help you become your own advocate. The only person you can count on to understand the problem, work hard to find solutions and to guarantee your happiness, in the end, is you!

Chavez Restoration & Cleaning is Your Restoration Advocate. We will be there to help you be your own advocate!

We pride ourselves on professionally restoring our client’s property while meeting their needs and exceeding their expectations. It is more than just our philosophy; this is a daily practice at Chavez Restoration.

-Dan Chavez, President – Chavez Restoration & Cleaning 

Free Consultations - 24-Hr Emergency Response - Call Today
2400 South Kansas Ave, Topeka, Kansas785-232-3779
1209 East 24th Street, Lawrence, Kansas 785-843-1515