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South Florida Homeowners Claims Attorney Explains The Role Of An Insurance Adjuster

As experienced South Florida homeowners insurance claims attorneys, we carefully scrutinize the work insurance adjusters perform when evaluating our client’s claim. It is a good idea to understand the role of the insurance adjuster in the claims process, that way you know what to expect if you have to file a claim on your homeowner’s insurance policy.

Some insurance companies employ adjusters. However, some adjusters are public adjusters. They are not beholden to any company, and the claimant can hire the public adjuster to evaluate the claim. An insurance adjuster estimates the owner’s claim of loss or damage. An important part of the adjuster’s responsibilities is to determine whether the claim is fraudulent. The adjuster does not only take the word of the claimant; rather the adjuster investigates the alleged loss. The adjuster will visit the property in question. The adjuster may take photographs, take measurements, and make other attempts to document the damaged area.  The adjuster can interview property owners and any witnesses, depending on the loss. The adjuster can also research police reports, fire reports, and medical reports as part of the investigation. 

Insurance companies work with adjusters to determine whether the insurance policy in issue covers the claim. Insurance companies consult with adjusters to evaluate how much of the claim the company should pay if the company decides that the claim should not be paid in full. The adjuster can consult other professionals to determine the cause and extent of the loss and whether the claim is covered. The adjuster may ask professionals such as attorneys, contractors, engineers, and architect for their opinion of whether the insurance policy covers the loss or whether the insurance company should pay the claim. Also, adjusters consult appraisers as well. Appraisers determine the replacement cost of an item or the fair market value of an article, depending on how the homeowner elected to be compensated for their loss.

Sometimes homeowners are unhappy with the adjuster’s findings. Other times, an adjuster makes a mistake, thereby causing the homeowner a loss. Under Florida law, the independent insurance adjuster owes a duty of care to the insurance company and not the homeowner. Florida courts have ruled that the insurance adjuster owes the duty of care to the insurance company because of the contract for services between the adjuster and the insurance company. The adjuster, even if not an actual employee of the insurance company, acts on behalf of the company, in the same manner, an employee would. That means the homeowner cannot sue an independent adjuster alleging that the adjuster was negligent when examining the claim. Additionally, the homeowner cannot sue the insurance company for negligence for failure to pay a claim. Florida law allows insureds to sue their insurance companies for acting in bad faith when evaluating the homeowner’s claim.

The rule does not mean that the homeowner is without recourse if the adjuster causes an injury to the homeowner in some fashion.  The homeowner also has the right to sue the adjuster for damages if the adjuster breaches a contract entered into with the homeowner. Also, the homeowner may bring a lawsuit if the adjuster intentionally injures the homeowner. Fraud is an obvious example of an intentional wrong. If the adjuster is liable for committing fraud against the homeowner, then the homeowner can ask the court to award attorney’s fees and costs incurred in the litigation.

Contact Miami Homeowners Insurance Claim Attorneys If You Experience Difficulty With The Claims Adjuster Involved With Your Claim

Let South Florida’s Top law firm – as voted by the Miami Herald – Greenberg, Stone, & Urbano, represent you with your homeowner’s insurance policy claim. The attorneys at Greenberg, Stone, and & Urbano have over 130 years of combined legal experience at your service. Call the South Florida homeowners insurance claim attorneys at Greenberg, Stone, & Urbano – an AV-rated firm by Martindale-Hubbell – today at (888) 499-9700 or (305) 595-2400 to schedule your free consultation.

Sources:

http://www.bls.gov/ooh/business-and-financial/mobile/claims-adjusters-appraisers-examiners-and-investigators.htm

King v. National Sec. Fire and Cas. Co., 656 So. 2d 1338 – Fla: Dist. Court of Appeals, 4th Dist. 1995

Howard v. Crawford and Co., 384 So. 2d 1326 – Fla: Dist. Court of Appeals, 1st Dist. 1980

 

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