Homeowners’ Guide to Insurance Adjusters: What They Do and How to Handle Your Claim

Home Insurance Claim Secrets: How to Handle Insurance Adjusters, Dispute Lowball Offers, and Maximize Your Payout

If your home has been damaged—whether from a storm, a burst pipe, or an unexpected fire—your first instinct might be to file an insurance claim and trust that your insurance company will take care of everything. After all, that’s why you’ve been paying premiums all these years, right?

Not so fast.

The insurance company’s job is to make a profit, and one of the ways they do that is by paying out as little as possible on claims. This is where an insurance adjuster comes in. Their role is to investigate your claim, determine the value of your loss, and recommend a settlement. While they might seem friendly and helpful, keep in mind that their primary responsibility is to protect the insurance company’s bottom line—not yours.

So, what does this mean for you as a homeowner? It means you need to be prepared, stay informed, and know how to advocate for yourself during the claims process.

This guide will break down everything you need to know about home insurance adjusters, from how they evaluate claims to the reasons they may use to reduce payouts. We’ll also cover how you can negotiate effectively and what to do if your claim is delayed, denied, or undervalued.

Let’s get started.

What Does an Insurance Adjuster Do?

Imagine you’re playing a game where the referee works for the opposing team. That’s what dealing with an insurance adjuster can feel like. They might come across as neutral, but their job is to minimize the insurance company’s financial liability.

When you file a claim, the insurance company assigns an adjuster to assess the damage to your home. This person is responsible for:

Inspecting the damage.
Reviewing your policy to determine what’s covered (and what’s not).
Interviewing you and possibly any witnesses.
Analyzing repair costs—often using software that favors the insurer.
Offering a settlement that saves the company money.

The adjuster’s ultimate goal is to close your claim in the most cost-effective way possible while staying within the legal limits.

That’s why you, as a homeowner, need to know exactly how they operate—and how to push back when necessary.

Insurance Adjuster vs. Public Adjuster: Who’s Really On Your Side?

If you’ve never filed a home insurance claim before, you might assume that all adjusters work the same way. But there’s a big difference between an insurance adjuster and a public adjuster, and knowing the difference can have a huge impact on your settlement.

Insurance Adjuster: The Company’s Gatekeeper

Insurance adjusters—whether they’re staff adjusters (employees of the insurance company) or independent adjusters (contractors hired by your insurer)—are there to protect the company’s money. Their role includes:

Minimizing payouts by carefully reviewing your policy for limitations.
Looking for ways to reduce costs, such as depreciating materials or attributing damage to poor maintenance.
Negotiating settlements that favor the insurer rather than the homeowner.

Think of them as the defense attorney for the insurance company—their job is to pay out the lowest amount legally possible.

Public Adjuster: The Homeowner’s Advocate

A public adjuster, on the other hand, works for you. They are hired by policyholders to maximize claim settlements and make sure you get every dollar you’re entitled to. Public adjusters:

Conduct their own property inspections.
Gather evidence to support a higher payout.
Negotiate directly with the insurance company on your behalf.
Often increase claim payouts significantly compared to what the insurer initially offers.

The downside is that public adjusters charge a fee, typically a percentage of your final settlement. But in large claims—such as total home losses—their fee can be well worth it if they get you a payout that’s tens of thousands of dollars higher than the insurance company’s first offer.

Which One Should You Use?

If your claim is straightforward and small (like minor water damage), you might not need a public adjuster. But if:

You’re dealing with major damage (fire, hurricane, structural collapse).
The insurance adjuster’s offer seems suspiciously low.
The claim process is dragging on with little communication.
The insurance company denies part or all of your claim.

Insurance Adjuster	Public Adjuster
Works for the insurance company	Works for you, the policyholder
Goal: Minimize claim payouts	Goal: Maximize your settlement
Free (covered by your policy)	Charges a fee (often a percentage of your settlement)
Follows insurer’s guidelines	Advocates for the homeowner

If your claim is large or complex, hiring a public adjuster can help ensure you get a fair payout.

How Do Insurance Adjusters Evaluate Claims?

When an adjuster assesses your property damage, their main objective is to find ways to reduce what the insurance company pays you. That means they’re not just looking at the damage—they’re also looking for ways to argue that it isn’t covered, or that it costs less to fix than you think.

What Do Adjusters Look For?

Is the damage really from the covered event?
If a tree falls on your roof during a storm, that’s covered. But if the adjuster notices that your roof was already in bad shape, they might claim the damage was due to poor maintenance—not the storm.
Can depreciation lower the payout?
Many home insurance policies cover items at their actual cash value rather than replacement cost. That means the adjuster can reduce your payout based on the age and condition of materials.
Do repair costs match their estimate?
Insurance companies use claim assessment software like Xactimate, which often underestimates real repair costs. If your contractor says it will cost thirty thousand dollars to fix the damage but the insurance adjuster’s software says twenty thousand dollars, guess which number they’ll use?

This is why getting independent repair estimates before accepting an offer is critical.

What Happens After an Insurance Adjuster Inspection?

Once the adjuster inspects your home, they’ll:

Prepare a report with their findings and cost estimates.
Make an initial settlement offer, usually lower than what you need.
Negotiate if you push back.
Close the claim once you accept an offer—or if you challenge it, they may delay, deny, or request more information.

What You Should Do

Take your own photos and videos before they inspect the damage.
Get at least two independent repair estimates before agreeing to their offer.
Read the settlement offer carefully and ask about any deductions.
Don’t accept their first offer if it seems low—you have the right to negotiate.

If their offer is way too low or they deny part of your claim, consider hiring a public adjuster or attorney.

How to Negotiate With an Insurance Adjuster

Insurance adjusters are trained negotiators who have one job: get you to accept the lowest payout possible. Here’s how to push back:

Know your policy inside and out. Be aware of coverage limits, exclusions, and deductible details.
Gather as much evidence as possible, including photos, contractor estimates, and receipts for temporary repairs.
Challenge any lowball repair estimates by presenting your own estimates as counteroffers.
Be patient and persistent. If they delay, keep following up until you get a fair settlement.
Be mindful of what you say. Adjusters can use your words against you. For example, if you say, “I guess the roof was getting old anyway,” they might claim wear and tear as a reason to lower your payout.

FAQ: Insurance Adjusters and Home Insurance Claims

What if the insurance adjuster’s estimate is much lower than my contractor’s estimate?

If the adjuster’s estimate is significantly lower than what your contractor says is necessary for repairs, don’t accept their offer right away.

Ask the adjuster for a detailed breakdown of their estimate and compare it to your contractor’s itemized estimate.
Provide the contractor’s written report and request a reconsideration.
If the adjuster refuses to increase the payout, consider hiring a public adjuster or an insurance attorney to negotiate for you.

Can I choose my own contractor, or do I have to use one recommended by the insurance company?

Yes, you can choose your own contractor. The insurance company may recommend a contractor from their “preferred vendor list,” but you are not required to use them.

Be cautious of insurance-recommended contractors, as they may have agreements with the insurer to keep repair costs low.
Always get multiple estimates before selecting a contractor.

What should I do if the adjuster says my damage isn’t covered?

If an adjuster claims that your damage isn’t covered, take the following steps:

Review your policy carefully—check for exclusions and limitations.
Ask the adjuster for a written explanation of why the damage isn’t covered.
Get an independent evaluation from a public adjuster or contractor.
If you believe the denial is unfair, file a claim dispute with your insurance company or contact your state’s insurance regulator.

Can I ask for a different adjuster if I feel mine is unfair?

Yes, you can request a different adjuster if you believe yours is being unfair or unresponsive.

Call your insurance company and explain why you need a reassignment.
Keep detailed records of any inaccurate assessments or unreasonable delays.
If the insurer refuses, consider hiring a public adjuster or filing a complaint with your state’s insurance department.

What if my insurance adjuster is taking too long to process my claim?

Insurance companies are required by law to process claims within a reasonable timeframe, but some adjusters intentionally delay claims to pressure homeowners into accepting lower settlements.

Follow up regularly and document all communication.
Check state laws—most states have deadlines for insurers to respond to claims.
Send a formal demand letter requesting action.
If delays continue, file a complaint with your state insurance commissioner.

Can I negotiate the depreciation amount applied to my claim?

Yes, depreciation is often negotiable, especially if you have a replacement cost policy rather than an actual cash value (ACV) policy.

Provide receipts, photos, or proof of maintenance to show that your damaged property was in good condition before the loss.
Challenge excessive depreciation if you feel the adjuster undervalued your items.

What should I do if my claim is partially denied?

If your insurance company pays for part of the damage but denies another part, you have options:

Request a detailed written explanation for the denial.
Get an independent evaluation from a public adjuster.
Submit additional documentation supporting your claim.
File an appeal with the insurance company.
If necessary, seek legal advice or contact your state’s insurance department.

Can the insurance company cancel my policy after I file a claim?

Yes, in some cases, an insurance company can cancel or non-renew your policy after you file a claim.

If they believe you are a high-risk policyholder due to multiple claims, they may refuse to renew your coverage.
If your claim involved fraud or misrepresentation, they may cancel your policy outright.
Some insurers have limits on how many claims you can file within a certain period.
Always check state regulations—some states have laws that prevent insurers from canceling policies due to a single claim.

Can I refuse an insurance adjuster’s settlement offer?

Yes, you are not obligated to accept the first settlement offer.

Provide evidence that supports a higher payout.
Request a re-evaluation if new damage is discovered.
Negotiate for a fairer settlement using independent contractor estimates.
If negotiations fail, hire a public adjuster or consider legal action.

Why does the insurance adjuster want a recorded statement? Should I agree?

Insurance adjusters ask for recorded statements to gather information that could be used to limit or deny your claim.

You are not legally required to give a recorded statement unless it’s specifically required by your policy.
If you agree, stick to the facts and avoid speculation.
Do not admit fault or say things like “it wasn’t that bad” or “I should have fixed that before.”
If you’re unsure, consult a public adjuster or attorney before providing a statement.

What if my home has additional damage after the claim is settled?

If additional damage related to the initial claim is discovered after your settlement, you may still be able to get compensation.

Contact the insurance company immediately and provide documentation of the newly discovered damage.
Some policies allow you to reopen a claim if damage was not immediately visible.
If the insurance company refuses, check your policy terms and consult a public adjuster.

What if my claim is denied for fraud, but I didn’t do anything wrong?

If your insurance company accuses you of fraud and denies your claim, take it seriously.

Request the specific reasons for the fraud accusation.
Gather documentation that supports your claim, such as receipts, photos, and contractor reports.
If the company does not reverse its decision, hire a legal expert who specializes in insurance disputes.

What can I do if the insurance company keeps requesting more documentation and delaying my claim?

Excessive requests for documentation can be a tactic to delay or frustrate homeowners into accepting low settlements.

Keep detailed records of everything you submit.
Ask the insurance company for a written list of all required documents.
If they keep asking for unnecessary paperwork, file a formal complaint with your state insurance department.

Can a homeowner negotiate a claim without a public adjuster?

Yes, homeowners can negotiate their own claims, but they need to be prepared.

Know your policy coverage and state insurance laws.
Gather independent contractor estimates to challenge low offers.
Keep all emails and communication records with the adjuster.
Stay firm in negotiations, and do not accept lowball offers.

Should I hire a public adjuster or a lawyer for my insurance claim?

A public adjuster is best if you want to negotiate a higher payout and your claim has not yet been denied.
A lawyer is best if your claim has already been denied unfairly or if you need to take legal action.

What should I do if my insurance company refuses to pay for temporary housing?

If your home is uninhabitable due to covered damage, your policy may include Additional Living Expenses (ALE) coverage. If the insurance company refuses to pay:

Check your policy for ALE coverage and present the terms to the adjuster.
Keep all hotel and rental receipts to submit for reimbursement.
File a formal complaint if they continue to deny valid expenses.

Protect Your Home, Protect Your Claim – Get Expert Help

The insurance adjuster’s goal is to save the insurance company money, but that doesn’t mean you have to settle for less than what you’re owed. The more informed, proactive, and persistent you are, the better your chances of getting a fair payout.

Here’s What You Should Do Next:

Review your policy before filing a claim so you know what’s covered.
Document all damage with photos, videos, and written descriptions.
Get independent repair estimates so you have proof if the insurance company lowballs your claim.
Be cautious in conversations with the adjuster—your words can be used against you.
Negotiate, because the first offer is rarely the best offer.
Consider hiring a public adjuster if your claim is large, delayed, or undervalued.

Get Help From YPA Public Adjusters

YPA Public Adjusters work for you, not the insurance company. Our team fights to maximize your payout and ensure you get every dollar you’re entitled to.

Call YPA Public Adjusters today at (682) 267-0336 for a free consultation or visit our website to learn more.