I've watched insurance adjusters lowball families hundreds of times. Not because they're bad people — they have a job, and that job is to close claims for as little as the company can pay. Your job is to get the full amount you're entitled to. These are fundamentally different goals.
Here's how to protect yourself.
The Three Types of Adjusters
| Type | Who They Work For | Your Interest |
|---|---|---|
| Company adjuster | Your insurance company | Their goal is to minimize payout. Be polite but cautious |
| Independent adjuster | Hired by your insurance company | Same as company adjuster — works for the insurer |
| Public adjuster | You (the policyholder) | Works exclusively for you. Paid from your settlement (10–15%) |
Before the Adjuster Arrives
- Document EVERYTHING — photos, video, written descriptions of all damage. Do this immediately, before any cleanup or repairs
- Make a list of damaged items — include brand, model, age, and purchase price when possible. This becomes your content claim
- Keep all receipts — emergency expenses (hotel, food, emergency repairs) are often covered under Additional Living Expenses
- Review your policy — know your coverage limits, deductible, and what's specifically covered before the adjuster tells you their version
- Don't start permanent repairs — temporary emergency repairs are fine (boarding up windows, tarping a roof), but don't start permanent work before the adjuster documents the damage
During the Adjuster's Visit
- Be present — walk through with them. Point out all damage, including things they might miss
- Don't minimize damage — let the adjuster see the full extent. Don't clean up or organize before their visit
- Take your own notes — write down everything they say, measure, or photograph
- Ask what's covered — for each item/area, ask specifically whether it's covered under your policy
- Point out hidden damage — water/smoke/biohazard damage extends beyond what's visible. Behind walls, under floors, in HVAC systems. Say: "The restoration company said we should check [specific areas]"
- Don't give a recorded statement without review — you may be required to give a statement, but you can request to do it in writing or have an attorney present
Common Adjuster Tactics (and How to Counter)
"We can only approve X amount"
Counter: "I'd like to see the specific policy language that limits this. Can you show me where in my policy this amount is capped?"
"Repair is good enough — replacement isn't necessary"
Counter: Get a written opinion from a qualified contractor or restoration company that repair won't restore the item/area to pre-loss condition. Most policies require restoration to pre-loss condition.
"Depreciation reduces your payout"
Counter: If you have Replacement Cost Value (RCV) coverage, you're entitled to the full replacement cost. The insurer may pay ACV initially and the remainder after you replace items. Know your policy type.
"Biohazard cleanup isn't covered"
Counter: Most homeowner's policies cover "sudden and accidental" damage. A death and resulting biohazard contamination is sudden and accidental. Ask for the specific exclusion in writing.
Lowball first offer
Counter: The first offer is almost always negotiable. Respond with your own documented estimate. Most claims settle at 1.5–3x the initial offer when properly challenged.
When to Hire a Public Adjuster
Consider hiring a public adjuster if:
- The claim is over $20,000
- The insurance company is denying or undervaluing your claim
- The damage is complex (fire + water + smoke, biohazard, structural)
- You don't have time or energy to fight the claim yourself (common after a death)
- The insurance company's estimate is significantly lower than your contractor's estimate
What a Public Adjuster Does
- Conducts their own damage assessment (often more thorough than the insurer's)
- Reviews your policy for all applicable coverage
- Prepares and submits a detailed claim package
- Negotiates directly with the insurance company
- Handles all communication and paperwork
Cost
10–15% of the final settlement. On a $50,000 claim, that's $5,000—$7,500. But if they increase your settlement from $30,000 to $50,000, you net $42,500—$45,000 vs. the $30,000 you would have accepted. The math works.
The Appeals Process
If your claim is denied or underpaid:
- Request the denial in writing — with specific policy language cited
- File a formal appeal — most insurers have an internal appeals process
- Contact your state insurance commissioner — they investigate complaints against insurers. File at your state's Department of Insurance
- Invoke appraisal clause — most policies have a dispute resolution mechanism. Each side hires an appraiser, and a neutral umpire decides
- Hire an attorney — insurance bad faith attorneys work on contingency. If the insurer is acting in bad faith, they may owe you the claim amount plus damages
Specific Tips for Biohazard Claims
- Get the restoration company's estimate before the adjuster visits — a professional biohazard estimate documents the full scope that an insurance adjuster (who typically isn't trained in biohazard) might miss
- Emphasize health and safety — biohazard contamination isn't cosmetic. It's a habitability issue. The home is unsafe until properly remediated
- Include HVAC decontamination — adjusters frequently miss ductwork contamination. Insist on air quality testing
- Document odor — odor is real damage that affects habitability. Get it in writing from the restoration company
- Additional Living Expenses — you cannot live in a biohazard-contaminated home. ALE covers hotel, food, and essential expenses during remediation
Need help navigating a biohazard insurance claim? Our vetted cleanup companies work directly with insurance and can provide the documentation you need. Call (855) 566-2405.