15 Secrets Your Home Insurance Claim Adjuster Doesn't Want You to Know

INSURANCE - HOME INSURANCE
Home insurance claims are meant to help you restore your home, and it's what you paid for, but these adjuster secrets could cost you big time.
Updated March 26, 2023
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Most people purchase home insurance to eliminate some money stress. They hope they never have to file a significant claim with it, but when you do, you also expect the process to be pretty straightforward.

The problem is that the adjuster isn’t your friend, no matter how nice they seem. Rather, their job is to reduce what’s paid out, and they have a few secrets they don’t want you to know.

If you have to file a claim for home insurance, you need to understand these secrets adjusters don’t want you to know.

Delay tactics are meant to frustrate you

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It’s quite common for home insurance claims processes to take a long time. What seems like a straightforward claim can take weeks or longer. That’s because the adjuster knows you’ll likely get impatient and just want to settle.

Don’t fall for it. Don’t accept a lowball offer just because you want to get the claims process moving forward and a check in your hand.

Instead, stay on top of them with constant requests for updates to keep them moving forward.

They want you to admit fault

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Fault is a big part of some home insurance claims, which could reduce their requirement to pay you. Insurance companies want you to say, “I’m sorry. It’s my fault.” Admitting this, though, could put you at risk of not receiving money for the loss at all.

Only provide facts to the insurance company. Don’t tell them what you “think” could have happened, but instead, provide the actual facts.

They will ask questions to try to shift the blame but stick to the same story. Remember, they’re not your friend trying to make you feel better.

Recording your statement might not be to your advantage

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Following along with getting you to admit fault is sometimes this step – they want you to record what you tell them. That way, it’s nearly impossible for you to go back and claim otherwise. They may do this if they suspect you are going to admit fault at some level.

If they’re requesting a recorded statement, again, stick to only the facts. Find out why and how it will be used. You can ask for a written statement instead to ensure all of what you say is clearly outlined.

And record yourself at the same time, providing that recorded statement. That way, they can’t “cut and paste” the parts that make you look guilty.

You don't have to share your medical records

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This is a home insurance claim, not a workers’ compensation claim. Yet, they may ask to see your medical records to validate your claim.

Don’t fall for it. This is unnecessary and may be an invasion of your privacy if you don’t agree to provide them.

There’s typically no reason they should need to see your medical records. Your doctor’s statement and medical bills from any claim are enough to meet their documentation requirements.

You don’t have to agree to the first offer

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The insurance adjuster makes an offer to you but tells you that you have to agree to the terms and the amount now or within a few days. Otherwise, the offer is off the table.

Don’t fall for this trick, as it’s meant to specifically limit how much you’re receiving. That fake deadline is meant to make you feel rushed to make a decision.

They know that you’re worried about paying your bills and that deadline makes you move through the process quickly. Don’t settle for less than what you know you’re owed.

That first offer is nowhere near your losses

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Unfortunately, it’s quite common for your first offer to be just that – an offer and not the final amount the insurance company could pay you.

They recognize that you are looking for money and need it soon, so they’ll offer a very low initial settlement. Don’t agree with it.

If you have verifiable losses from a claim, with documented proof of the financial loss you’ve suffered, there is no reason they shouldn’t pay out that full amount unless it’s more than your policy limits.

They deny your claim as a tactic

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If lightning strikes your home causing a fire, it’s pretty straightforward that the insurance company should cover your losses.

The problem is they may initially outright deny it, stating it’s not their responsibility for some reason. This is often a tactic used to get you to admit at least partial fault.

Don’t let a denial or any discussion of “I’m not sure we’ll cover this” frustrate you. Be sure, instead, that you outline your losses and make it clear that your policy covers them.

Asking for tax documents is a delay strategy

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Just like the medical record request, some insurance adjusters may ask you to provide tax returns or other documentation about your wages.

This is all done as a delay tactic and is often very unnecessary.

Ask why they need such information. Then, know your rights. If there’s no valid reason to verify this information tell them that you don’t have to provide that information.

They say there’s a loophole that limits your claim

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This can be a very frustrating type of tactic. Suddenly, the adjuster says there’s a loophole or a clause in your policy that limits their responsibility for covering the claim.

They may not tell you much more than that. It’s a lie in many cases.

Ask them to provide specific details about this clause. Read through it. Does it apply to your situation? If they are straight up denying your claim, tell them you’ll have your lawyer review it first.

They downplay the extent of your losses

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A home claims adjuster’s aim is to pay less, and one way they try to do this is to downplay the extent of your losses.

They may state that you’ve exaggerated the losses and that the claim is not as bad as you think. In some cases, they may do this if you’re filing a premises liability claim, such as after being hurt at someone’s home.

Always fall back on your documentation. You know the losses you’ve incurred. Don’t fall for this tactic, as it’s often just a way to lower what they pay you.

They’ll only use builder-grade replacement materials

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Let’s say your home needs extensive repairs after a fire, but the insurance company denies the contractor’s value placed on some of the materials.

Instead, they want to go with builder-grade materials which are far inferior to what you’ve had in your home. They are typically required to bring your home back to the way it was before the incident, including the grade of materials.

Be sure you have evidence of the type of materials used and, when possible, show receipts or values of them. Your contractor can help you verify and defend against this tactic.

They'll claim you don’t need an attorney

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They discourage you from hiring an attorney, often telling you that it is just going to add to your costs, reduce what you get, and slow down the process.

If they tell you not to work with an attorney, there’s likely a good reason for that. You have a right to hire an attorney or a public adjuster to work with you if your home insurance provider isn’t paying what you need and are owed.

Hands down, if they won’t work with you, you should seek out help because they’re probably not being honest.

They'll bring up wear-and-tear as an excuse

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Insurance adjusters may state that they cannot pay for the full extent of the damage because of wear-and-tear or existing damage to the structure.

Read through your policy carefully. If they are responsible for the loss, chances are good that they have to restore it to the condition it was in. You may have to fight to get proper coverage.

They’re super nice to you on purpose

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Many of the best insurance adjusters are super friendly. They ask about your family and want to make sure you’re okay. They may act like your friend and share stories or try to create a bond.

This is one of the most effective ways for them to get your guard down. You’ll trust them so much that you may be willing to agree to less than what’s owed.

They tell you there’s no room for negotiation

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They may tell you that the offer they have is a one-time deal and you must take it or leave it.

Worried, you hurriedly accept, knowing it's just a fraction of what you need. They may simply say there’s no room for negotiation.

That’s rarely the case. Most of the time, the first offer is a lowball offer, one that doesn’t cover everything and typically has a few areas of less coverage than is necessary to get your home repaired.

Bottom line

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Beyond any doubt, insurance claims adjusters are not your friend. Their goal (and what they’re paid for) is to reduce what’s paid out, saving the insurance company money.

It’s common for insurers to pass you around from one adjuster to the next, often requiring more time and growing your frustrations.

It’s important for you to avoid foolish mistakes and make sure you stick to the same factual story every time. Push for answers and a resolution where possible and reach out to an attorney with any issues.

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Author Details

Sandy Baker Sandy Baker is a has over 17 years of experience in the financial sector. Her experience includes website content, blogs, and social media. She’s worked with companies such as Realtor.com, Bankrate, TransUnion, Equifax, and Consumer Affairs.

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