If you have just suffered an insured loss resulting from a pipe burst, a fire, hurricane or some other demanding event, it’s probably not the best time to take a crash course on how to properly present an insurance claim. You may be dealing with a multitude of other matters, such as finding housing or an alternate business location. Handling the emotional trauma of a loss or simply going about your daily responsibilities, like work and family is unnerving enough. God forbid you may also have to tend to injuries or the inconceivable in connection with any event.

Consider the following points: You, the policyholder, is responsible to prove the extent of your loss to the Insurance Company’s claims adjusters. The burden of proof is the responsibility of the insured to prove the value and cause of loss under the named peril policy. The insured is obligated to produce estimates of loss and to separate the damaged property from the undamaged property. Thus, it is highly recommended that the policyholder engages the services of a Public Adjuster who, by law, will determine the value of the loss and present the claim (or proof of loss) to the insurance company.

A typical insurance policy is dozens of pages long and contains numerous provisions and stipulations. The policy is written in technical and legal terms. Additionally, your insurance policy contains various forms and endorsements which are constantly changing from year to year; and which add or exclude coverage from your policy. Most people have difficulty understanding what can appear to be a lot of legal verbiage. For example, did you know that for the insurance company to compensate you for your loss, there are certain conditions which YOU must satisfy? Did you know that your failure to satisfy these policy requirements could reduce your settlement amount or even cause your claim to be denied? Don’t feel bad. Most people don’t realize these aspects of their policy. A trained public insurance claims adjuster whom you trust can help to ensure you meet all the policy conditions, document your loss and get your claim paid.

No matter how organized you and your documentation is, filing and receiving payment on a claim is a time consuming and tedious process. If you do not sufficiently organize and document your damage, you may not realize the compensation you have paid premiums for and are entitled to receive.

A licensed, bonded and qualified Public Adjuster has the experience, knowledge and expertise to obtain your maximum entitlements under your policy. A Public Adjuster has, by law, the following responsibilities in the adjustment of a loss: Verify the effective date of coverage; verify coverage and proximate cause of loss, determine the named insured and who had insurable interest at time of loss; determine other entities that may have an insurable interest; determine if other insurance may apply to the particular loss; determine if the loss was caused by a third party or if subrogation may be pursued; verify if the insured has complied with their obligations within their policy and the law (by also protecting property from further loss; assist the insured in mitigating the loss; determine if any special provisions apply and the deductibles; is the damage property subject to policy limitations as regards limits or peril coverage; is the property insured in compliance with a coinsurance clause; is the property covered on an actual cash basis, replacement cost basis or a valued or agreed amount basis; determine the extent of the salvage, if any and its value.

Remember, the insurance company claims adjuster is representing the insurance company. It is not uncommon for the insurance company to misinterpret their own insurance policy or forget to apply case law or Florida Statutes which supersede their own policy. A public insurance adjuster is required to know current laws and how those laws affect insurance losses; enabling your public adjuster to best represent you. A public insurance adjuster has resources to help you through the maze of estimating, documenting, and filing your insurance claims. Your public adjuster will present your claim in the most advantageous manner to help you fully recover from your loss.

A Public Adjuster who belongs to the State or National Association of Public Insurance Adjusters adheres to a strict Code of Ethics and is able to take advantage of the best quality continuing education training in the country. Additionally, FAPIA and NAPIA members have a network of resources to best assist you in handling your insurance claim.

Yes you can. Be prepared to document all aspects of your loss, try to understand the insurance policy you purchased and follow through with the agent and the company. However, if your loss is significant (more than $10,000) you should consider hiring your own insurance professional, public Insurance adjuster to make sure you are properly represented. Remember, the insurance company has their own insurance professional expert representing them. Shouldn’t you have professional representation too?

​Author, Jay Feinman who wrote the book “Delay, Deny, Defend – Why insurance companies don’t pay claims and what you can do about it”, explains:

“Insurance works when the insurance company honors a simple promise: When a policyholder files a claim, the company will pay what it owes, no more but no less, and will do so promptly and fairly. Insurance doesn’t work when the company breaks it’s promise in order to increase its profits. Insurance doesn’t work when companies delay, deny, defend. When they delay payment of claims to wear down claimants and to increase their investment income, flat-out deny some valid claims in whole or in part, and defend against valid claims in litigation to back up the delays and denials, they break their basic promise”.

​ Compound the above assertion with the fact that many people have difficulty understanding the technical language of an insurance policy and the complicated procedures they must follow to comply with the policy’s terms. This problem is magnified when you have suffered a loss and are emotional about the situation. That is a perfect time to have an experienced professional on your side whose sole responsibility in the matter is to serve you, the insured. The insurance company certainly has an experienced professionals working for them.

Basically, if the insurance company paid you the funds you need to fully recover from your loss, you would not have to hire a public adjuster. Public Adjusters would not exist if the insurance companies honored their contracts with the policyholders. Even the state recognizes the insurance industry has issues; thus, the state created an avenue for the licensed profession of Public Adjusters. For more information on the State of Florida guidelines for Public Adjusters visit DFS

License & Appointment – Make sure their license and appointment are up-to-date with the State of Florida and make sure they are really a licensed Public Adjuster. Some people misrepresent themselves as public adjusters. Make sure they are state licensed public adjusters.

Experience – Public Adjusters come from a wide range of backgrounds – Ask about experience and training and it’s always a good idea to ask for references. Make sure the person who you are considering has the right mix for you.

Professionalism – Do not sign blank contracts. A professional public insurance adjuster will explain the fee structure up-front so you understand why and what you’re are paying for.

Comfort Level – This intangible may be quite important if your claim is complex or extensive. This claims adjuster individual or company will be helping you through a very traumatic time and resolving the claim could take some time…find someone who fits your needs. Make sure they show you their license and FAPIA ID Card – A public insurance adjuster who is a member of their state association of public insurance adjusters takes their profession seriously and subscribes to a strict code of ethics. FAPIA public claims adjuster members care about advocating for policyholders in Florida.​

No, your insurance company cannot cancel you; it would be a serious violation for any insurance company to discriminate against you for exercising your rights provided to you by the State. You have the right to engage the services of a Public Claims Adjuster.

We will need to review your claim. If you did not sign a release and the statute of limitation has not passed, we should be able to have your claim reopened. Contact D’Orsa and Associates, LLC at (877) 742-3587 for assistance.

Each insurance claim and insurance company are unique. Insurance companies (generally) dictate the speed of the claim. In cases of major disasters, due to the abundance of claims, the process may take longer than usual. The average claim takes approximately 3 to 4 months to settle. Our Public Adjuster will prompt the claim along quickly to secure a just settlement for you.