Adjusters, Appraisers & Umpires
After you declare a loss, an adjuster will be sent by your insurance company to examine the damage and give you an estimate of the cost of repair or replacement.
You may also get an estimate from your own contractor to compare with the insurance company’s estimate. If you need assistance, your insurance agent or broker may be able to help you fill out a claim form, gather necessary documents and materials, and provide very general guidance, but it is up to you to prove your loss to the insurance company.
Licensed Public Adjusters
If you experience a major loss such as a fire or severe windstorm which badly damages or destroys your home, and you reach an impasse in negotiating a settlement with your insurance company, you may want to consult an attorney or hire a licensed public adjuster to act on your behalf with your insurance company.
While most property claims can be resolved by dealing with your insurer and the the assigned adjuster directly, sometimes a consumer or business owner will decide that they prefer that someone else handle the insurance claim on their behalf.
In New York, public adjusters are licensed by the Department of Financial Services. When you hire a public adjuster, they represent you, not the insurance company. They will generally help you to take inventory of your loss, secure your home from vandalism, contact your insurance company, advise you on the extent of your coverage and help you secure the services needed to repair or rebuild your home. They will also negotiate on your behalf with the adjuster from the insurance company.
Find a Licensed Public Adjuster
In order to do business in New York, Public Adjusters must be licensed by the Department of Financial Services. The "Who We Supervise App" on the DFS Portal can help you find a Public Adjuster:
Public adjusters are paid by you, not the insurance company. The amount of the public adjuster’s fee is usually expressed as a percentage of the amount they recover and is negotiable, but by law may not be higher than 12.5% of the recovery amount. The adjuster must obtain a signed compensation agreement from you in which the amount of compensation is clearly stated. The agreement you sign to hire a public adjuster may be cancelled without penalty up to midnight of the third business day after the date on which you have signed the compensation agreement. In addition, public adjusters may not solicit your business between the hours of 6 p.m. and 8 a.m.
Keep in mind that if you hire a public adjuster, the insurance company may or may not agree with the estimate of the scope of damage.
The insurer is not obligated to accept the damages claimed by a public adjuster, though the insurer may negotiate. The insurance company is obligated to settle the claim in accordance with the terms and conditions of the policy it issued to the insured. Whatever the outcome of the claim, the consumer remains responsible for the Public Adjuster’s agreed upon fee.
Appraisers and Umpires
If an agreement cannot be reached between you and your insurance company, your policy provides for an appraisal process.
Every homeowner, tenant, cooperative apartment and condominium policy issued in New York contains a provision for you and your company to select a competent and disinterested appraiser. The two appraisers, in turn, select an umpire. Each appraiser must evaluate the loss and determine the value of each item. Any disagreements between the appraisers regarding the value of any items are submitted to and settled by the umpire. The costs of this process are paid by the policyholder and the insurance company.
Note that the appraisal process is not available for disputes involving the cause of the damage.