Claims Handling, Investigation, and Damage Evaluation Practices
What this domain tests
This domain tests the working method: how a public adjuster documents a loss, builds a defensible estimate, prepares the insured for carrier examinations, and negotiates line by line.
Opening the file
- Give notice promptly, advise on mitigation and emergency repairs, and preserve evidence before cleanup destroys it.
- Photograph and video every room and elevation, record moisture readings, and collect receipts, pre-loss photos, and purchase records for contents.
- Prepare a contents inventory by room with quantity, age, original cost, and replacement cost; flag specialty items needing appraisals.
Building the scope
Present an itemized, trade-by-trade scope with quantities, unit prices, and photographs for each line. Support structural or cause-and-origin disputes with an engineer's report and support code items with the adopted code sections. Request the carrier's itemized estimate and worksheets and compare every line rather than arguing totals. Claim overhead and profit only where the job genuinely requires a general contractor or three or more trades, and document depreciation method (age, life, condition) for both recoverable and nonrecoverable items.
Working with the carrier
Sworn proofs of loss, examinations under oath, recorded statements, and document demands are the insured's obligations. The public adjuster prepares the insured, explains each question's purpose, and never lets the insured estimate or speculate. Every disagreement should leave a written trail with evidence attached. Where the policy provides appraisal and the dispute is scope or valuation rather than coverage, appraisal can break a deadlock.
Worked example
A carrier's estimate excludes overhead and profit on a kitchen loss. The adjuster submits three trade bids plus a general contractor's proposal showing scheduling and supervision across trades, and O&P is added. The reasoning is documented complexity, not entitlement by default.
Traps
Sending a demand with no supporting estimate; allowing the insured to sign a release or sworn statement unprepared; letting the recoverable-depreciation deadline pass; failing to document pre-loss condition, which converts a covered loss into a maintenance dispute.