Claims Handling, Investigation, and Damage Estimation
What the exam tests
This domain tests the working method of a public adjuster: documenting the loss, establishing causation, building a defensible estimate, and communicating with the insurer on a schedule.
Investigation method
- Secure the scene, prevent further damage, and photograph or video all affected areas before repairs. Record moisture readings, pre-loss condition, and any expert inspections.
- Separate covered damage from pre-existing conditions, maintenance issues, and excluded causes. Causation must be documented, not merely asserted.
- Build a room-by-room estimate using quantities, unit costs, labor, material, overhead and profit where appropriate, sales tax, debris removal, and code upgrades. Keep depreciation calculations transparent.
- Calendar the policy deadlines and Nebraska claim-practice expectations: acknowledge communications, respond to insurer requests, and submit the proof of loss on time.
Worked example
A supply-line leak damages cabinets, flooring, drywall, and mitigation. The estimate is $6,000 cabinets, $4,000 flooring, $2,000 drywall, and $1,500 mitigation, or $13,500 RCV. Depreciation is $3,000, leaving $10,500 ACV. After the $1,000 deductible, the initial payment is $9,500. Once repairs are complete, the insured may claim the $3,000 recoverable depreciation, subject to the policy limit. The adjuster should also document that the leak was sudden and accidental, not long-term seepage.
Traps that cost marks
- Estimating only visible damage and missing subfloor, insulation, or matching costs.
- Mixing covered water damage with excluded mold or long-term leakage without causation evidence.
- Charging betterment as covered replacement without policy support.
- Missing the proof-of-loss deadline or failing to document pre-loss condition.
- Submitting an unsupported lump-sum estimate instead of line-item quantities and pricing.