Public Adjusting Practices and Claims Handling
This domain tests the working mechanics of a claim: contracting with the insured, investigating and documenting damage, presenting a supported estimate, and moving the carrier to a documented decision.
Contract first
The written contract must be signed before billable work begins. Confirm the date of loss, policy number, and that you represent the insured only, never the carrier, on that loss.
Investigate and document
Photograph and measure before repairs begin. Build a room-by-room, line-item estimate with quantities, and support each item with evidence: pre-loss photos, receipts, contractor bids, and building code citations. For business interruption, collect profit-and-loss statements, payroll records, and tax returns. For additional living expense, collect every hotel and meal receipt.
Present and negotiate
Submit a cover letter mapping each item to the policy language it triggers. Ask for the carrier's estimate and reconcile it line by line. When scope, not coverage, is disputed, demand appraisal under the policy's appraisal clause. When coverage is denied, demand the denial in writing with the specific exclusion cited.
Timelines
New Jersey's unfair claims regulations, N.J.A.C. 11:2-17, require prompt acknowledgment, reasonable investigation, and written communication. A properly executed proof of loss starts the clock for the carrier's affirmance or denial. Diarize every date.
Worked example
A burst supply line damages a kitchen and the adjoining dining room. The carrier pays to replace the kitchen flooring but not the continuous hardwood beyond the doorway, arguing no direct damage there. You document the tongue-and-groove continuation with pre-loss photos and a flooring contractor's written statement that the material cannot be matched, then submit a supplement citing the reasonably comparable material provision. The supplement is paid without appraisal.
Traps
- Signing a release or final proof of loss before the full scope is known.
- Letting the carrier's estimate become the benchmark.
- Estimates without quantities or supporting photos.
- Missing a deadline because no diary existed.