Claims Handling, Investigation, and Damage Assessment
The adjusting sequence
Handle every claim in the same defensible order: first notice of loss → acknowledgment → coverage analysis → investigation → damage assessment → valuation → documentation → settlement or denial → payment. Coverage is a legal question answered from the policy; damage is a factual question answered by inspection. Keep them separate in your notes so a coverage dispute never contaminates your factual findings.
Investigation standards
Determine cause and origin before pricing repairs. Look for the mechanism: hail direction and spatter, wind creases and shingle displacement, water source and migration path, burn patterns. Photograph and measure every affected area and every elevation, take moisture readings, date-stamp everything, and record what you did not find (pre-existing damage, prior repairs, code deficiencies). Use experts - engineers, meteorologists, industrial hygienists - when the cause is contested, and document why an expert was or was not engaged. Watch for fraud indicators: recently increased limits, no contents damage with total structure loss, receipts dated after the loss, uncooperative insureds.
Duties and communication
Insureds owe prompt notice, reasonable cooperation, protection of property from further damage, and a proof of loss when required. A public adjuster's job is to keep the file moving: written status updates, itemized requests, and a documented explanation whenever the insurer's position differs from yours. If the insurer requests more information, note the date - the §21.203 decision clock restarts on receipt of the last item.
Traps
Accepting the insurer's scope without independent measurement, ignoring additional living expense or loss-of-use claims, and failing to document damage you intend to argue about later. An undocumented item is an unpaid item.
Rule of thumb
The 3×3 documentation test: for each damaged item you should be able to produce a photograph, a measurement or quantity, and a cause explanation. If any of the three is missing, the item is not yet ready for the estimate.