Adjusters: Insurance Companies Preventing Policy Payouts

FORT WORTH (CBSDFW.COM) – Tuesday’s tornadoes steered clear of Kirk Dinkins’ home in Ridglea, but he can relate to the battle some homeowners may now weather with insurance companies.  “When they get their insurance claim, they shouldn’t accept it.”

Three moths ago, Dinkins’ air conditioning unit flooded his floor. It destroyed parts of his hardwood floor. His insurance company offered  him $394. “I was really close to thinking that is all there was and I should just accept that.”

Like many policyholders, Dinkins didn’t know how to fight a claim. But David Lee did. “He knows how the system works and what you have to do to get a fair claim.”

After Lee re-negotiated Dinkins’ claim, the insurance company agreed to pay Dinkins more than $21,000.  “We have seen, where we believe, people were not treated properly,” says Lee.

Lee and his partner, Heath Wakeland, both used to work as adjusters for insurance companies. They say they had to deny claims that policies should have covered. “There had been times we needed to pay the customer for the damaged property and the carrier would tie our hands and deny a portion of the claim that we know was a covered loss,” explains Lee.

Wakeland says his experience is the same.  “There were things I thought I should be paying for based on the contract and they wouldn’t allow me to or they would tell me to reduce the amount of money.”

Today, Lee (license #1687111) and Wakeland  (license #1674138) work as public adjusters. They say they opened their Arlington business, Cobalt Claims Services, Inc., out of frustration. (license #1725803)

A public adjuster reviews a policy, helps document damage, and negotiates the claim for the policyholder. A policyholder pays the public adjuster up to 10-percent of the final settlement.  An insurance company adjuster works for the insurance company.

Lee and Wakeland both say the insurance companies have an internal system that prevents policyholders from being paid everything they are owed. They both worry that tornado victims will not get what they deserve right now.

They say storm victims with damage should save all of their repair receipts and document their labor and time spent working on their homes. They say policyholders should particularly watch what they are offered with carpet replacements, roofs, and damages caused by broken glass. They say these are areas where insurance companies may not reimburse you for all that your policy likely covers.

Dinkins says it’s very simple. “I would say don’t accept the first claim that comes in. Get a second opinion to make sure it’s a sure claim.”

North Texans should also check out anyone who knocks on the door and offers help right now. The National Association of Public Insurance Adjustors tells CBS 11 there is a “big issue” with contractors, accountants, and other professionals trying to help you with claims. Only attorneys and public adjusters are licensed to negotiate a claim for you. You should always ask for a person’s license number and contact the Texas Department of Insurance to verify it.

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One Comment

  1. Kelly says:

    I think this story is extremely biased. My husband works as an adjuster for an insurance company and he does everything he can to help people. Adjusters are constantly battling the public perception that they are dishonest and trying to rip people off. They do not do that. This story just promotes that belief, and I think you did a big disservice to people trying to get help by airing this. If they follow your advice, they will face a longer period of trying to get things settled. You also failed to air the view that many believe public adjusters are crooks, like accidental injury lawyers, just trying to get a commission from someone else’s misfortune. This was a really irresponsible story. Why did you not talk to an insurance adjuster as well? You painted the insurance company in a horrible light, when their job is to help people rebuild with what they are entitled to.

    You should do a story from an insurance adjuster’s perspective and all they deal with when dealing with contractors and roofers who grossly over estimate the cost of jobs to take advantage of the insurance company and thus lead the homeowner to believe the adjuster is the one lying when in fact they aren’t. THIS is why people don’t trust adjusters. Adjusters are not trying to rip people off as you stated in your story. I can’t believe you aired this and have it printed on your site. Ridiculous.

    1. jakethesnake says:

      Between overpriced contractors, greedy insurance companies, and a weak state regulatory system, there is plenty of blame to go around. The only one I see fighting for the homeowner is the public adjuster. In this case the public adjuster helped the homeowner, even if they take a 10% cut.

      I’ll leave you with this. State Farm was ordered by the State of Texas to refund 350 million dollars to home policy holders in 2003. State Farm has not done so, and are still fighting against it.

  2. Nick Valentine says:

    After watching the story Ginger Allen did on this, I was concerned with the impression left on the veiwers. The problem I see with the story is that it was reported from one side. I am an adjuster and I do believe Public Adjusters have a place in the insurance industry, but I believe Mrs. Allen should have reported all the other free avenues the insured can take to get the same result. This story could have been much deeper and should have suggested the Public Adjuster as a last resort. By starting out the process with a Public Adjuster you have already lost at least 10% of the monies that you will recieve along with up to 2% for your deductible. Most insureds should have their home inspected with thier prefered contractor and let the adjuster and contractor work through the scope and pricing. If an agreement can not be reached then it can go to Appraisal where a third party will help settle. If it can not be settled there then the insured can let this go to Mitigation and let a judge settle. All three of these are free. (Contractor, Appraisal, Mittigation) Maybe after the contractor and adjuster inspect and can’t agree on the scope and price, then reseach a Public Adjuster, but dont give up 10% of the settlement from you insurance company before you know weather or not you are be cheated by the insurance company, let the adjuster inspect and then wait for his estimate, if you feel cheated then look at other avenues.
    While the story comes at a good time for homeowners, it’s important that reporters do enough due dilligence to educate the public on all their options before they report on a suggested course of action.

  3. Cathy Morgan says:

    You need to do your homework on Public Adjusters. They are only fighting the insurance company because they are being paid. They are no different than overpriced contractors. Most of them fall in the same catagory as attorney ambulance chasers. In most instances the insurance company pays the policyholder exactly what the estimating program figures which coincides with the industries repair cost to repair a home. Public Adjusters come in and take 10% leaving the policyholder to not only come up with their deductible but lose 10% of their repair cost. The policyholder does not realize this until after the claim has been paid. For example, if the policyholder’s house is totaled than the insurance company pays the maximum policy limit. The public adjuster takes 10% of that policy limit away from the policyholder. That can be alot of money to loose when trying to rebuilt a new home. Again, do your homework.

  4. s. alberts says:

    I hope all the insurance companies that advertize on your station pull their advertising. As for me I will never watch your station again!

  5. mavsin6 says:

    The report isn’t bashing adjusters people. It’s bashing the carriers. You must not have read it properly. She says the adjusters hands are tied because the carriers won’t let them pay out what people are entitled to under their policies.

    I know this first hand, as Allstate refused a claim on my roof when I had hail damage, 20 missing shingles, and a water leak going into my bedroom. the payout offer from them? $360.

    Yes, they are ripping people off. Not your fault, but the parent companies you work for.

  6. D says:

    As a licensed adjuster in Texas and a licensed public adjuster in 46 states, I find this article appauling. I have worked for carriers and have never short changed an insured, never not paid completely 100% what is owed less the policy deductible and applicable depreciation, and never, ever been advised to pay less or offer less by a supervisor or manager. Dollar amounts for claims are not randomly pulled out of a hat, they are based upon current, local pricing for materials and labor. There is a place for public adjusters in the market, absolutely, as I am one of them. But to present an article such as this, presenting blanket accusations without data to back up such claims and presenting one situation as a common, everyday occurrence is extremely unprofessional.

  7. kelly gevens says:

    This article is so very disheartening, and borders on actually being slanderous. I work for an insurance company and watch our adjusters sacrifice their personal lives to work long hours in often times in horrible conditions, all because they truly care about the people affected by these disasters. There are so many misconceptions regarding claim settlements created solely by the media. Shame on you for printing such a bunch of bunk.

  8. Steve in Allen says:

    All insurance (home, life, property, medical, et al) is paid socialism, and the companies are (to varying degrees) in the business of making a profit – depending on the scruples of the companies executives, the people’s (policy-holder’s) ability to seek legal recourse, and government regulation/enforcement. There is a solution, but it would require a major overhaul of our government and people’s perceptions – so not really likely in our media-brainwashed culture. It starts, though, with people taking control of all levels of government, and forcing out the politicians – starting with abolishing the political parties. Until representatives (all levels and offices) represent their constituents interests ONLY, this kind of legal malfeasance will continue. The fact that we are FORCED to buy insurance on our homes by the mortgage industry is arguable; but the fact that insurance companies continually get the support of our government officials (over our personal interests) is proof that they are complicit in a criminal racket.

    Yes, there is major criminal activity in our society, and it’s not exclusively in one area or another. There are those who try to ‘fight the good fight’, but they are quickly squashed by the much more prevalent voices of the politicians and their propaganda machine. I’m not just talking about the Liberal Media, either; because the right-wing (selective conservative) propaganda groups like Fox News, Limbaugh, and more greatly out-BS the left-wingers.

    This article is just one example of how the “system” works against you. You pay, because you really don’t have any choice; but you have no real recourse if the insurance company doesn’t honor the contract. With all the “tort reform” and other forms of “deregulation” over the past few decades, it no wonder Texas is so popular with the large corporations. Executives know that if they come to Texas they can make more money because our state will protect the wealthy and business interests over the individuals (workers, customers, and/or innocent victims). And, the propaganda in this state (media, schools, etc) helps reinforce the misinformation so that future generations continue maintaining the status quo – why mess up a good thing.

    1. Bob in Frisco says:

      Homeowners have all kinds of recourse when they disagree with the amount they were paid for their property damage claim. They don’t have to hire a public adjuster or attorney to get the insurer to reconsider its decision. The simplest thing to do is simply send your contractor’s estimate to the company if it is higher than the amount estimated by the adjuster. A reinspection by the adjuster with the contractor is also a good idea. This will usually result in a satisfactory resolution of the dispute. The formal appraisal process is another option. Beyond that, insureds have substantial legal protection in the event their insurer does anything wrong. Contrary to popular belief, Texas laws are among the most liberal in the nation for allowing policyholders to sue their insurance companies and recover large sums of money, including all of their attorney fees, even when the insurers really did nothing wrong. The thousands and thousands of Ike claim lawsuits that have been filed in south Texas are evidence of that. Basically, if you have a property insurance claim, you have a lawsuit. Plaintiffs’ attorneys and public adjusters are very happy to cash in on this situation. It is easy to just blame the insurance companies for high premiums, but exaggerated claims and huge numbers of lawsuits are big reasons why Texas homeowners pay higher insurance rates than anywhere else in the country. The problem is not too much government protection of insurance companies in Texas. The problem is too strict regulation and too much protection for plaintiffs’ attorneys. Until that changes, we will all pay high premiums in order to benefit plaintiffs’ attorneys, public adjusters, and a small percentage of homeowners who want a big windfall rather than simply to be paid for their covered damages.

  9. Guest says:

    If you have Farmers Insurance beaware that they will call everything on your roof foot traffice or wear/tear.

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