Battle of the Estimates

So, your insurance policy has agreed to cover your claim, but you cannot find any contractors willing to do the work for this amount. This is a common story amongst my clients. Policyholders often come to me asking if the insurance payout was fair? Why can’t I find a contractor to do the work for the amount that my insurance covers? Are they paying me the benefits I’m owed? Is the home insurance adjuster estimate too low? Is the cost of repairs actually equal to the amount of money that my insurance covers?

These are frustrating questions. Often, insurers will write their own repair estimate for a loss or damage. Unfortunately, the insurance claim adjusters who work for the insurers are not contractors and are not equipped to provide such estimates. Fortunately, there are regulations in California that specifically address how to handle insurers and refute those loss or damage estimates in these situations.

Under the California Code of Regulation, title 10, sec. 2695.9(d), it states:

“If losses are settled on the basis of a written scope and/or estimate prepared by or for the insurer, the insurer shall supply the claimant with a copy of each document upon which the settlement is based. The estimate prepared by or for the insurer shall be in accordance with applicable policy provisions, of an amount which will restore the damaged property to no less than its condition prior to the loss and which will allow for repairs to be made in a manner which meets accepted trade standards for good and workmanlike construction. The insurer shall take reasonable steps to verify that the repair or rebuilding costs utilized by the insurer or its claims agents are accurate and representative of costs in the local market area. If the claimant subsequently contends, based upon a written estimate which he or she obtains, that necessary repairs will exceed the written estimate prepared by or for the insurer, the insurer shall:

(1) pay the difference between its written estimate and a higher estimate obtained by the claimant; or,

(2) if requested by the claimant, promptly provide the claimant with the name of at least one repair individual or entity that will make the repairs for the amount of the written estimate. The insurer shall cause the damaged property to be restored to no less than its condition prior to the loss and which will allow for repairs in a manner which meets accepted trade standards for good and workmanlike construction at no additional cost to the claimant other than as stated in the policy or as otherwise allowed by these regulations; or,

(3) reasonably adjust any written estimates prepared by the repair individual or entity of the insured’s choice and provide a copy of the adjusted estimate to the claimant.”

With these regulations, you can make sure your insurer is handling the claim fairly and that you are receiving the proper amount for the payout of your settlement. After all, you are paying for your insurance policy, so it’s only fair that you be afforded the rights to your contract. Should you have any issues settling an insurance claim or feel that your insurance carrier is not respecting your contract, feel free to give us a call. We are here to help you through the insurance claim process. Contact us today!