What Is a Public Adjuster: The Difference Between an Insurance Adjuster and Lawyer

A fire or flood in your home is a difficult thing to experience on its own. Filing an insurance claim on top of the damage can be confusing, frustrating, and stressful. Relying on your insurance company to begin the process and guide you through the next steps can add to the stress you already feel if they fail to meet standards to handle your claim in a timely and effective manner.

If the claim is a sizeable one, it’s advisable to hire your own advocate to work with you through the process. An experienced professional can help you navigate the process and make it more manageable. But the question arises: who should you hire for help?

In Canada, there are two primary options: a public adjuster and an insurance lawyer. In this article, we are going to explain the differences between these two so that you can better understand how an insurance lawyer can assist you in different ways than a public adjuster.

What Is an Insurance Adjuster?

When you make a home insurance claim after a fire or flood, the insurer will send an insurance adjuster to handle the claim. Their main job is to evaluate and verify the details of your home fire insurance coverage. This involves:

• Evaluating the extent of the structural damage;
• Asking for proof of the value of personal belongings lost to fire or flood; and
• Reviewing receipts for Additional Living Expenses, such as gas or takeout.

The insurance adjuster may hire contractors or engineers to help them create an estimate of structural damage, or they may generate the estimate themselves. There is no industry standard here, which could lead to complications or disagreements.

The insurance adjuster becomes your primary point of contact until the insurance company makes you a settlement offer. If there are communication issues or disagreements early on, they can quickly make the claims process a more nerve-wracking experience.

They may also speak with the fire department about the cause of damage. In some cases where there are questionable circumstances, they may conduct their own independent investigation with a fire expert. If they determine that the fire was deliberately set by the homeowner, they may deny the claim.

The insurance claims adjuster is either an employee of the insurer or an independent insurance adjuster hired by the insurer. It’s important to note that an insurance adjuster works toward the best interests of the insurance company, and the company has a vested interest in reducing the size of the settlement on any given claim.

What Is a Public Adjuster?

Public insurance adjusters work for the policyholder, not the insurance company. In Canada, all adjusters go through the same licensing process regardless of who they work for. In order to become an adjuster, they must complete a series of courses offered by the Insurance Institute of Canada that cover a wide range of subjects, including property claims, auto claims, personal injury claims, and the process of claims adjusting. They must also pay a nominal fee when they obtain or renew their license.

A public adjuster in Canada may be self-employed or work with a firm. What makes them distinct from the insurer’s adjuster is that they work for the policyholder. However, some independent adjusters may work for either the policyholder or the insurer depending on the case.

Public adjusters in Canada are licensed in the province where they practice. Many, but not all, of the educational requirements are exempted for adjusters moving from one province to another.

What Does a Public Adjuster Do?

A public adjuster represents your interests when you file a claim. They bring their familiarity with the adjustment process to the table to help you smooth over issues with the insurance company or their adjuster. They know what the insurance company expects from you in terms of paperwork and proof of ownership or value when it comes to belongings.

A public adjuster can also assist if you believe any part of your claim has been undervalued by the insurance company. They may bring in experts such as a contractor or engineer if you want to dispute the company’s evaluation of structural damage. They can also help you negotiate the value of your lost contents if that becomes a point of contention.

When it comes to payment, public adjusters typically earn a percentage of the claim payout upon settlement. However, it is the policyholder, not the insurance company, that pays for this service.

Public Adjuster vs. Insurance Lawyer

An insurance lawyer does all of the things that a public adjuster does and more. They will help you through each step of the claim, beginning with helping you understand your home insurance policy and managing all of the paperwork. They can simplify complex legal language and explain how your policy works in practical terms. They will also negotiate with the insurance company if they undervalue any part of your claim.

An insurance lawyer can also help you push back when the adjuster or the insurance company’s demands seem unreasonable. Sometimes insurance companies use pressure tactics to get you to move faster than you’re comfortable with, such as getting you to sign off on a final Proof of Loss before releasing any advanced funds. If the insurer demands a Final Proof of Loss before giving you an advance, preventing you from replacing lost belongings in a timely manner, an insurance lawyer can step in to correct the course. Insurance companies may be less likely to apply these pressure tactics when they know the policyholder is working with an experienced insurance lawyer who is familiar with the claims process.

Finally, an insurance lawyer can deal with the more complicated claims. These often are claims that involve third parties, liability, or have the potential to become an ongoing dispute with the insurance company. A public adjuster cannot help if you have to take the insurance company to court over a dispute about your claim or if your claim is denied outright.

Virani Law works to avoid disputes through negotiation. A legal dispute can be time-consuming and costly, but should your claim reach that point, you would need a lawyer’s help to proceed.

When to Hire Help with Your Claim

Filing an insurance claim can be a challenge. You will need to do things like list all of your lost belongings, organize receipts for all of your Additional Living Expenses, and review how the adjuster has valued your losses. On top of this, you may not know exactly what you’re entitled to under your insurance policy. There are a number of reasons to hire an insurance lawyer to help you when you’re just getting started with the process.

#1 You Have a Major Claim or Total Loss

If you’ve experienced a total loss or you are making a significant claim in the hundreds of thousands of dollars, you will almost certainly benefit from getting help with your claim. Handling a claim of that size on your own puts your financial future in jeopardy.

You may also want to start looking for an advocate if you expect there will be complications. The larger the loss, the more you stand to lose if your insurer rejects a portion of your claim or undervalues the extent of your loss. When it comes to claims, an insurance lawyer can make a big difference in the size of your final settlement.

#2 There Is Third Party Liability

Third party liability is a significant complicating factor that can prolong your claim much longer than expected. Third party liability occurs when another party causes the damage through their actions or negligence. For example, a neighbour hires a contractor to do work on their property. Something goes wrong, and the contractor’s work results in a fire that not only damages the neighbour’s property but also affects your home. The contractor is clearly liable, and you can sue for damages, but your property is not the only one affected. The contractor’s insurance company may wait up to two years before they start settling claims as they wait for all parties to initiate a suit.

There are several ways you can proceed with third party insurance claims. You may make a claim with your own insurer, which allows the insurer to file a suit with the liable party through a process called subrogation. An insurance lawyer will be much more helpful than a public adjuster for a third-party liability claim. A lawyer can explain all of your options, as well as the advantages and limitations of pursuing certain actions. If your claim involves third-party liability, we can help guide you through a complicated process.

#3 Help with Stress and Difficulty of Filing a Claim

An insurance lawyer will also help you mitigate the stress that your family will face filing your claim. Your family has just experienced a significant loss, and it’s important not to downplay your emotional recovery. It can be difficult to adjust once you’ve been displaced. From living in a rental property, to not having access to any of your personal belongings, we understand that this is an extremely difficult time that you are having to live through. Strains on familial relationships can result from the difficulty children and the elderly have with adjusting to what has happened.

For some families, language barriers can make insurance claims and recovery even more challenging, and often involve a friend or family member to assist with communications and translations. Even native English speakers can struggle with the legal language of insurance documents and may not understand their obligations or what they are signing.

#4 The Insurer’s Offer Is Not Enough

Finally, you may want to get help after you’ve seen the insurer’s first settlement offer. Once you see it, you may feel that the insurer has not offered a fair amount and that you’re entitled to more based on your insurance coverage. There are several ways an insurer may try to undervalue a claim:

• Lowballing their evaluation of the damage done to your home;
• Using exclusions for things like wear and tear in order to claim that a damaged structure was the result of poor maintenance;
• Demanding receipts that have been discarded or potentially lost; and
• Claiming that poor documentation or tampering with the scene of the loss (such as making self-directed repairs or removing personal belongings) invalidates the claim.

An insurance lawyer will be familiar with these tactics. They can help you avoid mistakes and identify some of the ways insurers attempt to reduce their settlements.

What Makes Virani Law Different?

We can help at every stage of the process, from filing your paperwork to third-party liability. Our goal is to come to a fair settlement while avoiding unnecessary delays in the process. If we can avoid dispute resolution by pushing back against the insurer early on, we can help you start your recovery sooner.

Negotiating with the insurer is a much faster way to increase your payout. Insurers typically want to avoid the expenses of a dispute and are willing to negotiate. Contact us early on in the process, and we can make the process smoother for you and your family. From initiating the claim to submitting your expenses, having an advocate help you throughout the process will reduce the stress that you have to take on.

#1 We Can Service All of Canada

With a strong track record with many of Canada’s top insurers, we’re in a position to service the entire country. Although our home is Guelph, Ontario, we’ve helped families across Canada who have lost their homes to wildfires and suffered extensive damage caused by flooding. Virani Law operates across Canada, whether you need an insurance lawyer in Toronto, B.C., Alberta, or anywhere in Canada. If you are about to make a significant insurance claim in Canada, give us a call.

#2 We Have Relationships with Canada’s Top Insurers

Over the years, we’ve built good working relationships with many of the top insurers in Canada and the insurance adjusters who work for them. Going into negotiations knowing what’s fair for both parties can save time and headaches. Entering into formal legal processes takes time and resources. While we would like to successfully negotiate and settle claims fairly without formal litigation, we have the ability to take legal action when the situation requires it.

#3 We Lived It Too

We understand what you’re going through better than anyone because it happened to us. In 2014, Fy Virani’s family went through a tragic house fire that resulted in loss of life and devastation of the family home. After seeing firsthand the problems with the insurance claim process, Fy opened Virani Law to help families work through the claims process and make sure they receive fair settlements. In the wake of loss, getting support makes a huge difference.

Most law firms only handle disputes and they’re not brought in until the claim process is well underway, usually after the insurer has already made an offer and the policyholder disagrees with their evaluation of the loss or coverage. Though attorneys can be hired at any point in the process, not all firms know the ins and outs of insurance. We can go over your insurance policy, explain industry terminology, and make sure you understand your coverage and your rights. By getting involved from the beginning, we can save you a lot of stress.