How to Ensure Full Insurance Payouts

The insurance industry is notorious for systematically underpaying, delaying, and outright denying legitimate claims. Whether you manage an apartment complex, large institutional facilities, or multi-tenant commercial properties, it’s crucial to understand how insurers operate and how to protect your financial interests. Public adjusters, like Velocity Public Insurance Adjusters, who exclusively serve as first-party property damage adjusters, are key advocates for policyholders, fighting against these unfair claims settlement practices. This article aims to educate you on how to navigate insurance policies, ensure full insurance payout, and hold insurance carriers accountable.

The Reality of Insurance Claims

As consumers, we expect insurance companies to honor their promises and obligations when we file claims. However, the harsh reality is that nearly every claim faces hurdles like delays, denials, or underpayment. According to the National Association of Insurance Commissioners (NAIC), insurers are consistently reported for engaging in unfair claims practices. These companies often rely on the complexity and vagueness of policy language and the general lack of consumer knowledge to minimize insurance payout.

Leading consumer advocates like the American Policyholder Association (APA) and the National Association of Public Insurance Adjusters (NAPIA) have long pushed for reforms to hold insurers accountable for less than Good Faith claims handling. Jay M. Feinman, a professor of law and author of Delay, Deny, Defend, highlights how insurers use tactics to stall or reduce insurance payout, emphasizing the need for policyholders to understand their rights and options.

Understanding Your Policy: Knowledge is Power

One of the primary reasons claims are underpaid is due to the intricate and often misleading language found in insurance policies. Property managers and contractors should familiarize themselves with the key exclusions, limits, and conditions embedded in their policies. For instance, coverage for water damage might be limited to specific situations, such as burst pipes, while flood-related damage is excluded unless an additional policy is purchased. Similarly, business interruption insurance often has clauses that restrict coverage based on certain triggers.

Bill Wilson, author of When Worlds Collide, notes that understanding these nuances can be the difference between a denied claim and a fully paid one. In commercial settings, knowing how coverage works for equipment, structural damage, and loss of income is essential to ensuring that you are not caught off guard when disaster strikes.

Effective Documentation: Your First Line of Defense

Proper documentation is critical when filing any insurance claim. Public adjusters stress the importance of gathering detailed evidence of damage as soon as it occurs. Whether you are dealing with fire, theft, vandalism, water, or storm damage, clear, time-stamped photographs, inventories of affected items, and repair estimates are crucial to building a strong case.

David Skipton, a seasoned public adjuster and author of The Claims Game, warns that insurers often deploy “tricks and deceptive tactics” to devalue your claim. This includes lowball repair estimates or unreasonable requests for additional documentation. By proactively organizing your evidence and working with a public adjuster, you can effectively counter these tactics.

Negotiating with Adjusters: Know Your Worth

Insurance adjusters work for the insurance company—not you. Their goal is to minimize the insurance payout, often by overlooking damage and leveraging standardized estimates that don’t fully reflect the actual cost of repairs and replacements. However, this does not mean you have to accept their initial offer. Chris Voss, a former FBI hostage negotiator and author of Never Split the Difference, advises using evidence to justify your demands and remaining firm in negotiations.

If the adjuster's offer falls short, provide independent appraisals or expert opinions that reflect the true extent of your losses. The APA and NAPIA both recommend working with a public adjuster, like Velocity Public Insurance Adjusters, to level the playing field and secure the compensation you are owed under your policy.

What to Do if Your Claim is Denied

Even with meticulous preparation, some claims are denied. But this doesn’t mean the battle is over. The NAIC encourages policyholders to carefully review denial letters, which should cite specific policy exclusions or conditions. Once you understand the basis for the denial, gather additional evidence and submit a formal appeal.

In some cases, litigation may be necessary. Chip Merlin, an attorney, and author of Pay Up!, specializes in Bad Faith and Breach of Contract lawsuits against insurers who wrongfully deny claims. Merlin’s work highlights the importance of holding insurance companies accountable when they prioritize profits over policyholder rights.

The Importance of Policyholder Advocacy

Public adjusters are uniquely positioned to advocate for policyholders in these situations. Unlike insurance company adjusters, public adjusters work solely for the Policy Holder, ensuring that all losses are properly documented and fairly compensated. The National Association of Public Insurance Adjusters (NAPIA) and the American Policyholder Association (APA) have consistently supported the role of public adjusters in helping consumers level the playing field against insurance companies. These organizations emphasize that public adjusters are critical advocates who work exclusively for policyholders, ensuring fair and prompt claim settlements, particularly in cases where insurers engage in less than Good Faith practices such as delays, wrongful denials, or underpayments.

Don’t Get Shortchanged

If you’re managing a commercial property, multi-family housing, or a large institutional facility, you can’t afford to be underpaid on an insurance claim. Educate yourself on your policy, document your losses thoroughly, and don’t hesitate to seek expert help when dealing with your insurance company. At Velocity Public Insurance Adjusters, we serve clients in Indiana, Kentucky, Ohio, Wisconsin, Michigan, and Iowa, and offer claim and policy reviews to help you understand your coverage and ensure that you are not left out in the cold. Contact us today to schedule your FREE CLAIM CONSULTATION and take the first step toward securing the full insurance payout you deserve!