Wednesday, October 30th, 2019 by Tobie Stanger, Consumer Reports, Inc.
Homeowners insurance covers damage from fires—including wildfires like the ones ravaging California—so it's important to know how to file a claim if it happens to you.
The first step is to get in touch with your insurer or the agent who sold you the homeowners insurance. The insurance company will assign an adjuster, who will assess the damage and submit an estimate for review.
The amount you're paid will depend on the kind of coverage you have. While “replacement cost” coverage should cover the cost of repairing or replacing your home and any lost or damaged items, “actual cash value” coverage will pay you the value of your home and the damaged items inside, less depreciation.
To make sure you get your due, follow these tips:
Document all losses. After the fire, take photos of the damage and make a list of items that were destroyed or are in need of repair. Include the amount you paid for the items and gather any receipts you can find.
“The more you can document your property losses before the insurance adjuster arrives, the faster the claims-filing process will go,” says Michael Barry, a spokesman for the Insurance Information Institute (III), a not-for-profit group sponsored by the property and casualty insurance industry. “A standard homeowners insurance policy not only covers damage to the home’s structure but also the homeowner’s personal property.”
Verify the adjuster’s identity. Scammers can show up after natural disasters. To protect yourself, ask the insurance company for the adjuster’s name before he or she arrives, then ask for identification before letting the person into your home.
Show the adjuster all the damage. Make sure that you are home when the adjuster visits and that he or she gets a complete view of everything that was lost or damaged. It’s not enough just to walk through part of your home.
Document all contact with the insurance company. After the adjuster leaves, remain in contact by email so that you have backup of all your communication. Keep notes about when an adjuster visits as well as any missed appointments, unreturned phone calls, what you discussed, and even if he or she was rude. Though you probably won't need this information, it will be useful if any disagreements have to be resolved in court.
Make copies of all documents. Copy everything you give to the adjuster, such as your list of property lost or damaged. If the adjuster advises you to start repairs, get that permission in writing, advises Amber Mostyn, an attorney in Houston who represents consumers against insurers.
Mostyn says that in an emergency situation, the first adjuster may be replaced by a new one during the claims process, so having correspondence in writing could be helpful to you. “There’s often not a good hand off of information when the next adjuster comes in,” she explains.
Get additional estimates if necessary. If you have custom work in your house, an adjuster may not know how to properly estimate the value. Get an outside estimate from a contractor.
Verify what's covered by your policy. The III notes that in addition to covering damage caused by fire and smoke, the standard homeowners and renters insurance policy covers damage caused by firefighters while extinguishing a fire.
You also may have coverage for the "loss of use" of your home, and for additional living expenses such as rent or hotel bills, restaurant meals, and other expenses like transportation, up to a limit.
The California Department of Insurance (CDI) notes that even Sonoma County residents whose homes were not damaged may be able file for additional living expenses if they were evacuated by mandate. In many cases, there's no required deductible.
In the past, the CDI has made the same statement for victims of other fires, so check the website for updates that may affect you. (The III notes that this option isn't available in every state.)
A typical homeowners insurance policy also covers wildfire-caused damage to trees, shrubs, and plants for a dollar amount up to 5 percent of what your entire dwelling is covered for. The limit per tree, shrub, or plant is generally about $500, the III says. Debris removal also is covered; the amount depends on the policy.
Discuss any exclusions or limits in your policy. If your insurer maintains that your policy doesn't cover all the damages or if you think the compensation is too low, ask the carrier’s representative to explain in writing how he or she got to the estimate. The rep should also include any reason certain items aren't covered and whether there are any coverage limits.
If you think the wording in the policy is misleading, contact a local plaintiff’s attorney who specializes in insurance law. The Consumer Federation of America notes that courts have consistently ruled in favor of policyholders on policy ambiguities. File a complaint with your state’s department of insurance.
If you have a very large claim, you may want to turn to a public adjuster, an independent adjuster who works on your behalf and represents you for the claim. But be aware of fees. In some states a public adjuster’s fees are capped, typically at 10 percent to 12 percent of the insurance payout. In other states there are either no caps or adjusters simply charge a flat fee.
To find a public adjuster, check with the National Association of Public Insurance Adjusters. Ask for references from past clients and look to see whether he or she has several years of experience and a state license where required.
There are five states where no licensing is required—Alabama, Alaska, Arkansas, South Dakota, and Wisconsin. If you live in one of those states, Diane Swerling, a principal at Swerling Milton Winnick Public Insurance Adjusters in Wellesley, Mass., suggests contacting an attorney who works with catastrophe victims to help you find a reputable adjuster.