Dealing with an insurance adjuster can be one of the most frustrating parts of filing an insurance claim. While adjusters are tasked with evaluating your claim and determining a fair settlement, they often work on behalf of the insurance company—not the policyholder. If you’ve received a settlement offer that seems too low or your claim was denied outright, you have the right to dispute the decision. This article will walk you through the process of how to dispute a decision made by an insurance adjuster and get the outcome you deserve.
Understand the Role of the Insurance Adjuster
An insurance adjuster is responsible for investigating claims, reviewing damage, interviewing witnesses, and assessing how much the insurance company should pay. However, it’s important to remember that the insurance adjuster works for the insurance company, not for you. Their goal is often to minimize the payout to protect their employer’s bottom line.
Knowing this can help you stay cautious and proactive during every interaction with the insurance adjuster.
Review Your Policy in Detail
Before disputing a decision, take the time to read your insurance policy thoroughly. Understand what’s covered and what isn’t. Often, disagreements stem from misinterpretations of coverage limits or exclusions. If the insurance adjuster based their decision on incorrect assumptions about your policy, this gives you a strong foundation to begin your dispute.
Request a Written Explanation
Ask the insurance adjuster to provide a written explanation of how they reached their decision. This should include specific policy language and documentation they used to justify their conclusion. A formal explanation can reveal gaps or errors in their assessment that you can challenge with proper evidence.
Gather Your Own Evidence
To successfully dispute a claim, you need to build a strong case. This includes:
- Photos of the damage
- Receipts or estimates for repairs
- Medical reports (if applicable)
- Witness statements
- Independent assessments
The more comprehensive your documentation, the harder it becomes for the insurance adjuster to deny your claim unfairly.
Get a Second Opinion
You can hire a public insurance adjuster or an independent contractor to inspect the damage and provide their own evaluation. Unlike the insurance company’s insurance adjuster, a public adjuster works for you and can provide an unbiased estimate of the losses. This can be powerful evidence when challenging the insurer’s original decision.
File a Formal Dispute or Appeal
Most insurance companies have a dispute or appeals process in place. Contact the insurer’s claims department and inform them that you want to dispute the decision made by the insurance adjuster. Submit all your evidence, including the second opinion, and explain why you believe the decision was incorrect.
Make sure to keep all communication in writing and document each step. If the insurance adjuster made an error or overlooked key details, your case may be re-evaluated and approved for a better settlement.
Consider Legal Help
If you’ve followed all the steps above and still believe the insurance adjuster acted in bad faith, it may be time to consult an attorney. Legal professionals who specialize in insurance claims can help you hold the company accountable. Often, just hiring a lawyer sends a strong message that you’re serious about the dispute.
Conclusion
It’s not uncommon for policyholders to feel intimidated or frustrated when dealing with an insurance adjuster. But remember, you have rights. If you believe the insurance adjuster made a mistake, you don’t have to accept their decision without question. By understanding your policy, collecting solid evidence, and seeking professional advice when needed, you can challenge an unfair claim decision with confidence.
At Ocean Point Claims, we help people like you fight back when insurance decisions don’t reflect the true value of your losses. Let us assist you through the process—because you deserve fair treatment from every insurance adjuster you encounter.
