Most policyholders are unaware of how to dispute and resolve their insurance claim settlement amount with the insurance company. You do have a provision within your insurance policy for this purpose.
It's called the “Appraisal Clause”, also known as the “Appraisal Provision”.
What is an Insurance Appraisal?
“If you and we fail to agree on the actual cash value, amount of loss, or cost of repair or replacement, either the policyholder or insurance company can make a written demand for appraisal. Each will then select a competent, independent, appraiser and notify the other of the appraiser's identity within 20 days of receipt of the written demand. The two appraisers will choose an umpire. If they cannot agree upon an umpire within 15 days, you or we may request that the choice be made by a judge of a district court of a judicial district where the loss occurred. The two appraisers will then set the amount of loss, stating separately the actual cash value and loss to each item.” - IAUA Insurance Appraisal & Umpire Association
The Insurance Appraisal Process?
Appraisal is a Policy Provision found in the Loss Settlement section. It is an Alternate Dispute Resolution, which can resolve disagreement when the Insurance Carrier and Policyholder (Insured) do not agree on the amount of loss. It is an alternative to filing a lawsuit. Insurance Claim Appraisal does not address coverage issues, but can include or exclude items based on causation depending on the state.
Pros & Cons
Appraisal vs Lawsuit
Quick & Expedient
Relatively less costly
May be less adversarial
No litigation potential
Must pay fees/costs
Less strict procedures
Much more costly
Appeal is possible
May recover fees/costs
Appraisal is a binding contractual process available to settle valuation disputes between policyholders and their insurance company when they fail to agree on the amount of loss or the scope of damages. Many insurance policies contain a provision which states that if either party disagrees as to the amount of the insured loss, or the scope of work, the insurance company or the policyholder has the right to demand an “Appraisal”. The purpose of the Appraisal process is to offer both parties to the insurance policy contract a less expensive and more expedient alternative to going to court in order to reach a settlement to the insurance claim.
The insurance claim appraisal process is similar to binding arbitration, but the two processes are not identical. The Appraisal Panel is made up of three participants.
1. the Insurance Company and 2. the Insured each select a competent Appraiser for the process. Then, 3. the two Appraisers mutually agree to an Umpire. The umpire serves as the final decision maker should the two Appraisers have differences that they cannot resolve. The Umpire only rules on the differences of the two Appraisers in the amount of the loss and/or scope of work.
The Appraisers and the Umpire do not have the authority to make decisions as to coverage within the policy. The insurance company cannot dictate to their appraiser, offer their opinions or provide recommendations as to the insurance claim appraisal results.
It's a resolution to the dispute of the final amount of the insurance claim.
While the actual physical damage from fire or smoke, water leak or storm damage will be devastating, the loss from "Business Interruption" will prove to be the most devastating loss.
We provide the expertise and resources to document, present and negotiate your claim in a professional manner with your insurance company appraiser.
The Insurance Claim Appraisal Process may be right or you.
For most of us, our home is our single largest investment. When property damage from a fire, hail storm, water leak, an act of vandalism occurs, it's very traumatic for the entire family. It's imperative that you receive the funds from your insurance claim to restore your property to its previous condition. As you have now discovered, the insurance claim process can be very complicated.
Do you have customers involved in storm damage insurance claims? Did the insurance company grossly under pay the claim? Are you concerned that the insurance claims adjuster excluded General Contractors overhead and profit?
The Insurance Claim Appraisal process may be right or your customer's claim.
Attorneys will all agree that a lawsuit is not the answer to every insurance claim dispute. The Insurance Claim Appraisal Clause was originally initiated to reduce the number of lawsuits filed against insurance companies. Many times, Attorneys or the judge will advise the policyholder to engage in the Appraisal Process before a lawsuit may go forward. Using the "Insurance Claim Appraisal" process instead of a lawsuit can often save a lot of time and money for all the parties involved.
The insurance company adjuster has been making all the decisions, and now you’re at an impasse.
Get your insurance claim out of your insurance company adjusters hands and into the hands of a competent insurance claim appraiser.
Who We’ve Helped
“THIS IS IMPORTANT INFORMATION FOR ALL WHO LIVE IN TEXAS. I HAVE HAD AN AMAZING EXPERIENCE. HIS NAME IS CHES BOSTICK”.
I had a huge tree in my yard that fall on my house and car a couple of years ago destroying my entire front yard over $35,000.00 worth of landscape, a roof, and smashed my car roof in. I fought and fought with my insurance company and was in tears many days fighting with them over my claim. They were sure I would give up! I was about to when I met Ches Bostick.
I never knew there was such a thing as insurance claim appraisal until I met Ches Bostick. He is the most patient, laid back Texas cowboy with a big truck I ever met that can work his magic. Gave him my folder of information and he went to work. After two + years of fighting on my own Ches Bostick with Abba Claims Consultants got right on it and bingo I will have a new roof on my house. All of this was really stupid that my insurance company was trying to skit around the issue but Ches was amazing”.
Donna Tomasi – Dallas, TX
“When our new home flooded from the pipe burst, we were devastated. We were overwhelmed with the insurance claims process and the amount of documentation necessary for an insurance claim. The insurance company adjuster did not have our best interest and I know that using Abba Claims Public Adjusters was the best decision we could have made. It is an invaluable asset to have a professional Public Insurance Claims Adjuster working on the behalf of the customer. If anyone ever experiences a tragedy such as this I will recommend Ches Bostick and Abba Claims Consultants with confidence. Thank you Abba Claims for getting us the proper claim settlement!”
Hunter Miller – Norman, OK
“I have been working in home improvement for many years. Unfortunately, when working with insurance companies, they often don’t award their customers the true value of the homeowner’s claim. Negotiating with them was frustrating and usually a losing battle. Since working with Ches and Abba Claims Consultants that frustration has been removed. They knock it out of the park every time and always amaze me by finding things which should have been covered that I wouldn’t have thought to ask for. When dealing with insurance companies you want Abba Claims in your corner fighting for you!
– Bill Mead, Dallas, TX