Questions People Ask Us

Most people meet the term "public adjuster" for the first time when something has already gone wrong. So here are the questions we actually get asked, answered straight — including the ones where the honest answer is that you might not need us.

If yours isn't here, call (864) 497-2151. The first conversation is free and we'll tell you straight whether you need us.

About Public Adjusters

What is a public adjuster?
A licensed professional who represents you — the policyholder — in a property insurance claim. We inspect the damage, prepare the estimate, handle the paperwork and negotiate the settlement with your insurance company.

How is that different from the adjuster my insurance company sent?
There are three kinds. A company adjuster is employed by your insurer. An independent adjuster is a contractor the insurer hires. Both are paid by the insurance company and represent its interests. A public adjuster is the only one who works for you.

Are you licensed?
Yes. Public adjusters are licensed and regulated by each state. We're licensed in North Carolina, South Carolina and Georgia.

Can my contractor negotiate the claim for me?
No. Only a licensed public adjuster can adjust or negotiate a claim on behalf of an insured. In South Carolina, state law specifically reserves first-party claim negotiation to public adjusters. A contractor can give you a repair estimate, but they cannot represent you to the carrier.

Do I actually need one?
Not always, and we'll say so. On a small, straightforward loss the carrier's process usually works fine. Where it's worth calling us is when the damage is substantial, the estimate looks low, the claim has been denied, or you simply don't have time to fight it while running a household or a business.

When should I bring you in?
As early as possible. The scope of a claim is largely set in the first inspection, and changing it afterwards is harder than getting it right at the start. That said, we can come in at any stage — mid-claim, after a denial, or on a claim that's already been closed.

What It Costs

What do you charge?
A percentage of what you recover. Nothing upfront, no hourly billing. If there's no settlement, there's no fee.

Is the fee negotiable?
Percentages are regulated in some states and vary with the size and complexity of a claim. We'll tell you the figure before you sign anything.

Do I pay if you don't improve the settlement?
No. Our fee comes out of what's recovered.

Is it worth it on a smaller claim?
Sometimes not, and that's an honest answer rather than modesty. If we don't think we can improve your position enough to justify the fee, we'll tell you at the first conversation.

How a Claim Works

What happens when I call you?
We talk through what happened, what your policy says, and where the claim stands. That conversation is free and carries no obligation.

What do I need to have ready?
Your policy if you can find it, any correspondence from the carrier, and photographs if you took them. If you don't have any of that, call anyway — we can obtain most of it.

Will I have to deal with the insurance company?
Not for the day-to-day. We handle the correspondence, the inspections and the negotiation. You'll need to sign certain documents yourself, and you may be asked to give a statement, but the running of the claim comes off your hands.

How long does a claim take?
It depends entirely on the size of the loss and whether it's contested. A straightforward claim can settle in weeks. A disputed total loss can take the better part of a year, and reconstruction adds to that.

What is a proof of loss?
A sworn statement setting out what was damaged and what you're claiming. It's a formal document with a deadline attached, and getting it wrong — or missing the deadline — can end a claim. On NFIP flood claims the deadline is 60 days and it's strict.

Should I accept the first offer?
Read it carefully first. An initial estimate is an opening position, usually written before anyone has looked behind a wall. That doesn't make it wrong, but it does make it worth checking.

Settlements and Coverage

Do I have to repair the property to get paid?
No. You're entitled to a settlement whether or not you replace what was lost. Where a policy holds back recoverable depreciation until work is done, replacing may be worth more — but the choice is yours.

What's the difference between replacement cost and actual cash value?
Replacement cost pays what it costs to replace the item today. Actual cash value pays that figure minus depreciation for age and wear. Which one applies is written into your policy, and it makes a very large difference on contents.

What is recoverable depreciation?
Where a policy pays replacement cost, carriers often pay actual cash value first and release the remainder once the work is completed and evidenced. That remainder is recoverable depreciation, and it is frequently left unclaimed.

Can I recover more than my policy limits?
Sometimes. Many policies include additional coverages — debris removal, ordinance or law, additional living expenses — that sit outside the main dwelling limit. Properly documented, these can take a recovery above the headline figure.

What are additional living expenses?
The extra cost of living elsewhere while your home is uninhabitable — temporary accommodation, higher food costs, storage, pet boarding, extra travel. It has its own limit and is routinely under-claimed.

What is ordinance or law coverage?
An endorsement that pays for the cost of meeting current building codes when repairing damage. Older buildings are rarely code-compliant, and without this coverage those upgrade costs fall on you.

Will my premium go up if I claim?
That's a question for your agent rather than us. Rating practices vary by carrier and by state, and the answer differs for a weather event compared with a claim considered preventable.

Denials and Disputes

My claim was denied. Is that final?
Usually not. A denial is the carrier's position, not a verdict, and a great many are reversed. What matters is which argument they're making — whether the loss is covered at all, whether the event caused it, or what it costs to put right. Those need completely different responses.

They say the damage was pre-existing. What now?
That claim is asserted far more often than it's demonstrated. What defeats it is evidence of the property's condition immediately before the loss — photographs taken for other reasons, prior inspection reports, completed repair records from an earlier claim.

What is the appraisal clause?
A provision in most property policies. Where the dispute is purely about the amount — not whether the loss is covered — either side can invoke it. Each appoints an appraiser, the two select an umpire, and that panel determines the value. It's binding, generally faster than litigation, and considerably cheaper. It doesn't resolve coverage disputes.

Should I complain to my state insurance department?
It costs nothing and creates a record. A complaint won't overturn a denial by itself, but it does require the carrier to respond in writing to a regulator, which sometimes produces a more considered position. North Carolina: ncdoi.gov. South Carolina: doi.sc.gov. Georgia: oci.georgia.gov.

Do I need a lawyer instead?
Sometimes, and we'll say so. A public adjuster works the claim — documenting, estimating, negotiating. A lawyer is the right tool when the dispute is about the contract itself, when the carrier's conduct raises bad-faith questions, or when a legal deadline is approaching.

Is it too late? My claim closed months ago.
Possibly not. Closed claims can often be reopened, particularly where damage surfaced later or where the original scope missed something. It's worth a conversation before assuming otherwise.

Types of Claim

What kinds of damage do you handle?
All first-party property damage claims on homes and businesses — fire, smoke, water, storm, wind, hurricane, hail, flood, theft, vandalism, vehicle impact, explosion. Also business interruption and equipment breakdown on the commercial side.

Is flood damage covered by my homeowners policy?
No. Flood — water arriving along the ground — is excluded from every standard homeowners policy and covered only by NFIP or private flood insurance. Water from a burst pipe or entering through a storm-damaged roof is a different thing and generally is covered.

The carrier says my water damage is a flood. Can they do that?
They can take that position, and it ends the claim if it holds. Whether it's right depends on where the water came from and at what elevation the damage occurred. Where a storm caused both, the damage has to be separated rather than attributed wholesale to the excluded peril.

Is mould covered?
Usually to a limited sub-limit, and sometimes not at all. Where mould results directly from a covered water event and the response was reasonable, it's generally treated as part of that loss. Where it followed a delay in drying, carriers argue it falls under the mould limitation. Documented rapid drying protects the rest of your coverage.

What is business interruption coverage?
It replaces income a business loses while it can't trade because of covered damage. Calculating it properly is a discipline of its own, and the period it runs for — until the business can actually operate, not until construction finishes — is the most commonly disputed part.

Do you handle commercial claims?
Yes. Restaurants, retail, offices, warehousing, manufacturing, medical facilities, multi-family housing, hotels and schools.

Working With Us

Where do you work?
North Carolina, South Carolina and Georgia — coast, piedmont and mountains.

How long have you been doing this?
Insurance Claims Consultants has been operating for 35 years. Our founder, Jeffrey A. Raines, has more than 45 years in property claims.

Will you tell me if I don't need you?
Yes. There's no benefit to us in taking a claim we can't improve, and no benefit to you in paying a fee for one.

What if my claim is already with a lawyer?
That's fine and it happens. Public adjusters and attorneys often work the same claim from different angles — we handle the documentation and valuation, they handle the legal position.

(864) 497-2151