Should I use a Public Adjuster? My roofer thinks so.

Question

A roofer is asking me to hire a Public Adjuster (PA) to negotiate a hail claim with my insurance company.  The roofer sent me a 1/2 page contract that would let the PA work on my behalf for $225/hour with no cap.  I'll talk with the PA soon.  Should I:

1) Work with the PA?

2) Look for a PA with a      different fee structure?  In CO it      appears that PAs are not restricted in how they charge fees unless in the      case of a "catastrophic disaster" per Colorado Revised Statutes      § 10-2-41.

3) Have a different roofing      company review my roof?

Background:

A property in Denver, CO was hit with quarter sized hail, a roofing company sees what they consider obvious signs of hail damage, however two different insurance adjusters from my insurance company denied the claim citing that the damage doesn't look new.  I see what may be hail damage, but I'm looking with an untrained eye.  The roofer had a Public Adjuster review the roof in person and he also feels that the roof has hail damage.  Naturally the roofer wants to install a $25K roof, the Public Adjuster wants work and the insurance company wants to mitigate paying out any money.  My insurance agent said that my only next step is to submit a request for a third review of my roof, but it's unlikely that the request will be accepted. A neighbor 3 houses away with the same insurance company and same roofer had a hail claim approved for a full roof replacement.

Thank you!

Matthew Olszak · Answer

In Illinois, SF used to be great, they'd pay out anything. Since 2020 though, they are downright dreadful. I have their adjusters as well as Allstate's on body-cam straight up admitting a roof is damaged, but "they don't know why". Calling hail hits blemishes. That doesn't matter under a DO3 policy - its their responsibility to find an exclusion, not your's to find its an included loss as any loss not excluded is covered. Its gross, but we don't have strong laws here to hold their feet to the fire like they somewhat do in CO. And 9 times out of 10 their "old damage" argument is completely wrong.

So in MOST insurance policies and states, as long as coverage is "opened", IE they say some part of the roof system is damaged, you can invoke appraisal. What that means is you demand appraisal, you name an appraiser (who is basically a non-interested 3rd party adjuster), SF does the same, and the appraisers determine the amount of the loss and either agree upon an umpire who will settle their differences or you'd have to petition the court to do so if they cannot (not that common). They as disinterested parties then determine the amount of the loss. And by disinterested, that happens by you hiring the appraiser for a flat fee vs. a percentage which a PA would receive. HOWEVER, SF usually around here with either ignore the appraisal award and force you to file suit to enforce it at a heavy legal cost, OR they'll gut it and say certain items aren't covered which is garbage.

If the insurer is refusing to properly inspect a loss or adjust it, I usually go the DOI route first. You file a complaint for adjusting in bad-faith, which helps set you up for a lawsuit later when you may be able to recover your legal costs. Noting missed statutory timelines is key. However under your policy you likely have responsibilities as well, such as providing a specific Proof of Loss with certain information, which any PA worth their weight would know to do within the policy timelines.

Javier Ramirez · Answer

How can the insurance adjusters possibly prove that it’s old damage? Who knows if the damage is old but you, Mother Nature, and god? Insurance adjusters are usually full of sh***. They’re trained well and equipped with many delay tactics. Insurance companies profit every single day that they hold on to your money from their investment income. If you have an HO3 policy, you should definitely hire a public adjuster. They will guarantee that you get the most amount of money, and that you end up getting a full roof replacement. However avoid paying fees from your claim money to both parties. Hire the public adjuster first, deposit the funds into your account, then hire the roofer to start the work. Don’t tell the roofer how much the public adjuster got you! Shop around!

Matthew Olszak · Answer

Respectfully, the part about old damage is wrong. That line is frequently touted by carrier adjusters. It depends heavily on location, time of year, and shingle age - even the sworn-upon and carrier-owned HAAG Engineering training [farce] states that. Simply slightly moistening the bruise can make it look new, while a 3 month old bruise can look old if it sits in hot direct sun for a couple months. Its all about the weather data and impact size. But overall that's irrelevant unless underwriting excluded the roof, because they agreed to insure the roof and had ample opportunity to inspect it at yearly renewal for existing damage and age (which rarely happens), and adjust coverage and premium accordingly. They accepted a full premium so they owe for full coverage - otherwise, one would expect a discount or declination if the property had existing damage that wasn't covered. But frankly, in Midwestern states there is almost ALWAYS at least one hail storm per year, so the point becomes moot unless we're talking about a brand new roof.

I definitely agree about the roofer tips, and ensuring they are licensed and insured. Also check if your roofer pays their crews on W2 or 1099 - the 1099 is likely just paying local scab crews to do work and isn't local nor do they care about reputation and warranty.

Cameron Moore · Answer

As an insurance broker, I love this!! I also agree with everything Javier said.

Chris Milosevich · Answer

@Matthew Olszak my insurance company is State Farm.  Can you expand on what the "appraisal/legal route" is?  I like your idea of contacting the CO department of insurance (DOI) and hiring my own public adjuster so the PA and roofer are working for me and not colluding.  Thanks for your insight on the $225 hourly fee, which seemed extremely fishy to me.  It's good to know that what’s common is for a PA to charge ~15% of the money paid by the insurance carrier.

@Javier Ramirez thanks also for your advice.  Hiring my own public adjuster seems key.  Then, if I get a settlement from the insurance carrier, I'll re-engage the roofers.

Matthew Olszak · Answer

@Chris Milosevich What insurance company do you have? There are some of the big carriers that frankly just won't pay out any damage unless you go the appraisal/legal route - the adjuster simply knows they won't have a job anymore if they approve the damages. So that might be a cheaper route, invoke appraisal and name and name your appraiser if the insurance company has opened coverage on ANY part of the roof, even if its just a single turtle vent. Or you can try a complaint to the DOI - that'll usually push your file into a supervisor's inbox.

I always recommend hiring your own adjuster (ie a public adjuster). But this $225/hr is crap - they should be charging a percentage of the funds obtained over what the carrier has already approved, most commonly 15%. And Javier is right, those are your funds, so don't go just agreeing to pay out the whole amount to the roofer.

I'm licensed as a public adjuster in Colorado, but I only take on larger losses and "desk adjuster" type jobs which it doesn't sound like this would fall in to. However if you'd like, feel free to reach out and we can discuss further and I can hopefully give you some better direction on how to approach this.

Should I use a Public Adjuster? My roofer thinks so.

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