Insurance Adjuster Basics

Adjusters are not there to “help you through the claim.” Their job is to apply the policy as cheaply and cleanly as possible. They aren’t your enemy, but they’re not your advocate either. Understanding how they think and what they look for keeps you from getting minimized or dismissed during a damage inspection.

If you’re not familiar with what your policy actually covers, review coverage explained first. An adjuster’s decisions come straight from that document.

1. What an Adjuster Actually Does

Adjusters evaluate damage, compare it to the policy, and determine how much the insurer owes. They look for:

• Cause of loss (sudden vs. maintenance)
• Severity and scope of damage
• Signs of neglect or pre-existing issues
• Whether the loss is excluded by policy language

They document everything. Anything that looks like long-term wear becomes leverage to reduce or deny the claim.

2. They Judge Damage Through the Policy, Not Emotion

Adjusters don’t make judgment calls on fairness. They follow the contract. If the policy excludes a type of loss, the adjuster can’t override it.

That’s why it’s crucial to understand limitations like policy exclusions before a claim ever happens.

3. What Adjusters Look for During an Inspection

Inspections are methodical. Expect close attention to:

• Roof shingles, flashing, soft spots, and hail patterns
• Water source, path, and signs of prior leaks
• Electrical panel age and wiring type
• Plumbing age and pipe condition
• Evidence of mold or past moisture
• Foundation cracks or settling

Anything suggesting long-term deterioration becomes a reason to limit payment.

4. Why Documentation Matters More Than Opinions

Adjusters lean heavily on written proof—receipts, photos, videos, and contractor estimates. Homeowners who rely on verbal explanations lose almost every dispute.

• Take photos the moment damage occurs
• Record the source of water intrusion
• Save receipts for temporary repairs
• Keep a running log of conversations

If you haven’t built a good record before the inspection, read how to document your home and fix that gap now.

5. How Adjusters Calculate Your Payout

Adjusters typically use estimating software that calculates repair or replacement cost line-by-line. Then they subtract:

• Your deductible
• Depreciation (if ACV applies)
• Excluded portions of the damage

If your belongings are being valued under ACV instead of RCV, expect significantly lower numbers. Check ACV vs RCV if you’re unsure what your policy uses.

6. What You Should Do Before the Adjuster Arrives

• Clean up clutter so damage is easy to see
• Don’t repair anything structural yet—just stop further damage
• Have documentation printed or ready
• Walk the adjuster directly to the damage (don’t assume they’ll find it)
• Point out hidden or secondary issues

Adjusters are busy. If you don’t show them the full picture, they won’t go digging for it.

7. How to Push Back Without Being Confrontational

You can challenge an adjuster’s conclusions respectfully and effectively:

• Ask them to include line items they missed
• Provide contractor estimates for comparison
• Request written explanations for partial denials
• Escalate to a supervisor if something seems incorrect

Professional persistence works better than arguing.

8. When to Bring in a Contractor or Public Adjuster

For large or complex losses, you may need a second opinion.

• Contractors help identify damage adjusters may miss
• Public adjusters negotiate on your behalf for a percentage fee
• Use them if the insurer drastically underestimates damage

9. Know the Adjuster’s Limits

Adjusters don’t write policy. They interpret it. If the loss is excluded, they can’t overturn it, no matter how sympathetic they seem.

Strengthen your policy now so future claims don’t hinge on luck—start with essential endorsements.