Public Adjusters And The Appraisal Clause: A Closer Look

When it comes to filing insurance claims for property damage, many policyholders find themselves overwhelmed by the complex and often confusing process. This is where public adjusters come in.  

Navigating the nuances of insurance claims requires expertise and guidance from seasoned professionals. Avner Gat, Inc. prides itself on a team of highly skilled public adjusters in Newport Coast, CA, who excel in securing fair settlements. Their top team of public adjusters in Coto de Caza, CA, possesses a distinct edge in claim negotiations, while their exceptionally skilled public adjusters in Villa Park, CA, are adept at maximizing returns for clients. Additionally, Avner Gat, Inc. features proficient public adjusters in Laguna Niguel, CA, ensuring comprehensive coverage and meticulous attention to claim details.

And In this blog post, we will take a closer look at public adjusters and the appraisal clause, exploring what they are, how they can help policyholders, and the challenges and controversies surrounding their role. 

What are Public Adjusters?

Public adjusters are licensed professionals who work on behalf of policyholders to help them navigate the insurance claim process. Unlike insurance company adjusters who are employed by the insurance company, public adjusters are independent and work exclusively for the policyholder. Their primary role is to ensure that the policyholder receives a fair and accurate settlement for their loss.

Public adjusters are knowledgeable about insurance policies and have expertise in evaluating and documenting property damage. They handle all aspects of the insurance claim process, including assessing damages, preparing and presenting documentation to the insurance company, negotiating with the insurance company on behalf of the policyholder, and obtaining a fair settlement.

The Appraisal Clause Explained

The appraisal clause is a provision that is included in most insurance policies. It provides a mechanism for resolving disputes between policyholders and insurance companies regarding the value of a property loss that is covered under the policy. The appraisal clause is an alternative to litigation and allows for a more efficient and cost-effective resolution.

When a policyholder and their insurance company disagree on the value of a claim, either party can invoke the appraisal clause. This triggers a process in which each side selects an appraiser who evaluates the loss independently. If the appraisers cannot agree on the value, they submit their findings to an impartial third-party appraiser, known as an umpire. The decision of the umpire is binding and determines the amount of the settlement.

Benefits of Hiring a Public Adjuster

There are several benefits to hiring a public adjuster to assist with your insurance claim:

  • Expertise: Public adjusters have extensive knowledge of insurance policies and the claim process. They can help policyholders navigate the complexities of the process and ensure that they are aware of their rights and entitlements.
  • Documentation: Public adjusters are skilled in assessing and documenting property damage. They can provide a comprehensive and accurate assessment of the loss, which is essential for obtaining a fair settlement.
  • Negotiation: Public adjusters have experience in negotiating with insurance companies. They can advocate on behalf of the policyholder and work to secure a favorable settlement.
  • Time and Stress: Handling an insurance claim can be time-consuming and stressful. By hiring a public adjuster, policyholders can offload the burden of the claim process and focus on rebuilding and recovering from their loss.

Steps Involved in the Appraisal Process

Initial Evaluation of Damages

The appraisal process begins with an initial evaluation of damages. This involves assessing the extent of the property damage and determining what repairs or replacements are needed. A public adjuster will inspect the property and document the damages to prepare a comprehensive claim.

Selection of Appraisers

Once the appraisal process is initiated, both the policyholder and the insurance company select an appraiser to represent their interests. These appraisers are responsible for independently evaluating and assessing the property damage.

Inspection and Documentation

The appraisers will conduct inspections of the property to assess the damages. They will document their findings, take photographs, and gather any other relevant evidence to support their assessment. This documentation is crucial in determining the value of the loss.

Determining the Value of Loss

After the inspections and documentation, the appraisers will review their findings and determine the value of the loss. If the appraisers agree on the value, the process ends, and a settlement is reached. However, if they cannot agree, the appraisal moves to the next step.

Finalizing the Appraisal Award

If the appraisers cannot agree on the value of the loss, they submit their findings to an umpire. The umpire independently reviews the evidence presented by both appraisers and makes a final decision on the value of the loss. This decision is binding and determines the settlement amount.

Challenges and Controversies Surrounding Public Adjusters

Lack of Regulation and Oversight

One of the challenges surrounding public adjusters is the lack of consistent regulation and oversight. While some states have specific licensing requirements and regulations for public adjusters, others do not. This lack of uniformity can create a disparity in the quality and professionalism of public adjusters across different regions.

Conflict of Interest Concerns

Another controversy surrounding public adjusters is the potential for conflicts of interest. Public adjusters are paid a percentage of the final settlement amount, which can create an incentive for them to maximize the value of the claim. This can lead to accusations of inflated or exaggerated damages, which may result in higher insurance premiums for policyholders.

Questionable Practices and Ethical Issues

There have been instances of unethical practices among public adjusters, including providing false or misleading information, pressuring policyholders to file inflated claims, or entering into undisclosed referral agreements with contractors. These practices undermine the credibility of the profession and can harm policyholders.

Disputes with Insurance Companies

Public adjusters often find themselves in disputes with insurance companies over the value of a claim. Insurance companies may dispute the appraisers’ findings or question the validity of the damages. These disputes can prolong the claims process and create additional stress for policyholders.

Controversies Surrounding Fee Structures

The fee structure of public adjusters has also been a subject of controversy. Public adjusters typically charge a percentage of the final settlement amount as their fee. Some critics argue that this fee structure can incentivize public adjusters to prolong the claims process in order to increase their fees.

Common Misconceptions about Public Adjusters

There are several misconceptions about public adjusters that are important to address:

  • Public adjusters are unnecessary: While policyholders have the right to file and negotiate their claims directly with the insurance company, public adjusters can provide valuable expertise and advocacy, especially for complex or high-value claims.
  • Public adjusters always inflate claims: While there have been instances of inflated claims, it is not representative of all public adjusters. Most public adjusters are dedicated to providing an accurate and fair assessment of the damages.
  • Public adjusters are prohibitively expensive: Public adjusters work on a contingency fee basis, meaning they only get paid if they successfully obtain a settlement for the policyholder. Their fees are typically a percentage of the settlement, which can vary based on the complexity and value of the claim.

Should You Hire a Public Adjuster for Your Claim?

Deciding whether to hire a public adjuster for your insurance claim is a personal choice. Consider the following factors:

  • The complexity and value of your claim
  • Your familiarity with the insurance claim process
  • Your comfort level with negotiating with insurance companies
  • The time and effort you are willing to invest in the claims process

If you feel overwhelmed or unsure about any aspect of the claims process, hiring a public adjuster may be beneficial.


Public adjusters play a crucial role in helping policyholders navigate the complex world of insurance claims. By providing expertise, advocacy, and guidance, they can ensure that policyholders receive a fair and accurate settlement for their losses. While challenges and controversies exist, the value that public adjusters bring to the insurance claims process cannot be overlooked. If you find yourself in need of assistance with an insurance claim, consider consulting a public adjuster to help you navigate the process.

News Reporter