Insurance Claim Appraisal

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What Is An Insurance Claim Appraisal?

Insurance Appraisal is a means of a binding alternative dispute resolution. Insurance Claim appraisal is a process by which you can get a disputed property damage insurance claim resolved! It is not simply accessing the damages! It is not the same as an art appraisal or real estate appraisal. It is not like art appraisal where the appraiser arrives at a value on art work for an estate or insurance coverage! It is not like a home appraisal where a real-estate appraiser after viewing comparable home sales arrives at a figure that a bank may loan you money.

Appraisal is not simply estimating the damage or providing an assessment of damages for a value!

Insurance Claim appraisal is a process when you have a property damage disputed insurance claim? Perhaps it might be better to think of insurance appraisal like an arbitration. Yet insurance claim appraisal is much different than arbitration.

What Do I Want To Consider Before Going To Appraisal?

After the insurance company says your property damage insurance claim is a covered loss under the insurance policy; and the insurance company makes a payment. Or the insurance company tells your insurance claim is less than your deductible. When (YOU) the policy holder does not agree with what the insurance company (PAID) valued for the insurance claim (SETTLEMENT) damages is the time to consider going to appraisal!

In Florida when the insurance company sends you a claim payment for your home, condominium, commercial property you can still dispute your insurance company offer of settlement. Receiving a payment from the insurance company does not mean your claim is properly settled and over or closed! As the Florida Insurance Companies wants you to believe? For Florida Hurricane Claims you have three years from the time you submitted your Hurricane claim to dispute your insurance settlement! In Florida you have five years to dispute a regular non hurricane insurance claim. Such as Water / Mold insurance claims, Fire / Smoke insurance claims, Vandalism / Theft insurance claims, Lightning Insurance Claims, Wind / Tornado / Hail Insurance Claims, etc.

How Do I know If I Can Go To Appraisal?

Many insurance policies have an appraisal clause in the language of the insurance policy.

The insurance policy has to be reviewed to determine if you have the policy language to allow you to enter into this type of binding dispute resolution. We will review your insurance policy at no cost to you?

Under Florida Law the Florida insurance companies must notify you have the right to attend mediation thru the Florida Department of Financial Services if you have a dispute over $500 dollars.

Download the consumer guide from the Florida Division of Consumer Services below:

However, the Florida Insurance Companies do not have to tell you also have the right to go to appraisal under your insurance policy!

Who Can Request Insurance An Insurance Claim Appraisal?

An unhappy policy holder is the proper decision maker under the insurance policy to decide if they wish to request appraisal as their binding dispute resolution method! Unless the policy holder signed an Assignment of Benefits to give this authority to a restoration contractor such as a roofer, general contractor, mold restoration contractor, etc.

Policy holders that have hired public insurance claim adjusters may have been presented with the option of seeking appraisal as a settlement method.

Insurance Companies often may request appraisal as a means of resolving an insurance claim dispute too! The Florida insurance companies when they have learned that you are unhappy with their insurance payment often wish to go to appraisal as means of resolving a disputed insurance claim too!

We have found certain insurance carriers like FedNET Insurance Company, First Protective, and Citizens Property Insurance Corp have often requested appraisal for the Hurricane Irma and Hurricane Michael hurricane insurance claims in Florida.

Many Florida court Judges have also pushed many lawsuits in to first going to appraisal. Even though you hired an attorney to represent you to seek a proper settlement?

Reviewing An Example Of An Insurance Appraisal Policy Language

Appraisal:

If you and we fail to agree on the amount of the loss, Either may demand an appraisal of the loss. In this Event, each party will choose a competent and impartial appraiser with 20 days after receiving a written request from the other. 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 court of record in the state where the Described Location is located. The appraisers will separately set the amount of loss. If they fail to agree, they will submit their differences to the umpire. A decision agreed to by any two will set the amount of loss.

Each party will:

  1. Pay its own appraiser; and
  2. Bear the other expenses of the appraisal and umpire equally.

Let me start by stating that not all appraisal language is the same for all insurance policies. The appraisal language changes from insurance policy to insurance policy.

Some insurance policies allow either the policy holder or insurance company to request appraisal.

Some insurance policies state that both the policy holder and the insurance company must both agree to go to appraisal.

Some insurance policies state who can represent you as your appraiser. Some insurance policies state what can be appraised too!

Some states have appraisal laws that the appraisal process must adhere too!

A prudent policy holder would get the above questions answered by an attorney along with their potential appraiser before they decide if appraisal is the proper method to seeking to get their insurance claim resolved? As every insurance claim dispute has their own set of particular facts!

How does the insurance claim appraisal process work?

  1. Each party will choose a competent and impartial appraiser.
  2. The two appraisers will choose an umpire.
  3. If they can not agree upon an umpire within the time frame set by the appraisal language. The policy holder (or policy holder attorney) or insurance company may request the choice be made of a judge of a local court.
  4. If the two appraisers can not agree on the amount of damages? The disputed differences between the two appraisers go to the umpire (neutral).
  5. The appraisal award must be agreed by Any two out of the three people involved in the appraisal. This three people involved in the appraisal is known as the appraisal panel.
  6. Any two signatures will make the appraisal award binding.
    A binding appraisal award means the policy holder must accept the final award as well as the insurance company! There are many moving parts in going to appraisal so there can be no guarantee as to the outcome!
  7. The policy holder pays for the services of their own appraiser.
  8. As part of the appraisal process an umpire must be selected, but not in every appraisal is the umpire utilized! Sometimes that two appraisers can agree upon the damages without the need of using an umpire.
  9. If an umpire is utilized as part of the appraisal process?
    • The policy holder pays for ½ the cost of the umpire (neutral) and the insurance company pays the other ½ of the umpires cost.
    • Umpires fees average from $250.00 per hour to $450.00 per hour.
    • Or on the average $3000 - $5000 total fee
    • Umpire fees depend on the complexity of the appraisal, residential or commercial loss, the size of the dispute, the qualifications of the umpire (claim export, contractor, engineer, retired judge) and the amount of time the umpire spends going to the loss and assist in the negotiation.

In general, an appraisal award in Florida can not be overturned in a court, except for fraud or collusion between that appraisal panel. I am not an attorney and therefore I am not making a legal opinion!

Insurance Appraisal Process

Example of how an appraisal award breaks down

Insured received prior payment of$9,500
Appraisal Award Dwelling damages$25,000
Insured receives new payment$15,500
Court costs to name umpire$0
Umpire Fee$0
Two appraisers settled claim (no umpire)
Pay your own appraiser
TBA