Surprised Policyholder Receives Insurance Check for Lesser Amount

ACV vs. RCV Explained: Why Your Insurance Check Is Usually Less Than Your Loss

January 8, 2026 No Comments

Many policyholders are surprised when their first insurance payment falls far short of repair costs. This often stems from the difference between Actual Cash Value (ACV), which deducts depreciation, and Replacement Cost Value (RCV), which reflects the cost to replace damaged property. Insurers commonly issue ACV first and withhold depreciation until repairs are completed, placing a financial burden on property owners. When depreciation is overstated, damage is under-scoped, or deadlines are missed, policyholders may never recover the full replacement cost they expected. Understanding how ACV and RCV work early in a claim can help prevent delays, disputes, and unrecovered losses.

What Does a Public Insurance Adjuster Do — and When Should You Hire One?

January 6, 2026 No Comments

After property damage, many policyholders assume someone will help manage their insurance claim at no cost. In reality, professional claim advocacy is skilled, regulated work that cannot be “free” without hidden risks. Public insurance adjusters are licensed professionals who represent policyholders—not insurance companies—by documenting damage, interpreting coverage, and negotiating fair settlements. Hiring a public adjuster can be valuable in complex or disputed claims, but it requires a good-faith commitment to the contractual relationship. Seeking professional help without intending to honor those terms can disrupt the claim, create legal exposure, and ultimately harm the recovery process.

Suit Limitation Clauses in Insurance Policies: The Deadline That Quietly Ends Claims

January 2, 2026 No Comments

Suit limitation clauses in insurance policies impose strict contractual deadlines for filing lawsuits that are often much shorter than state statutes of limitations. Many policyholders and contractors mistakenly believe that ongoing claim negotiations, appraisal, partial payments, or the absence of a formal denial will pause or extend these deadlines. In reality, courts frequently enforce suit limitation provisions as written, and missing the deadline can permanently bar recovery—even when damage and underpayment are undisputed. Understanding and tracking these time limits from the date of loss is critical to preserving a policyholder’s ability to challenge claim decisions and protect their rights.

Married couple reading letter from insurance company requesting Proof of Loss form

Proof of Loss Form Submissions: One Letter That Can Decide the Fate of an Insurance Claim

December 30, 2025 No Comments

A Proof of Loss submission is a critical contractual requirement that can significantly impact the outcome of an insurance claim. When a policyholder fails to submit the form—whether sworn or unsworn—within the timeframes required by the policy or state administrative rules, insurers may deny, reduce, or limit coverage regardless of the legitimacy of the underlying damage. Many policyholders mistakenly rely on contractors or assume that estimates and invoices satisfy the requirement, but courts often enforce Proof of Loss deadlines strictly once the insurer has provided written notice. Missing or improperly executing this submission can eliminate negotiating leverage, impair appraisal or litigation rights, and, in some cases, permanently bar recovery. #Proof of Loss #POL #SPOL #Deadline

Insurance Claim Deadlines That Are Frequently Missed — and Why They Matter

December 30, 2025 No Comments

Insurance policies impose strict deadlines that can significantly affect a property owner’s ability to recover full claim benefits after a loss. Commonly missed requirements include timely notice of loss, sworn proof of loss submissions, deadlines to complete repairs in order to recover depreciation, and suit limitation clauses that restrict how long a policyholder has to pursue legal action. These deadlines often continue running even while a claim is being adjusted or negotiated, and missing them can reduce or permanently bar recovery. Understanding and tracking these contractual time limits is critical to protecting coverage rights and avoiding preventable claim denials. #POL #SPOL #Suit Limitation #Proof of Loss

Walking the Line: Staying Neutral When Ego Enters the Room

October 30, 2025 No Comments

When two parties clash over ego or personality differences, resolving the issue often becomes less about facts and more about feelings. Professionals caught in the middle must balance empathy with objectivity — listening to both sides without being drawn into personal loyalties or emotional narratives.

Maintaining neutrality requires a focus on documentation, process, and shared objectives rather than assigning fault. Clear communication, factual summaries, and forward-looking language help redirect energy toward productive solutions. Setting healthy boundaries and avoiding private alliances preserve credibility and prevent further escalation.

Ultimately, successful conflict resolution relies on professionalism, transparency, and emotional discipline — guiding all sides toward mutual respect and a common outcome, even when egos are at their loudest.

Contractors in Ohio: The Wisconsin Warning You Can’t Ignore

October 28, 2025 No Comments

Wisconsin’s recent enforcement action against a contractor for violating Wis. Stat. § 629.10(3) highlights growing regulatory scrutiny over contractors who engage in the Unauthorized Practice of Public Adjusting (UPPA). The contractor was fined for combining repair services with “claim assistance,” a violation of consumer protection laws.

For contractors in Ohio, this serves as a critical warning. The same activities—negotiating insurance settlements, interpreting policy coverage, or marketing claim management services—can expose businesses to significant penalties under Ohio law. The issue is further complicated by the Cinnamon Ridge v. State Farm decision, which adopted the “line of sight” rule for determining material replacement boundaries. That ruling expands repair obligations but also increases the temptation for contractors to discuss claim scope or coverage—conversations reserved for licensed public adjusters.

To remain compliant, contractors should focus strictly on construction and restoration activities, ensure their contracts exclude claim negotiation, train staff to recognize legal boundaries, and refer insurance-related matters to licensed public adjusters. Collaboration and education within the industry are essential to prevent future enforcement actions and to protect both consumers and legitimate contractors from costly missteps.

Balancing fair practices when handling insurance claims

When “Too Late” Isn’t Fair: Allstate’s Holdback Refusals and Ohio’s 60-Day Notice Rule

October 22, 2025 No Comments

Allstate and other insurers are increasingly denying replacement cost benefits by citing a 180-day deadline found in their “How We Pay for a Loss” and “Building Structure Reimbursement” provisions. Policyholders who complete repairs and request payment afterward are sometimes told their claim is “untimely” — even when no prior warning was given. Under Ohio Administrative Code 3901-1-54(G)(5), insurers must provide written notice at least 60 days before any contractual limitation expires if the claimant is not represented by counsel. Failure to do so can invalidate the carrier’s reliance on the 180-day rule. This article explains the legal duty to notify, outlines defenses against untimely denial, and offers best practices for public adjusters and policyholders to protect recovery rights when carriers fail to communicate looming deadlines.

When One Storm Becomes Three Claims: Understanding Causation and Policyholder Remedies

October 20, 2025 No Comments

When a single event, such as a lightning strike, causes multiple types of damage, some adjusters may insist the policyholder file separate claims for each resulting loss. In most cases, however, these damages should be treated as one claim arising from a single occurrence. This article explains how improper “claim splitting” can cost policyholders multiple deductibles, delay payment, and distort their claim history. It also outlines steps Ohio policyholders can take to challenge such determinations, including filing a complaint with the Ohio Department of Insurance under Administrative Code 3901-1-54, engaging a licensed public adjuster, and preserving their rights under bad faith protections.

Category: Adjusting

The Insurance Claim Learning Hub

ACV vs. RCV Explained: Why Your Insurance Check Is Usually Less Than Your Loss

What Does a Public Insurance Adjuster Do — and When Should You Hire One?

Suit Limitation Clauses in Insurance Policies: The Deadline That Quietly Ends Claims

Proof of Loss Form Submissions: One Letter That Can Decide the Fate of an Insurance Claim

Insurance Claim Deadlines That Are Frequently Missed — and Why They Matter

Walking the Line: Staying Neutral When Ego Enters the Room

Contractors in Ohio: The Wisconsin Warning You Can’t Ignore

When “Too Late” Isn’t Fair: Allstate’s Holdback Refusals and Ohio’s 60-Day Notice Rule

When One Storm Becomes Three Claims: Understanding Causation and Policyholder Remedies

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