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

When a Claim Fails Before It Begins: What Leonard v. State Farm Teaches About the Value of a Public Adjuster

November 21, 2025 No Comments

The outcome of Leonard v. State Farm illustrates how insurance claims can fail when they are not properly documented, framed, or supported. The homeowner’s attorney attempted to argue for full roof replacement based on building code requirements, but the argument was misapplied and unsupported by the factual record. Critical evidence—such as detailed repairability analysis, code-based justification, and even the insurance policy itself—was missing from the case. As a result, the court found no basis to compel appraisal, no factual dispute over the scope of damage, and no grounds for breach of contract or bad faith.

The case highlights the important role a public adjuster can play in developing a strong claim foundation. A public adjuster would have documented repair feasibility, created a code-compliant narrative, established causation, and ensured the policy and supporting materials were properly presented. With the correct framing and a well-developed record, the homeowner’s position could have been significantly stronger.

Proposed Pennsylvania Legislation Threatens Homeowner Recovery Rights

October 24, 2025 No Comments

Pennsylvania’s proposed House Bill 1972 and its companion Senate Bill could drastically limit the ability of public adjusters to help homeowners and small business owners recover after property losses.

The bills would cap public adjusting fees at 15% on all claims and just 10% on catastrophe claims, impose a 15-business-day right of rescission, and ban adjusters from owning or receiving payment from construction or restoration companies. They also double bonding requirements and forbid any financial relationships or referrals between contractors and adjusters.

Supporters state the bills protect consumers, but in practice they would force many small adjusting firms out of business, leaving some policyholders without independent representation during the claims process. Without public adjusters, many insureds would face underpayment or delays, with little recourse other than costly litigation.

The legislation could represent a significant shift of power toward insurance companies, undermining consumer rights and professional advocacy in claim recovery. Public adjusters, homeowners, and small business owners are encouraged to contact their legislators and oppose these bills to preserve access to fair claim representation in Pennsylvania.

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.

Does Spatter Matter? The Debate Over Hail Verification and Aluminum Siding

October 7, 2025 No Comments

When hail hits, everyone starts looking for proof — and “hail spatter” often becomes the focus of debate. Does the presence or absence of spatter really determine whether damage is recent or covered? This article explores both sides of the argument, from the contractor’s field perspective to the attorney’s view of the carrier’s duty to investigate. Ultimately, while spatter can help tell the story of a storm, it’s only one clue in a much larger picture.

Category: Claims

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

When a Claim Fails Before It Begins: What Leonard v. State Farm Teaches About the Value of a Public Adjuster

Proposed Pennsylvania Legislation Threatens Homeowner Recovery Rights

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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