Insurance
Insurance, in plain English.
Most of our jobs are insurance claims, and most of our customers are on their first one. This is what the words mean, what to say on the first call, and where people get tripped up.
01 · First things
Before you call your insurance company.
- 01
Stop the source and make the house safe. That comes before any phone call.
- 02
Photos and video of everything, before anything is cleaned up or thrown out. Wide shots of each room, then close-ups.
- 03
Find your policy number. It's on the declarations page, or in your insurance company's app.
- 04
Don't throw anything away yet, even ruined carpet. Adjusters want to see it, or at least a photo of it.
- 05
Call us before or right after. We can be on site documenting and drying while you're still on hold.
02 · The first call
What to say.
Keep it short and factual. Something like this.
“I have a water loss at my home. It started on [date] from [what broke]. The source is stopped. I have a restoration contractor mitigating. I'd like to open a claim.”
- 01
Say what you know and nothing you don't. If you aren't sure how long it's been leaking, say that. Guessing 'a while' can get a claim denied as long-term seepage.
- 02
Don't call it a flood. To an insurance company, a flood is rising water from outside, and that's a separate policy most people don't carry. A burst pipe or an overflowing tub is a water loss, not a flood.
- 03
Write down the claim number and the adjuster's name and phone number. Everything from here on goes through that number.
- 04
If they push their preferred contractor, you don't have to use them. It's your home, and you decide who does the work.
03 · The words
What the adjuster's words mean.
Nobody explains these on the phone. If you hear one we've missed, ask us.
- Loss
- Their word for the damage. A 'water loss' is a water damage event. The 'date of loss' is the day it happened, and it matters, so get it right.
- Adjuster
- The person who decides what the insurance company pays. A staff adjuster works for the carrier. An independent adjuster is hired by the carrier. A public adjuster is hired by you and takes a cut. Most residential claims never need one.
- Mitigation
- The emergency part: stopping the damage from getting worse. Extraction, drying, demo of what can't be saved, antimicrobial treatment. Policies expect you to mitigate promptly, which is why waiting a week can cost you.
- Rebuild, or reconstruction
- Putting the house back after it's dry. Drywall, paint, flooring, trim, cabinets. Often written up and approved separately from mitigation, and done by a general contractor. We don't do the rebuild ourselves; we handle the mitigation.
- Pre-loss condition
- The physical state, quality and value of your property right before the damage happened. It's the target the whole claim aims at: the carrier owes you a house put back to pre-loss condition, no better and no worse, and it's the yardstick we write every estimate against.
- Xactimate
- The estimating software nearly every insurance carrier and adjuster uses to price a claim. We write our estimates in Xactimate too, so the adjuster sees the same line items and the same pricing they would write themselves. Fewer arguments, and nothing gets left off the scope.
- Category 1, 2 and 3 water
- How dirty the water was. Category 1 is clean supply water. Category 2 is gray water, like a washing machine. Category 3 is sewage or water that's been sitting for days. The category decides what can be dried and what has to be thrown out.
- Scope and estimate
- The scope is the list of what needs doing. The estimate is the price on that list, written line by line in the format adjusters expect. If the adjuster's estimate is shorter than ours, we sit down and compare them.
- Supplement
- A request for more money after the first estimate, because the wall was opened and there was more damage than anyone could see. Normal on water jobs. Not a sign anything went wrong.
- Deductible
- Your share, taken off the top of what they pay. If the whole job costs less than your deductible, there's no point filing, and we'll tell you that.
- ACV and RCV
- Actual cash value is what your ten-year-old carpet was worth the day before the loss. Replacement cost value is what new carpet costs. Many policies pay ACV first and the rest, called recoverable depreciation, after the work is done and receipts are in.
- ALE
- Additional living expenses. If the house isn't livable while the work is being done, most policies pay for a hotel or a rental. Ask about it on the first call.
- Sudden and accidental
- The kind of water damage most policies cover: a pipe bursts, a supply line lets go, a water heater fails. What they usually don't cover is a slow leak nobody dealt with for months. It's why the date of loss matters and why you should call promptly.
- Matching
- When half a floor is ruined, does the carrier pay to replace the whole floor so it matches? It depends on the policy and the state. Arizona doesn't require it, so it's often negotiated, and it's one of the things we push on.
04 · Our side of it
What we do with your claim.
We've been on the contractor side of a lot of claims. This is the part you're paying us for.
- 01
Photograph and document everything from the first visit, including moisture readings on every wall, so there's no argument later about how far the water went.
- 02
Write the estimate in Xactimate, the same software every carrier uses, line by line with the reason for each line. Speaking the adjuster's language is how we make sure every bit of the damage gets counted and paid for.
- 03
Meet the adjuster at the house and walk the job with them. Most disagreements get sorted out standing in the room.
- 04
Bill the insurance company directly, so you're only responsible for your deductible.
- 05
Tell you honestly, before any of this, whether the job is worth a claim at all.
05 · Questions
Insurance questions.
Short answers about claims. If yours isn't here, call and ask.
Yes, before anything else. If the whole job costs less than your deductible there's no point filing, and sometimes the honest answer is to pay out of pocket and keep your rate. We'll say so.
Yes, always. Your insurance company can't make you use their preferred contractor. It's your home, and you decide who does the work.
Yes. We meet the adjuster at the house and walk the job with them, and we write our estimate in Xactimate, the same software every carrier uses, so we're speaking the adjuster's language. On that visit we make sure everyone involved is on the same page before any work moves forward, which prevents problems down the road.
Yes. We bill the insurance company directly, so you're only responsible for your deductible.
We sit down and compare them line by line. If a wall was opened and there was more damage than anyone could see, we send a supplement, which is normal on water jobs and not a sign anything went wrong.
If the house isn't livable while the work is being done, most policies pay for a hotel or a rental. It's called additional living expenses, or ALE. Ask about it on the first call.
Not if it's going through insurance. We just need your claim number, and we bill the insurance company directly. If you're paying for it yourself, yes: we ask for half up front and the rest when the job is done.
No two claims are the same, so it depends. The biggest things that decide it are how big the loss is, how responsive your insurance company is, what type of loss it is, and what materials need to be remediated or replaced.
Ideally, your insurance agent reviews your policy before you call the claims department, so the insurance company isn't handed a reason to deny the claim. If a claim is denied anyway, we don't charge you what we'd charge the insurance company. Going through this is hard enough, so we do what we can to cut costs and keep our work affordable.
One who is faithful in a very little is also faithful in much, and one who is dishonest in a very little is also dishonest in much.
Not sure it's worth a claim?
Call and describe it.
Sometimes the honest answer is to pay out of pocket and keep your rate. We'll say so. About damage assessments