What we verified in “Home insurance claims: adjusters, denials and complaints”

Statements and where we checked them

The statements with rules, figures or dates, with the exact place in the source and the date we checked them.

1. According to the NAIC home insurance guide, your policy is your guide to the losses that may or may not be covered; how often and what kind of claims you file can affect your premium and whether the company renews your policy; if the repair costs not much more than your deductible, you might prefer to pay without filing; and most companies report your claims to private nationwide databases, such as CLUE, that other insurers check.

   Sources 1 · A Consumer's Guide to Home Insurance (NAIC, 2022), p. 11, 'Filing a Claim': 'Read your policy—it’s your guide to the types of losses that may or may not be covered'; 'How often you file a claim and the types of claims you file often affect your premium and whether your insurer will renew your policy'; 'If the cost to repair the damage is not much more than your deductible, you might want to pay for the repairs without filing a claim'; 'Most insurance companies report your homeowners claims to private nationwide claim databases (such as the Comprehensive Loss Underwriting Exchange, better known as CLUE)' · Checked October 31, 2026

2. According to the NAIC, to file a claim contact your agent or company as soon as possible and ask which forms or documents you need; you must protect your home from further damage, for example by boarding it up or cleaning up water; the company assigns an adjuster, who may be an employee or an independent contractor, and you should cooperate with the investigation; and it helps to note the dates of every conversation with your agent or adjuster.

   Sources 1 · A Consumer's Guide to Home Insurance (NAIC, 2022), p. 11: 'To file a claim, contact your insurance agent or company as soon as possible. Ask about forms or documents you’ll need'; 'You’re also required to protect your home from further damage. For example, you might need to board it up or clean up water'; 'The insurance company will assign a claims adjuster'; 'These adjusters may be employees of the company or independent contractors'; 'You should cooperate with the adjuster’s investigation'; 'Jot down notes and keep track of the dates of any conversations' · Checked October 31, 2026

3. According to the NAIC, if you disagree, first try to resolve it with your insurer and do not feel rushed to agree to something you are not comfortable with; it may help to have your contractor meet with you and the adjuster; if you still disagree about the value of the claim, check your policy for an appraisal clause, or you can hire an attorney or a public adjuster; public adjusters are not attorneys or government employees, they charge a fee, and where allowed they must be licensed; your state insurance department has consumer services staff who help you resolve disagreements with your insurer; and the NAIC website lists each state department's website.

   Sources 1 · A Consumer's Guide to Home Insurance (NAIC, 2022), p. 11: 'first try to resolve them with your insurer. Don’t feel rushed or pushed to agree'; 'It might help to have your contractor meet with you and the insurance adjuster'; 'check your policy for an appraisal clause. Another option is to hire an attorney or a public adjuster'; 'Public adjusters aren’t attorneys or government employees – they’re freelance adjusters that charge you a fee. Not all states allow public adjusters, but those that do require them to be licensed'; 'Your state insurance department has consumer services personnel who can help you work with your insurer to resolve disagreements'; p. 12: 'To find the Web site address of your state department, visit the National Association of Insurance Commissioners (NAIC) Web site' · Checked October 31, 2026

4. According to the California Department of Insurance claims guide, after a loss it is very important to make temporary repairs to prevent further damage, such as covering the roof, walls, doors and windows with plastic sheeting or plywood; the policy may not cover ensuing damage if you did not take reasonable steps; the company reimburses reasonable costs to protect the home if you save receipts; beware of contractors who encourage you to spend a lot on temporary repairs; and do not make extensive permanent repairs until the adjuster has seen the damage.

   Sources 2 · Residential Property Claims Guide (Form 405, revised February 28, 2025), 'Protect the Property': 'make temporary repairs to prevent further damage'; 'covering damage in roof, walls, doors, and windows with plastic sheeting or plywood'; 'may not cover ensuing damage to your property if you have not taken reasonable steps'; 'Your insurance company will reimburse you for all reasonable costs to protect your property, as long as you save receipts'; 'Beware of building contractors that encourage you to spend a lot of money on temporary repairs'; 'don’t make extensive permanent repairs until after the claims adjuster has been to your home' · Checked October 31, 2026

5. According to the California guide, when you report the loss ask whether your policy covers the damage, how long the claim will take, whether you need repair estimates and what your deductible is; the company may send a proof of loss form, a formal statement about the loss; the adjuster may first do a brief inspection (scope of loss) and return to complete it; and you should keep a log of calls and copies of all correspondence.

   Sources 2 · Residential Property Claims Guide, 'Call Your Insurance Agent': 'Does my policy cover the property damage to my home? How long will it take to process my claim? Will I need to obtain estimates for repairs to the structure? What is my deductible?'; 'Dealing with Your Insurance Adjuster': 'a claim form, known as a “proof of loss” form'; 'a formal statement made by a policy owner to an insurer regarding a loss'; 'scope the loss'; 'a second visit necessary to complete the inspection'; 'Keep a log of all phone calls and correspondence, and make copies' · Checked October 31, 2026

6. According to the California guide, if your home is not safe to live in, keep receipts for all relocation expenses, such as shelter, clothing and food, because they may be covered under the loss-of-use part of your policy; additional living expenses include food and housing, extra transportation to work or school, relocation and storage and furniture rental; the company usually advances money for those costs, and advances count toward the final settlement; and for belongings, list the damaged items with brands and model numbers and take photos.

   Sources 2 · Residential Property Claims Guide, 'Additional Living Expenses': 'keep receipts for all expenses associated with your relocation, such as emergency shelter, clothing, and food'; 'may be covered under the “loss-of-use” portion of your policy'; 'Any advance payments received will be counted toward your final claim settlement'; 'extra transportation costs to and from work or school, relocation and storage expenses, and furniture rental'; 'Your insurance company usually advances you money'; 'Personal Property': 'Include the brand names and model numbers'; 'take photographs of the damage' · Checked October 31, 2026

7. According to the California guide, if your home has a mortgage, the check to repair the structure is generally made out to you and your lender, who must endorse it; lenders generally put the money in an escrow account and release it as the work is completed; show the lender your contractor's bid and how much the contractor wants up front; the lender may want to inspect the finished work before the final payment; and you generally get separate checks for belongings and additional living expenses.

   Sources 2 · Residential Property Claims Guide, 'How The Payment Process Works': 'you generally receive two separate checks'; 'a separate check covering your additional living expenses'; 'the check for home repairs will generally be made out to you and the mortgage lender'; 'the mortgage company or bank will have to endorse the check'; 'Lenders generally put the money in an escrow account and release the funds to the policyholder as the work is completed'; 'show the mortgage lender your contractor’s bid'; 'may want to inspect the finished job before releasing the funds for final payment' · Checked October 31, 2026

8. According to the California guide, if your policy pays replacement cost for your belongings, you normally have to replace them before the company pays that cost; if you decide not to replace something, you are paid its actual cash value; and the company generally gives you several months from the cash value payment to replace it, so ask how many.

   Sources 2 · Residential Property Claims Guide, 'Personal Belongings': 'If you have a replacement cost policy for your possessions, you normally need to replace the damaged items before your insurance company will pay you the replacement cost'; 'If you decide not to replace some items, you will be paid their actual cash value'; 'will generally allow you several months from the date of the cash value payment to replace the item. Find out how many months you are allowed' · Checked October 31, 2026

9. According to the California guide, in that state the fair claims rules set deadlines for the company to acknowledge, evaluate, decide and pay claims and limit the information it can demand; a denial must be in writing, with the reasons, and tell you the Department of Insurance can review it if you believe it was wrongful; if you disagree, talk to the claims manager and send a letter with copies to the claims executive at headquarters; and the Department can open a claims review or refer you to its mediation program, which is free to you.

   Sources 2 · Residential Property Claims Guide, 'Know Your Rights Under the Unfair Practices Act and the Fair Claims Settlement Practices Regulations': 'The regulations specify time deadlines within which insurers must acknowledge, evaluate, make and communicate decisions on claims, and pay claims'; 'restrict the information that can be demanded from a claimant'; 'a denial of a claim must be in writing, with specified reasons for the denial'; 'the matter may be reviewed by the Department of Insurance'; 'Talk to the Claims Manager'; 'send a letter and copies of documents to the claims executive'; 'Request for Assistance (RFA)'; 'Claims Services Bureau'; 'Mediation Program'; 'this program is free to the consumer (the insurer pays the fees)' · Checked October 31, 2026

10. According to the Texas Department of Insurance, if you disagree with the adjuster's estimate, explain why and send supporting documents such as a contractor's estimate; your policy may include an appraisal process; you can hire a public adjuster; the department helps with complaints about companies, agents and adjusters it regulates, but not about mortgage companies, contractors or roofers, and it cannot make a company pay unless not paying violates the law or the policy, or decide facts such as whether damage came from a storm or wear and tear; when you complain, it contacts the company, which has 15 days to respond and can ask for 10 more; and if you are still unhappy, you may need to sue.

    Sources 3 · How to get help with a homeowners or renters insurance complaint (last updated September 23, 2026): 'If you disagree with the adjuster's estimate, explain why'; 'Send the company any supporting documents such as a contractor’s estimate'; 'Your policy may include an appraisal process'; 'Some people hire public insurance adjusters'; 'We can help with complaints about insurance companies, agents, and adjusters we regulate. We can't help with complaints about service providers, including mortgage companies, building contractors, and roofers'; 'Make a company pay a claim unless the failure to pay violates a law or the terms of your policy'; 'we can’t determine whether damage was caused by a storm or normal wear and tear'; 'Companies have 15 days to respond to us and can ask for a 10-day extension'; 'you may need to sue your insurance company' · Checked October 31, 2026

11. According to the Texas Department of Insurance, a public adjuster is someone you can hire to negotiate your claim with the company, and in Texas must be licensed; they can charge up to 10% of the total the company pays, not just the disputed amount; you can ask for the fee in dollars in the contract; even if the company does not raise its offer, you might still have to pay them, and you still pay your deductible; in Texas they cannot act as your contractor, knock on your door seeking business during a natural disaster or after 9 p.m., give legal advice or keep you from talking with your company; and you can call the department to check their license and complaints.

    Sources 4 · Public insurance adjusters (TDI): 'You can hire a public insurance adjuster to negotiate with your insurance company to settle your claim'; 'licensed by TDI'; 'can charge up to 10% of the total amount the company will pay for your claim'; 'not just the amount you’re disputing'; 'put their fee in a dollar amount'; 'you might still have to pay the public adjuster. And you still have to pay your deductible'; 'can’t act as your contractor'; 'Knock on your door asking for business during a natural disaster or after 9 p.m.'; 'Practice law or provide legal advice'; 'Keep you from talking with your insurance company'; 'If the public insurance adjuster is licensed by TDI' · Checked October 31, 2026

12. According to the LSC, it is an independent nonprofit established by Congress to fund civil legal aid for low-income people in every state, the District of Columbia and the territories; on its website you enter an address or city to find the nearest organization, and LawHelp.org has free legal information and forms.

    Sources 5 · I Need Legal Help: 'LSC is an independent nonprofit established by Congress in 1974 to provide financial support for civil legal aid to low-income Americans'; 'in every state, the District of Columbia, and U.S. Territories'; 'enter an address or city below to find an LSC-funded legal aid organization near you'; 'You can also visit LawHelp.org' · Checked October 31, 2026