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How to Advocate for Yourself During Insurance Restoration

Nobody plans on experiencing a home disaster. Yet 3.5 million homeowners file an insurance claim every year. If you’re one of them, navigating the intricacies of restoration can feel overwhelming. The process not only requires understanding the fine print of your insurance policy but also requires you to advocate for your interests and ensure your home is restored to its original condition. Yet, with the right approach and information, you can navigate this journey more confidently and effectively.

At Lamont Bros., we understand the stress and uncertainty of filing insurance claims for home restoration. We have spent years guiding homeowners in the Portland Metro Area through this process. Our team of experts not only understands how to perform high-quality restoration and repairs but also recognizes the value of empowering homeowners to ensure their needs are met. With the right support and knowledge, you can effectively advocate for yourself and achieve a successful restoration outcome.

This article will equip you with practical advice and insights to help you better advocate for yourself throughout the insurance restoration process. We’ll discuss your roles and responsibilities as a homeowner in the restoration process. With this information, you’ll be able to make informed decisions for your home and ensure that the scope and quality of the restoration meet your needs. The specific topics we will discuss include:

Your Role in the Insurance Restoration Process

When facing the aftermath of a home disaster, you need to understand the role you play in the restoration process. As the person most directly affected by the outcome, repairing your home is about more than submitting a claim. Understanding your role in the insurance restoration process allows you to actively advocate for your needs and ensure the process aligns with your expectations for restoration.

People talking in a circle outside a construction zone
As the homeowner, it’s your responsibility to coordinate communication between your contractor and insurance company.

Advocacy and Communication

As the homeowner, your primary responsibility in the restoration process is to ensure your home is restored to pre-loss condition. This means directly communicating with both your insurance company and your contractor to communicate your needs and get them addressed.

It’s important to remember that while contractors can provide estimates and advice regarding construction, they do not have a contractual relationship with your insurance company. As a result, you are the one who is ultimately responsible for fostering communication throughout the project. This means making sure your adjustor is communicating with you and your contractor. It also means you may need to push for the consideration of reasonable construction estimates.

Understanding Your Policy

A thorough understanding of your insurance policy is also essential when advocating for your needs during the restoration process.

Being familiar with what your policy covers, including the specific limits and any exclusions, prepares you for what to expect from the insurance coverage. This knowledge is your best tool when it comes to challenging any discrepancies or denials.

Insurance companies tend to underestimate construction costs and settle claims by paying out as little money as possible. Understanding your policy enables you to present your case with confidence.

It’s important to understand the coverage and limitations of your insurance policy.

Effective Communication & Documentation

Navigating the insurance restoration process requires intentionality and attention to detail, especially when it comes to communication and documentation.

Keep in mind that the contractor will be the ones to document the specific construction needs of the restoration project. As a result, you should make sure to hire a contractor who has a proven process for documenting their work and communicating clearly with their clients.

Here’s how you can ensure that your needs are met and that the scope and quality of the restoration align with your expectations.

Open Lines of Communication

From the moment you initiate your claim, establish clear and open communication with your insurance adjuster. Promptly report the damage and be prepared to provide detailed information about the extent and nature of the damage.

Regular follow-ups are essential to keep your claim moving forward. Remember, insurance adjusters handle multiple claims simultaneously. One of the best ways to advocate for yourself during the restoration process and avoid unnecessary delays is to keep your claim on the insurance company’s radar by frequent communication.

According to Oregon state law, insurance companies legally have 30 days to reply to all communications from you. To ensure your project remains efficient and prevent the insurance company from being able to intentionally drag out the project, include as much important information as possible per communication.

Most adjusters are friendly and do what they can to help within the guidelines of their job. However, their primary responsibility is to limit the cost of the claim for the insurance company. So even if you get a great adjuster who is willing to do everything they can, they still have their hands tied by the guidelines that are dictated to them. It’s always helpful to maintain a friendly demeanor while understanding what their jobs actually are.

Thorough Documentation

To make sure your insurance company covers the full scope of damages, it’s important to document everything related to your claim. Keeping a thorough record of losses, progress, and communications is another effective way to advocate for yourself through the insurance restoration process. This includes:

Photos and Videos:

Before any cleanup or repairs begin, take extensive photos and videos of the damage from multiple angles. This visual evidence is crucial for supporting your claim.

As the homeowner, you’ll want to keep record of damages and repairs.

Inventory of Damaged Property:

Your construction company should document the condition of the structure and what it takes to repair it.

You’ll want to take a detailed inventory of damaged belongings including their age, purchase price, and estimated replacement costs. This inventory will be invaluable in ensuring you’re adequately compensated for all of the losses.

Record of Communications:

Keep a log of all communications with your insurance company, including dates, names of the individuals you spoke with, and a summary of the conversations. This record can be crucial in case of disputes or misunderstandings.

Expenses and Invoices:

In addition to documenting the physical damage and your communications, tracking all expenses related to the claim is critical. This includes immediate remediation costs, living expenses incurred if you have to relocate, and the invoices from your contractor as the restoration progresses.

Professional Assessments

Keep in mind that your insurance adjuster has a vested interest in keeping repair payouts as low as possible. In some cases, you may need to hire independent professionals, such as a public adjuster or a contractor with experience in insurance restoration, to advocate on your behalf and provide a realistic assessment of the damage.

These professionals can help ensure your claim accurately reflects the scope of work required to restore your property. Their expertise can also be instrumental in identifying damages that your insurance estimate may overlook.

Restoration Costs & Financial Considerations

Navigating the financial aspects of a home restoration project involves understanding both the costs associated with the restoration and whether those costs will be covered by insurance, personal funds, or financing options. Here’s a breakdown of what homeowners need to consider:

Understanding Restoration Costs

Work with your contractor to obtain a detailed estimate of the restoration work needed. This estimate should include all costs related to materials, labor, and any additional services required to bring your home back to its pre-loss condition.

Insurance Coverage and Gaps

In some cases, your restoration may require repairs or services not covered by your policy. When this happens, it becomes the homeowner’s responsibility to pay for these expenses. Here are some of the most common reasons a homeowner may have to pay out of pocket:

Policy Limits:

Be aware of your insurance policy’s limits and how they align with the estimated restoration costs.  In cases where the restoration costs exceed your policy limits, you’ll need to identify how to cover the difference.

For example, if your policy covers up to $1,000,000 in damages, but the final restoration cost is $1,300,000, you would be responsible for the additional $300,000 in repair costs.

Coverage Exclusions:

Identify any exclusions in your policy that might affect coverage for certain aspects of the restoration. Understanding these exclusions upfront can help you plan for any out-of-pocket expenses.

Some policies will exclude code upgrades, which can be a challenge for restoration work in older homes. It’s also common for insurance policies to limit repair work on secondary structures, meaning ADUs and outbuildings aren’t covered, either.

Woodlawn ADU
Some insurance companies may place lower coverage limits on secondary structures, such as Accessory Dwelling Units.

Actual Cash Value vs. Replacement Cost Value:

Insurance policies can differ significantly in how they compensate for lost or damaged property. Actual Cash Value (ACV) policies pay out the estimated value of the lost property, factored for depreciation.

In contrast, Replacement Cost Value (RCV) policies cover the cost of replacing damaged items with new ones, regardless of the original item’s age or condition.

Understanding whether your policy provides ACV or RCV can dramatically affect your financial planning for the restoration. Homeowners with ACV coverage may need to prepare for higher out-of-pocket expenses to fully restore their property to its original state.

Managing Payments and Reimbursements

For restoration following an insurance claim, it is sometimes difficult to manage payments and approvals from the insurance company. Occasionally if the insurance company is slow to issue approvals you’re put between a rock and a hard place of waiting for full approvals from the insurance company or of getting your home fixed in a reasonable amount of time.

Immediate Action, Insurance Approval and Getting the Job Done

Sometimes, the insurance company gives full approval to all funds prior to any major restoration work starting but this isn’t always the case. Other times the insurance company doesn’t give full approval, but requests work to get started and you to submit invoices as you go along. Either way, they will typically cut you a check immediately so you can get started with planning work required to compete the repairs.

Rarely we’ve had situations where the insurance company both refuses to authorize the work to be started and refuses to approve the estimate for the work that is required to repair the home. In these rare occasions it may be necessary for you to get legal advice in order to advance your claim to repair your home.

It’s important to remember as work progresses what each party’s responsibilities are.

  • Your contractor is responsible for completing the agreed-upon work.
  • You are responsible for paying for the work.
  • The insurance company is responsible for giving you money to pay for the work.

If any of those things fail to happen, someone has failed to meet their agreement and you may need to escalate the situation by discussing your claim with an attorney. Some construction companies may not be clear with you about your responsibility or may minimize it, so it is important to understand the hierarchy of relationship and work with a construction company that is open an honest about it.

Feel free to reach out to us through our contact us page for a recommendation of the best attorneys in the Portland Metro that help solve insurance issues for you.

If you want restoration work to begin right away, you may need to front some of the cash and wait for your insurance to reimburse you.

The Reimbursement Process

If you choose or need to move through a renovation process before a full approval from the insurance company for all costs, you should submit all related invoices and receipts to your insurance company for reimbursement. Most of the time, your contractor will do this directly as a courtesy so that you don’t have to.

Important Timeline Info

Timeline Limits for the Insurance Company:

It’s important to note that insurance companies have specific timelines within which they must respond to claims and reimbursement requests. They must accept the claim within a certain amount of time and respond to communications within a certain amount of time. Some insurance companies respond quickly, while others may intentionally drag out the process as long as possible. By doing so, they can pressure you to settle the claim for less than the full cost of repairs.

Timeline Limits and Expectations for You:

You also often have specific timelines by which you need to do certain activities that may be dictated to you in your policy. Often there are limits of when after a loss happens you can file a claim and how long until you get the work completed or you may be in breach of your policy.

Understanding these timelines can help you manage your expectations, plan your restoration and get to a successful resolution.

Positive Outcomes & Success Stories

Navigating the insurance claim process with diligence and the right strategies can lead to highly favorable outcomes. By learning how to effectively and intentionally advocate for yourself through the insurance claims process, you’re more likely to end up with a restoration that looks and feels like nothing ever even happened.

The Power of Expert Advocacy

While you are ultimately responsible for advocating for your needs, having a knowledgeable contractor or public adjuster on your side can make a substantial difference.

These professionals can effectively communicate the extent of damages and the necessary repairs or replacements in a way that justifies the associated cost, ensuring that the claim reflects the true scope of work required.

The authority of professional expertise can lead to insurance companies approving more comprehensive restoration efforts, often including upgrades that significantly improve the home’s value and functionality.

Professional design services can help you pinpoint a more accurate cost estimate for the full restoration project.

The Benefit of Honesty and Diligence

Approaching your insurance claim with honesty and diligence often leads to reciprocal fairness from insurance companies.

It’s important to document all damages and work within the guidelines of your policy. By doing so, you signal to your insurance provider that you are seeking a just resolution, not exploiting the situation. If you plan any enhancements or upgrades to your home during the restoration, make sure to keep the associated costs separate from the insurance claim and communicate that these additional charges are at your own expense.

This goodwill can result in insurance adjusters working more collaboratively with you and your contractor to ensure your home is restored to a state that meets your expectations.

Instances of Insurance Companies Going Above and Beyond

In our years of restoring homes, we’ve seen firsthand how insurance companies can exceed expectations, providing homeowners with outcomes that generously ensure the home’s restoration to pre-loss condition.

In one case, our team worked on a home that was struck by a falling tree during a wind storm. Although the damage was clear in the areas of the home that were crushed by the tree, there were also other far-reaching effects. Primarily, the jarring force of the tree striking the home had offset many of the windows throughout the home, making them difficult to open.

The homeowner took the initiative to advocate for themself to their insurance company during the restoration. They requested that the insurance company do something to fix this widespread issue of misaligned windows. While there was no way to prove that the windows were any different before the incident or that the tree was what caused the windows to lose functionality, the insurance company agreed to replace all of the windows in the home as part of the restoration.

In the end, the insurance company went beyond what was legally required of them to provide the homeowner with a positive restoration experience and a fully restored home.

Have More Questions About Home Restoration?

After reading this article, do you feel equipped to advocate your needs for your insurance restoration project? As you continue to formulate a plan to restore your home, continue learning about the roles and responsibilities of insurance adjusters and contractors as they relate to your project. Check our article: “The Restoration Triangle: Homeowner, Contractor, and Insurance Company Roles & Responsibilities.”

Need to get a professional’s insight into the true scope and cost of your restoration? If so, click the button below to schedule a free design consultation with a member of our team. We’ll help you navigate the tricky process of restoration and provide you with expert guidance to navigate the challenges of insurance claims.