Does Your Unfair Insurance Settlement Make you Feel Like the Loser in a Crooked Poker Game?
- Gary Timmons
- Jan 23, 2014
- 3 min read

When your property is damaged by a fire or other catastrophe, you’ll probably heave a sigh of relief once you realize that the damage is covered by your insurance policy. You’ll cooperate with the property adjuster, even if you don’t understand everything he’s trying to do. You’ll do whatever it takes to get your property repaired so you can get back to normal.
But what do you do when the insurance company adjuster closes his file and walks away, leaving you with the nagging feeling that you’ve received an unfair insurance settlement. What happens when you feel like the insurance company was playing a crooked game of poker where you were destined to be the big loser?
The claims process can sometimes feel like a game
You may not always realize when you’re the victim of unfair insurance settlement practices, but it can sometimes feel like a poker game where the rules are rigged in favor the other guy. The rules say that you must reveal all of your cards upon request, but the insurance company doesn’t have to reveal what cards they’re holding until the game is over.
As a policyholder, it’s your duty to show your hand –give the adjuster a formal “proof of loss” listing all of your damages– whenever they ask you to. The adjuster might then settle your claim in full, but he could quote a tricky policy clause that limits your payment. He decides what damage is excluded or not caused by an insured peril. He decides how much depreciation to take on your property, or whether to pay you at all.
Even after you’ve laid all your cards on the table, you won’t know how much of a settlement the insurance company intends to pay until they decide to pay you. Or not pay you. You can comply with all policy provisions and an insurance company can still refuse to pay your claim due to exclusions, no coverage, suspicions of arson, or any number of other reasons.
Remember… the insurance adjuster works for the insurance company
As the claim process progresses, you could be lulled into a winning feeling, a sense that it will all be over soon… until you receive a payment that doesn’t quite cover the damage. Or your wake up call could come after the insurance adjuster meets with you, gets your statement, inspects and photographs the damage, and reviews your construction company estimate, then sends you a formal Reservation of Rights letter or a Declination of Coverage instead of a check.
You could be well into the insurance claims process before it hits you that the insurance adjuster works for the insurance company, not you. His job is to protect the insurance company’s interests, not yours; and you should probably have someone doing the same things for you.
It’s not a game
Public adjusters can help you take the gamesmanship out of getting your claim resolved. They have the same backgrounds in commercial or personal property losses as insurance company adjusters. They know insurance coverage, even the tricky policy clauses. They know how to write estimates, and they can work with your contractor to get your property back to the way it was.
Most importantly, public adjusters know when an insurance company’s conduct is in violation of the “Texas Insurance code: Unfair Claim Settlement Practices.” If your insurance company violates those guidelines, a public adjuster won’t let them get away with it.
It’s never too late to have someone on your side
When your personal or commercial property sustains damage, it’s a good idea to consult with an independent claim professional on day one. But even if the insurance company has made their decision, issued a check, and closed your claim file, contact us because we can still intervene on your behalf.
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