The Role of the Restoration Industry in Catastrophic Claims

By  //  November 2, 2021

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When big storms like hurricane Ida strike, claims managers for insurance carriers must launch into high gear and respond in efficient, organized manners that ease the need and do not further exacerbate the situation. Catastrophe property claims come with unique concerns and require a special skill set to execute the best response.

As estimators and adjusters begin the process of answering a claim, the restoration industry must strike a balance between emergency response and a relationship with both the property owner and insurance company. That requires diligence in documentation, estimating, and understanding the insurance coverage and policy. 

BluSky Restoration Contractors, a national leader in the restoration industry, understands the nuances and needs of catastrophic events and encourages property owners to move forward with a clear understanding of the claims process. “The faster a trained catastrophe team can respond to your disaster, the sooner you can rest easy that your property is in expert hands,” says a representative of the company.

“Licensed, reputable restoration companies keep disaster response teams at the ready for catastrophic events. Property owners who understand that the next call after their insurance company should be to a reputable restoration contractor have the benefit of the quickest response and mitigation of further damage to property and personal belongings.”

As restoration estimators and adjusters work to provide accurate, professionally presented property estimates, the adjuster must figure in coverage, insurance contracts limitations and exclusions as they apply to the estimates. Adjusters drive the work toward an end result that satisfactorily addresses the insurance carriers’ policy parameters.

Documenting a Catastrophic Claim

When estimators and claims adjusters provide a detailed and well-documented claim or estimate, claims can move forward in a timely, streamlined manner.

This is essential in catastrophic claims where bulk claims are coming in for a single event affecting hundreds, even thousands of property owners, and restoration companies are at the ready to step in and provide their services. When a claim tells the proper story, it can be approved and paid quickly, allowing work to be completed and owners to return to their properties sooner. 

With the evolution of electronic documentation, the process becomes more efficient, but the professionals—creating content inventories, building estimates and claim files—must provide due diligence to the process and include all necessary information so that a claim does not stall.

Clear, complete documentation is easy to follow for contractors stepping in to perform the necessary work and keep projects on track. 

Project Scope 

Documentation provides proof of the project scope and helps eliminate issues with under-scoping and over-scoping projects. When a project is scoped, the adjuster or estimator must account for damage to structure as well as personal property. When an item is omitted in the inventory or estimate, the project is under-scoped, which can lead to frustrations and complaints on the part of the policyholder.

When over-scoping occurs, the claim may be marked and require amendments which slow down the claims process, once more causing frustration on the part of the policyholder.

Restoration professionals must work within the scope of a claim, and their responsibility to a quality job must balance the wants of the claimant and the parameters of the insurance company. The systematic process of scoping a loss requires attention to detail, proper documentation, and photos to reflect the scope of damage.

Supporting Photographic Evidence

As with written documentation, proper photos displaying the detailed damage in the catastrophic claim are an essential component of moving the claim along in a timely manner. When an adjuster or estimator captures photographs of the damage, they’re creating a case to put before the claim examiner for review.

Quality photographs which properly exhibit the damage will bring the claim to life and tell the story of the disaster, giving the claims examiner a full image of what has transpired and what repairs need performed. Quality photographs assist both the claim examiner and the contracted restoration specialist as they devise a systematic plan to complete the work and restore the property to safe, usable conditions. 

Catastrophes will continue and the role of the restoration contractor includes understanding the insurance policies and contracts to keep projects on track and within the scope of the insurance company. Relationships with TPAs, insurance companies and independent adjusters require the professionalism and diplomacy to maintain the project and execute the plans within the proper scope of the claim.

The victims of catastrophic events rely on cool heads and professionals with comprehensive knowledge to help navigate what is already a stressful and traumatic time. A successful plan is executed when the restoration company understands its role in the process and is fully involved and present with the insurance company