Insurance giving you grief?
That’s by design.
Let’s get you armed with what you need to get what you’re entitled to.
*This information has been checked for accuracy and non-bias by licensed insurance experts and representatives from National 501c3’s specialized in insurance advocacy. We are not insurance brokers. Consult with a licensed professional about your insurance policy and specific situation.
Here are some basic rules to always follow:
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It’s your adjusters job to shrink what the company pays you. If they find evidence of fraud they have the right to pause payouts while they investigate and potentially cancel your policy altogether. Also….insurance fraud charges are no joke. Keep everything 100% above board.
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Every time you speak to your adjuster, follow up with an email outlining what was said. If they say anything about payouts or dollar amounts or things they will or won’t do, ask for it in writing.
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Your insurer legally has to respond to you on certain timelines. If they’re dragging their feet or making this unnecessarily hard, you’ll want a call log and email train that you repeatedly tried to reach them. The more detailed this is, the better. Here is a template for Google Drive (best functionality), and here is a template for any spreadsheet software.
1.
Know Your Policy Inside & Out
The better you know your policy, the better you can advocate for what you’re entitled to.
If you need help understanding your coverages, click here.
2.
Know Your rights
As a California insurance policyholder you actually have a lot of rights. Click here to get familiar with what they are.
The more you can reference your legal entitlements, the less likely you are to get pushed around.
3.
Get organized
• Request a complete copy of your full insurance policy, including Declarations, Endorsements, and Amendments.
• Create a claim file with copies of all communications, estimates, receipts, and notes from every call or meeting. We recommend doing this in Google Drive once you’ve set up a dedicated email account for your post-fire dealings.
• Keep a detailed log of dates, times, names, and summaries of every interaction with your insurer. If you’d like a template for this, we have one for Google Drive here or any spreadsheet software here.
4.
Get everything in writing
• Require all decisions, denials, or settlement offers to be provided in writing.
• Demand that the insurer cite specific sections of your policy when denying coverage or reducing payments.
• Politely but firmly refuse to make important agreements verbally.
5.
KNow and enforce timelines
• Insurers must acknowledge your claim within 15 calendar days.
• Insurers must accept or deny your claim within 40 calendar days after receiving all requested information.
• Payment must be made promptly once your claim is accepted.
• If deadlines are missed, request immediate written explanations.
Relevant Law:
• California Fair Claims Settlement Practices Regulations (CCR Title 10, Chapter 5, Subchapter 7.5)
6.
Challenge lowball estimates
• Get independent estimates from licensed contractors.
• Submit competing estimates and insist they be reviewed.
7.
escalate within the insurance company
• If you are getting nowhere with your assigned adjuster, request a supervisor review.
• Escalation shows you are serious and often unlocks additional authority to settle claims.
8.
Demand a Fair investigation
• If your property was damaged by smoke, ash, or debris, demand professional testing (Certified Industrial Hygienist reports).
• Do not accept visual inspections or verbal assurances without documentation.
9.
use the appraisal process
• If you and your insurer disagree about the amount of the loss (not whether it is covered), you can invoke the Appraisal Clause in your policy.
• Each side hires an independent appraiser, and the two appraisers select a neutral umpire.
• The appraisal decision settles only the value of the loss, not your policy limits or coverage terms.
10.
file a complaint
• If delays, low offers, or mistreatment continue, file a formal complaint with the California Department of Insurance.
• Filing a complaint triggers regulatory oversight and forces the insurer to explain their conduct.
Where to File:
• California Department of Insurance Complaint Portal
• Phone: 1-800-927-4357
11.
know when to bring in help
If you have tried all of the above and are still hitting a wall, consider consulting some professionals.
• Public Adjusters: Licensed advocates who can prepare, document, and negotiate your claim. For details on public adjusters, click here.
• Insurance Attorneys: Legal specialists who can file bad faith lawsuits if your insurer delays, denies, or underpays improperly. For information on bad faith claims, click here.
Note that public adjusters and attorneys both take a portion of the payout they get for you, and bringing in an attorney will change the nature of the negotiation so choose that direction with awareness.
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