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Final Settlement: $41,951.57
Initial Incident
Water losses rarely happen at convenient times. In fact, they often occur while homeowners are asleep—silent and unnoticed until the damage is done. That’s exactly what happened to one of our insured clients.
Late at night, a blocked HVAC drain line caused the float valve to fail, resulting in a significant water intrusion event. Water had spread throughout the first floor, flowing into the hallway and all three adjoining bedrooms.
The next morning, our client awoke, stepped into a puddle, and immediately realized something was wrong. They did everything right from the start:
- Reported the loss immediately to their insurance company
- Hired a water mitigation company to begin drying out the home
- Took every action required under their policy
Despite doing everything by the book, the response from their insurance carrier would prove to be both frustrating and unfair.
The Insurance Company’s Response
After the initial inspection, the carrier issued a payment of $10,181.96. That payment was presented as a full and final settlement.
However, it wasn’t even close to what was needed.
- The payment didn’t cover even the kitchen cabinets, which had sustained water damage
- The insurance estimate left out multiple rooms, despite visible, documented damage
- The desk adjuster assigned to the claim had little to no construction experience and was unwilling—or unable—to explain the omissions
When questioned about why certain rooms were excluded, or why the payout was so low, the desk adjuster refused to respond. They merely echoed talking points provided by their supervisor. They wouldn’t justify the estimate, wouldn’t answer basic questions, and wouldn’t acknowledge the evidence presented.
At this point, it was clear: the adjuster wasn’t trying to fairly resolve the claim. They were trying to close it.
How We Helped
The insured brought in Coast 2 Coast Adjuster to represent them. From the start, it was obvious this was a case where experience would make all the difference.
We immediately:
- Performed a detailed site inspection and documented all visible and hidden damages
- Wrote a new comprehensive estimate that accounted for the kitchen, hallway, all three bedrooms, flooring, drywall, trim, and other affected materials
- Scheduled a reinspection to walk the property again with the carrier
- Attempted to negotiate directly with the desk adjuster for a fair settlement
Throughout this process, the desk adjuster remained uncooperative, failed to provide justification for the initial payment, and refused to address clear omissions in their scope. It was evident that this claim wouldn’t be resolved through negotiation alone.
Thankfully, the insured’s policy included an appraisal clause. We invoked appraisal, removing the inexperienced desk adjuster from the process and bringing in two licensed, impartial appraisers to evaluate the loss on-site.
The Final Result
After completing the appraisal process, the final settlement came back at $41,951.57.
That’s a 312.01% increase from the carrier’s original payment of $10,181.96.
Thanks to the appraisal clause and our team’s efforts, our client finally received a fair settlement—enough to fully restore their home after a significant water loss.
Conclusion
If this homeowner hadn’t called us, they would have received only 24% of what their claim was actually worth. Their home would have remained partially repaired, with visible damage and serious out-of-pocket costs—despite paying their premiums and doing everything right.
This case is a clear reminder that insurance carriers don’t always have your best interest in mind. Some desk adjusters have little to no hands-on experience, yet are allowed to make decisions that impact the future of your home.
At Coast 2 Coast Adjuster, we don’t just write estimates—we bring real-world construction knowledge, industry expertise, and insurance policy understanding to every claim.
Initial Offer: $10,181.96
Final Settlement: $41,951.57
Total Increase: $31,769.61
Percentage Increase: 312.01%
When your home floods overnight, you need professionals who will show up the next morning ready to fight. That’s who we are.
