Claim Appraiser/Umpire Services
What is a Certified Umpire and Appraiser?
When you disagree with the amount your insurance company paid for your property damage, many policies have an alternative and binding dispute resolution known as Appraisal. This is a method to resolve differences that could arise between you and the insurance company.
How a Certified Appraiser Evaluates Property Damage
A Certified Appraiser performs a complete and detailed analysis of the property damage resulting from a covered loss. They inspect damaged property and carry out an impartial evaluation and assessment of repair costs. Appraisal is a policy provision found in the Loss Settlement section of your policy. It can also be utilized as an alternative to a lawsuit. Appraisal does not address coverage issues but can include or exclude items based on causation depending on which state your loss is located. When the appraisal provision of the insurance policy is invoked, the insurance company assigns their appraiser, and you will assign yours. Before meeting at the property, both Appraisers must agree on a mutual Umpire. The Umpire that is agreed upon will assist in the resolution of your claim only if the two Appraisers reach an impasse.
A Certified Umpire for insurance claims provides a means of resolution by an unbiased third party if an insurer’s Appraiser and an insured’s Appraiser cannot agree on the amount of a claim payment. The Umpire looks at both Appraiser’s estimates and, like a mediator, they determine the outcome of the appraisal.
The owner of Lioness Claims, LLC, Peggy Martin, is a Certified Appraiser and Certified Umpire for all 50 states.
Pros & Cons
Evaluation of Appraisal vs Lawsuit
Appraisal
Quick – Expedient
Relatively less costly
May be less adversarial
No appellate potential
Must pay fees/costs
Procedure based on your policy
Lawsuit
Slower – protracted
Generally more costly
More adversarial
Appeal is possible
Stricter procedures
When is Appraisal Appropriate?
Sometimes there is a disagreement over the insurance company’s valuation of an insurance claim. Policyholders often think the only way to settle the dispute is to hire a lawyer. Fortunately, this is not the case. Appraisal is a method of Alternative Dispute Resolution often found in many homeowner and commercial insurance policies.
The language will often, but not always, state that appraisal is mandatory when properly demanded by the insurer or insured. It is important to have a qualified individual, such as a Public Adjuster, review your policy to determine your options.
When properly executed, appraisal is binding on the parties as to the amount of loss only. Appraisal does not determine coverage. If not properly invoked, employed, and/or carried out the process may not be binding, so it is important to select a certified Appraiser and Umpire who understands the process.
How does the Insurance Appraisal Process Work?
The appraisal language in some policies typically reads as follows:
Appraisal. If you and we fail to agree on the actual cash value, amount of loss, or cost of repair or replacement, either can make a written demand for appraisal. Each will then select a competent, independent appraiser and notify the other of the appraiser’s identity within 20 days of receipt of the written demand. The two Appraisers will choose an Umpire. If they cannot agree upon an Umpire within 15 days, you or we may request that the choice be made by a judge of a district court of a judicial district where the loss occurred. The two Appraisers will then set the amount of loss, stating separately the actual cash value and loss to each item.
Once the Appraisal clause/provision is invoked, the insured’s Appraiser and the insurance carrier’s Appraiser will estimate the damage and try to come to an agreement on the amount of loss.
If the Appraisers fail to agree, they will submit their differences to the Umpire. The Umpire decides which of the two Appraiser’s estimates they agree with, which sets the amount of loss. Such award by the Umpire shall be binding.
Each party will pay its own Appraiser fee and bear the other expense of the Umpire equally.
