What Claims Adjusters Are Thinking vs What They're Saying

After a natural disaster, few of us are at our best, but here's what to keep in mind when you're interacting with your insurance company's claims adjuster.

By Karl Susman, CPCU, LUTCF, CIC, CSFP, CFS, CPIA, AAI-M, PLCS

published 18 April 2025

in Features

An insurance claims adjuster and a homeowner check out a damaged ceiling. — (Image credit: Getty Images)

Everywhere across the country, we are seeing natural disaster after natural disaster. Wildfires out West and tornadoes and flooding in the South, and hurricane season is coming soon. After each of these events, many of us get to deal with our insurance company and, by extension, a claims adjuster.

Here are the top three things your claims adjuster says to you and what they are actually thinking.

1. After a fire

You are evacuated due to a massive fire heading your way. You hole up at a hotel and await finding out your home’s fate. Sadly, not much is left once the flames are extinguished. Your first conversation with your insurance company’s claims adjuster may go like this:

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You: I’ve lost everything! I can’t believe this. I need you guys to get busy rebuilding my house, like tomorrow. Just wire me my policy limits for everything. Seriously, the fire is out, let’s get the ball rolling so I can get my house back before everyone else starts hiring the good contractors.

Claims adjuster: I am so sorry for your loss. Let’s start the process, gather the information we need, get you some money right away so you are as comfortable as possible and move forward from there.

What the claims adjuster is thinking: Poor fella. Everything is gone. But start rebuilding your house tomorrow? Dude, the place is still smoldering, and it is going to take 12 to 18 months before all of the debris removal is completed and the toxins are gone. I can’t just write a check for everything — the policy has requirements for things we both have to do. Take a breath, you’re alive and have a policy — you’re much better off than some. And don’t worry, there will be plenty of contractors fighting to get money from us to rebuild your place.

2. After a storm

Toto, I’ve a feeling we’re not in Kansas anymore. A tornado destroyed your house. It’s going to take a lot of money to rebuild it.

You: Can you believe this weather? Like, out of nowhere, this tornado moved in and basically ripped apart half of my house. I barely escaped. Have you seen the house? I don’t want to live there anymore. Just write me a check and take the house. You can have it.

Claims adjuster: I am so sorry for your loss. It must be very emotional to have just barely escaped the storm. Let’s see what options are available for you under your insurance policy.

What the claims adjuster is thinking: No, you can’t have the money from your policy meant to rebuild your home and just hand your home over to us. You have a loan on that house, remember? I don’t think your bank would be very happy to see you walk away from it and take your insurance proceeds.

3. After a flood

It’s pouring cats and dogs. Not just a lot of rain, but the kind of rain that you can’t even see through, day after day after day. Then water makes its way up your driveway and starts coming under your front door. Soon, your home isn’t under water, but the water is in your home, from the bottom up.

You: My house is effectively a large swimming pool. The water level has risen above the couches, above the beds, and even some of my wall shelves are wet. I wouldn’t be surprised to see water shooting out of the chimney. I’m glad I have my homeowners insurance policy to pay for all of this.

Claims adjuster: That sounds absolutely horrible. I am so, so sorry to hear this. Unfortunately, flood damage is specifically excluded from your homeowners insurance policy. The policy lists in Section I – Exclusions, “We do not insure loss caused directly or indirectly by flood, surface water, waves, water backup, water below the surface.” This type of coverage would be covered by a Flood Insurance policy, available from FEMA or an insurance agent or broker. Would you like information for the Small Business Administration on obtaining a loan to fix your damage?

What the claims adjuster is thinking: So apparently you’ve never read your insurance policy. The first section under exclusions is literally labeled “Flood.” It’s right there. And don’t get irritated at me — I didn’t write the policy.

So what can we learn to do (or not do) from these exchanges?

Keep your expectations realistic when it comes to what your insurance company can do and how quickly.
Understand the limits of what your insurance does. Insurance policies are indemnity policies, meaning they are designed to put you back to the way you were before the loss. If that meant you had a house, then rebuilding that house. They are not designed to cash you out.
Read your insurance policy so you know what’s covered and not covered.
Don’t take your frustrations out on the claims adjuster — they’re just doing their job.

Want to learn more about insurance? Visit KarlSusman.com.

Disclaimer

This article was written by and presents the views of our contributing adviser, not the Kiplinger editorial staff. You can check adviser records with the SEC or with FINRA.

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Karl Susman is a veteran insurance agency principal, nationally engaged insurance expert witness and broadcast host who translates insurance from jargon to judgment. For more than three decades, he's helped consumers, courts and policymakers navigate coverage, claims and compliance. As Principal of Susman Insurance Agency, Karl works directly with households and businesses to compare options and make clear, defensible coverage decisions.