Trying to do the right thing regarding an insurance claim
Most Popular Reply
Lender · CA · Member since 2018 · 637 posts · 393 votes
1yQuote from @Mark Towey:
Hey, thanks for sharing this — I’m still pretty new to how insurance claims work, so I had a quick question:
If the insurance company approves the $12K estimate, do they just cut you a check for that amount no matter what, or do they usually wait to see receipts or proof of work before paying it all out?
I’ve never had to file a claim like this, so I’m trying to wrap my head around what’s normal or allowed. Appreciate any insight — this was helpful to read through!
They send an adjuster who will confirm/deny the cost. They cut you a check for the amount that the adjuster confirms (best case adjuster says 12k is reasonable) then they will cut the check for 12k - deductible (say he is carrying a $2500 deductible he would get a check from insurance for 9500).
15 Replies
- Lender · CA · Member since 2018 · 637 posts · 393 votes1y
You have a valid estimate at 12k. If you are able to do it for less, good on you and recoup some of all the premiums you are paying. I just did the same thing with an AC unit that was smashed to bits and the copper wiring was stolen. We had a contractor bid at nearly 11k and I was actually going to go with him, but the insurance payout was only 8k so I shopped around afterward and found someone to do it for 8k.
- Member since 2024 · 179 posts · 76 votes1y
@Clayton Silva thank you.. What i'm struggling with is that the $12K contractor filled out a lot of the paperwork for me and without that paperwork i would not have gotten the claim approved.. so i kind of feel obligated to go with the $12K contractor...
- Lender · CA · Member since 2018 · 637 posts · 393 votes1y
Quote from @Marc Shin:
@Clayton Silva thank you.. What i'm struggling with is that the $12K contractor filled out a lot of the paperwork for me and without that paperwork i would not have gotten the claim approved.. so i kind of feel obligated to go with the $12K contractor...
I get that, and there is definitely value in that. Send that contractor the 7k quote and see if there is a way he can cut down on cost a bit. Maybe if he can get to 10k or some magic number you give him the business? But it gives him a chance to get it dialed in for you since he put in the work
- Real Estate Agent · Wichita, KS · Member since 2023 · 34 posts · 11 votes1y
Hey, thanks for sharing this — I’m still pretty new to how insurance claims work, so I had a quick question:
If the insurance company approves the $12K estimate, do they just cut you a check for that amount no matter what, or do they usually wait to see receipts or proof of work before paying it all out?
I’ve never had to file a claim like this, so I’m trying to wrap my head around what’s normal or allowed. Appreciate any insight — this was helpful to read through!
- Lender · CA · Member since 2018 · 637 posts · 393 votes1y
Quote from @Mark Towey:
Hey, thanks for sharing this — I’m still pretty new to how insurance claims work, so I had a quick question:
If the insurance company approves the $12K estimate, do they just cut you a check for that amount no matter what, or do they usually wait to see receipts or proof of work before paying it all out?
I’ve never had to file a claim like this, so I’m trying to wrap my head around what’s normal or allowed. Appreciate any insight — this was helpful to read through!
They send an adjuster who will confirm/deny the cost. They cut you a check for the amount that the adjuster confirms (best case adjuster says 12k is reasonable) then they will cut the check for 12k - deductible (say he is carrying a $2500 deductible he would get a check from insurance for 9500).
- Real Estate Agent · Wichita, KS · Member since 2023 · 34 posts · 11 votes1y
Quote from @Clayton Silva:
Quote from @Mark Towey:
Hey, thanks for sharing this — I’m still pretty new to how insurance claims work, so I had a quick question:
If the insurance company approves the $12K estimate, do they just cut you a check for that amount no matter what, or do they usually wait to see receipts or proof of work before paying it all out?
I’ve never had to file a claim like this, so I’m trying to wrap my head around what’s normal or allowed. Appreciate any insight — this was helpful to read through!
They send an adjuster who will confirm/deny the cost. They cut you a check for the amount that the adjuster confirms (best case adjuster says 12k is reasonable) then they will cut the check for 12k - deductible (say he is carrying a $2500 deductible he would get a check from insurance for 9500).
Hey thanks for that response Clayton, definitely helps better put into perspective.
- Investor · Get yourself trained before doing something inadvisable. · Member since 2024 · 3k+ posts · 1k+ votes1y
Quote from @Clayton Silva:
Quote from @Mark Towey:
Hey, thanks for sharing this — I’m still pretty new to how insurance claims work, so I had a quick question:
If the insurance company approves the $12K estimate, do they just cut you a check for that amount no matter what, or do they usually wait to see receipts or proof of work before paying it all out?
I’ve never had to file a claim like this, so I’m trying to wrap my head around what’s normal or allowed. Appreciate any insight — this was helpful to read through!
They send an adjuster who will confirm/deny the cost. They cut you a check for the amount that the adjuster confirms (best case adjuster says 12k is reasonable) then they will cut the check for 12k - deductible (say he is carrying a $2500 deductible he would get a check from insurance for 9500).
I have not seen nor heard of an insurance company paying 100% to make an insured whole.
I'd love to hear the story and circumstances if someone has one.
As stated, the amount paid is determined by the adjustor. He works for the insurance company. His job is to make the insurance company profitable, not to make you whole. - 1yOwen RosenBusiness MemberProfessional · Clinton Township, MI · Member since 2015 · 678 posts · 259 votes
Quote from @Ken M.:
Quote from @Clayton Silva:
Quote from @Mark Towey:
Hey, thanks for sharing this — I’m still pretty new to how insurance claims work, so I had a quick question:
If the insurance company approves the $12K estimate, do they just cut you a check for that amount no matter what, or do they usually wait to see receipts or proof of work before paying it all out?
I’ve never had to file a claim like this, so I’m trying to wrap my head around what’s normal or allowed. Appreciate any insight — this was helpful to read through!
They send an adjuster who will confirm/deny the cost. They cut you a check for the amount that the adjuster confirms (best case adjuster says 12k is reasonable) then they will cut the check for 12k - deductible (say he is carrying a $2500 deductible he would get a check from insurance for 9500).
I have not seen nor heard of an insurance company paying 100% to make an insured whole.
I'd love to hear the story and circumstances if someone has one.
As stated, the amount paid is determined by the adjustor. He works for the insurance company. His job is to make the insurance company profitable, not to make you whole.Huh? This is ludicrous.
Royal Oath Insurance Group4.9203 Reviews - Investor · Get yourself trained before doing something inadvisable. · Member since 2024 · 3k+ posts · 1k+ votes1ySilly you.
Quote from @Owen Rosen:
Quote from @Ken M.:
Quote from @Clayton Silva:
Quote from @Mark Towey:
Hey, thanks for sharing this — I’m still pretty new to how insurance claims work, so I had a quick question:
If the insurance company approves the $12K estimate, do they just cut you a check for that amount no matter what, or do they usually wait to see receipts or proof of work before paying it all out?
I’ve never had to file a claim like this, so I’m trying to wrap my head around what’s normal or allowed. Appreciate any insight — this was helpful to read through!
They send an adjuster who will confirm/deny the cost. They cut you a check for the amount that the adjuster confirms (best case adjuster says 12k is reasonable) then they will cut the check for 12k - deductible (say he is carrying a $2500 deductible he would get a check from insurance for 9500).
I have not seen nor heard of an insurance company paying 100% to make an insured whole.
I'd love to hear the story and circumstances if someone has one.
As stated, the amount paid is determined by the adjustor. He works for the insurance company. His job is to make the insurance company profitable, not to make you whole.Huh? This is ludicrous.
It's a fact.
Who determines the amount of loss?????? - 1yOwen RosenBusiness MemberProfessional · Clinton Township, MI · Member since 2015 · 678 posts · 259 votes
Quote from @Ken M.:
Silly you.Quote from @Owen Rosen:
Quote from @Ken M.:
Quote from @Clayton Silva:
Quote from @Mark Towey:
Hey, thanks for sharing this — I’m still pretty new to how insurance claims work, so I had a quick question:
If the insurance company approves the $12K estimate, do they just cut you a check for that amount no matter what, or do they usually wait to see receipts or proof of work before paying it all out?
I’ve never had to file a claim like this, so I’m trying to wrap my head around what’s normal or allowed. Appreciate any insight — this was helpful to read through!
They send an adjuster who will confirm/deny the cost. They cut you a check for the amount that the adjuster confirms (best case adjuster says 12k is reasonable) then they will cut the check for 12k - deductible (say he is carrying a $2500 deductible he would get a check from insurance for 9500).
I have not seen nor heard of an insurance company paying 100% to make an insured whole.
I'd love to hear the story and circumstances if someone has one.
As stated, the amount paid is determined by the adjustor. He works for the insurance company. His job is to make the insurance company profitable, not to make you whole.Huh? This is ludicrous.
It's a fact.
Who determines the amount of loss??????Let's take deductibles out of the equation. Using the example from this threat, you're saying the insurance company will NEVER give the insured $7,000 or $12,000 and he'll have to pay for the repair out of pocket or the property won't be repaired? No.
All that being said, @Marc Shin do you know how much (if any) service line coverage you have? This coverage is typically optional and usually capped at $10,000 or $15,000 so you should double check that if you haven't already.
Royal Oath Insurance Group4.9203 Reviews - Investor · Get yourself trained before doing something inadvisable. · Member since 2024 · 3k+ posts · 1k+ votes1y
Quote from @Owen Rosen:
Quote from @Ken M.:
Silly you.Quote from @Owen Rosen:
Quote from @Ken M.:
Quote from @Clayton Silva:
Quote from @Mark Towey:
Hey, thanks for sharing this — I’m still pretty new to how insurance claims work, so I had a quick question:
If the insurance company approves the $12K estimate, do they just cut you a check for that amount no matter what, or do they usually wait to see receipts or proof of work before paying it all out?
I’ve never had to file a claim like this, so I’m trying to wrap my head around what’s normal or allowed. Appreciate any insight — this was helpful to read through!
They send an adjuster who will confirm/deny the cost. They cut you a check for the amount that the adjuster confirms (best case adjuster says 12k is reasonable) then they will cut the check for 12k - deductible (say he is carrying a $2500 deductible he would get a check from insurance for 9500).
I have not seen nor heard of an insurance company paying 100% to make an insured whole.
I'd love to hear the story and circumstances if someone has one.
As stated, the amount paid is determined by the adjustor. He works for the insurance company. His job is to make the insurance company profitable, not to make you whole.Huh? This is ludicrous.
It's a fact.
Who determines the amount of loss??????Let's take deductibles out of the equation. Using the example from this threat, you're saying the insurance company will NEVER give the insured $7,000 or $12,000 and he'll have to pay for the repair out of pocket or the property won't be repaired? No.
All that being said, @Marc Shin do you know how much (if any) service line coverage you have? This coverage is typically optional and usually capped at $10,000 or $15,000 so you should double check that if you haven't already.
.
@Owen Rosen: Your comment "Let's take deductibles out of the equation."
That's laughable
Let's own a car and take tires out of the equation. Gas in my tank lasts a lot longer if I can't drive my car.When you submit a claim, even if the claim was denied, your insurance rate goes up.
It's registered in the database for you and for that property. If two neighbors have claims, your rate goes up even though you didn't submit a claim. The insurance company will argue with you about the cause of the damage to wear you out to try and pay less than what should be paid. Oftetimes you have to sue to get your claim paid.
I was legally parked in a tire shop lot and someone left the road and totalled my car. I was paid half of blue book, NADA, and what they were selling for in ads. Claims are denied all of the time. An employee got hit by a car, after 6 months was offered $1500 on a settlement and the damage and bills were $30,000. How many of these examples do you need?
I'm familiar with cases where the insured had to come up with the money to make the repairs on the property before the insurance company released funds. How is that helpful?As I said, an insurance company is in it to make money and stay in business, not to see to it that you're made whole.
I don't know what you're smoking, You said that I said "the insurance company will NEVER give the insured $7,000 or $12,000 and he'll have to pay for the repair out of pocket or the property won't be repaired?"
That isn't from me, I never say never and that totally misrepresents what I said.
You need to get your act together and get honest.
A dishonest insurance sales agent, who'd a guessed it?
- Investor · TX · Member since 2025 · 31 posts · 22 votes1y
Honestly, if you’re asking what’s the right thing to do - go with the $7K contractor if they do quality work, and let the insurance company know the actual cost. They’ll usually just adjust the payout or ask for the invoice.
Keeping the extra could be seen as insurance fraud, even if it feels small. Best to just be upfront. You’ll avoid any risk later, especially if you have to file claims again in the future.
- 1yTheresa HarrisPro MemberMember since 2019 · 15k+ posts · 11k+ votes
Don't just look at the price, look at what it includes and the quality of their work. Get a third quote and see if it is closer to the $7K or $12K. Also what happens if they find something else and it goes over? Wait until everything is done. I agree with Clayton and you want it done right. Ask both of them what warranty they come with.
- 1yOwen RosenBusiness MemberProfessional · Clinton Township, MI · Member since 2015 · 678 posts · 259 votes
Ken, are you familiar with the Dunning-Kruger effect? Read up on it. How about the fallacy of anecdotal evidence? Check that out too.
Your verbatim comment:
"I have not seen nor heard of an insurance company paying 100% to make an insured whole.
I'd love to hear the story and circumstances if someone has one."So, yeah, my question about the $7,000 or $12,000 and paying for the repairs holds.
Since you're likely to reply with more incoherent nonsense, I won't be replying any more unless anyone has honest questions like the original poster and many of the other great people on this forum. I apologize for wasting everyone's time engaging.
Also, @Ken M. I hope you have good insurance because I don't appreciate being called dishonest WHEN YOU DON'T KNOW WHO I AM OR HAVE ANY BUSINESS WITH ME because you're going to get your self sued.
Royal Oath Insurance Group4.9203 Reviews- Investor · Get yourself trained before doing something inadvisable. · Member since 2024 · 3k+ posts · 1k+ votes1yNah, quoting what someone said about me is not a suable offense. You're more likely to be removed from the forum for liable. I suggest you stop before you dig yourself in deeper.
Quote from @Owen Rosen:
Ken, are you familiar with the Dunning-Kruger effect? Read up on it. How about the fallacy of anecdotal evidence? Check that out too.
Your verbatim comment:
"I have not seen nor heard of an insurance company paying 100% to make an insured whole.
I'd love to hear the story and circumstances if someone has one."So, yeah, my question about the $7,000 or $12,000 and paying for the repairs holds.
Since you're likely to reply with more incoherent nonsense, I won't be replying any more unless anyone has honest questions like the original poster and many of the other great people on this forum. I apologize for wasting everyone's time engaging.
Also, @Ken M. I hope you have good insurance because I don't appreciate being called dishonest WHEN YOU DON'T KNOW WHO I AM OR HAVE ANY BUSINESS WITH ME because you're going to get your self sued.
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