Insurance Claim Estimator

Claim-worthiness combines three factors: how well the event aligns with typical coverage patterns (sudden and accidental vs gradual), whether the repair cost materially exceeds the deductible, and how prepared your documentation package is.

Your coverage alignment score of 54/60 reflects the event type, cause, and suddenness.

Your economic sense score of 25/25 reflects a repair estimate of $18,000 against a deductible of $2,500.

The "limited case" scenario assumes partial recovery: endorsement sub-limits, mold caps, ACV depreciation holdback, or coverage disputes reduce the payment. The exact multiplier we use starts at 55% of the best-case payment, drops toward the water-backup endorsement limit if you have one, and drops further if you marked this policy as ACV.

Your documentation readiness of 10/15 reflects the mitigation and evidence steps you have already taken. Every additional photo, receipt, and moisture reading moves this number up and strengthens every downstream conversation with your carrier.

Palm Build can help you organize the record without pretending to negotiate your policy for you. We document, dry, and restore — then you bring the clean package to your carrier.

This is the single biggest reason homeowners feel shortchanged on a covered claim. Understanding the difference can recover tens of thousands of dollars on a large loss.

When your policy pays a loss, it pays either Actual Cash Value (ACV) or Replacement Cost Value (RCV). ACV is what the damaged item was worth immediately before the loss — which means the carrier subtracts depreciation based on the item's age and remaining useful life. RCV is what it would cost to replace the item with one of like kind and quality at today's prices, without subtracting depreciation.

Most modern HO-3 policies pay RCV on the dwelling (Coverage A) and Coverage B, but pay ACV on Coverage C (personal property) unless you purchased the Replacement Cost Coverage endorsement on contents. This is a common and expensive surprise: you lose a ten-year-old sofa to a water loss and receive 30% of its current cost because depreciation ate the rest.

Here is the part most homeowners miss: even on an RCV policy, the insurer typically initially pays you the ACV and holds back the "recoverable depreciation" until you actually complete the repair and submit receipts. This is called the depreciation hold-back. Many homeowners never claim it — which leaves real money on the table. If your policy is RCV, the contract gives you the right to recover the hold-back when you finish the work.

If you are mid-claim, the first question to ask your adjuster is: "Is this a Replacement Cost or Actual Cash Value settlement, and what is the depreciation hold-back amount?" The answer changes everything.

Sources: III: "Actual Cash Value vs Replacement Cost" · NAIC Consumer Alert: Understanding Depreciation

A denial is not the end of the conversation. It is the start of a second conversation — one you win with paperwork, persistence, and the rights your policy already gives you.

First, get the denial in writing. Every state requires insurers to provide a written explanation with the specific policy language they are relying on. If your adjuster told you "no" on the phone, ask for a written denial letter with the reason cited to policy section. This is not confrontational — it is standard practice, and it starts the clock on your appeal rights.

Second, read the reason carefully. There is a huge difference between "excluded" (the policy never covered this) and "not sufficient documentation" (the policy might cover it, but you have not proven your case). The first requires a coverage argument; the second requires more evidence. Photographs, moisture readings, contractor reports, and a written timeline are the building blocks of a successful appeal.

Third, use the tools your contract already gives you. Most homeowners policies contain an "appraisal clause" — a dispute-resolution mechanism where you pick an appraiser, the insurer picks an appraiser, and the two pick a neutral umpire. Unlike a lawsuit, appraisal usually resolves a scope-or-amount disagreement in 60–120 days and costs far less. It does not resolve coverage disputes, but it is powerful for supplements and lowball scopes.

Fourth, file a complaint with your state Department of Insurance if the carrier is ignoring you, violating prompt-payment rules, or acting in bad faith. DOI complaints are free, public, and often produce a response within two weeks because carriers are required to respond to them in writing. They do not guarantee a win, but they often unstick a stalled claim.

Sources: NAIC Model Unfair Claims Settlement Practices Act · III: "How to file an insurance complaint"

There are three kinds of adjusters who might show up on your claim, and knowing who is who will save you from some very expensive misunderstandings.

A staff adjuster is an employee of your insurance company. An independent adjuster (often called an "IA") is a contractor hired by your insurer in catastrophe situations when the staff adjusters are overloaded. A public adjuster (PA) is a licensed professional you can hire to work for you — not the carrier — in exchange for a percentage of the settlement, typically 10–20%. All three are called "adjusters," but their duties and loyalties are very different.

Your adjuster will prepare a "scope of loss" — a room-by-room inventory of the damage and the estimated cost to repair it, usually using Xactimate or Symbility software. This document is the foundation of your settlement. Read it carefully. Is every affected room listed? Are the correct line items present (antimicrobial, R&R drywall, detach & reset baseboard, content manipulation, mold containment)? Are quantities right? A missing room or an undersized quantity is the single most common reason a settlement feels too low.

If you find something missing or undersized, you do not have to accept the scope as-is. You can request a "supplement" — a formal addition to the scope for items that were missed, undervalued, or discovered after the initial inspection. Most carriers will honor reasonable supplement requests if you provide a clear list of items and a contractor estimate to back them up. Many homeowners never request supplements because they did not know they could.

Sources: NAIC Public Adjuster Licensing Model Act · III: "What does a public adjuster do?"

Most homeowners have never read their policy in full. That is okay — but the terms below are the ones you actually need when something goes wrong. Understanding them flips the power dynamic with your adjuster.

A homeowners policy is a contract. It is organized into coverage buckets that each have their own limit, and it lists both the things it covers and the things it excludes. The most common form in the United States is the HO-3 — it covers your dwelling on an open-peril basis (everything except what is specifically excluded) and your personal property on a named-peril basis (only the perils listed).

HO-5 is a richer version — it covers personal property on an open-peril basis too, which matters if you own nicer contents and want broader protection. HO-6 is for condo owners and only covers the interior "studs-in" portion. DP-3 is the dwelling policy most landlords carry for a rental house; it excludes personal liability for tenants and often has tighter water coverage.

Inside the policy, your coverage is split into four buckets: Coverage A (dwelling — your structure and attached assemblies), Coverage B (other structures like detached garages and fences, usually 10% of A), Coverage C (personal property, usually 50–70% of A), and Coverage D (loss of use and additional living expenses if the home is uninhabitable). Each bucket has its own limit and sometimes its own sub-limits for categories like jewelry, electronics, or cash.

Sources: Insurance Information Institute, "Understanding Your Insurance" · NAIC Consumer Guide to Homeowners Insurance

Palm Build operates across seven states, and every one of them has quirks that matter on a property-damage claim. These are the rules we most often see homeowners miss.

State insurance law layers on top of your policy contract. In most cases, state law sets deadlines, defines bad-faith conduct, establishes dispute-resolution programs, and requires specific disclosures on your declarations page. Knowing the rules for your state is often the difference between a cleanly paid claim and a long, painful one.

Nothing on this page is legal advice. If your claim is contested, confirm the specific rules with your state Department of Insurance or a licensed property-insurance attorney before acting.

Sources: State Departments of Insurance (FL, NC, SC, TX, GA, TN, NJ) · NAIC Model Laws