How this work
gets paid for
Most of it goes through an insurance claim, and the part people misunderstand is what a restoration company can and cannot do about that claim on their behalf.
What Direct Insurance Coordination means
Direct Insurance Coordination means working directly with your insurance company through the life of the claim: talking to the adjuster, providing the documentation they need in the form they need it, and keeping the file moving so that decisions are not waiting on paperwork.
In practice that is the moisture mapping, the daily drying readings, the photographs, the scope of work, and the estimate written in Xactimate, which is the estimating platform carriers in this state read. All of it goes to the adjuster as the job runs rather than arriving in one bundle at the end.
It also means you are not the messenger. Homeowners in the middle of a loss should not have to relay technical questions between an adjuster and a technician, and that is the practical value of the arrangement.
Not a public adjuster
Adjusting a claim on a policyholder’s behalf is licensed work in Arizona and is done by a public adjuster, which is a different job from restoration. We document what we found and what we did. We do not negotiate your claim for you.
What it does not mean
This is the part worth being precise about, because it is where it usually goes wrong, at the point when the money is supposed to arrive.
- 01
Not the insurer paying and you owing nothing
What you owe depends on your policy, your deductible, your coverage limits and what the carrier approves. Any company that tells you otherwise before reading your policy is guessing.
- 02
Not the deductible going away
The deductible is your share of the loss and it is set by your policy. Waiving or absorbing a deductible is a serious problem in an insurance context, and anybody offering to do it is telling you something about how they operate.
- 03
Not everything being covered
Coverage is decided by the cause of the loss and by the terms of your policy. Surface water, sewer backup without the endorsement, and long term seepage are the three exclusions that catch people here most often.
- 04
Not representation against your insurer
That is a public adjuster’s work, and it is a different licence held by a different person.
A restoration company does not decide what your insurance company pays. It documents the loss to the standard the carrier needs.
How a claim usually runs
- 01
You report the loss to your carrier
Do this the same day, before anybody has finished any work. You can do it while the emergency response is still happening. The claim number that comes out of that call is what everything else attaches to.
- 02
Emergency mitigation starts straight away
Stopping the damage getting worse does not wait for an adjuster, and your policy expects you to act to prevent further loss rather than to leave it. That work is documented from the first hour.
- 03
An adjuster reviews the loss
Sometimes in person, increasingly by photographs and documentation. This is where a properly documented file does the work: readings, photographs from consistent positions, and a scope that explains why each item is there.
- 04
The scope and estimate are agreed
Written in Xactimate. Where the carrier and the contractor disagree on scope, that is a conversation about evidence, which is why the evidence is collected as the job runs.
- 05
Supplements are raised when found
Material found wet behind something that could not be inspected on day one is a legitimate supplement. It gets raised at the point it is discovered rather than at the end, because a supplement that arrives with the final invoice is a supplement that gets argued about.
- 06
Payment is settled
Usually in instalments, often with the mortgage company involved if the loss is large, and always subject to your policy terms.
If the work is not going through insurance
Plenty of jobs are not claims. The loss is smaller than the deductible, or the cause is excluded, or the owner would rather not file. Those are paid directly, and the scope is agreed in writing before work starts in exactly the same way.
[CLIENT SLOT: payment methods accepted, and the financing partner if the branch works with one. If there is a financing partner, supply the partner’s name and their own approved wording. No rate, term, monthly figure or approval claim will be published, because that language belongs to the lender and has to be theirs.]
Before signing anything
What exactly am I authorising right now? Is this an assignment of benefits? What happens if my carrier approves less than the estimate? Will I get the documentation as well as the adjuster?
Get the answers before the work, not after it. It is your loss and your claim.
The estimate is a
conversation.
Direct Insurance Coordination / Estimates written in Xactimate