CALL NOW! 937-215-8663

Understanding the Insurance Appraisal Process

Has your insurance company forced you into the Appraisal Process?

Many homeowners and business owners find themselves disagreeing with their insurance company’s analysis of their insurance claim. However, most are unaware that they can dispute the insurance company’s findings via the Insurance Appraisal Process! Even though the policyholder (you) submits a contractor’s estimate, receipts for repairs or materials, or even photos showing damages that the insurance company did not include for repairs… they still won’t budge. Most policyholders are unaware of how to dispute and resolve their claim with the insurance company. Policyholders have a choice and a voice within their policy for this very purpose. It’s called The Appraisal Clause – also known as The Appraisal Provision. Now, don’t let this scare you. It may seem like a fancy clause that would take a law degree to understand. However, a simple way to understand it is that it’s the insurance industry’s version of arbitration. Although similar, the Appraisal Process is NOT an arbitration or mediation and the umpire is not an arbitrator, mediator, or judge. Insurance Appraisal, Mediation, and Arbitration are separate things. In short; Arbitration requires attorneys and a legal process, where Insurance Appraisal does not require attorney’s or a legal process.

Most Policies Have the Insurance Appraisal Clause

If you feel you’re at a dead end with your insurance company and want to resolve your claim, you’ll need to check your policy for the Appraisal Clause. Most policies will have the provision listed under the “What to do after a loss,” section or the “Conditions” section of the policy. Below, you will find a sample of a typical Insurance Appraisal Clause included in most policies. Keep in mind that policies can be different in each state. Therefore, you should read your own policy to see if this clause exists. It will say something similar to the following ;

APPRAISAL – If you and we fail to agree on the amount of loss, either one can demand that the amount of the loss be set by appraisal.  If either makes a written demand for appraisal, each shall select a competent, independent appraiser.  Each shall notify the other of the appraiser’s identity within 20 days of receipt of the written demand.  The two appraisers shall then select a competent, impartial umpire.  If the two appraisers are unable to agree upon an umpire within 15 days, you or we can ask a judge of a court of record in the state where the residence premises is located to select an umpire.  The appraisers shall then set the amount of the loss.  If the appraisers fail to agree within a reasonable time, they shall submit their differences to the umpire.  Written agreement signed by any two of these three shall set the amount of the loss.

OK, But How Does the Insurance Appraisal Process Work?

The Appraisal Provision allows the policyholder (you) to hire an independent appraiser to determine the value of their damages. In turn, the insurance company will also hire their own independent appraiser. The two appraisers will then get together and select an umpire. The umpire is basically the arbitrator, or what you might call the judge. If a disagreement between the two appraisers arises, they can present their differences to the umpire who will make a ruling.

OK; so far so good, the basics of the insurance appraisal process are beginning to come together. We have an independent appraiser for the policyholder. We have an independent appraiser for the insurance company. Finally, there is an Umpire. These three individuals are known as The Appraisal Panel. The object of the Appraisal Panel is to set or determine The Amount of Loss. The Amount of Loss is the total dollar amount needed to return the damaged property back to its original condition, either by repair or replacement.

Once the Appraisal Panel is set, the policyholder’s chosen appraiser and the insurance company’s chosen appraiser will review the documents, estimates, and differences between them. The two independent appraisers will try to discuss and resolve the differences in damage and in cost. For example; the insurance company may determine that brick on a home does not need to be replaced. Whereas, the contractor or appraiser for the policyholder says that it does have to be replaced. The two appraisers will discuss their reasons for their position and try to come to an agreement, first if it should be repaired or replaced, and secondly the cost to return the brick back to it’s original condition prior to the loss.

One benefit of the Insurance Appraisal Process is that the two independent appraisers have not been subject to the bickering and anger between the policyholder and the insurance company. Basically, it’s the hope that cooler heads will prevail. All the appraisers really have is the amount of the damage and the difference between the two estimate numbers. They do not have the previous baggage or anger that led up to the Appraisal. The process was designed so that these two individuals, who have no interest in the outcome, could discuss a settlement based on the facts presented to them.

Sometimes issues arise where the two independent appraisers can’t agree on certain items. In this event, the two appraisers will submit their differences to the chosen umpire. The three will discuss the issues and try to reach an agreed settlement of the differences. As stated above; the settlement or final number is called The Amount of Loss. The final amount is known as the Appraisal Award. The Award is signed by the individuals who agree on The Amount of Loss. However, only TWO of the three individuals need to agree. (An agreement between the two independent appraisers, or the umpire and either appraiser) Once any TWO of the three individuals on the Appraisal Panel sign the award… the dispute is over! The amount on the Award is binding and is paid by the insurance company, to the policyholder.

Can I Use An Insurance Attorney To Dispute My Claim?

The Appraisal Clause was initiated to lower the number of lawsuits filed against insurance companies. The courts found that many lawsuits were entering the legal system where the cost to repair or replace damaged property was being disputed. In many cases the suits were being resolved when professional engineers and contractors could address the issues. The Appraisal Process was created to get such individuals together and keep these disputes out of the courtroom. Assuming you acquired an estimate of repair to your property for $100,000, from a contractor or insurance claims expert. Your insurance company has created an estimate for $30,000. This would be a clear dispute between the amounts of damage. This type of dispute is exactly what the Appraisal Clause was developed to resolve.

The clause allows parties on both sides of the insurance policy to dispute their differences using this less costly provision. Let’s face it; the courts are filled with lawsuits. The Insurance Appraisal Process allows for the dispute to be settled out of court. Using Insurance Attorneys and lawsuits can have insurance claims tied up in court for years. The Appraisal Provision was designed to keep these disputes out of court for a less costly and timelier resolution.

Insurance Claim Attorneys will usually represent policyholders for bad faith practices. Bad Faith is a whole other issue and sometimes happens after the Appraisal Process has been completed. Bad Faith claims are for much larger suites against insurance companies when it is alleged that they did not act with good faith of the policy they sold to the policyholder. In summary; disputes between the amount of damages and repairs will follow the Appraisal Process before entering into the legal system. Many Insurance Attorneys will also advise the policyholder to engage in the Appraisal Process before any lawsuits will begin.

How Do I know if the Insurance Appraisal Process is a Good Option for My Claim?

If the Appraisal Clause is in your policy then it is always an option. However, it’s wise to point out that Appraisal is usually an option when there is a substantial difference in the amount between the two estimate totals. For example; let’s say a fire completely destroys a house and the homeowner’s personal property within it (Known as the Contents). The differences between what the insurance company wants to pay and what you wish to receive is $5,000. In this situation, the Appraisal Process is not the best idea. After paying the fees involved for the appraisal, you may not end up with much of the $5,000 being disputed.

Now, if we take the same fire that destroys the property and the dispute between the policyholder and the insurance company is $40,000, appraisal should be considered. The policyholder now has a chance to recover substantially more money than originally offered.

Also, the Appraisal Clause is only applicable if a dispute arises from a covered loss. If the insurance company denied the claim as something not covered then this is not a dispute on the amount to repair, but rather a dispute on coverage. For example; homeowners and business policies due not cover floods. Flood policies are purchased separately. So, if there is no coverage for the flood damages then the Appraisal Process is not an option.

Simply put, the Insurance Appraisal Process is to determine the “amount of loss,” to property only. The Appraisal Panel is not to determine coverage, policy provisions, deductibles, how much was previously paid on the claim, etc. Let’s say there was an appraisal for a grand piano that fell off a delivery truck on the highway. The Appraisal Panel’s job is not to determine who’s at fault, the policy coverage limit, if the truck had a registration, or anything other than “How Much is the Piano Worth.”

As with our example earlier, if the insurance company offers a settlement of $10,000 to repair a roof and the policyholder has contractor bids for $15,000, then the Appraisal Process may not be the best option. The Appraisal Process may cost more than the $5,000 that’s being disputed. Unfortunately, the differences in repair/replacement costs are usually much greater. When an insurance company generates an estimate for a claim of $75,000 and the policyholder has acquired professional bids from several contractors of $200,000 or more, its time to invoke the appraisal clause.

Beginning the Insurance Appraisal Process

Either party associated with the policy can invoke the Appraisal Process. However, such a request must be made in writing. Each policy will have a time limit of when this can take place. Even if a claim has been closed for many years, either party can still dispute the claim and reopen for review. It’s recommended that the request to invoke appraisal be sent via certified mail. Once the request to invoke the Appraisal Clause has been initiated, as explained earlier, each party, the insurance company and policyholder, appoints an Independent Appraiser. (If you wish to invoke the appraisal clause in your policy you need to submit a letter to your insurance company. Helping Hands Restorations, LLC can assist you with this process. Contact us today for assistance).

Choosing An Independent Appraiser

It’s important to select an Independent Appraiser that has experience with the damages being disputed in the claim. A person with expert knowledge of insurance claims handling and firsthand knowledge of the damaged property and its replacement cost. For example; a person with expert knowledge of insurance claims handling and with expert knowledge of the Appraisal Process, but with little experience on the costs to replace an antique grand piano may not be the best choice. In the case of a home or building fire; a good Appraiser is someone who can generate their own line-item detailed estimate to repair or replace the damaged property, can secure multiple bids from reputable contractors to back up their findings, knows building codes, and can articulate unforeseen costs of repairs. If a building has historic features with materials like solid Adler doors, large detailed moldings, and custom cabinets, a great amount of research with a salvager may be needed. The Appraiser should have experience with building procedures, materials and the cost of such terms to create an accurate “amount of loss,” to return the property to its pre-claim condition. See, the policy provides coverage to replace the damaged property with those of like kind and quality. An Independent Appraiser that is not familiar with that does not have experienced contractors, engineers, and other experts to consult with about mold, demolition, cost associated with contents, and in some cases, additional living expenses. You should choose your Independent Appraiser wisely. Look and interview someone with experience of the type of damage you have and with the type of property damaged, as well as a specialist when it comes to the Insurance Appraisal Process and also Insurance Claims Handling.

Many people confuse the words Independent Appraiser with that of a real estate appraiser. As you can see, a real estate appraiser is far from what is needed for an Insurance Appraisal. An Independent “Insurance,” Appraiser is an insurance claims expert on costs and processes to repair or replace damaged property. 

 The next question is, “Who will have such knowledge?” People requesting assistance in the past have asked if the following experts with the following backgrounds are good choices ;

Structural Engineers: This person may be a structural expert and could probably provide a good estimate to replace a building, but what about the contents (furniture, food, etc.) damage? Do they know anything about the insurance policy, the claims process, the software used by insurance companies, the Appraisal Process?

Construction Attorney: A Construction Attorney most likely has knowledge of construction contracts and issues that building contractors have. Do they know anything about the insurance policy, the claims process, the software used by insurance companies, the Appraisal Process, the contents damaged? (NOTE: If you retain an attorney as Appraiser, remember, there is NO attorney/client privilege because the attorney is being hired as an Appraiser, not as an attorney.)

Construction Superintendent or General Contractor: Again, excellent choice for generating a structural estimate, but is most likely not familiar with insurance claims… and even more importantly, the Insurance Appraisal Process.

Insurance Claim Attorney / Lawyer: Keep in mind that the process was designed to keep these types of disputes out of court. You can surely use an attorney as your appraiser; however, the fees can exhaust your reward. Attorney’s fees range between 30% and 40% of the amount collected. This will dig deep into the net amount you receive. An Insurance Attorney will also have expert knowledge of the policy. However, the Appraisal Provision clearly notes that no policy provisions will apply. Has the attorney represented their clients in many appraisals or mostly in court cases? How familiar are they with the Appraisal Process, building costs, construction practices, the contents damaged? Does the attorney know anything about the software used by insurance companies? (NOTE: If you retain an attorney as Appraiser, remember, there is NO attorney/client privilege because the attorney is being hired as an Appraiser, not as an attorney.)

Independent Insurance Appraiser: Doesn’t it make sense to hire an individual who is an expert of the process in which you are about to engage? You’ve heard the expression, “Would you go to your auto mechanic if you needed brain surgery?” It is highly recommended to use a qualified, professional, Insurance Appraiser. This professional will already know the Insurance Appraisal Process. They will also have qualified professionals (engineers, contractors, inspectors, etc.) at there disposal to back up their analysis.

Regardless of background, an Independent Appraiser will also require good communication skills and agree with the position they are defending. They should know about the insurance policy, the claims process, the software used by insurance companies, the Appraisal Process, contents damage, structural damages, building costs and processes, as well as materials and building codes. Makes sense, right?

Advantages to the Appraisal Process

There are several advantages to the Insurance Appraisal Process. The most obvious is costs. Insurance Attorney’s will usually charge 30% to 45% of the total award. On a $200,000 claim, the attorney’s fee would be in the range of Sixty to Ninety-thousand dollars ($60,000 to $90,000). That can hurt a policyholder trying to rebuild their life. Remember, the Insurance Appraisal Process was designed to keep these disputes out of the courtroom.

The advantage of invoking appraisal allows for a less formal or non-legal proceeding. An Independent Appraiser usually charges in the range of $125 to $200 per hour. Using the same example above with an award of $200,000; if the dispute took 25 to 50 hours, the cost would be in the range of Five Thousand to Ten Thousand dollars ($5,000 to $10,000). This can be a significant difference.

Another advantage is time. The courtroom can delay an insurance claim dispute for years, where the Appraisal Process usually only takes a few months. Sometimes it can last longer depending on the complexity of the claim. However, the courtroom will most certainly be longer. The result of less time and less cost becomes a less of a burden for both sides of the dispute.

Once an award is signed the insurance company has 30 to 60-days (depending on state) to settle the award.

Should I Demand Appraisal?

When the dispute is real and the damages are real, the policyholder usually see’s a greater return at the end of the appraisal. If the policyholder’s claim is supported by an Insurance Claims Expert, building or repair contractors, or an engineer – and the amount of money between the two estimates is large, the Appraisal Process is a no-brainer. However, if a contractor or Public Adjuster is trying to beef-up the damages for their own benefit, then it’s the policyholder that pays dearly for it. If you’re considering invoking appraisal on your claim you should consult an insurance claim expert to see if it’s worth your time and effort.

Being that the Appraisal Award is binding, the policyholder should be sure before they cost themselves unwanted anguish. If the outcome of your Appraisal Award is not what was to be expected, both parties must live with the result. As stated, the Appraisal Award is binding on “both parties.”

At the end of the day nothing is risk free. There are no promises or guarantees with the outcome of any Appraisal. However, if you have a dispute over $20,000 you’re more than likely to have a result you can live with. Do your homework and remember to choose an Independent Appraiser that is educated and experienced with the type of damages you have, what caused the damage, and the type of property damaged. Keep in mind that this is “YOUR” property and “YOUR” insurance policy. Your policy protects you with the Insurance Appraisal Process, so that…

The Playing Field Remains Level, and The Process Works Fairly For Both Parties… Not Just The Insurance Companies!

Why A Homeowner Needs A Contractor in Dayton, OH

So why does a homeowner need a contractor in Dayton, OH? Why our role is so important.

When a homeowner files a claim for roof damage, the insurance company assigns an “adjuster” who represents the insurance company to come inspect the property to decide whether or not it is damage that is covered by the policy, and also to discern what amount of money will be allowed to repair the damages. Like any field, there are people who are good at their jobs and people who are not so good. It’s like waitresses at a restaurant; sometimes you get a real doll, sometimes you don’t. The problem is, if an inexperienced, unknowledgeable, lazy, or cranky adjuster is assigned to your claim, do you really get a fair assessment of the damages? Probably not. Large hail and wind storms affect thousands and thousands of homes, and there are only so many adjusters available to process all of the claims. Even the greatest and fairest adjusters are dealing with up to or 12 claims per day, seven days a week for months on end, and when they are that busy, it’s hard for them to be as thorough as they should be.

This can result in overlooked damages, missing items on estimates, mis-measurements, and other mistakes that lead to an inaccurate or unfair assessment for the homeowner’s claim. Let’s say a homeowner files a claim, and their insurance adjuster comes out and says there’s no damage on their roof. How does the homeowner know that’s correct? Your average homeowner is not going to get on their roof to double check, and even if they did climb up on the roof, they have no idea what they’re looking for.

Let’s say the adjuster does approve the roof to be replaced, and writes a check to the homeowner to get their roof repaired. The homeowner is happy, but how do they know that everything that was supposed to be paid for was actually paid for? What if the check is not enough? So what’s the solution? If the adjuster is there in the best interest of the insurance company, and there’s no second professional opinion, the homeowner is really at a disadvantage, and is in a position where they can only hope they get a fair and accurate assessment from their insurance adjuster.

Who represents the homeowner? You would never go to court without a lawyer, right? If the adjuster is there on behalf of the insurance company, then a contractor should be there on behalf of the homeowner. Insurance companies are businesses, and like any business, they exist to make money.

Therefore, does an insurance company want to pay as much money as possible on claims, or as little money as possible on claims? Obviously they want to minimize their losses, and it is in their best interest financially to pay out less money in claims. On the other hand, contractors would love for estimates to be as large as possible, because it is in their best interest financially. So if the adjuster is present on behalf of the insurance company who would rather pay zero dollars, and the contractor is present on behalf of the homeowner who would rather have a ten-thousand-dollar claim, they can meet in the middle and negotiate a fair and accurate settlement that is fair for all parties involved. That way the insurance company upholds their contract with the homeowner, the homeowner gets enough money to get the repairs done, and the contractor gets paid what they are deserved for the work that they do.

If your Insurance Company is giving you the runaround, or you are getting ready to file a claim, call Helping Hands Restorations, LLC today to schedule your FREE inspection and let our experienced team go to work for you!


Roofing – Understanding Storm Damage Insurance Claims Process

Have You Had Recent Wind, Hail, or Storm Damage To Your Roof or Property? 

Here is some information to help you better understand the process of filing an insurance claim for roof and storm damage.

FAQ: Roofing and Storm Damage Insurance Claims Dayton, OH


Hail Damage can’t be seen very easily most of the time. You usually will never see actual holes or indentations in the roof. Hail will drastically shorten the life of your roof. Even many roofing contractors do not know what to look for when it comes to hail damage.

If you have damaged siding, vehicles, or have noticed neighbors getting their roofs replaced, more than likely you have hail damage as well.


Hail can damage your roof without any visible signs from the ground. Hail normally has to be the size of a golf ball before it will break through your roof or cause bruising. Sometimes these damages do not show up quickly or are easily overlooked. The integrity of the shingle may be damaged, do not take a chance on it. If hail is driven by high winds or if it lasts longer than a few minutes, even small-sized hail can cause your roof to suffer severe damage and the loss of their protective granules, which will greatly reduce the life of your roof. Loss of granule layers will leave the shingles exposed to the suns UV rays. This will cause serious deterioration of the shingle in a short period of time.

Hail and high winds can cause serious damage to your roof and exterior of your home. An evaluation by one of our trained Inspectors can verify the extent of your damages and outline the means by which they should be repaired or replaced. There are a lot of good roofers around that have no clue how to inspect for hail damage or work an insurance claim. You need a professional working on your side.


No. Homeowners Insurance does not work like Auto Insurance. You will not be penalized for filing a claim. Rate increases are based on your geological location. If you are in an area that has sustained substantial storm damage, your rates may increase even if you do not file a claim.

If you had hail or wind damage in your neighborhood, CALL US! We want to be present when the adjuster comes out to do his/her inspection. It is your legal right to have a professional represent you during the inspection. Do not rely on only your adjuster’s inspection. The adjuster works for and is paid by the insurance company, and they are not in the business of writing checks. In many instances, if you do not have a contractor there representing you, they will try to claim there is not enough damage, or will give you a very small settlement for “repairs” even though your damages are sufficient enough for a full roof replacement. You need a professional contractor present at the adjuster’s meeting to advocate for you to make sure you get fully funded for the best roofing system possible. 

Ask yourself these questions:

  • Do you know what the insurance should pay for your damage?
  • Are you aware of the local codes pertaining to roof replacement?
  • Did the insurance adjuster pay for everything to bring your home up to code?
  • Are you sure the adjuster didn’t miss anything?
  • Are you sure the adjuster measured correctly?
  • Are you sure the adjuster paid ‘Fair Market Value’ for your area?


The adjuster will look at your property during working hours, so you probably won’t be home when the adjustment is taking place, which means you have no input in the matter. We ask that you allow us to represent you during the inspection. The adjuster will inspect your roof and exterior of your home for visible signs of damage only. For the roof, he will measure out a “Test Square” (10′ x 10′) on different sections of your roof. If he can find a sufficient amount of bruises or breaks for each “Test Square”, the insurance company will pay you for a new roof.


It is possible that your roof was the only one on the block that wasn’t damaged. And it is also possible that the adjuster is new and missed identifying the damage. We have had several roofing claims that we were able to get the insurance to buy, after previously they had denied. You are entitled to a re-inspection by another adjuster within the same firm. So, if you’re not completely satisfied with the results of your claim, don’t settle. Ask for another inspection. Let us work for you in getting what you deserve.


Most occur when the adjuster has not assessed the same amount of damage as the contractor. Whether it is for the roof, gutters, siding or other exterior or interior damage. So if you have interior damage or other hard to see damages that can be easily overlooked, chances are the adjuster will probably miss it. This is another reason that you need us to represent you during the inspection.

You are entitled to have your contractor of choice represent you during the adjustment process to expedite the settlement of your claim. In order to save you time off from work and the headache of the entire process, we ask that you allow us to represent you during the inspection process. We will work with your adjuster to determine the extent of the damage, clarify pricing and offer a repair/replacement price agreeable to the insurance company. All you pay is your deductible. Let us work for you in getting a fair and amicable settlement.


In most cases, about a week after the adjuster has estimated your property, you will receive your first check. This is most commonly called the ACV. (Actual Cost Value)

This check should represent the actual cost to repair or replace the damaged property, MINUS DEPRECIATION. Depreciation is a misleading term. Many think that the first check they get from the insurance company is the only money they will get.

When work is completed, the insurance company will issue a 2nd check for the RECOVERABLE depreciation amount only if the total expenses are equal to, or greater than the total settlement.

Many homeowners never get the depreciation amount back because they do not understand the process or the contractor they chose didn’t understand the proper procedures.


The insurance company has allowed you $5,000.00 to replace your roof.

Your deductible is $500.00

Your total withheld recoverable depreciation is $2,000.00

So your first check from the insurance company is $2,500.00.

If you choose a contractor to replace your roof for $3,500.00, your 2nd check from the insurance company will only be $500.00 because:

“if you have replacement cost coverage, you may be entitled to the withheld recoverable depreciation after repairs have been completed, provided the cost of the repairs exceed the amount of your deductible and your initial claim payment”. – statement on insurance claim payments.

Beware of roofing companies that advertise no deductible.

You are not allowed to profit from a loss. Insurance fraud is a class 3 felony punishable by up to 10 years in prison and fines up to $5,000.00!

Due to the amount of recent storm damage claims in Ohio and ‘shady’ roofing company practices, Insurance companies are now auditing 1 out of every 3 claims. If you profit in any way from your insurance claim (such as not paying your deductible, or pocketing any insurance money) you and possibly your contractor are committing fraud. Your paperwork from the insurance company clearly states what laws apply to your claim, so there is no “I didn’t know” excuse.

We can provide our customers with options to help with your deductible such as In-House Payment Plans and Paying You For Referrals. Ask one of our consultants for more details.


  • No. Your insurance company has a defined price list they use. More than likely it is Xactimate software, which is the same software we use, as well as most roofing companies that specialize in storm damage. The Insurance will only pay actual costs for repairs (according to their price list), regardless of what prices you may get. However, Xactimate pricing is updated monthly, and it’s very likely the adjuster is using an out-dated price sheet. If that is the case, we will send them a supplemental invoice with the corrected prices.

Think of it this way. What reward will the insurance company give you for finding the lowest price for them? Will they lower your premium?

Your insurance company will pay a reputable contractor only “Fair Market Price”.

Example of 3 different Roofing bids:



You are only saving the insurance company money and costing yourself quality when you get several estimates. You need to make a decision on which contractor you use based on who you feel comfortable with and their reputation, and experience in roofing and insurance claims.


All your doing is compromising in quality of the roof and not saving yourself any money, besides, what reward will the insurance company give you for finding the lowest price for them? Will they lower your premium? OF COURSE NOT.


Only choose a Local Roofing Contractor willing to help with the claims process, the cost for repairs for your home is then determined by the insurance company and the contractor. Helping Hands Restorations, LLC has successfully mastered the storm damage insurance claims process and we have helped many local families get approved for a full roof replacement, even when they thought it was impossible. On top of that, we always install top quality materials, install the roofing system to manufacturer specifications, and all of our customers receive a unique “IRON CLAD” PROTECTION warranty from the manufacturer. We have extensive experience in working with insurance companies to replace your Storm Damaged Roof, Siding, Windows, Gutters and more. Call Us Today! Or, visit our website to learn more about the services we offer here at Helping Hands Restorations,