Our goal is to help you, the policyholder, to begin restoring your home or business as quickly as possible. TWIA’s initial claim assessment and any payments are intended to help start this process. The initial assessment and claim payment may not be all that is eventually owned to you on a claim. Additional damage or concerns may be discovered as a result of further damage assessments or during property repairs.
If you believe the total cost to repair or replace your damaged property is more than TWIA’s claim assessment(s), you are entitled to request additional (supplemental) payment(s). There are deadlines that apply to requesting supplemental payments. Please read your policy and claim letters and discuss with TWIA any deadlines that may apply to you.
Do not wait to cash your first check. Any additional payment will come as another check.
How does TWIA estimate repair costs?
When assessing coverage for your loss and estimating your total claim payment, TWIA considers:
- field adjuster reports and estimates for replacement or repair work,
- recommendations by engineers and construction experts, and
- estimates and other information submitted by the policyholder.
The Field Adjuster Inspection, Estimate, and Report
The field adjuster performs an onsite inspection to review damage and take detailed photographs and measurements of the property. Then they create a report and estimate. It is helpful if you are present at the time of inspection so you may allow the field adjuster to inspect both the exterior and interior of the property, point out your damaged property, and answer any questions the field adjuster may have. Field adjusters will document but do not estimate the cost to repair or replace items with pre-existing damage or that are excluded from all TWIA policies (ex: damage caused by flooding).
The field adjuster does not have the final authority to determine what is and isn’t covered by the policy or to determine if your property is a total loss.
The Estimating Software
The field adjuster uses an industry-standard software to estimate repair costs. They sketch a detailed diagram of your structures within the software program, often with the combination of aerial imagery and onsite measurements. The company that produces the estimating software conducts regular market research to determine repair cost prices in any given geographic area. However, after a hurricane the price of labor and materials can increase rapidly and the software pricing may not always be up to date.
The TWIA Claims Examiner Team
After the field adjuster has completed and submitted their report and estimate, your claim will be assigned to the TWIA claims examiner team. After a hurricane, due to the large volume of claims, TWIA uses a team approach to work your claim. You may work with multiple TWIA claims examiners.
The TWIA claim examiners will:
- Review the field adjuster’s report, estimate, photos, and any additional supporting documents.
- Determine if additional experts or other investigative steps are necessary to evaluate your claim.
- Determine what is and what is not covered by your policy.
- Calculate the claim payment amount based on your deductible, amount of recoverable depreciation, and amount of non-recoverable depreciation.
- Contact you to discuss the claim assessment.
- Send a detailed letter explaining your claim assessment, the basis for deciding what is covered and what is not, a breakdown of any payments made, and next steps for you to follow if you disagree with the assessment or have any questions or concerns.
Property Changes to Reflect Personal Preferences
TWIA policies only cover what was in place at the time of loss. For example, if you wish to replace your asphalt shingle roof with a metal one, TWIA can only pay to repair or replace an asphalt shingle roof.