How to Create Your Claim Workflow

The majority of public adjusters (PAs) wonder about what to do when the opportunity presents itself and you have a chance to sign a new claim. You know what to do in theory but when real experience comes knocking on your door, it’s an entirely different story.
I know all of you want to do everything right but you start stressing over it. This is where situations happen that you might forget something important, unintentionally, of course.
That’s what this article is all about. I will help you create your own claim workflow by sharing mine with you. I’ll also provide you with a few tips and tricks that will help you stay on track.
So, without further ado, let’s have a closer look at how to create your own claim workflow.
Build your referral list
Before we dig deeper into the claim workflow, I’d like to share a useful tip with you. It’s very important to build your referral list. The main reason is that you’ll get more claims coming your way if you have people who are out there in the field.
The majority of my referrals come from the people I often work with, such as plumbers, roofers, water mitigation companies, and so on. What happens is they basically refer you and you refer them in return when there’s damage that needs to be fixed.
This is a good relationship to have because it works exceptionally well for both parties.
Get there as soon as possible
So, once your referral comes in and you find out that the loss has occurred, you need to get to the site as soon as possible.
This is very important because you need to preserve any evidence of the loss and repair or mitigate any damages right then and there.
For example, if there’s a pipe burst at the homeowner’s house, you want to get the plumber there to fix the burst. Moreover, if everything is wet due to the pipe burst, you need to call the water mitigation company to dry everything out so there’s no further damage.
Assess the claim
As mentioned before, once you get to the site of loss, you have to assess the claim. What that means is that you have to determine what the cause of the loss is, is there a need for an immediate repair, and which expert you need to call if there is.
Assuming there’s a need for immediate repairs and that you need to call experts in, they must provide you with expert documentation. This means that you need all the documentation from licensed experts regarding what they’ve done to repair the damage, what caused the damage, and why they had to repair it straight away.
This will be of great assistance later on when you have to file a claim but we’ll get to that later. Furthermore, it’s important that you take photos as well.
This will help you back up your estimate and serve as additional proof of loss.
Get the claim signed
Now, this is arguably the most difficult part of the claim process because you need to convince the homeowner to sign the claim.
This is important because that’s how you get paid. If you leave the house without your contract signed, chances are that you won’t have that claim signed.
Therefore, try to be as convincing as possible and try not to leave without the contract signed.
There might be a lot of explanation involved because your client won’t understand why some of the things are included in the contract and you have to explain that you have to get paid as well.
Take as many photos as you can
As mentioned before, taking photos is important when assessing the claim but this is also important to help you keep track of the claim.
Moreover, taking photos of every little bit of damage that occurred helps you defend your claim.
As you may know, some claims may go to litigation, which can take a long time to settle. Photos will play an essential role if you have to defend your client during litigation.

Prepare your file
Once you signed the claim, obtained all the necessary expert documentation, and taken all the photos that you could, it’s time to prepare your file for the case.
What I do is use project management software and various other tools to help me stay organized.
For example, I use Trello to help me organize my files and I update everything into the cloud so that I always have a backup.
Technology is more reliable and more convenient than having everything on paper within some chaotic filing cabinet.
Get an estimate and file the claim
Once your file is done you need to get an estimate. You can either do it yourself or hire an estimator to do it for you.
Just inform the insurer that you or the estimator will come by to scope everything out. Once that is done, you’re ready to file a claim.
Now, you can do this by phone or over the Internet. I personally do this by phone. I call the insurance company and it takes about ten minutes tops to get the information and insurance number.
That way you know that you’ve filed a claim.
Here’s another tip for you. Once I’ve filed a claim I email them my LOR (Letter of Representation).
This way, the insurance company cannot claim that they don’t have it, I know I’ve sent it and I have proof. You should do the same.
Wait for the initial inspection
Once you’ve filed a claim, that’s pretty much it.
Now everything is moving and all you have to do is wait for an insurance company to schedule an initial inspection.
What I like to do, on the day of the initial inspection, I like to get the information and email address of the insurance adjuster and send them my file either right there on-site or later that day.
As mentioned before, I’ve prepared a file before filing a claim and you should do the same.
Your file must include a few essential things. Here’s an example.
👉 Your letter of representation.
👉 Your estimate.
👉 All the photos you’ve taken.
👉 Expert documentation.
👉 Water mitigation documentation (if any).
The main reason this is important is that you’ve provided the insurance company with everything they need.
You can do a follow-up a week later and tell them that it’s time to pay the claim unless they need anything else.
The whole purpose is to avoid dragging things out and have that claim paid sooner rather than later.

That’s all for the claim workflow that I use when coming across new claims. You can always create something of your own that suits your needs more.
This workflow has worked for me over the years and I’m hoping that it will work for you as well.
If you need more information, feel free to check out my social media or my YouTube channel.