Defining Terms

Below is a list containing some words that not everybody may be familiar with. Insurance policies and industry language may be a little challenging for some. We have put common language to the words below. If you would like to see a word added, let us know.

• Insured – The person or entity who has actually purchased the insurance policy.
• Insurer – The insurance company or insurance carrier who has sold the policy.

• Insurance policy – The contract describing the coverages the insurance company has sold to their customer.  Where we find policy insurance limits and rules to follow to ensure proper payment of a claim.
• Contents – Otherwise known as personal property.  These items are your personal items that may have been damaged in the loss but not attached to or part of the structure. Therefore these items even though may be covered are routinely treated differently than items that are considered “the structure”.
• Structure – The residential or commercial building that has suffered a loss.
• Damage – There are many types of damage. An insurance policy only covers “sudden and accidental” damage. Fire, wind, Hurricane, Tornado, Fire and broken pipes or water is a short list of damage.
• Maintenance issue-Usually not covered by your insurance policy. A long-term or ongoing problem is usually considered a maintenance issue.
• Covered claim -Covered claims are claims that the insurance adjuster has inspected the house and agree that a payment will be made to the insured at some point in the future. At that exact moment, it is possible an amount has not been determined. The insurance company will create an estimate and move forward with the claim. Shortly after the decision the claim will be covered, payment will follow.
• Denied Claim – A denied claim means the insurer has decided they will not pay a claim. The insured is left abandoned.  A denied claim is hard to process for an insured. The insured may feel as though the decision is unfair or unjust. The insurance company may have many reasons for a denial decision. Maybe wear and tear has been the deciding factor for the denial. If you feel you have a legitimate denial discrepancy, contact us. Pfister Adjusting has previously convinced  carriers  to overturn denied claims and have collected money for insureds. Contact us if you recently been denied  a claim. Not all claims can be overturned, however, contact us to be sure.

• Insurance Carrier– The company that the insurance policy was purchased from. Pfister Adjusting, Inc. negotiates with all insurance carriers.
• Indemnification– This term refers to the insured’s right to have a claim paid so that the damage is repaired to the way it was before the loss.