Alternative Claim Dispute

The Difference Between an Insurance Claims Appraiser and an Insurance Claims Umpire

When you make an insurance claim, you always hope that things will go smoothly. Ideally, you would file your claim, an insurance adjuster would inspect the damage and write an estimate for the cost of repairs. You would then receive the amount needed to repair your damaged property.
 
Unfortunately, it doesn't always work this way. An insurance adjuster may not always agree with the policyholder as to the value of the claim. Sometimes the amount offered by the insurance company might be significantly lower than what the policyholder making a claim might have expected. In some cases, your policy will have an alternative dispute resolution process where you can dispute the claim and try to get the insurance company to pay more for your damages.
 
If there's a dispute over an insurance claim, there are various ways to resolve the situation. One way to move forward is to invoke the appraisal clause in the insurance policy. In this example, both the policyholder and the insurance company designate an individual to serve as their appraiser for the claim.  Both appraisers meet at the property to inspect the damages and discuss the differences between the two estimates and try to come to an agreement.  If they are unable to do so, a third party called an umpire, is called in to make a final decision and resolve the dispute.
 
The umpire must be competent to make such a decision, with in-depth knowledge of property dispute resolutions, which relate to the kind of claim being disputed. The umpire must also be disinterested and impartial and not be connected in any way to either the insurance company or the policyholder who is making the claim.  The insurance claims umpire will meet both appraisers at the property and listen to both of their positions on why they feel they are correct.
 
The umpire will then render a decision which is binding and final.  Both the policyholder and the insurance company have to accept the result. That is why it is important to choose an expert insurance claims appraiser, and if needed, an umpire who can make a fair claims settlement.
 
We are Certified Insurance Appraisers and Umpires (CPIAU) and have the knowledge and expertise having handled many claims dispute resolutions throughout our careers.