Mastering the Insurance Claim Process: Practical Tips for Dealing with Adjusters

When disaster strikes — whether it’s a fender bender, a burst pipe, or a house fire — insurance is supposed to step in and make you whole again. Yet for many policyholders, the claim process feels confusing, slow, and at times, downright frustrating.

Why does it seem like some claims go smoothly while others stall? Why do some adjusters seem compassionate and responsive, while others leave homeowners feeling ignored?

According to Karl Susman, insurance expert and host of Insurance Hour, much of the stress around insurance claims comes down to one critical — and often misunderstood — element: the claims adjuster.

In this insightful episode, Susman broke down what really happens behind the scenes during a claim, explained how to communicate effectively with adjusters, and offered practical steps for homeowners to take control of the process.

Why Understanding Adjusters Matters

When you file a claim, your insurer assigns a claims adjuster — the person responsible for investigating the loss, verifying coverage, and determining how much money you’ll receive.

But as Susman reminds listeners, adjusters are not faceless bureaucrats or corporate villains.

“Claims adjusters are just people,” he said. “They have good days and bad days. One adjuster’s behavior doesn’t define an entire company or the whole industry.”

That simple truth is the foundation for navigating claims successfully. Adjusters operate under company policies and legal obligations, but human judgment still plays a big role in how a claim is handled.

“You can’t take the experience of one claims adjuster and assume it represents how an entire insurer operates,” Susman explained. “Every adjuster is different — and that’s why how you communicate with them matters so much.”

The Human Element of Insurance

Claims adjusting is a demanding job. Adjusters deal daily with people who have just experienced loss — homeowners whose roofs are gone, drivers whose cars are wrecked, families whose possessions are ruined.

As Susman put it:

“They’re dealing with people who are emotional, upset, sometimes angry — and understandably so. It’s not an easy job.”

That doesn’t mean you should excuse poor service or accept subpar treatment. But it helps to remember that empathy works both ways. When policyholders approach the claim process with calm professionalism rather than hostility, the results often improve dramatically.

“If you’re frustrated,” Susman said, “take a breath. Don’t yell at your adjuster. They’re not the enemy — they’re the person who can help you.”

When Things Go Wrong: It’s Okay to Escalate — The Right Way

Of course, not every claim goes smoothly. Sometimes, communication breaks down or delays mount. When that happens, many homeowners make a crucial mistake: they go on the offensive.

“Don’t say, ‘You suck — who’s your boss?’” Susman joked. “That guarantees you’re not going to get the best treatment.”

Instead, he recommends a calm, constructive approach.

If you feel your claim isn’t being handled properly, say something like:

“I feel like my claim isn’t moving as quickly as I expected,” or “I’m concerned that my claim isn’t being handled the way I hoped — can I please speak with your supervisor?”

Framing your concern around your experience rather than the adjuster’s performance keeps the conversation professional and productive.

Susman’s tip is simple but powerful: put the focus on you, not them.

“When you phrase it that way, you’re not accusing anyone,” he explained. “You’re opening the door for them to help you — or to connect you with someone who can.”

Good Adjusters vs. Bad Adjusters

Just as there are good and bad teachers, doctors, or mechanics, the same applies in insurance.

A good claims adjuster will:

Communicate promptly and clearly.
Explain next steps and timelines.
Be transparent about what’s covered (and what’s not).
Treat you with respect and empathy.

A bad adjuster may be unresponsive, defensive, or dismissive. But even in those cases, policyholders have recourse.

“If you’ve gone through the normal steps — asked for a supervisor, tried to resolve it internally — and still aren’t getting results,” Susman said, “you can go to your state Department of Insurance.”

Every state’s insurance department exists to protect consumers, and they can often intervene if a claim isn’t being handled properly.

In California, for example, the Department of Insurance (CDI) allows policyholders to file formal complaints online, prompting the insurer to respond within a set timeframe.

The Relationship Between You and Your Insurer

Susman reminds listeners that the insurance relationship is simple in theory:

“We pay premiums. They pay claims. That’s the deal.”

But it’s also a relationship built on mutual obligations. Policyholders must provide accurate information, respond promptly to documentation requests, and maintain honesty throughout the process.

Insurers, in turn, are obligated to investigate claims in good faith and pay valid losses promptly.

Understanding that dynamic helps consumers advocate for themselves more effectively.

“You’re not begging for help,” Susman said. “You’re exercising a right under a contract you’ve paid for. But like any relationship, how you handle the conversation matters.”

How to Prepare Before Filing a Claim

While many people only think about their insurance after a loss, preparation beforehand can make all the difference. Susman offered several key tips:

1. Keep a Home Inventory

Document your belongings — photos, receipts, serial numbers. This makes it easier to prove value later.

2. Know Your Policy

Understand your coverage limits, deductibles, and exclusions before a loss occurs.

“If you don’t know what’s covered, you’ll have a harder time navigating your claim,” Susman said.

3. Communicate in Writing

Follow up phone calls with emails to create a record of your interactions. Documentation is your friend.

4. Be Prompt and Honest

Report claims as soon as possible and provide accurate details. Misrepresentation can delay or jeopardize your claim entirely.

5. Ask Questions Early

Don’t wait until you’re frustrated. Ask your adjuster about timelines, next steps, and documentation needs at the start.

The Psychology of Claims: Why Emotions Matter

Susman emphasized that emotional awareness — on both sides — can make or break the claims experience.

“Most people don’t file claims very often,” he noted. “So when they do, they’re already stressed. But if you go in expecting a fight, you’ll probably get one.”

Instead, he encourages policyholders to adopt a mindset of collaboration. Adjusters are more likely to respond positively to respectful, solution-oriented communication than to anger or threats.

“If you show that you’re reasonable, you give them a reason to go to bat for you,” he said.

When to Involve a Public Adjuster or Attorney

In complex or high-value claims — such as major fire or flood losses — policyholders sometimes hire public adjusters or attorneys to represent them.

While Susman supports consumers knowing their rights, he cautions against jumping to that step prematurely.

“Most claims can be resolved without outside help,” he said. “But if you’ve exhausted all options with your insurer and you’re still getting nowhere, then yes — get professional representation.”

Public adjusters typically charge a percentage of the claim payout (usually 5–10%), while attorneys may charge hourly or contingency fees. Both can be useful, but homeowners should do their homework and verify credentials before hiring anyone.

The Most Important Takeaway: Adjusters Are People

If there’s one lesson Susman wants homeowners to remember, it’s this: claims adjusters are human beings doing a hard job.

They juggle dozens of files, navigate bureaucracy, and often deal with policyholders in crisis. That doesn’t excuse bad behavior — but it does mean that kindness, patience, and professionalism go a long way.

“At the end of the day,” he said, “you get further with cooperation than confrontation.”

He encourages policyholders to use empathy as a strategy:

Assume good intentions unless proven otherwise.
Communicate clearly and respectfully.
Ask for help when needed — and escalate through the right channels.

Final Thoughts: Knowledge Is Power

As Insurance Hour wrapped, Susman summed up his mission succinctly:

“Insurance isn’t sexy,” he laughed, “but it’s important. You just need to know more than you used to.”

The takeaway is clear: understanding how insurance claims work — and how to work with adjusters instead of against them — empowers homeowners to protect their rights, avoid unnecessary stress, and get faster, fairer outcomes.

In an era when California’s insurance landscape is more turbulent than ever, mastering the claim process is one of the smartest investments any policyholder can make.

Because in the end, as Susman reminds us, the goal of insurance is simple:

“We pay premiums. They pay claims. Everything else is just the process of getting there.”

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