Choosing a path
Public Adjuster or Appraisal? Identify the Dispute First
Two different processes, two different questions. Here is how to tell which one your claim actually needs.
Public adjusting and appraisal solve different problems. One handles the claim; the other decides the amount of a covered loss. Naming the actual disagreement first tells you which one fits.
What each one is
A public adjuster is licensed by the Texas Department of Insurance to represent policyholders on a claim. A public adjuster is licensed by the Texas Department of Insurance to represent policyholders on a claim. That means understanding the policy and applying its provisions to the documented facts of the loss, identifying how coverage, conditions, limitations, and available benefits affect what is being claimed, developing the supporting evidence and estimate, and presenting and negotiating the policyholder's complete claim position with the insurance company.
Appraisal is a process inside the policy for one question: the amount of a covered loss. Each side appoints an appraiser, and a neutral umpire resolves what the appraisers cannot. Appraisal does not decide whether something is covered, what caused the damage, or whether the claim was handled properly.
Neither is a substitute for the other. A claim can need representation first and appraisal later, or representation and never appraisal at all.
Side by side
Primary function
- Public adjuster
- Prepares, documents, presents, and negotiates the insurance claim on the policyholder's behalf.
- Appraisal
- Determines the amount of a covered loss, including the physical extent, quantities, and repair method necessary to value it.
Coverage and claim representation
- Public adjuster
- Represents you throughout the claim, applying the policy to the facts and evidence and presenting your complete claim position.
- Appraisal
- Does not construe the policy or decide whether the insurance company owes coverage for a loss.
Negotiation
- Public adjuster
- Negotiation is central: scope, pricing, code, depreciation, and benefits.
- Appraisal
- Not a negotiation. Two appraisers value the loss; a neutral umpire resolves what they cannot.
Amount determination
- Public adjuster
- Reached by agreement with the insurance company, or not reached at all.
- Appraisal
- Set by agreement of any two of the three participants, and binding on the amount.
Typical fee structure
- Public adjuster
- Contingency, capped at 10% of claim proceeds under the Texas Insurance Code, agreed in writing.
- Appraisal
- Flat fee or hourly, independent of outcome. Never a percentage of the award at this firm.
Best fit
- Public adjuster
- The claim file is incomplete, scope or benefits are missing, coverage is in question, or nothing is moving.
- Appraisal
- Coverage is accepted, the full loss has been documented, and the remaining disagreement is the amount.
Role posture
- Public adjuster
- Advocate for the policyholder, licensed by the Texas Department of Insurance.
- Appraisal
- Appointed by one side but expected to act impartially in determining the amount of loss.
Outcome and finality
- Public adjuster
- A negotiated settlement. Other options remain available if it does not resolve.
- Appraisal
- An award that is binding on the amount, except in narrow circumstances such as fraud or material mistake.
Three situations, three answers
1. Covered roof, disagreement on extent and price
The insurance company accepted that the roof is covered, but the two sides disagree on how much of it was damaged, whether repair or replacement is necessary, and the pricing that follows. All of that is amount of loss, and it is the situation appraisal was written for. Appraisal is broader than a unit-price comparison.
2. Roof accepted, other categories missing
The roof is approved, but interior water damage, code-required work, gutters, fencing, or detached structures never made it onto the estimate. Invoking appraisal now values an incomplete loss. Complete the claim review first, then decide. See what to do when items are left off the estimate.
3. The insurance company points to wear and tear
If the position is that the damage was caused by age, deterioration, or something the policy does not cover, the disagreement has moved to coverage and liability. Some causation analysis can be unavoidable when a panel values a loss, but appraisal does not decide whether the insurance company owes coverage. A licensed public adjuster can apply the policy provisions to the damage, evidence, and benefits at issue, and develop and present your complete claim position. Start with denied claim representation and, if the issue calls for legal advice or litigation, an attorney.
Partial acceptance is not full acceptance
A letter that accepts part of a claim does not mean every damaged component or every policy benefit has been accepted. Roof approval says nothing about interiors, contents, code coverage, mitigation costs, or additional living expense. Before treating a claim as an amount-only dispute, confirm line by line what has actually been accepted and what was never addressed. An underpaid claim and an amount-of-loss dispute can look identical on the check stub and be completely different problems.
How our two engagements stay separate
Public adjusting and appraisal are separate engagements at this firm, with separate agreements and different fee bases. We do not serve as appraiser on a claim where we are the public adjuster; those clients use an outside appraiser. If you are weighing timing, read when to use appraisal on a Texas property claim and our Texas property insurance appraisal services.
General information, not legal advice. Policy terms and applicable law control any given claim. Frost Property Loss Advisors LLC, Texas Department of Insurance firm license #3513777.
Identify the dispute before choosing the process.
Upload the estimate and any coverage letter. A licensed Texas public adjuster will explain what has been accepted, what may be missing, and whether appraisal fits. Free, no obligation.