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Tools of
the Trade

A single home for methods-first white papers, briefs, and downloadable tools. Everything is organized by the claim journey so you can grab what you need—read the abstract, skim key findings, then download the file and put it to work the same day.

Fire, Smoke and Soot Damage Statistics

House fires can be devastating, but they don’t always mean a total loss. Emergency home restoration can make homes livable again by removing odors and damage from water, smoke and soot. This return to normalcy doesn’t come cheap. Fire restoration contractors typically charge a flat rate that varies depending on the type of work done […]
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Water Damage Statistics

When you consider the statistics, it becomes clear just how common and devastating a water damage problem can be. According to industry estimates, 14,000 people in the US experience a water damage emergency at home or work each day, and 98% of basements in the US will suffer from some type of water damage during their lifetime.
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Latest News
Know What Matters

Timely updates on what’s changing in claims: regulation, technology, litigation trends, and real-world practice. Each post translates headlines into practical implications, so you know what matters and how to respond.
A.I. and Ethics

How human can robots be? A detailed review

Very Large Array

Visiting the Radio Astronomy Observatory

Life on Mars

Looking for ways to make Mars habitable

13 September 2021

New Maze Tablet

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04 September 2021

Latest Netbooks

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31 August 2021

New Speaker

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Frequently Asked
Questions

Straight answers to the questions that stall progress—written in plain language and grounded in evidence. Use this living reference to align teams, set expectations, and keep files moving without back-and-forth.

Foundations & Process

What actually happens after First Notice of Loss (FNOL)?
FNOL logs the claim, triggers coverage verification, and opens an investigation plan (documents, statements, site work). Expect a timeline, a point of contact, and a list of what’s needed; speed and completeness here reduce rework later.
What’s the difference between ACV and RCV?
Actual Cash Value (ACV) reflects depreciation; Replacement Cost Value (RCV) reflects the cost to replace with like kind and quality. Policies outline when depreciation is recoverable—often after repairs are completed and documented.
How are reserves set—and why do they change?
Initial reserves are estimates based on early facts, policy terms, and typical severity. As scope clarifies (photos, reports, vendor invoices), reserves adjust; accurate documentation and timely updates keep them credible.
What documentation matters most early on?
Dated photos, receipts/invoices, prior condition records, and a simple timeline of events. Chain the sources (who/when/where) so facts can be verified without guesswork.

Claim
+Tell

Turn today’s facts into a clean, defensible record. Get the Claim + Tell Kit (Mini) free when you join our monthly newsletter—fillable pages for facts, photos, and timelines, ready to use on your next file. Prefer the complete playbook? Upgrade anytime to the 12-page Claim + Tell All Kit (Full).

Investigation & Evidence

How do adjusters decide what’s covered versus what’s maintenance?
They test cause and timing against the policy’s insuring agreement and exclusions. Evidence (forensics, moisture mapping, roof/structural inspections) separates sudden loss from long-term wear or pre-existing conditions.
When does an Examination Under Oath (EUO) make sense?
EUOs are used when facts are material but inconsistent, incomplete, or contested. They preserve the record, clarify statements, and can resolve issues that would otherwise stall a determination.
What are reasonable red flags for potential fraud—and what are not?
Reasonable indicators involve patterns (mismatched timelines, altered docs, duplicate estimates), not stereotypes. Each flag should lead to a documented, bias-checked step—verify first, conclude later.
What documentation matters most early on?
Dated photos, receipts/invoices, prior condition records, and a simple timeline of events. Chain the sources (who/when/where) so facts can be verified without guesswork.

Estimating & Scope

Why do estimates differ so much between parties?
Different scoping assumptions, missing quantities, or code/permit treatments commonly drive gaps. Align on scope first (materials, quantities, conditions) before price—most “pricing disputes” are really scoping disputes.
Do codes and ordinances always increase the claim value?
Only when applicable and supported by policy (e.g., Ordinance or Law coverage). Proper citations to adopted codes and required methods, plus jurisdiction authority, keep upgrades defensible.

Disputes & Resolution

When does appraisal help—and when doesn’t it?
Appraisal is effective for amount of loss when coverage is largely settled and evidence is organized. It’s less effective when causation or coverage is still disputed, or when exhibits are thin.
Mediation vs. arbitration vs. litigation—how should we choose?
Mediation aims at negotiated agreement; arbitration yields a binding or advisory award; litigation is formal adjudication with broader discovery. Consider speed, cost, confidentiality, and the type of dispute (coverage vs. scope).
How are reserves set—and why do they change?
Clear exhibits, consistent logic, and professional conduct. Briefs that separate facts, assumptions, and opinions—and that show math—are far more persuasive than volume.

Special Topics

What’s realistic to expect during catastrophe (CAT) surges?
Cycle times strain from access limits, labor/material shortages, and volume spikes. Triage, documented temporary repairs, and early agreement on critical path items protect outcomes.
How should water mitigation invoices be evaluated?
Look for daily logs, psychrometric data, equipment counts/durations, and photos that match the scope. Reasonable pricing follows defensible scope; excessive line items without data invite disputes.
Does AI meaningfully help SIU or claims ops today?
It can assist with triage and pattern spotting, but human review sets context and prevents false positives. Start with workflow clarity and evidence standards; let tech support—not replace—method.

Policyholders & Communication

What should a policyholder do to avoid delays?
Report promptly, document conditions, keep receipts, and communicate changes (repairs, temporary housing). Provide requested items in a single, labeled packet to reduce back-and-forth.
What if a contractor’s estimate is higher than the insurer’s?
Reconcile scope line-by-line: quantities, material grade, code items, and access methods. Where the facts align, differences usually close quickly; where they don’t, add photos, measurements, or third-party opinions.
When do business interruption claims get traction?
When there’s a clear causal link to covered damage, credible financial records, and a reasonable mitigation plan. Establish assumptions (seasonality, trends) and support them with contemporaneous documents.

Ethics & Professionalism

How do we keep bias out of claims decisions?
Use checklists, source hierarchies, and peer review on complex files. Write determinations that separate facts, policy application, and judgment—so anyone can follow the reasoning.
What does “defensible” look like in a claim file?
Dates, sources, and methods are explicit; photos and measurements tie to scope; decisions link back to policy language. If a third party can re-trace the steps, it’s defensible.