Getting and Reading the Adjuster's Estimate on a Virginia Property Claim

If all you have from your Virginia claim is a number — read to you on a call, or printed at the bottom of a one-page letter — you have the carrier's answer without its working, and a number with no lines behind it leaves nothing to check line by line and nothing specific to answer. The reasons are in the estimate, and Virginia's claim-settlement regulations speak to that document directly.

If you're in Northern Virginia with a hail-pocked roof, in Richmond with a tree through the bedroom ceiling, or in Hampton Roads with wind-driven rain in the walls, and you have a figure but not how it was reached, the first job is getting the estimate. The second is reading it against the regulation's own standard, a test you can apply without an estimating program or a contractor's license.

This article walks through getting the estimate, checking that it is whole, reading each line, six things to ask for in writing, and where a Bureau of Insurance complaint, appraisal and Virginia's fee statute fit. Property People Law represents property owners against their insurers, and our Fairfax office handles claims across Virginia. Every policy is different, every claim turns on its own facts.

The Adjuster's Report and the Estimate: What Virginia's Regulations Say About the Copy

A payment letter's totals — replacement cost, depreciation, the deductible, the net payment — are each the sum of lines the letter leaves out: which rooms, how many square feet of drywall, whether the roof was priced as a repair or a replacement.

Virginia's claim-settlement regulations for property policies address the longer document. When an insurer prepares an estimate of the cost of repairs, the estimate is to be "an amount for which the damage may reasonably be expected to be satisfactorily repaired," and the insurer is to give the claimant a copy of the estimate. A letter of totals generally summarizes that document rather than reproducing it. The trigger is the insurer preparing one. If the carrier says it didn't, the question becomes what the figure was built from, and that question belongs in writing.

How to Tell Whether You Have the Whole Insurance Claim Estimate

A PDF can still be partial. The cover page identifies the claim, the date the estimate was written and, where one is shown, the price list code. Check the page numbers for gaps, and check that each damaged part of the property — the roof, each affected room, the siding, a detached garage — has its own group of lines. An item missing from the estimate is missing from the total.

Each line carries a description, a quantity and unit, a unit price and a total, with depreciation and actual cash value columns on a replacement cost policy. Add the group totals and compare them with the summary page; a mismatch can mean a page or a revision is missing.

Reading Each Line Against the Satisfactorily Repaired Standard

What the standard requires on a disputed line turns on the facts, but the question it puts to each line on your estimate — could this damage reasonably be repaired, satisfactorily, for this amount? — has three parts.

Quantity is the measured area, length or count, and the sketch is its check. Room dimensions head each room's group; a wall entered a few feet short carries the error into the drywall, insulation, paint and baseboard lines below it. Compare the sketch with a tape measure, and the roof's squares with your roofer's count. A quantity smaller than the damage prices a smaller repair than the one needed, whatever the unit price.

Product and method are in the description: remove and replace, repair, clean, detach and reset, paint. A hollow-core door priced where a solid-core door hung, or a "clean" line where your contractor says the material has to come out, is the kind of line the standard puts in question — the price can fit the work described and still not pay for the repair the damage needs. Photographs of what is there, and the contractor's note on why, are what put that question to the carrier.

Price is local. The question is whether the work on the line can be done for that amount in Arlington, Henrico or Chesapeake, and itemized bids in the estimate's own units — per square, per square foot, per linear foot — answer it better than a lump sum. Where two or three local prices for the same unit sit well above the line, that line is the one to ask about in writing, bids attached.

Six Things to Ask the Carrier for in Writing in Virginia

Each is a document or an explanation to request from the carrier; keep a copy of each request.

1. The complete estimate comes first. Cover, line items, summary page and attachments, for the current version.
2. The sketch and measurements are what the quantities rest on. Room dimensions, the roof diagram, and wall and elevation lengths, to set beside your own measurements.
3. The adjuster's photographs show what was looked at. Labeled by area and set beside your own photographs from the day of the loss, they show whether any damaged area went unphotographed.
4. The price list sets the unit prices. If the cover doesn't name it, ask which list the estimate used and as of when.
5. Earlier versions show what moved. Ask for each one with its date, and for the reason any line went down.
6. A written answer on each line raised is worth asking for. It shows whether the line changed and, if not, why — and, where the reason is coverage rather than price, which policy provision the carrier relied on. A letter that names four lines, each with its photograph, measurement or bid, asks for four answers; one that says the estimate is too low asks for one.

What Virginia Law Adds When the Estimate Is Missing or Low

What these rules give a file is a basis to ask, in writing, for each version and the reason for each cut.

A complaint puts the file before the Bureau of Insurance, which asks the company for an explanation and reviews whether it followed Virginia insurance laws and the policy. The Bureau's complaint page says it cannot determine the monetary value of a claim, and our research turned up no state-run mediation program for Virginia property claims, so a disagreement over what a repair costs goes elsewhere.

Virginia's standard fire policy terms provide for appraisal when the sides disagree on actual cash value or the amount of loss, and appraisal generally decides the amount, not coverage. Virginia also has a fee statute that can matter in a suit on the policy. A missing copy, a disputed price and a refused claim are different problems, and once the estimate is in hand, reading it line by line usually shows which one a file has.

How Property People Law Reads a Virginia Insurance Estimate

We start with what the carrier has produced; if the file holds only a figure or a letter, our first letter asks for the estimate, the sketch, the photographs and each version. We check the estimate for missing pages and missing rooms, then set your contractor's bid beside it and mark each difference as quantity, product and method, or price. Each version goes against the one before it, and the payment letters against the summary page.

Where a line comes up short, we send the carrier that line with the measurement, photograph or bid that supports it. If the carrier stands by its number, the marked-up estimate tells us whether the question is one for the Bureau, for appraisal, or for a suit under the policy — and that choice is the owner's, made with the record in front of both of us.

Our VA residential and commercial property work is generally on contingency — we only get paid from the recovery, not your pocket. Past results in other cases don't guarantee outcomes in any new matter, and every claim turns on its own facts.