Paid Does Not Always Mean Fully Resolved

If your claim has already been paid but the amount does not fully address the damage or necessary repairs, the file may need a careful second review.

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When a Paid Claim Still Needs Attention

A claim can receive payment while parts of the loss remain unaddressed. Sometimes the carrier’s scope does not capture the full extent of the damage. In other situations, repair requirements become clear over time, or supporting information was never fully developed during the original adjustment.

We compare the documented loss and repair requirements with the carrier’s scope and payments to determine what remains to be addressed and whether additional payment is supported under the policy.

Our Forensic Review Process

Capital Public Adjusters, Inc. conducts a detailed review of the claim and its claim-related documents (CRDs) to determine what may have been omitted, underscoped, or insufficiently documented, and what remains unresolved (open items). That review may include estimates, photographs, inspection materials, payment history, correspondence, invoices, expert reports, repair records, and the carrier’s current position on the claim.

We analyze how the file was handled, what support was previously provided, and what additional information may be necessary to present the claim more completely.

How We Assist in Moving the Claim Forward

We use the findings from our review to prepare and present additional information to the carrier. Depending on the claim, this may include updated or supplemental estimates, expert reports, photographs, and other CRDs that clearly explain the loss, the repair requirements, and the basis for the additional amounts requested. We communicate directly with the carrier, explain the support for the requested changes, and work to resolve differences in the scope or valuation. Our objective is to provide the carrier with a complete and professionally supported basis to reconsider its assessment and issue additional payment where the facts and policy support it.

Focused Advocacy for Existing and Underpaid Claims

An existing or underpaid claim often needs a disciplined review of what was missed and what is still required. This is one of our core areas of work.

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