@espadinya EDIT - I was responding to another message you wrote, I think.
This sounds EXACTLY like my experience.
I had a pipe burst while I was traveling and hired called my insurance company immediately. Insurer suggested I call ProServ but they never got back to me, so I found my own mitigation company. Mitigation company sets up an insane amount of equipment, fans, dehus, air scrubbers everywhere. They tell me they need to gut my kitchen, downstairs bathrooms, and flood cut through 2700 SF of living space. I ask them to wait until I receive guidance from my insurance company.
I have no idea what to do, where to sleep, or what coverage I have, and I can barely get my adjuster to talk to me. And then, when we're on the phone, there's never any substantiative answers. A lot of "umms", circuitous talking, and avoidance of specifics of any kind. They ask a lot of questions to keep you talking, and prevent themselves from having to say much.
I called and emailed for 10 days straight, trying to get approval for ALE coverage. My house had no running water and the sheer volume of the dehumidifiers and fans made it deafeningly loud. At one point, when pressing him for ALE, the adjuster said "the home may be uncomfortable, but its not uninhabitable". Finally, after escalating to a manager, they agreed I needed ALE.
It's very clear what the name of the game is for the cat teams at major insurance carriers. By initially denying the claim, or portions of a claim, a percentage of the people just give up right there. Maybe that weeds out some insurance fraud, but its definitely denying valid claims, too. Those that push harder will receive a lowball initial settlement, and many will take that chump change offer and either do the work themselves or pocket the money. The homeowners that push harder, or hire a public adjuster, maybe they receive some more money. Claims that hire attorneys, etc. etc. etc.
This is a well-oiled machine we're talking about (insurance industry is worth about $5 TRILLION).
Was your claim a catastrophe loss? I swear - they must be training those adjusters to never put anything in writing. The cat adjuster on my claim probably wrote 10 words for every 5,000 words I wrote, if that. My guess is that most of the people posting here and on r/Insurance sub are likely not cat adjusters.
After 5 months, my insurance had provided only $20k to rebuild the home, even though I was sitting on over $500k total in estimates for mitigation, pack out, and build back. I got fed up, and eventually emailed every executive I could find at the company, filed complaints with every government official that could be concerned with this behavior, and my claim was escalated to its 700th adjuster.
This escalation adjuster was slightly more reasonable at considering my previously denied incurred costs, even admitted that things were handled incorrectly. He even paid me $12k in interest under the Texas Prompt Payment of Claims Act.
The straw that broke the camel's back was my personal property. After paying out about $400k on dwelling, the insurer offered me $11k for contents. Their recommendations included offering $108 to clean my $6,000 mattress + bedframe, a mere $8 to clean a $1,200 designer purse, an an expectation that I provide a technicians report for over 100 items, cables, etc.
Frustrated, I emailed the insurance company executives again, met with officials with the Texas Department of Insurance, opened an OAG: Consumer Protection complaint, emailed the mayor, governor, U.S. Senators & Congressmen, State Senators & Congressmen, the OPIC...basically I emailed everyone but President Biden.
I must've finally pissed off the insurer, because they hired outside counsel and invoked appraisal. They cut off paying my ALE out of spite, and haven't responded to me in 4 months. I wasn't aware that my insurance company could ghost me, but they're doing it.
....that's where I'm at right now.
There's really only been one silver lining here. I realized that I hate my insurer and I will do anything to raise awareness about policyholder rights and that the public adjuster option exists. I've realized that I can't just sit by while these mega corporations keep transferring money from everyday Americans into their own pockets. Insurance executives are making millions, with top CEOs raking in over $10M per year. I want to call for an increase in transparency from the insurance agencies - they should be held to higher standards than what they're able to get away with today.
My experience pushed me to get a public adjuster license of my own, about 2 weeks ago. But I want to do something larger-scale than just handle a few local claims. Just figuring out how to make a difference.