You know how to document the damage, prepare the estimate, and present the property loss. But some claims develop into legal disputes involving coverage, causation, exclusions, underpayment, liability, or litigation. That is where an insurance attorney can add value.
I am Jonathan Herrera, founder of Herrera PLLC. Before becoming an attorney, I spent more than a decade working on the insurance carrier side of property and casualty claims. I have evaluated the same estimates, policy provisions, causation issues, and damages disputes that public adjusters encounter every day, and I bring that experience to representing policyholders when a claim requires legal counsel.
When Should a Public Adjuster Bring in an Attorney?
Not every property claim requires an attorney, but certain circumstances make early legal involvement particularly useful.
Coverage is being questioned
The carrier is relying on an exclusion, limitation, endorsement, or reservation of rights to limit or deny the claim. An attorney can evaluate the policy language and the carrier’s position to determine whether that coverage analysis is actually supported by the policy and applicable law.
The carrier disputes causation
The insurer agrees damage exists but disputes what caused it, something that comes up constantly with water intrusion, foundation movement, roofing losses, construction defects, storm damage, mold, or fire.
The claim is significantly underpaid
The carrier accepts some responsibility, but its estimate or valuation does not account for the full scope of the loss. An attorney can address the legal issues around the disputed amount while you keep doing what you do best, documenting and establishing the physical damage.
The claim has been denied
A denial does not necessarily end the analysis. It should be examined to determine whether the real dispute is coverage, causation, an exclusion, liability, policy interpretation, or the evidence supporting the claim.
The claim is heading toward litigation
Once negotiations stall and litigation becomes a real possibility, involving counsel early helps preserve evidence and evaluate the legal claims and defenses before options start closing off.
There is no single point at which every claim should be referred. The right time depends on the facts, the policy, the size and complexity of the loss, and the position the carrier is taking. Some claims benefit from legal review before the carrier ever takes a final position; others do not need an attorney until there is a denial, a substantial underpayment, or a carrier that will not meaningfully resolve the claim.
Background That Matters to Your Clients’ Claims
- Adjuster: I spent over a decade as a licensed Executive General Adjuster and claims counsel on the carrier side, handling bodily injury, property damage, construction defect, business interruption, and excess and reinsurance files. I know how a reserve is set, how a scope of loss is evaluated internally, and where a carrier looks to limit a payout.
- Claims Counsel: I have advised carriers directly on how to handle and resolve claims, so I know the questions being asked internally before a position is ever communicated to the insured or the public adjuster.
- Defense Counsel: I have represented carriers in coverage litigation, so I know how a denial or coverage dispute is defended once it reaches suit, and how to build a claim file that holds up if it gets there.
- Coverage Counsel:I have reviewed policy language and exclusions from the carrier’s side of the desk to determine whether and how much a policy responds to a loss, the same analysis your client’s claim will face.
I understand how an insurance company approaches a claim before its position is ever communicated to the policyholder, what questions the adjuster is likely to ask, how coverage issues get evaluated internally, and how a damages presentation is received inside a claims organization. That perspective matters most once a claim moves past documenting damage and becomes a legal dispute.
You Know the Damage. We Know the Insurance Claim.
Public adjusters bring real value to property claims: inspecting the loss, documenting the damage, developing the scope, preparing the estimate, and advocating for the policyholder on the amount of the physical loss.
Our role is different. When legal issues arise, Herrera PLLC can assist with coverage disputes, policy interpretation, claim denials, significant underpayments, causation disputes, policy exclusions, reservation of rights issues, bad faith issues, liability disputes, appraisal related legal issues, and litigation. The goal is not to duplicate the work you already do well. It is to add legal counsel where the claim actually requires it, and your role in the claim continues throughout.
What Types of Claims Can Public Adjusters Refer?
- Residential Property. Homeowners dealing with significant or disputed claims, including denied, delayed, or underpaid losses.
- Commercial Property. Businesses facing significant property losses, business interruption issues, coverage disputes, or other complex claims.
- Construction Related Losses. Claims involving contractors, construction defects, resulting property damage, causation disputes, and related insurance issues.
- Complex or Large Property Losses. Claims where the scope of damage, coverage, causation, or potential litigation makes legal involvement particularly important.
How the Referral Process Works
If you have a Texas policyholder whose claim needs legal counsel, send us the available claim materials. Helpful documents include the insurance policy, carrier correspondence, any denial or reservation of rights letter, the carrier’s estimate, your own estimate, photographs and videos, expert reports, proof of loss documentation, claim history, and any relevant contracts or construction documents.
We will review where the claim stands and talk through the potential legal issues with you before anything is filed. Your work documenting and presenting the physical loss remains important throughout; our role is to address the legal issues the claim requires.
If you are a public adjuster with a Texas policyholder claim that needs legal counsel, contact Herrera PLLC to discuss the file.
Frequently Asked Questions
It depends on the claim. Legal involvement may be appropriate when the carrier disputes coverage, causation, liability, or the scope or value of the loss, or when litigation is becoming a possibility.
No. The public adjuster and the attorney serve different functions. You continue documenting and presenting the physical loss while we address coverage, liability, policy interpretation, negotiation, and litigation issues.
Yes. Some claims benefit from legal review before a denial or other adverse coverage position occurs, particularly where a significant coverage or causation issue is already apparent.
Whatever is available: the policy, carrier correspondence, estimates, photographs, expert reports, and any denial or reservation of rights letter. We will determine what else is needed once we review the file.