How Mitigation Mistakes and Adjuster Relationships Can Inflate Insurance Claims

This Started With a Simple Pipe Burst

This loss started with a second-floor pipe burst at a shower valve body.

From there, water traveled:

• into the hallway

• into multiple bedrooms

• down into the kitchen

• across adjoining living areas

• and into the finished basement

👉 As water moves downward, it spreads outward

That’s how a localized loss becomes a large one

How I Got Involved in This Claim

I was brought into this claim by a public adjuster to write the estimate.

This is something I’m often called in to do. I work with a limited number of public adjusters who understand that estimates need to be written based on actual scope and real construction logic — not inflated numbers.

The goal is not to increase a claim artificially.

👉 The goal is to write an estimate that is accurate, justified, and defensible

In many cases, those estimates end up in the same range others try to reach — but they get there the right way, without relying on unsupported scope or excessive labor.

This particular claim involved a second-floor pipe burst at a shower valve, and I was asked to prepare a full estimate based on the actual damage.

The First Problem: How the Repair Was Handled

When the repair was performed, tile in the bathroom was removed to access the valve body.

The issue:

👉 access could have been achieved from the opposite side of the wall

On the other side, drywall had already been removed, exposing the repair area.

That means:

👉 the tile removal was not necessary to complete the repair

Why This Matters

Even if materials are damaged, the process matters.

In mitigation and restoration:

👉 you must attempt the least invasive method first

That includes:

• accessing from the opposite side

• attempting drying procedures

• evaluating whether materials can be saved

In this case:

👉 that sequence was never followed

The Missed Step: Attempting to Dry First

Before removing materials:

👉 an attempt to dry must be made

That includes:

• structural drying

• monitoring moisture levels

• evaluating whether materials can be preserved

Here:

👉 no attempt was made to preserve the bathroom

Instead:

👉 materials were removed immediately

Why This Is a Bigger Problem

This is not just about one bathroom.

This is about process.

When mitigation is done incorrectly:

👉 the size of the loss increases

In this case:

👉 approximately $50,000 in additional damage could have been avoided

How the Loss Became a Large Claim

Because of how the loss was handled:

• upper-level damage expanded

• lower-level damage increased

• water spread across multiple rooms

• the basement became involved

👉 what started as a contained issue became a full-scale claim

The Estimate That Reflected the Actual Damage

When the estimate was written properly:

👉 the total scope came to approximately $465,000

This included:

• full scope of affected areas

• proper material replacement

• accurate construction costs

👉 This is what a properly written estimate based on actual damage looks like

What Happened Next

Instead of submitting that estimate immediately:

👉 the public adjuster chose to wait

The reason:

👉 to see what the independent adjuster would produce

This is a common dynamic in the insurance claim process

When the Independent Adjuster Responded

The independent adjuster returned with an estimate in the range of:

👉 $750,000

At first glance:

👉 that appears to benefit the homeowner

The Problem Inside That Estimate

When the estimate was reviewed:

👉 the increase was heavily driven by labor

Not necessarily by:

• expanded scope

• additional materials

• clearly defined construction needs

👉 but by labor-heavy line items throughout

Why That Matters

This is one way to identify when an estimate may not align with actual construction logic.

Proper estimating should reflect:

• scope

• materials

• sequence of work

Not excessive labor as a substitute for scope

This is a core issue in how insurance claim estimates are written and reviewed

Why It Was Still Approved

Because the estimate came from the independent adjuster:

👉 it was accepted

This is where relationships and process dynamics come into play

The Role of Relationships in Claims

Public adjusters and independent adjusters often interact repeatedly.

Over time:

👉 working relationships develop

Those relationships can influence:

• how aggressively a claim is challenged

• how estimates are positioned

• how quickly agreements are reached

In this case:

👉 that dynamic benefited the homeowner

But This Is the Real Issue

Even when it benefits the homeowner:

👉 it creates inconsistency

Because the outcome is no longer based strictly on:

• damage

• scope

• cost

It becomes influenced by:

• process

• relationships

• positioning

Why This Affects Everyone

This is not just about one claim.

When claims are:

• over-scoped

• under-scoped

• inconsistently written

👉 it affects the entire system

That includes:

• carrier costs

• claim frequency

• premium increases

What Should Have Happened

This claim should have been based on:

• proper mitigation sequence

• accurate scoping

• correct material evaluation

• justified pricing

Not:

• unnecessary demolition

• inflated labor

• delayed positioning

The Key Takeaway

There are two separate issues here:

1. Improper mitigation increased the size of the loss

2. Estimate dynamics created an inflated outcome

Both come from the same root problem:

👉 the process was not followed correctly

What Homeowners Should Understand

If you’re dealing with a claim:

• proper drying should always be attempted first

• access methods matter

• scope should match actual damage

• estimates should reflect real construction logic

And most importantly:

👉 outcomes should not depend on who writes the estimate first or who has the stronger relationship

The Bottom Line

This claim worked out in the homeowner’s favor financially

But that does not mean it was handled correctly

👉 the process increased the loss
👉 the estimate inflated the outcome
👉 and the system allowed it

If you still have questions about your claim, visit our Homeowners Insurance Claim FAQs page for quick answers and links to detailed guides.

Learn More At ClaimHelpMe.com

This page explains the basics of how this part of the insurance claim process works.

However, inside ClaimHelpMe.com, homeowners can access real repair estimates, detailed examples, and step-by-step explanations showing how claims are documented, evaluated, and presented to insurance carriers.

The free content explains the fundamentals.
The ClaimHelpMe platform shows how the process actually works.

Explore more homeowner insurance claim guides in our Claim Guides section.

About The Author

Mark Grossman is a Licensed Public Adjuster and NASCLA Certified Contractor with 28 years in the restoration insurance industry and 35 years in construction.

Learn more → Mark Grossman