Who owns each step of a claim

Hover a row to see why the boundary sits where it does

Your agentYou

AgentDrafts the notice of loss: policy number, date, cause, address, contact details.

YouFile it. Only the policyholder can report a loss — an agent cannot stand in for you here.

AgentBuilds the dated evidence pack: photos logged by room or panel, receipts, every contractor quote.

YouTake the photos and keep the originals untouched. Originals are the evidence.

AgentRuns the deadline calendar: acknowledgement windows, adjuster visits, appeal clocks, follow-ups.

YouShow up to the inspection and let the adjuster in.

AgentReconciles the adjuster's estimate against your quotes, line by line, and flags the gaps.

YouHire and instruct a licensed contractor — the estimate has to come from them, not from you.

AgentDrafts the appeal, quoting your policy wording clause by clause, with the evidence attached.

YouRead it, sign it, send it. An appeal is your correspondence, in your name.

AgentPrepares the complaint to your state insurance department, with the timeline and documents.

YouFile it, and decide whether to accept any settlement offered.

Steps no agent should ever take

Sign · submit · accept a settlement · interpret coverage as final · impersonate you on a call. Approval is a human action every time. On a large or contested claim, that human is a public adjuster or a lawyer.

Agent work Human-only Off-limits

Boundaries follow the law, not capability. A capable agent could draft, send and chase everything on this page — the split exists because reporting a loss, signing a document and accepting money are acts that belong to the policyholder. The NAIC's consumer guidance on appealing a denied claim is the reference for the appeal step.