When water or fire damages your home, the restoration company works on the property and your insurance company works on the claim. Knowing who does what, and what Illinois requires of insurers, helps you keep the claim moving. This guide walks through the usual order of events, using guidance from the Illinois Department of Insurance, the NAIC and Illinois claim rules.
What should you do in the first few hours?
The Illinois Department of Insurance’s Property Insurance Consumer Guide lays out the early steps in order.
- Make sure it is safe. The Department warns against entering your home before you know the structure is safe to enter.
- Call your agent or insurer. The guide says to contact your agent immediately and describe the damage. The NAIC adds that the time you have to report a claim varies by state.
- Take photos before cleanup. Photograph the damage, but only in areas that are safe to reach.
- Prevent further damage. The guide says “It is your responsibility to mitigate against the possibility of further damages.” Its examples include removing standing water, covering roofs and walls and boarding windows.
- Keep receipts and damaged items. Save receipts for supplies and temporary repairs. Keep items you think are a total loss until the company representative has examined them.
The EPA says it is important to dry water-damaged areas and items within 24 to 48 hours to prevent mold growth.
What does the restoration company do during a claim?
Our work starts with mitigation, the insurance word for stopping damage from getting worse. On a water loss that means finding the source, removing water and drying the structure, which is the core of water damage restoration. After a fire or storm it can mean boarding openings and covering the roof, as in storm damage and board-up.
The NAIC says insurance will typically reimburse the cost of these temporary repairs as part of your claim, assuming the loss was covered.
While we work, we document. That record usually includes the following.
- Photos of each affected area before, during and after the work
- Moisture readings that show where water traveled and when materials are dry
- A list of damaged building materials and contents
- A written scope and estimate for repairs
The NAIC suggests having your contractor meet with you and the adjuster. That way the adjuster sees the damage and the documentation together.
Before permanent repairs, the Department of Insurance advises getting your adjuster’s approval before you contract for the work, and the NAIC notes the adjuster may want to review estimates before repairs begin.
Who does what during the claim?
| Task | You | Insurer and adjuster | Restoration company |
|---|---|---|---|
| Report the loss | Call your agent or insurer | Opens the claim | Helps you describe what happened |
| Stop further damage | Responsible for it | Reviews the mitigation costs | Does the emergency work |
| Document the damage | Photos, inventory, receipts | Inspects the property | Photos, moisture readings, scope |
| Decide coverage | Reads the policy | Makes the coverage decision | Shares documentation |
| Estimate repairs | May get your own estimate | Prepares its own estimate | Prepares a repair estimate |
| Start repairs | Signs the contract | Approves before work starts | Does the approved work |
How long does an Illinois insurer have to respond?
Illinois sets claim-handling standards in the Insurance Code and in Part 919 of Title 50 of the Illinois Administrative Code. Here is what those sources say.
| Step | Standard | Source |
|---|---|---|
| Acknowledge your communications about a claim | Within 15 working days of receipt | 919.40 and 154.6(b) |
| Send claim forms you request | Within 15 working days | 215 ILCS 5/154.6(o) |
| Make a bona fide effort to communicate when liability is reasonably clear | Within 21 working days after notice of the loss | 919.40 |
| Offer payment once liability is affirmed and the amount is not in dispute | Within 30 days | 919.50(a) |
| Explain a denial or a lower offer in writing | Within 30 days after the investigation and determination of liability is completed | 919.50(a)(1) |
| Explain a delay in writing | If the claim is unresolved 75 days after it is reported, or 25 days after proof of loss is received, whichever is less | 919.80(d)(7)(B) |
The denial and delay letters must include a Notice of Availability of the Department of Insurance, which tells you how to reach the Department. The delay rule applies to fire and extended coverage policies as defined in 215 ILCS 5/143.13, which covers residential property up to and including a four-family dwelling.
What if the insurer’s estimate is lower than the repair estimate?
Illinois has a specific rule for this in 50 Ill. Adm. Code 919.80(d)(7)(C). It applies when a partial loss is settled on a written estimate prepared by or for the insurer.
- The insurer must give you a copy of its estimate if you ask.
- Its estimate must be reasonable and allow for repairs to be made “in a workmanlike manner.”
- If you get your own written estimate showing necessary repairs will cost more, the insurer must review it, respond promptly in writing and give you the name of a repair shop or contractor that will make the repairs in a workmanlike manner.
- If it does not name a contractor, it must give you written notice that reasonable costs above its estimate will be reimbursed.
You can also hire a public adjuster, though you are not required to. The Department’s guide says public adjusters work for you, usually charge 10 percent or more of your claim, and their fees are not covered by your insurance.
How do insurance payments usually arrive?
- More than one check. The NAIC says you may receive more than one check, and the first will likely be an emergency advance.
- Your mortgage holder may be named. The Department says the check for the house may be payable to you and your mortgage holder, while contents payments are made out to you. The NAIC says a lender may hold the funds in escrow and pay for repairs as work is completed.
- Living expenses. If you cannot stay in the home, Loss of Use coverage “pays for some of your additional living expenses while your home is being repaired,” according to the Department. Keep hotel and meal receipts.
- Two ways to value a loss. The Department explains that actual cash value pays replacement cost minus depreciation, while replacement cost pays what it costs to rebuild today with like kind and quality materials.
What should you know before signing a repair contract?
Under the Illinois Home Repair and Remodeling Act, before starting home repair or remodeling work over $1,000, a contractor must give you a written contract or work order that states the total cost, including parts and materials and any charge for an estimate, plus the business name and address (815 ILCS 513/15). The contractor must also give you a brochure titled “Home Repair: Know Your Consumer Rights” (815 ILCS 513/20). The Act covers single-family homes and buildings with six or fewer units (815 ILCS 513/10).
The Illinois Attorney General points out two cancellation rights.
- You can cancel a contract within three business days if you signed it based on the contractor’s visit to your home.
- In the case of disaster repair, if your insurer denies coverage, you can cancel within five days of the denial.
The NAIC also urges caution before signing an assignment of benefits (AOB), which lets a third party act for you and can allow direct payment from the insurer. Our insurance claims page explains how we share documentation with you and your adjuster.
This article is general information, not legal or insurance advice. Check your own policy and talk with your agent, your adjuster or an attorney about your specific claim.
When to call a restoration company
Call as soon as you know water, fire or smoke has damaged your home. A person answers 24/7. We ask what happened, where the water or smoke went and whether everyone is safe. Then we send a crew to stop the damage and start drying or securing the property. From the first visit we document everything with photos, moisture readings and written notes, so you have a clear record for your insurance claim. Contact us any time.