If your home is damaged by a fire, storm, water leak, or other covered event, your homeowners insurance policy is designed to help pay for repairs or replacement. But many homeowners are unsure what actually happens after a claim is filed.
Here’s a clear breakdown of how the homeowners insurance claims process works in California and across the U.S.
1. A Loss Happens (Covered Event)
A claim begins when your home suffers damage from a covered peril, such as:
- Fire or smoke damage
- Wind or storm damage
- Water damage from a burst pipe
- Theft or vandalism
- Certain falling objects
Most modern policies (HO-3 policies) cover your home on an “open perils” basis, meaning everything is covered except exclusions listed in the policy.
Common exclusions include:
- Earthquake damage
- Flood damage
- Wear and tear
- Pest damage
In California, homeowners often purchase separate earthquake insurance because standard policies do not include it.
2. Protect the Property From Further Damage
After damage occurs, the homeowner must take reasonable steps to prevent additional damage.
Examples include:
- Shutting off water after a pipe burst
- Boarding up broken windows
- Placing a tarp over a damaged roof
Insurance companies may deny parts of a claim if additional damage occurs because no action was taken to protect the property.
Always take photos or videos before making temporary repairs.
3. File the Insurance Claim
Next, contact your insurance company or your insurance agent.
You will typically need to provide:
- Policy number
- Description of the damage
- Date and time of the incident
- Photos or documentation of the damage
Most companies allow claims to be filed:
- Online
- Through a mobile app
- By phone
- Through your insurance agent
At Starwest Insurance Services, we often help our clients submit claims and guide them through the process.
4. Insurance Adjuster Inspection
After a claim is opened, the insurance company assigns an insurance adjuster to investigate.
The adjuster will:
- Inspect the property damage
- Review the cause of loss
- Estimate repair costs
- Determine whether the claim is covered
They may use software such as Xactimate to calculate repair costs based on local construction pricing.
For large claims, contractors may also provide estimates.
5. Claim Approval and Payment
If the claim is approved, the insurance company will issue payment based on your policy coverage.
Most homeowners policies pay claims in two stages.
First Payment: Actual Cash Value (ACV)
The first payment reflects the depreciated value of the damaged property.
Example:
- Roof replacement cost: $15,000
- Depreciation: $5,000
- Initial ACV payment: $10,000
Second Payment: Recoverable Depreciation
After repairs are completed and receipts are submitted, the insurer pays the remaining amount (if your policy includes replacement cost coverage).
6. Pay Your Deductible
Homeowners are responsible for the policy deductible, which is the portion you pay before insurance coverage applies.
Example:
- Claim amount: $20,000
- Deductible: $2,500
- Insurance payout: $17,500
Higher deductibles generally mean lower insurance premiums.
7. Repair or Replace the Damage
Once payment is issued, the homeowner hires contractors to repair or rebuild the property.
Some insurance companies may recommend preferred contractors, but you are usually free to choose your own.
Always verify:
- Contractor license
- Insurance
- Written estimates
Important Tip: Not Every Loss Should Be Claimed
Many homeowners don’t realize that too many claims can increase premiums or make coverage harder to renew.
You may want to avoid filing small claims if:
- Damage is close to your deductible
- You have filed multiple claims recently
- The issue is maintenance-related
An experienced insurance agent can help you decide whether filing a claim makes sense.
What Homeowners Insurance Typically Covers
A standard homeowners policy usually includes:
Dwelling Coverage
Protects the structure of your home.
Other Structures Coverage
Covers garages, fences, and sheds.
Personal Property Coverage
Protects belongings like furniture and electronics.
Loss of Use Coverage
Pays for temporary housing if your home becomes unlivable.
Liability Coverage
Protects you if someone is injured on your property.
Need Help With a Homeowners Insurance Claim?
Navigating a homeowners insurance claim can be stressful, but having the right coverage and guidance makes the process much easier.
At Starwest Insurance Services, we help homeowners throughout Orange County, Westminster, Irvine, and across California review their coverage and assist with the claims process.
If you’d like help reviewing your home insurance policy or getting a quote, feel free to contact us today.