Two Very Different "Adjusters"
After a water, fire or storm loss, most Long Island homeowners hear the word "adjuster" from at least two different directions — and the two people it refers to are not on the same side. Understanding the difference before you sign anything can materially change how your claim goes.
Your insurance company's adjuster is an employee or contracted representative of the carrier. Their job is to investigate the loss and determine what the policy covers and what it's worth — on behalf of the company that pays the claim. A public adjuster is a separate, independently licensed professional you can hire yourself, who works exclusively for you, the policyholder, and is paid a percentage of what they recover for you.
Is a Public Adjuster Licensed in New York?
Yes — and this matters more than most homeowners realize. New York Insurance Law defines a public adjuster as someone who, for compensation, acts on behalf of an insured in negotiating or effecting the settlement of a property claim (Insurance Law §2101(g)(2)), and requires that person to hold a state license (§2102(a)(1)). Acting as a public adjuster without that license is a misdemeanor under New York law.
Before hiring anyone who offers to "handle your claim" for a fee, it's worth confirming they actually hold this license — it's a meaningful legal line, not a formality.
What Does a Public Adjuster Cost?
New York regulates this directly. Under 11 NYCRR §25.7(a), a public adjuster's fee is capped at 12.5% of the claim recovery. Since an amendment effective October 8, 2021, a public adjuster may charge up to 20% on a supplemental claim specifically — but only if the total fee across the entire claim still stays at or under that 12.5% aggregate cap. Referral compensation the adjuster receives from service providers also counts toward that cap.
You also have a built-in exit: a public adjuster retainer agreement in New York may be cancelled without penalty up until midnight of the third business day after signing, per New York's Department of Financial Services homeowner guidance.
📋 Public Adjuster Rules in New York — Quick Reference
| Rule | Detail |
|---|---|
| License required | Yes — NY Insurance Law §2102(a)(1). Unlicensed practice is a misdemeanor. |
| Fee cap | 12.5% of the recovery (11 NYCRR §25.7(a)); up to 20% on a supplemental claim if the aggregate stays at or under 12.5% |
| Cancellation right | Without penalty, up to midnight of the third business day after signing |
| Solicitation hours | Cannot solicit a loss adjustment between 6 p.m. and 8 a.m. (11 NYCRR §25.3(a)) — including indirectly through a contractor |
What a Restoration Contractor May and May Not Do on Your Claim
This is a common point of confusion, so it's worth stating plainly and generally — this describes what New York law allows any contractor to do, not a description of a specific service Greene Group Construction is offering to perform on your claim:
- A contractor may not negotiate with, or effect a settlement with, your insurer on your behalf for compensation. That crosses into unlicensed public adjusting, regardless of how the arrangement is framed.
- A contractor may not act as an indirect solicitation channel for a public adjuster outside the permitted hours, or take part in an undisclosed referral-fee arrangement with one.
- A contractor may inspect and document damage, write its own detailed scope and estimate, provide moisture readings and photos, meet the carrier's adjuster on site to walk through the physical scope of work, perform emergency mitigation, and discuss its own repair estimate with the carrier as the party pricing the repair.
Your Insurer's Deadlines Under New York Regulation 64
Homeowners often assume an insurer can take as long as it wants. New York's claim-handling regulation, 11 NYCRR Part 216 (commonly called Regulation 64), sets real deadlines:
⏱️ Insurer Response Deadlines — 11 NYCRR Part 216
| Requirement | Deadline |
|---|---|
| Acknowledge receipt of your claim | 15 business days (§216.4(a)) |
| Begin investigating | 15 business days from notice (§216.5(a)) |
| Accept or reject in writing, after a complete proof of loss | 15 business days (30 if arson is suspected) (§216.6(c)) |
| Pay any amount finally agreed on | 5 business days (§216.6(f)) |
One provision is worth knowing on its own: under §216.6(e), where only part of your claim is disputed, the insurer must still pay the undisputed portion — it cannot hold your entire payment hostage while one line item is argued over. That single rule is often the most useful thing a homeowner mid-claim can know.
How Long Do You Have to Sue Your Insurer?
New York's general contract deadline is six years, but your homeowners policy almost certainly shortens that. The standard ISO HO-3 policy form's "Suit Against Us" clause requires any lawsuit to start within two years of the date of loss, and New York Insurance Law §3404(e) sets the same two-year (24-month) limit for standard fire policies. New York's highest court, the Court of Appeals, upheld exactly this kind of two-year clause in Farage v. Associated Insurance Management Corp. (Nov. 26, 2024).
Don't assume six years. Read your own policy's "Suit Against Us" language, and don't let a disputed claim sit while the clock runs.
Do You Need a Public Adjuster?
There's no single right answer — it depends on the claim. A straightforward, undisputed loss with clear documentation often moves fine with a homeowner working directly with the carrier, especially with a contractor providing thorough photos, moisture readings and a detailed estimate along the way. A large, complex, or disputed claim — particularly one involving a coverage denial, a major structural loss, or a carrier that's slow to respond despite the Regulation 64 deadlines above — is where a licensed public adjuster's negotiating expertise is most likely to be worth the fee.
Whichever path you choose, thorough documentation from day one is what makes any claim — adjuster-negotiated or not — go smoothly. Photograph everything before cleanup begins, keep every receipt, and get a detailed written scope from whoever assesses the damage.
Related Resources for Long Island Homeowners
Explore these additional resources on the claims and restoration process:
- Insurance Claim Documentation Support — how Greene Group Construction documents damage for your carrier.
- Does Homeowners Insurance Cover Sewage Backup?
- Letting Insurance Pay for Basement Water Removal
Frequently Asked Questions
What's the difference between a public adjuster and my insurance company's adjuster?
Your insurance company's adjuster works for and is paid by the insurer. A public adjuster is a separate, independently licensed professional who works for and is paid by you, the homeowner, to help document, scope and negotiate your claim.
How much does a public adjuster cost in New York?
New York caps public adjuster fees at 12.5% of the claim recovery under 11 NYCRR §25.7(a). Since an October 2021 amendment, a public adjuster may charge up to 20% on a supplemental claim, provided the total fee across the full claim still does not exceed 12.5% of the total payment.
Can Greene Group Construction negotiate my insurance claim for me?
No. Negotiating or settling a property claim with an insurer on a homeowner's behalf for compensation is public adjusting, which requires a New York license. We document damage, provide photos and moisture readings, and give you and your carrier a detailed written estimate — but we don't act as your negotiator. See the section above for the full breakdown.
How long does my insurance company have to respond to my claim?
Under 11 NYCRR Part 216, an insurer generally must acknowledge your claim within 15 business days, begin investigating within 15 business days of notice, and accept or reject the claim in writing within 15 business days after receiving a completed proof of loss and all requested documentation.
How long do I have to sue my insurance company if my claim is denied?
Most homeowners policies shorten New York's general six-year contract deadline to two years from the date of loss, and New York's Court of Appeals upheld a two-year suit-limitation clause in 2024. Check your own policy's "Suit Against Us" section rather than assuming the general deadline applies.
🚨 Need Documentation for an Active Claim?
Greene Group Construction provides photo documentation, moisture readings and a detailed written estimate your carrier or public adjuster can use — 24/7 across Long Island.
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