Claims Glossary

The 24 terms that decide what a property claim pays, defined the way an estimator would explain them across a table.

Actual Cash Value (ACV): Replacement cost minus depreciation for age and wear. On a replacement-cost policy it's the first payment; the withheld depreciation is released after repairs.Calculator
Adjuster (staff / independent / public): A staff adjuster is the insurer's employee; an independent adjuster is a contractor hired by the insurer; a public adjuster is licensed to represent the policyholder for a percentage of the recovery.Guide
All Other Perils (AOP) deductible: The flat-dollar deductible that applies to losses not caused by a named hurricane — typically $1,000–$5,000.
Appraisal: A policy clause for resolving disputes over the amount of loss: each side appoints an appraiser, the two pick an umpire, and the award on value is binding. It does not decide coverage.
Assignment of Benefits (AOB): A contract transferring the policyholder's claim rights to a contractor. Florida prohibited AOBs on residential and commercial property policies issued after 1 January 2023 (SB 2-A).
Coverage A: The dwelling limit on a homeowners policy. Percentage hurricane deductibles are calculated on this number, not on the loss.Calculator
Date of loss: The date the damage occurred. In Florida every notice deadline runs from this date, not from discovery.Calculator
Depreciation (recoverable / non-recoverable): The reduction for age and wear. Recoverable depreciation is paid once repairs are complete under a replacement-cost policy; non-recoverable depreciation is never paid (ACV-only policies or certain items).Calculator
Desk adjuster: An adjuster who scopes the claim from photos, reports and phone calls rather than an on-site inspection. Desk estimates commonly omit line items a full-scope estimate includes.
Estimate (Xactimate® / Symbility™): An itemized, priced scope of repairs in the software carriers use. Line items carry quantities, unit prices from a regional price list, and notes.
Hurricane deductible: A separate deductible — 2%, 5% or 10% of Coverage A in Florida — that applies once per calendar year to losses from a named hurricane.Guide
Line item: One priced entry in an estimate (for example 'Remove & replace 3-tab shingles, 25 SQ'). Missed line items are the most common reason estimates come in low.
Matching: The requirement that repairs produce a reasonably uniform appearance. If material can't be matched, a larger area — sometimes the whole roof or floor — may have to be replaced.
Mitigation: Emergency work that stops damage getting worse — water extraction, drying, board-up. Policies require it, and it's billed separately from the rebuild.
O&P (overhead and profit): The general contractor's markup, typically 10% + 10%, owed when a job is complex enough to need a GC coordinating trades. Often omitted from desk estimates.
Price list: Xactimate's regional pricing database (for example FLMI for Miami, FLTA for Tampa). Estimates must use the correct list and month for the carrier to accept the numbers.
Proof of loss: A sworn statement of the amount claimed, usually required within 60 days of the insurer's request. Missing it can suspend the claim.
Replacement Cost Value (RCV): What it costs to replace the damaged item with like kind and quality today, before depreciation.Guide
Reservation of rights: A letter in which the insurer investigates the claim while reserving the right to deny coverage later. Not a denial, but a signal to document carefully.
Scope: The list of work the claim covers — rooms, materials, quantities. Scope disputes (what is damaged) are separate from pricing disputes (what it costs).
Supplement: An additional claim for damage found after the initial adjustment, such as rotted decking under a roof. In Florida it must be reported within 18 months of the date of loss.Guide
Twenty-five percent rule (Florida): A Florida Building Code rule requiring a whole roof section to be brought to current code when more than 25% is repaired in 12 months; roofs built to the 2007 code or later are exempt (SB 2-D).Guide
Umpire: The neutral third party in appraisal who decides the amount when the two appraisers disagree.
Wear and tear exclusion: Policy language excluding gradual deterioration. The most common basis for roof claim denials; rebutted with storm data and dated damage evidence.