It often feels like you’re at a disadvantage when dealing with a large insurance corporation. They have teams of adjusters and legal experts working to protect their bottom line, while you’re left trying to piece your life back together after property damage. When their settlement offer falls short, it can feel like an impossible battle. But as a policyholder, you have rights, and their initial assessment is not the final word. You can push back, present your own evidence, and hold them accountable to the policy you’ve paid for. This is your guide to leveling the playing field, helping you effectively dispute an insurance claim settlement and advocate for what you’re rightfully owed.
Key Takeaways
- Document Everything to Build a Stronger Case: Your position is most persuasive when it’s backed by solid proof. Gather independent contractor estimates, take detailed photos of the damage, and keep all related receipts to create a clear file that justifies a higher settlement.
- Maintain a Professional and Documented Dialogue: Treat every communication with your insurer as part of the official record. Keep a log of all conversations, follow up phone calls with summary emails, and insist on receiving all settlement offers and explanations in writing.
- Recognize When to Escalate or Call for Help: If your direct negotiations stall, you have other options. You can use the insurer’s formal appeals process, file a complaint with the state, or consider hiring a public adjuster for complex or high-value claims to ensure you have an expert on your side.
Why Dispute an Insurance Settlement?
Receiving a settlement offer from your insurance company can feel like the final step, but it’s often just the beginning of a conversation. If the number on that check doesn’t seem right, you have every right to question it. Disputing a settlement isn’t about being difficult; it’s about making sure you receive the fair compensation you need to properly repair your property and move forward. Many property owners find themselves in this exact position for a handful of common reasons.
Understanding why you feel the offer is inadequate is the first step toward building a stronger case. Whether the initial assessment missed hidden damage or the insurer is misinterpreting your policy, you don’t have to simply accept an offer that leaves you paying out-of-pocket for covered damages. Recognizing these common scenarios can help you feel more confident in your decision to push back and advocate for the full amount you’re entitled to. It’s your property, and ensuring it’s restored correctly is the ultimate goal.
The Offer Feels Too Low
That gut feeling you have when you look at a settlement offer is worth paying attention to. If the amount seems too low to cover the actual cost of repairs, it probably is. You are not obligated to accept an initial offer, especially if it doesn’t fully address your damages. An insurer’s first offer may not account for the rising cost of materials, local labor rates, or damage that isn’t immediately visible. It’s a starting point for negotiation, not a final decision. Trust your instincts and take the time to break down the numbers to see if they truly line up with your repair estimates.
You Disagree on What’s Covered
Insurance policies can be incredibly complex, and it’s common for homeowners and insurance companies to have different interpretations of the coverage. Your claim could be underpaid or denied based on the insurer’s reading of policy exclusions, limitations, or specific clauses. For example, they might argue that a certain type of water damage isn’t covered under your policy, even if it seems clear to you. Disagreements over what your policy actually covers are a valid reason to dispute a settlement. It often takes a careful review of the policy language to successfully challenge the insurer’s position and demonstrate why your damage should be covered.
The Damage Assessment Seems Incorrect
The person who assesses your property damage plays a huge role in determining your settlement amount. If their evaluation seems rushed or incomplete, it could lead to a low offer. An adjuster might overlook hidden damage, like moisture behind walls or structural issues that aren’t obvious at first glance. If you believe the scope of work is inaccurate, you can get a second opinion from a trusted contractor or a public adjuster. Presenting a more detailed assessment from another expert can be a powerful way to show the insurance company what their initial evaluation missed.
Your Policy’s Fine Print is Used Against You
Sometimes, an insurer might deny or reduce a claim based on a technicality buried in your policy’s fine print. They might point to a missed premium payment, a delay in reporting the claim, or a piece of missing documentation as a reason to not pay the full amount. While it’s important to follow your policy’s rules, these clauses can sometimes be used in ways that feel unfair. If you believe a technicality is being used to wrongfully deny your claim, you may be able to challenge it. Often, these situations can be resolved by providing the necessary information or clarifying the circumstances with your insurer.
Your First Steps After a Low Settlement Offer
Receiving a settlement offer that doesn’t even come close to covering your damages can feel like a second disaster. It’s frustrating and disheartening, but it’s important to remember that an initial offer is just that—an offer. It’s a starting point for a negotiation, not the final word. Before you get overwhelmed, take a deep breath. You have the power to challenge their assessment and fight for the fair settlement you deserve. The key is to be methodical and prepared.
Your insurance company has a team of professionals working to protect their bottom line; it’s only fair that you have a clear strategy to protect yours. This doesn’t have to be an emotional battle. Instead, think of it as a business transaction where you need to present a clear, evidence-backed case for why you are owed more. An insurer may be counting on you to simply accept their first offer without question. By taking a few strategic first steps, you can build a solid foundation for your dispute and show your insurer that you mean business. Let’s walk through exactly what you should do right now to get started on the right foot.
Review Your Insurance Policy
Before you pick up the phone, pick up your policy. This document is the contract between you and your insurer, and its language is what will ultimately guide the outcome of your claim. Read through it carefully, paying close attention to the declarations page, coverage limits, and any exclusions that might apply. You need to understand exactly what your policy covers and for how much. It can be dense and full of legal jargon, but having a basic grasp of your coverage is the first step in identifying where the insurance company’s offer may have fallen short. Highlight any sections that seem relevant to your specific damages.
Ask Your Adjuster for an Explanation
Once you have a better handle on your policy, it’s time to talk to the insurance adjuster. Politely ask them to explain how they arrived at their settlement amount. Don’t be confrontational; your goal here is to gather information. Ask them to point to the specific language in your policy that justifies their low offer. This conversation can reveal a lot. It might be a simple misunderstanding, or it could uncover a misinterpretation of your coverage on their part. Request that they send you this explanation in writing so you have a clear record of their reasoning as you move forward with your dispute.
Gather Your Evidence
Your claim is only as strong as the evidence that supports it. Now is the time to organize all the documentation you have related to your property damage. This includes any photos or videos you took of the immediate aftermath, receipts for temporary repairs, and a detailed inventory of all damaged or destroyed items with their estimated replacement costs. If you’re dealing with something complex like water damage, your documentation should be especially thorough, noting the extent of the damage in every affected area. The more proof you can provide, the harder it will be for the insurer to justify their lowball offer. Don’t throw anything away until your claim is fully settled.
Calculate the True Cost of Damages
The insurance company’s estimate is not the final word on what it will cost to repair your property. To effectively dispute their offer, you need your own numbers. Reach out to at least two or three reputable, licensed local contractors and ask for detailed, itemized estimates for the repair work. This gives you a realistic understanding of the true costs involved. Comparing these independent estimates to the insurer’s offer will likely highlight exactly where their assessment is lacking. This step is crucial because it shifts the conversation from their opinion of the cost to the actual market rate for the repairs you need. A public adjuster can also be an invaluable resource in this process.
What You Need to Build a Stronger Case
When you dispute a settlement, your opinion alone isn’t enough to change the outcome. You need to build a case supported by clear, compelling evidence. Your goal is to present a file so thorough that it leaves no room for doubt about the true value of your claim. This means gathering specific proof that demonstrates why the insurer’s offer falls short. Each piece of evidence you collect acts as a building block, strengthening your position and improving your chances of a fair resolution.
Photos and Videos of the Damage
Your smartphone is your most important tool here. Take more photos and videos than you think you need, capturing the damage from every angle—wide shots for context and close-ups for detail. A video walkthrough where you narrate what you’re seeing can be especially powerful. If the damage worsens over time, like a spreading water stain, keep documenting it. This creates a clear visual record of the full extent of your loss, making it much harder for an insurer to minimize the severity of the situation.
Estimates and Invoices from Contractors
The estimate from your insurer’s adjuster is their opinion of the cost, not the final word. To build a strong counterargument, get your own estimates from two or three trusted, licensed contractors. Ask for detailed, itemized quotes that clearly separate the costs of labor and materials. These documents serve as powerful evidence, showing the real-world price of restoring your property in your local market. This isn’t just about getting a second opinion; it’s about gathering the financial proof you need to justify a higher settlement amount.
Relevant Medical Records (If Applicable)
If the incident that caused the property damage also led to a personal injury, it’s crucial to document it. For instance, if a hidden leak caused a slip-and-fall accident or mold growth led to respiratory problems, your medical records become a key piece of evidence. These documents from your healthcare provider can establish a clear link between the property issue and your health condition. Be sure to gather all related paperwork, including diagnoses, treatment plans, and medical bills, to fully support your claim for any health-related costs.
Reports from Independent Experts
For complex claims involving structural problems, fire damage, or widespread water damage, a contractor’s estimate might not be enough. In these cases, a report from an independent expert—like a structural engineer, an industrial hygienist, or a roofing consultant—can be invaluable. These professionals provide an unbiased and highly detailed assessment that carries significant weight in negotiations. Their findings can effectively challenge an insurer’s assessment. A public adjuster can be your best resource for identifying the right experts and incorporating their reports into a winning claim strategy.
How to Communicate Effectively with Your Insurer
When you’re disputing a settlement, clear and consistent communication is your best tool. How you interact with your insurance company can significantly influence the outcome of your claim. The key is to be organized, professional, and persistent. Think of it as building a case—every email, letter, and phone call is a piece of evidence. Keeping your communication factual and focused on the details helps remove emotion from the conversation and centers the discussion on resolving the issue fairly. This approach not only shows the insurer that you’re serious but also creates a comprehensive record that can support your position if you need to escalate the dispute.
It’s about creating a clear, undeniable narrative of your claim and your efforts to settle it reasonably. By treating every interaction with purpose, you establish a pattern of diligence that can be very persuasive. It also prepares you with all the necessary documentation should you need to bring in a professional like a public adjuster or an attorney to advocate on your behalf. Remember, the person on the other end of the line is just doing their job, but their job is to protect the insurance company’s bottom line. Your job is to protect your own interests. A calm, documented, and methodical approach is the most effective way to do that. It prevents miscommunication and ensures that every piece of information you provide is officially on the record, making it harder for the insurer to ignore or misinterpret your points.
Ask for Everything in Writing
Phone calls can be helpful for quick questions, but they don’t create a paper trail. If an important decision or explanation is communicated verbally, it can be difficult to prove later. Always ask your insurer to provide important information in writing. Request a written explanation for why your claim was partially paid or denied, and ask for a copy of any reports they used to make their decision. After a phone call, it’s a good practice to send a follow-up email summarizing the conversation and asking the representative to confirm its accuracy. This simple step creates a record and helps prevent misunderstandings down the line.
Write a Clear Dispute Letter
A formal dispute letter officially communicates your dissatisfaction and kicks off the negotiation process. This isn’t the time for a lengthy, emotional story; instead, be direct and professional. Draft a letter that clearly states you are disputing the settlement offer. Be sure to include your name, address, policy number, and claim number at the top. In the body of the letter, explain why you disagree with their assessment and state the settlement amount you believe is fair, based on the evidence you’ve gathered. List all the supporting documents you’re including, such as contractor estimates or expert reports. Sending this letter via certified mail can also provide proof that the insurance company received it.
Keep a Record of All Communication
From the very first call to your insurer, you should maintain detailed documentation of every interaction. Create a dedicated folder or digital file for your claim and keep everything in one place. For every phone call, log the date, time, the name of the person you spoke with, and a brief summary of what was discussed. Save all emails and letters you send and receive. This meticulous record-keeping is invaluable. It helps you track the progress of your claim, remember important details, and hold your insurer accountable for the information they provide. A well-organized file is your strongest asset if your dispute becomes complicated.
Follow Up Consistently
Insurance adjusters handle many claims at once, so it’s possible for yours to get lost in the shuffle. Consistent, polite follow-up is essential to keep your claim moving forward. If you don’t hear back within the timeframe they provided, don’t hesitate to reach out. Start by discussing your concerns with your claims representative. If you feel you aren’t making progress, you can ask to speak with a supervisor or the head of the claims department. Set reminders for yourself to check in regularly, perhaps every one to two weeks. This persistence shows the insurer that you are committed to reaching a fair resolution.
What to Do if Your Insurer Won’t Budge
It can feel incredibly disheartening when you’ve done everything right, but your insurance company still refuses to offer a fair settlement. When your calls and letters lead to a dead end, it’s easy to feel like you’re out of options. But this is often the point where you can take more formal steps to get your claim the attention it deserves.
Don’t give up. When direct negotiation stalls, there are several established paths you can take to escalate your dispute. These processes are designed to provide a check on the insurer’s power and give you a fair chance to present your case. From using the company’s own internal review system to involving state regulators or a neutral third party, you have more power than you might think. The key is to be persistent, stay organized, and understand the next strategic move to make. This isn’t about starting a fight; it’s about ensuring you receive the compensation you’re entitled to under your policy. Taking these next steps shows the insurer you are serious about your claim and are prepared to see it through.
Use the Insurer’s Internal Appeal Process
Your first formal step after a stalemate is to use the insurance company’s internal appeal process. Every insurer is required to have a system in place that allows you to formally dispute their decision and have it reviewed again. This isn’t just another phone call; it’s an official request for a second look.
To start, you’ll need to write a formal appeal letter. In it, clearly state that you are appealing their decision, explain exactly why you disagree with their assessment, and reference specific parts of your policy if you can. Attach copies of all the evidence you’ve gathered—your photos, contractor estimates, and expert reports. A well-documented letter shows you’re serious and gives them everything they need to conduct a full and fair review of your claim.
File a Complaint with the State
If the internal appeal doesn’t produce a better outcome, your next move could be to file a complaint with your state’s insurance department. In Florida, this is the Department of Financial Services. This government agency is responsible for regulating insurance companies and protecting consumers. Filing a complaint is free and can put significant pressure on your insurer to take your case more seriously.
When you file, you’ll provide all the details of your claim and your dispute. The department will then investigate your complaint by contacting the insurance company on your behalf to get their side of the story. Sometimes, just the involvement of a state regulator is enough to get an insurer to reconsider its position and offer a more reasonable settlement.
Consider Mediation or Arbitration
When you and your insurer are still at an impasse, mediation or arbitration can be a good alternative to filing a lawsuit. These methods are often faster and less expensive than going to court. In mediation, a neutral third party—a mediator—helps facilitate a conversation between you and your insurer to find a mutually agreeable solution. The mediator doesn’t make a decision but helps you both negotiate a compromise.
Arbitration is a bit more formal. A neutral arbitrator acts like a judge, hears evidence from both sides, and then makes a binding decision. Before agreeing to arbitration, it’s important to understand the terms, as you may be waiving your right to a lawsuit. Both are effective ways of resolving claim disputes with the help of an impartial expert.
When to Call for Professional Help
While you can manage some smaller disputes on your own, there are times when the complexity and stakes of an insurance claim call for backup. Trying to fight a large insurance company by yourself can feel like an uphill battle. They have teams of experts working for them, and you deserve to have an expert on your side, too. A public adjuster works for you, not the insurance company, and their job is to manage your claim and negotiate for the fair settlement you’re entitled to.
If you find yourself in a situation that feels overwhelming or the communication with your insurer has stalled, it may be time to bring in a professional. They can take the weight off your shoulders by handling the paperwork, evidence collection, and difficult conversations, allowing you to focus on getting your property—and your life—back in order. Recognizing when you need this support is a key step in successfully disputing a low settlement offer.
Your Claim is Complex
Is your claim straightforward, or does it involve multiple layers of damage? For example, a fire can lead to smoke, soot, and significant water damage from firefighting efforts. These complex scenarios often involve different clauses in your policy and require extensive documentation for each type of damage. When a claim has this many moving parts, it’s easy to miss a crucial detail that could impact your settlement. An experienced professional knows how to gather the right evidence to support every aspect of your claim and can competently negotiate with the insurance adjuster to reach a fair agreement.
The Financial Stakes are High
When the damage to your home or business is extensive, the settlement offer represents your ability to rebuild. A low offer isn’t just an inconvenience; it can put your financial future at risk. If you’re looking at major repairs and the insurer’s offer won’t even cover the cost of materials, the financial stakes are too high to leave to chance. Before you accept or reject a settlement that could change your life, getting a professional opinion is a wise move. An expert can help you understand if the offer is fair and what your options are for securing the funds you truly need to recover.
Your Claim Was Denied or Severely Underpaid
Receiving a denial letter or an offer that’s a fraction of your repair costs can be incredibly frustrating. Insurers may deny claims for various reasons, such as missing documentation or disputes over what the policy actually covers. But a denial isn’t always the final word. A public adjuster can review your policy and the insurer’s reasoning to see if the decision was justified. Many professionals have experience re-opening denied claims and successfully negotiating for a much higher settlement by presenting a stronger, more detailed case on your behalf.
You Suspect the Insurer is Acting in Bad Faith
If your insurer is dragging its feet, refusing to return your calls, or giving you vague reasons for delays, you might be dealing with bad faith practices. An insurance company that repeatedly postpones a decision on your claim without a valid reason could be acting in bad faith. These situations are serious and can be difficult to prove on your own. If you feel your insurer is intentionally creating roadblocks or not treating you fairly, it’s a clear signal that you need an advocate. A professional can identify these tactics and hold the insurance company accountable to its legal obligations.
Understanding the Formal Appeals Process
If your informal negotiations have hit a wall, it might be time to start the formal appeals process. This is a more structured way to have your claim re-evaluated, first by the insurance company itself and then potentially by an outside party. It sounds official—and it is—but think of it as the next logical step in ensuring your case gets the serious attention it deserves. The process is designed to provide a clear path for resolving disagreements when initial offers don’t line up with the reality of your damages. It requires careful preparation and a clear understanding of the stages involved, but it’s a powerful tool for property owners. By following the formal procedures, you are signaling to your insurer that you are serious about receiving a fair settlement for your property damage claim.
The Insurer’s Internal Appeal
Your first move in the formal process is to request an internal appeal. This means you’re officially asking your insurance company to take a second, more thorough look at its decision. Every insurer is required to conduct a full and fair review when a policyholder disputes a claim. If the initial review doesn’t change anything, you can escalate your case by contacting the head of the claims department. Many larger companies also have specific departments set up to handle customer complaints. This internal process is your chance to present your evidence again, clarify any misunderstandings, and make your case directly to a higher authority within the company before taking outside action.
What to Expect from an External Review
If the internal appeal doesn’t lead to a resolution you’re happy with, you can often pursue an external review. This is a significant step because it brings in an independent third party to evaluate your claim. This person or organization has no connection to your insurance company, ensuring an unbiased assessment of the facts. The external reviewer will look at all the documentation from both you and the insurer to decide whether the company’s decision was appropriate based on your policy and the damage. The great thing about an external review is that it takes the final say out of the insurer’s hands, offering a fresh, impartial perspective on your claim.
Getting Your Paperwork Ready for an Appeal
Solid preparation is everything when you’re heading into an appeal. Start by organizing all the evidence that supports your case. This includes any photos or videos of the damage, contractor estimates, expert reports, and all correspondence you’ve had with the insurer. You’ll also need to draft a formal appeal letter. In it, clearly state why you disagree with the settlement offer, referencing specific parts of your policy and the evidence you’ve gathered. Be sure to include your claim number and contact information on every document. Having a complete and well-organized file for your water damage or fire damage claim makes it easier for the reviewer to understand your position and strengthens your argument for a higher settlement.
Know Your Rights During a Dispute
When you’re in a dispute with your insurance company, it can feel like they hold all the cards. But as a policyholder, you have established rights designed to protect you from unfair treatment. Understanding these rights is the first step toward leveling the playing field and advocating for the settlement you deserve. It helps you know what to expect and what you can demand throughout the process.
Protection from Bad Faith Practices
Insurance companies have a legal obligation to act in “good faith,” which means they must treat you fairly and honestly. When they don’t, it’s known as acting in bad faith. This can look like repeatedly delaying a decision on your claim without a good reason, failing to conduct a proper investigation, or misrepresenting the facts or policy provisions. If an insurer breaches their duty to deal in good faith, they may forfeit their right to enforce certain policy rules. Keep an eye out for these red flags, as they could indicate that your insurer isn’t handling your claim ethically.
How State Regulations Protect You
Your state’s government provides a layer of oversight for the insurance industry. In Florida, the Department of Financial Services regulates insurance companies and provides a formal process for consumer complaints. If you believe your insurer is not complying with the law or the terms of your policy, you can file a complaint with the state. While they can’t always force a specific outcome, they can investigate your case, review the insurer’s conduct, and ensure regulations are being followed. This official channel can add significant weight to your dispute and pressure the insurer to handle your claim more fairly.
Your Rights as a Consumer
As a consumer, you have fundamental rights throughout the claims process. First, you do not have to accept a settlement offer that you believe is too low or doesn’t adequately cover your damages. You are entitled to negotiate. Second, if your claim is denied, the insurance company must provide a clear, written explanation for their decision. You have the right to appeal an insurance company decision you disagree with. Knowing these rights empowers you to question the insurer’s findings, present your own evidence, and continue pushing for a fair resolution instead of accepting an unsatisfactory outcome.
What Are the Possible Outcomes of Your Dispute?
When you decide to dispute an insurance settlement, it can feel like you’re stepping into a complex and uncertain process. But it’s important to remember that you’re not just voicing a complaint—you’re actively working toward a better resolution. Challenging a low offer or a denial doesn’t always lead to a drawn-out battle. Often, it opens the door to more productive conversations and, ultimately, a fairer outcome for you and your property. Understanding the potential positive results can give you the confidence to move forward and advocate for the compensation you deserve. From a better settlement to simply getting clear answers, here are a few of the outcomes you could achieve.
A Higher Settlement Offer
Let’s be honest: this is usually the main goal. If your insurer’s initial offer won’t cover the cost of repairs, pushing back is a necessary step. The first offer is rarely the final one. Think of it as the start of a negotiation. Insurance companies are businesses, and they often want to avoid a costly lawsuit. When you present a well-documented dispute, you show them you’re serious about getting a fair amount. This can prompt them to re-evaluate your claim and come back with a revised offer that more accurately reflects the extent of your damages and what it will truly cost to make things right.
Clearer Answers on Your Coverage
Sometimes, the most frustrating part of a low settlement is not understanding why. A formal dispute can compel your insurance company to provide a clear, written explanation for their decision. You have the right to ask your insurer why they only paid for part of your claim and to request a copy of your policy and any evidence they used. This process can uncover simple misunderstandings about your coverage or even errors in their assessment. Getting these details in writing gives you the information you need to build a stronger counter-argument and ensures everyone is working from the same set of facts.
A Realistic Timeline for Resolution
Insurance claim delays can be a major source of stress, leaving you in limbo while your property needs repairs. Disputing the settlement can help bring clarity and structure to the process. When you initiate a formal dispute, you create a documented timeline of communication and force the insurer to adhere to state-regulated deadlines for responding. While it may not speed everything up overnight, it holds the company accountable and can help establish a more realistic schedule for resolution. Understanding the causes of delays and taking action can help you regain a sense of control over the situation and move toward a final settlement.
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Frequently Asked Questions
Will my insurance company drop me if I dispute a settlement? This is a common worry, but you shouldn’t let it stop you from advocating for yourself. Insurance companies are generally prohibited from dropping your policy in retaliation for filing a legitimate claim or disputing a settlement. However, your claims history can be a factor they consider when it’s time to renew your policy. The best approach is to keep all communication professional and focused on the facts of your claim. A well-documented, reasonable dispute is simply part of the business process, not a personal fight.
Can I still dispute the settlement if I’ve already cashed the check? Cashing the check can complicate things, but it doesn’t always close the door on further negotiations. In many cases, the initial check is considered payment for the undisputed portion of your claim. The key is to look for any language on the check or accompanying documents that says “full and final settlement.” If you’ve signed something with that wording, it could be more difficult to reopen the discussion. If you haven’t, you may still be able to pursue a supplemental claim for the remaining damages.
What’s the real difference between my insurance company’s adjuster and a public adjuster? This is a crucial distinction. The adjuster sent by your insurance company works for them. Their job is to assess the damage on behalf of the insurer and protect the company’s financial interests. A public adjuster, on the other hand, is someone you hire to work exclusively for you. Their responsibility is to represent your best interests, from documenting the full extent of your loss to negotiating with the insurance company to secure a fair and just settlement on your behalf.
How long do I have to file a dispute? Time is definitely a factor, and you don’t want to wait too long to act. Your insurance policy will likely outline specific time limits for filing claims and disputing settlements. Additionally, state laws set deadlines, often called statutes of limitations, for taking legal action related to insurance claims. It’s important to review your policy documents and act promptly after receiving a low offer to ensure you don’t miss a critical window for action.
Is it worth the effort to dispute a smaller claim? This really depends on your specific situation and the principle of the matter. A difference of a few hundred dollars might not seem like much, but if that amount is what’s needed for a proper repair, it’s significant. The best way to decide is to get an independent estimate from a trusted contractor. If their quote shows the insurer’s offer is truly inadequate, then pursuing the difference is about making sure you are made whole, which is the entire point of having insurance in the first place.