A prior or previous home insurance claim will usually be reviewed by an adjuster on any new claim you file within a certain time period, for example the past 5 years. Pertinent facts about prior claims may be entered into a new claim file by a clerk working on behalf of the adjuster.
Your insurance company is looking specifically for related prior claims. For example if you have a water backup endorsement on your policy and three years ago you filed a claim for damages and was paid. The file notes show water backed up through a drain in your 1,200 square foot finished basement, damaging drywall, wood paneling, carpet in two rooms, kitchen cabinets, 2 sofas, a love seat, a bookcase , clothing and other personal property belonging to you and your family. Your total loss exceeded the endorsement limit of $5,000 and you were paid the limit.
In your new claim the adjuster will review damages and determines you basically had the same damages as in the prior claim. The adjuster will need to verify that the previous damages were repaired in order to avoid paying you twice for the same damages.
The same goes for your roof and most other property covered under your policy. If you were paid to have your roof replaced two years ago there may already be proof in that claim that you had the work completed, because your contractor may have submitted a work completed invoice so that recoverable depreciation could be released to you – the final payment from your insurance company once the work is completed. If there is no contractor invoice, and no other type of proof the work was completed, the current adjuster will need some other kind of verification.
If you do not have invoices or receipts, the adjuster will consider any kind of proof work was completed, including photographs of the completed roof, or confirmation from a contractor who completed the work. If you do not have proof the work was completed you should not expect the adjuster to pay you again on the new claim. Most insured have some way of proving prior repairs were made, and the adjuster wants to help you prove it so the new damages can be addressed.
Although not as common as verifying prior repairs were made, sometimes previous claims raise a red flag to the adjuster. Take for example the water backup claims. Let’s say the prior claim history shows 4 water backup claims in less than 2 years. The current adjuster researches and discovers there may be a faulty pipe system running to the insured’s home from the town water and sewer station. This claim could be referred to the subrogation department of the insurance company to investigate whether the town has any liability in this loss. Some sort of corrective action would seem appropriate since the insurance company does not want to continuously pay the same preventable damages over and over. The insurance company position is likely supported by the policy issued to the insured, that the insured is obligated to prevent further damage. In this claim the insured is aware of a possible problem. They should take and document action to prevent further damage.
Otherwise, an adjuster should have no reason to question a large number of prior claims. If you live in an area that has frequent storms, you will likely file more claims than someone who does not. I have never heard an adjuster say to an insured, “Well you have filed five storm claims in the past five years.” An adjuster is not concerned with the number of claims, just that payments made for previously damaged items were taken care of by the insured before the adjuster pays for new damage to the same items.
Insured should note that policies and provisions vary from state to state and insurance company. Regulations may be suddenly amended following a major catastrophe. Insured are recommended to contact their agent for updated information, and only make major repair and mitigation decisions after speaking with your adjuster. While it seems logical to you that something you are having done is covered by your policy, only your adjuster can verify coverage.