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Carriers & TPAs are NOT General Contractors

Jan 01, 2024


 In the world of restoration, professionals play a crucial role in bringing damaged properties back to life. Whether it's water damage, fire, or other unforeseen disasters, restoration experts are there to assess, repair, and rebuild. However, there can sometimes be confusion about the roles of insurance companies and restoration professionals. It's important to understand that insurance companies are not general contractors and should not interfere with the job of restoration professionals. 

The independence between restoration professionals and insurance carriers has  inherent advantages that are often overlooked or ignored. This independent approach streamlines the restoration process, making it more efficient and transparent. Clients can select a restoration company based on merit, reputation, and expertise without the influence of insurance preferences. Restoration professionals, on the other hand, can focus solely on delivering exceptional services without diverting attention to complex insurance negotiations. In this blog, we'll explore the distinct roles of insurance providers and restoration experts and why it's essential to maintain clear boundaries between the two.

Understanding the Insurance game:

Insurance companies have a vital role in providing financial protection to individuals and businesses in the event of a loss. Homeowners or property owners purchase insurance policies to safeguard themselves against potential risks and damages. When a covered event occurs, policyholders file a claim to receive compensation for the losses incurred. While compensation should be based solely on the coverage of the policy that the home/property owner chose, financial gain is always the goal of the insurance companies. They make money on premiums. They lose money on claims… so spending as little as possible on a claim is their primary concern. There are a lot of examples where client satisfaction and safety is ignored.

The Role of Restoration Professionals:

Restoration professionals, on the other hand, are experts in assessing and repairing the physical damage caused by disasters such as floods, fires, storms, or accidents. They are skilled in the technical aspects of restoration, including structural repairs, cleaning, and rebuilding. Their primary focus should on restoring the property to its pre-loss condition.

Sadly they end up taking on the burden of the client due to the overwhelming amount of empathy that they have as individuals.  They have a hard time keeping clear boundaries, and end up wasting time, energy, and money fighting a fight that isn’t theirs to win. 

Restoration professionals should focus on doing the right work for their clients and not seeking approval for compensation after work is complete. 

At Restoration Advisers, we help our clients build systems and processes to gain the independence they deserve using a business operation system (not a software) called R[OS]™️ - Restoration Operating System. 

Clear Boundaries:

While insurance companies provide financial support for covered losses, they are not general contractors. It's crucial for property owners to recognize the distinction between the two entities. Restoration professionals are hired by property owners to execute the necessary tasks to restore a property, and their scope of work is determined by the specific damage incurred. Unfortunately, the landscape has changed so much by the insurance companies that the restoration professionals must spend time educating the property owners on their rights so that they can get the service they deserve. 

It is important that the restoration professionals educate the property owners on the fact that insurance companies may recommend or suggest restoration professionals, but they should not interfere with the actual restoration process. This means that insurance adjusters should not dictate how restoration work should be conducted, what materials should be used, or which professionals should be hired. These decisions are best left to the expertise of the restoration professionals who understand the unique requirements of each restoration project.

In cases where it makes sense, it’s important for the restoration professional to educate the property owner on the benefits of choosing an independent contractor versus going with a program vendor. 

Benefits of Maintaining Separation:

  1. Expertise: Restoration professionals have the specialized knowledge required to assess and address the unique challenges presented by each restoration project. Independent restoration professionals are bound by OSHA and IICRC, and not what insurance is willing to pay or the influence of scope.
  2. Efficiency: Allowing restoration professionals to manage the restoration process without interference from insurance companies ensures a more streamlined and efficient restoration timeline. There are also many examples where the reimbursement process is expedited once there is a cost incurred by the policyholder. Many policies have verbiage in them that suggest that when a cost or debt is incurred by the policy holder… the insurance company is obligated to reimburse in full within a specified amount of time based on coverage. This is supported by the book Delay, Deny, Defend. The insurance companies know that if they can get in and use any of the 3 tactics with a heavy dose of fear mongering that they will be able to reduce the amount that affected parties are willing to accept… thus increasing the profits of the insurance companies. 
  3. Quality: Restoration professionals are committed to delivering high-quality results. And they have 2 prominent governing bodies. OSHA & IICRC. Allowing them to focus on their expertise contributes to the overall success of the restoration project.


In the aftermath of property damage, it's crucial for restoration professionals to be the leader in maintaining clear boundaries and ensuring that all parties understand the distinct roles of each party. Insurance companies provide financial support, while restoration professionals bring their technical expertise to restore properties effectively. By recognizing and respecting these boundaries, property owners will ensure a smoother and more satisfying and successful restoration process.

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