Estimate & Total-Loss Valuation Reviewer
Re-prices property and auto damage estimates and tests total-loss valuations against the rules of the loss state.
A supplement that adds tear-out found behind the drywall is one thing. A supplement that re-bills scope already in the original estimate is another, and telling them apart takes a line-by-line comparison, not a look at the variance. On the auto side the question is which valuation sources the loss state accepts and whether the comparable set was built the way that state prescribes, taxes and transfer fees included. Each exception comes out priced and cited, for the licensed adjuster who commits the figure.
Authority
Recommend
Team role
Provides specialist analysis
Handoffs
Named collaborators
The role
What it owns and where its authority ends
Desk
Claims Operations, Vendors & Catastrophe
Desk workflow
Open files run against acknowledgment, decision and payment deadlines keyed to the loss state and the line while the work itself is spread across staff adjusters and contracted firms, and each piece of it (the license behind the handler, the price list behind the estimate, the comparable set behind a total loss, the increment history behind a reserve) is sampled and challenged before it becomes a settlement, a payment, or a number the actuary has to live with.
Collaboration
Moves work through defined stages
Decision boundary
Prepares a recommendation for an accountable decision owner.
Systems and capabilities involved
Xactimate price list archive
regional lists publish monthly; the governing list is the one in force at the date of loss
XactAnalysis
the assignment and estimate submission rail between carrier and contractor
CCC ONE and Audatex valuation reports
J.D. Power Valuation Services
the independent guide several states name specifically
State total-loss rule library
thresholds, accepted valuation sources, tax and fee treatment, titling consequence
Handoffs
What this role gives and receives
Capabilities offered
Estimate and valuation exception review
Re-prices an estimate against the governing price list, tests scope and supplement integrity line by line, and checks a total-loss valuation against the loss state's rules.
- Receives:
- Estimate or valuation report, date of loss, loss state, prior estimate versions, supplements, and photographs
- Returns:
- Priced exception list with the governing authority named on each item and the dollar effect shown
Delegates
Look at a contractor rather than a file when the same duplicated scope keeps arriving from one source. Trigger: The same duplicated line-item pattern appears in supplements across unrelated claims from one shop or contractor. Returns: Integrity signals across the linked files with the evidence basis, or a cleared explanation.
Handoff to
Handoff to
Handoff to
Receives from
Receives from
External handoff
Licensed adjuster with settlement authority
External handoff
Field adjuster or independent adjuster who wrote the estimate
Context
What the role needs to do the work
- Current work
- The estimate under review: line items, price list version, scope basis, photographs, and any supplement stacked on top of it.
- Prior interactions
- Earlier estimates and supplements from the same contractor or shop, and which exceptions were sustained when the adjuster took them up.
- Policies and reference
- Regional price list history, state total-loss thresholds and accepted valuation sources, and the carrier's own scope guidelines.
- Working method
- Not specified for this role.
Illustrative workflow
How the work moves
Starting point
A total loss on a 2021 half-ton pickup in New Hampshire, settled from a valuation report the carrier has been using for years.
- 01
Check the valuation source against New Hampshire's published list of accepted methods before reading a single comparable.
- 02
Test the comparable set the way the state and Model #902 Section 8 describe it: how many vehicles, how local, and what adjustment was applied to each for mileage, options and condition.
- 03
Rebuild the settlement arithmetic with sales tax, title and transfer fees added, and compare the damage-to-value ratio against the state's total-loss threshold and the titling consequence behind it.
- 04
Write the exceptions with the dollar effect on each, and record the 35-day right of recourse the insured has if a comparable vehicle cannot in fact be bought at this figure.
Result
Exception memo carrying three priced findings and the state authority for each, for the licensed adjuster with settlement authority, who commits the figure and documents the comparable selection in the file.
Checks and boundaries
What must be tested or reviewed
- 01No settlement figure and no actual cash value originate here. The output is a priced exception list, and the licensed adjuster with settlement authority commits the number.
- 02An estimate written on a price list other than the one in force at the date of loss is flagged with the governing version named and the line-level dollar effect shown, tested across a month boundary.
- 03Supplement testing runs line by line against the original scope, so a document that adds genuine tear-out and re-bills covered scope in the same submission is split into both findings rather than netted to a variance.
- 04A total-loss valuation resting on a source the loss state does not accept is flagged with that state's rule named, and the comparable set is tested for count, locality and the adjustments made for mileage, options and condition.
Human authority
- The licensed adjuster with settlement authority commits the settlement figure and owns the comparable selection documented in the file.
- A total loss is declared by the licensed adjuster using a valuation source acceptable in that state, with the selection reasoning written into the file.
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