ESCALATION TO HOMEOWNERS

ESCALATION TO HOMEOWNERS

Overview: This document will help Relationship Managers know when to recommend that the Raving Fan escalate a claim to the Homeowner.

Contents:
      I. When Do We Escalate to the Homeowner?
      II. What the Homeowner Needs to Know
      III. Scripts & Templates for Relationship Managers
      IV. FAQs / Additional Guidance

I. When Do We Escalate to the Homeowner?

Aligned with dealing with unresponsive adjusters, this KB will guide Relationship Managers in identifying what the triggers are for when they need to consider reaching out to the Raving Fan (contractor/roofer) and request their help in involving the Homeowner to get the claim moving forward.

Escalation to the Homeowner should be considered when one or more of the following scenarios has been met:

1. No response from the adjuster after multiple follow-ups.
There is still no progress/response after the claim has already been escalated internally (tried to reach managers). This is likely the situation if the escalation reached Follow-up #8 (around Business Day 10) in CX KB - https://claimsupplementpro.zohodesk.com/portal/en/kb/articles/calls-follow-ups-cx

2. Time-sensitive issues are at risk (e.g. scheduled installation).
The adjuster’s lack of response is preventing urgent or time-sensitive aspects of the job/claim from moving forward. Immediate action is needed to avoid job-site disruption or homeowner dissatisfaction.

3. The adjuster is avoiding or delaying inspection.
Inspection appointments are being pushed off or rescheduled repeatedly.

4. The adjuster is unresponsive or not communicating in good faith.
Although we received responses to our calls and emails, the adjuster’s responses are vague or evasive with no action. There’s a pattern of delay or  avoidance.

5. Coverage or high-dollar items are being denied without justification
The carrier is rejecting large-value items or key scope components without providing clear documentation, reasoning, or policy references.

II. What the Homeowner Needs to Know

Our Raving Fans should keep communication to the HO simple and clear, avoiding technical language.

Key points the HO should understand:
1. Their claim is being delayed due to lack of response from the insurer (or meets one of the criteria mentioned above).
2. Their contractor has already followed up multiple times.
3. As the policyholder, they have the most influence in getting a response.


III. Scripts & Templates for Relationship Managers

1. Suggested Script: What to Say to the Contractor (RF)
Start with Context (please tailor it to fit your particular situation):

“Hey [RF’s Name], just wanted to give you a quick update on [HO’s Name]’s claim. We’ve reached out to the adjuster several times—calls, emails—but haven’t received any response. It’s holding up the process.”

Transition to the question:

“At this point, it’s usually most effective if the homeowner gets involved. Adjusters tend to respond more quickly when the policyholder is the one calling in.”

"Would you mind reaching out to the homeowner and letting them know what’s going on? Just ask them to call their insurance company and let them know there’s been no response from the adjuster, and that it’s holding up the claim.

Offer to help with what to say:

“If it helps, we can provide sample wording or even a short message they can use when they call or email. The key is that they mention the claim number and that their contractor hasn’t been able to get a response.”

Reassure and wrap-up:

“We’ll keep trying on our side as well, but getting the homeowner involved usually gives things a push. Let me know once you’ve spoken to them—or if you’d like us to draft something you can forward.” 

“Appreciate you helping move this along!”

2. Email Template to Send to the Contractor (RF)

Subject: Request to Escalate to Homeowner – Adjuster Unresponsive [or whatever the situation is]

Body:

Hi [RF’s Name],

We’ve followed up multiple times with the adjuster assigned to [Homeowner Name]’s claim but have not received a response. At this point, we recommend escalating to the homeowner to help move things along. 

Could you please reach out to [Homeowner Name] and ask them to contact their insurance agent directly? As the policyholder, their involvement can help get a faster response or escalate it internally. 

Let us know once they’ve been contacted or if you'd like help with suggested language for them to use. 

Thank you, 
RM’s name

3. Optional Message Contractors Can Forward to the Homeowner

This is a message you can offer the contractor to copy/paste or modify as needed:

Suggested HO Message (to be used by the homeowner):
“Hi, I’m [Homeowner Name], [Policy #]. My contractor has been trying to reach the adjuster regarding my claim, but hasn’t gotten a response. Can you please check the status of the claim and escalate it if needed? This is holding up necessary repairs to my property.”

IV. FAQs / Additional Guidance

Q: Can we reach out to the homeowner ourselves?
A: No. All communication to the HO must go through the contractor/client.

Q: What if the contractor is unsure or reluctant?
A: Explain the benefit of HO involvement and offer ready-made scripts or messages they can forward. Reassure them it’s a light lift for the HO.

Q: What if the HO is frustrated?
A: Encourage the contractor to reassure the homeowner that delays are due to insurance process issues, and they’re taking the best next step by calling directly.

If you have any comments, feedback or questions, please let us know—we greatly appreciate your input: GOOGLE FORM
    • Related Articles

    • Anatomy of Siding

      Overview: Siding plays a crucial role in protecting a home or multifamily dwelling by shielding its exterior from harsh weather, physical impacts, and potential damage from insects or other intrusive elements. Beyond its functional benefits, siding ...
    • Identifying, Requesting, & Handling RLS/SLS Cases

      Overview: In this article, we will discuss the Roofing and Siding Matching Service (RLS/SLS)—a specialized program offered exclusively by State Farm to ensure that homeowners receive proper repairs or replacements for their damaged exterior ...
    • Calls & Follow-ups (CX)

      Latest update: 10/25/2025 (please check yellow highlights for the latest update) Overview: This article provides detailed instructions for following up with insurance adjusters, managing claims, and ensuring proper communication through CRM, email, ...
    • CSP Project Launch Framework

      CSP Project Launch Framework *WORK IN PROGRESS* Last Updated: 09/26/2025 What's updated: Added the Process Compliance Guide (Pre-Launch Planning - Step 4), and email acknowledgement (Soft Launch Piloting - Step 2 & Hard Launch Execution - Step 1) The ...
    • Unresponsive ADJ/Managers Process Scripts

      IMPORTANT TALKING POINTS WHEN DOING CONFIRM RECEIPT Follow-up 2: Always ask if the assigned ADJ is still the current one on this claim and what the timeframe is for them to receive an email/package. Can you confirm that [ADJ name] is still the ...