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As I was reading your post, I choked on my coffee spilling it on the carpet & spitting up at the same time.  KingBee Cleaners can be here in an hour to remove the stains and clean the entire room of carpet for $500.  Or I can throw down a dry towel to sop up the majority of the spill, and have XYZ Carpet Cleaners come in later at the usual & customary rate of $39.99 per room with a minimum of 2 rooms.   There's something to be said about having the advantage or taking advantage. 

Well said, dnjsdad.

From the tone of the question, I surmise the question is coming from an insured who has had this particular situation occur. In light of that, I could answer in very general terms, but would be loathe to second guess the adjuster or carrier in a particular situation without a lot more information.

In general, however, the answer is "No, the insurance company does not usually have to pay whatever the invoice says." There is something called "price gouging", which is actually a crime in some states. Michigan comes to mind as a state that diligently pursues price gougers. Just ask the gas station owners who raised the price of gasoline in Kalamazoo to $4.00 a gallon on 09/11/2001 while I was buying gasoline for less than half that price from a gas station where I could see the smoke rising from the Pentagon.

As to your specific situation, 72 tree, I have no comment because I have no idea what the facts are.

well what im asking is. when the homeowner agrees to a price for the work. How can the insurance company not pay the full amount? Next question how do adjusters put a price on the risk of dangerous tree removal jobs. Or lets say i have 15 guys on a job and i get 125 a man hr. how can a adjuster tell me that im not going to pay the the full price of the claim if i have the men doing the job? Or if i say that it had to be done this way and they dont think its worth it.

Reasonable and customary for the work performed are two key words. The fact that you may have charged a homeowner $10,000 to remove a 30' X 6" diameter tree from their roof doesn't mean the insurance carrier owes the insured the $10,000. All too often the "emergency" workers that come in immediately after an event take advantage of the situation and price gouge the homeowners for work they do (roof cover up, water extraction companies, tree removal companies, etc).

See the limitations in the policy for tree debris removal the limit is $1,000 for pne tree or many trees. All policys have limitations on "add on coverage".

Also depends on the policy type, and applicable coverage . Certain policies, like forced coverage or for a better term if you don't know what i mean, would be lender placed. These types have no covereage for trees etc. but will sometimes depending on the carrier and examiner pay a reasonable rate to remove the tree from the rooftop to the ground,and after it is of the structure any pulping, cleanup, hauling etc is at the homeowner's expense. However, even if the carrier will pay for removal from the roof, they are going to have a limit they will pay. You want likley be laughing on the way to the bank.

You have an agreement with the homeowner at a certain price. You seem to be asking how can an adjuster pay less than your agreement. You are right; the adjuster can not tell you how much you can charge. You can not tell the insurance company how much they can pay. The carrier's liability follows the policy wording...not the wording of the agreement between you and the insured. That policy most likely uses the word "reasonable".

Imagine an envelope called "reasonable". Below a certain amount would be unreasonably low, above another amount would be unreasonably high. The adjuster's job is to settle the claim within that envelope. If you have an agreement with the insured for an unreasonable amount, the adjuster and the insurance company will only pay the "reasonable" part. Whatever portion of the amount you've agreed upon is outside the relm of reasonable is between you and the insured.

If you have a different idea of what reasonable is, you can make your case to the adjuster, the carrier, the homeowner, and finally the judge. The dictionary, the adjuster, carrier, homeowner, and the judge all may have different ideas of what "reasonable" means, but that envelope is probably smaller than you think.

Randy Cox

It it doesn't fit...adjust it!

price gouging isnt applied to service work unless u are threee tiime u avg rate. the company that i have used is the best and there normal rate is very high!!! so when i had this problem i called them and they took care of it. but there prices are justifed and they can prove they have charged this befor. let say a adjuster says thats way to high, but the contract shows them that they have charged that to there company 20 other times and have been payed. why do they try to tell them there not paying.

Other than my cookies, there are a lot of non-specific gray vague hypothetical's being thrown out.  Two wrongs don't make a right...do ten or twenty?