Appraisal Or Lawsuit?

By Taylor Grant, licensed public adjuster · Published November 9, 2022 · Updated September 24, 2026

One question decides it: are you arguing about whether it is covered, or about how much it is worth? Get that wrong and you spend a year in the wrong process.

People arrive at this fork with a strong feeling that the carrier is wrong and no clear idea which machinery resolves it. The sorting question is short.

Are you arguing about whether it is covered, or about how much it is worth?

Appraisal is right when

• The carrier agrees the loss is covered and you disagree on the number.
• The dispute is about scope and pricing - line items, quantities, unit costs, whether the whole roof or two slopes.
• Matching is disputed and coverage is not. Matching.
• Your documentation is finished. Appraisal is where you present a case, not where you build one.
• You want it resolved this year.

A lawyer is right when

• The claim was denied outright on coverage or on an exclusion.
• The carrier says the damage is wear and tear, pre-existing, or from a different storm - those are causation and coverage, not amount.
• There is a policy condition fight: late notice, proof of loss, examination under oath, failure to mitigate. Proof of loss.
• The conduct looks unreasonable. Colorado's C.R.S. 10-3-1115 and 10-3-1116 allow recovery of two times the covered benefit plus attorney fees where benefits were unreasonably delayed or denied. Only a lawyer can pursue that. More here.
• The suit limitation is approaching. Commonly one or two years from the date of loss in Colorado. Appraisal does not reliably pause that clock, and assuming it does is how claims die.

The messy middle

Two situations do not sort cleanly.

Causation disputes. "It is hail damage" versus "it is age" looks like coverage, but where the carrier has agreed some hail damage exists and is arguing about how much of the roof it affected, that starts to look like amount. Courts have gone both ways and it depends on the facts and the policy. It is also a place carriers reframe an amount dispute as a coverage one specifically to avoid appraisal - which is worth challenging rather than accepting.

Partial denials. Coverage accepted on the roof, denied on the interior. You can appraise the covered part and pursue the rest separately. Running both is normal.

They are not mutually exclusive

Appraisal frequently runs first because it is fast and cheap, and it resolves the amount. If the carrier then refuses to pay the award, or if there is a separate bad-faith exposure, the legal claim is still available - and an itemised appraisal award in hand makes that a much simpler case.

The sequence that works most often: finish the scope, demand appraisal on amount, keep the legal claim in reserve, and watch the limitation date the whole way through.

Before either

Get the complete claim file - notes, photographs, estimate, expert reports, the adjuster's CV, the certified policy, the reserve. Half the fights we see are resolved by reading what the carrier already has, because their own photographs frequently do not support their own letter.

Send us the denial or the estimate and we will tell you which side of this line your claim sits on. If it needs a lawyer, we will say so, and we work alongside attorneys on these files regularly.

Keep reading