Over 5 months after Hurricane Ian, a devastating category 4 storm, caused widespread damage to the west coast of Florida, one has to ask themselves why are homeowners who have consistently paid their insurance premiums not getting paid by their insurance carriers properly for their claims?
A recent investigative piece by the Washington Post brings to public light what many of us in the industry have already known. Insurers slashed Hurricane Ian payouts far below damage estimates, deleted photos, and changed the field adjusters reports! I highly recommend reading the article, which includes interviews with field adjusters who have opened up and revealed their estimates were slashed, in some cases from around $200,000 of damages to less then $30,000!
Unfortunately, this is nothing new to us. We have recordings of adjusters telling us “I put in my estimate to replace the windows” yet the carrier removed it. We have seen punctured roofs that were 8′ higher then the highest flood waters with the wind insurance carriers claiming the damages were all due to flood.
Which begs the question. Are insurance carriers, and their employees committing fraud? And if so, why is nothing being done about it?
The Insurance Information Institute states on their website “Insurance fraud is a deliberate deception perpetrated against or by an insurance company or agent for financial gain.” In fact, as Public Adjusters in the state of Florida, we are required to print on our contract : “Pursuant to s. 817.234, Florida Statutes, any person who, with the intent to injure, defraud, or deceive an insurer or insured, prepares, presents, or causes to be presented a proof of loss or estimate of cost or repair of damaged property in support of a claim under an insurance policy knowing that the proof of loss or estimate of claim or repairs contains false, incomplete, or misleading information concerning any fact or thing material to the claim commits a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084, Florida Statutes.” Based on the above, when insurance carriers are deliberately revising estimates and reports, and deleting documentation from the reports, with the clear intent to pay the homeowner less then what is owed, for the carriers financial gain, it would seem that the answer is YES. THEY ARE COMMITTING FRAUD.
So why are the carriers blatantly getting away with this behaviour? There is an old saying “Why is Bribery illegal? Because it works.” As long as Insurance carriers can get away with this without consequences, and it continues to be financially rewarding, they will continue with these strategies.
Not only that, our legislature has recently doubled down on rewarding Insurance Carriers for their bad behaviour. When Insurance refuses to pay Policyholders properly on their claims, they turn to Public Adjusters & Attorneys. Until recently, in the state of Florida we had a statute that essentially said, when a carrier refuses to pay an insured properly, and the policyholder hires an attorney to file suit against the insurance carrier, if the policyholder wins, the Insurance Carrier has to pay the policyholders attorney fees. The insurance carriers went crying wolf saying “Hey, we can’t make money if we are penalized for our bad behaviour” and successfully lobbied to have the statute removed. (If you have a Hurricane Ian claim, our understanding from attorneys we have discussed with, is that this change of law does not apply to Hurricane Ian claims, and carriers will still have to pay the attorney fees.)
Which brings up the question. We keep hearing the same insurance carrier narrative, year after year. “Premiums are going up due to the high cost of litigation”. “If we cut down the time period homeowners can fight their claims, premiums will go down”. “We need to pass this statute and premiums will go down”. All these excuses for passing statutes that limit homeowners from being paid properly. Yet what we do not hear of is action taken against the carriers when they blatantly commit fraud!
With the Florida Legislature in session, once again they will try to pass additional bad legislation. This includes restrictions such as requiring the Public Adjuster to notify carrier of their representation within 3 days instead of 30 days (As a Public Adjuster, we might hold off filing the claim until we ascertain the facts, and ensure it makes sense for the policyholder to file a claim), would prevent Public Adjusters to be hired by homeowners who have mortgage placed insurance, and other ambiguous language that can be damaging to policyholders.
If your claim has been underpaid or denied, give our office a call at 833-PANTHER / 726-8437, and one of our adjusters will come out for a free consultation.
I highly encourage you to call your state representatives and ask them what they intend to do to combat Fraud on the side of insurance carriers, as well as to vote NO on bills that will harm policyholders.
Representative Mike Giallombardo – R- Veteran (850) 717-5079
Nick DiCeglie R (vice chair of Senate Banking and Insurance Committee (850) 487-5018
Senate President, Kathleen Passidomo (850) 487-5028
Speaker of the House, Paul Renner (850) 717-5019
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Your own Senator and Representative – You can find them here