Florida’s Fraud Problem & the ICA’s Working Group

I’m hopeful that Insurance Consumer Advocate (ICA) Robin Westcott’s working group called, the Homeowners’ Policy & Claims Bill of Rights Working Group, will provide much needed information that will lower costs for Florida’s premium payers. I’m hopeful but, not yet convinced.

On the other hand, I am convinced that Florida’s property market may be one of the most fraud plagued in the US.  I continually hear of considerable efforts by DFS and the Division of Insurance Fraud to stem the tide–the number of investigations, arrests and convictions are substantial and impressive. Kudos!

To the chagrin of some I’ve pointed in the direction of a contingency fee system I believe pays too much to those public adjusters that NAPIA indicated might have a “weak moral compass.”

In a previous blog on Assignment of Benefits (AOB) I pointed to remediation companies, water extraction companies, contractors, sub-contractors, et al, that are perhaps more contributory to Florida’s growing fraud problem than any contingency fee could possibly be.

You’ve seen their ads and billboards, too. You’ve listened to the recorded phone messages promoting “claim inflation” and “premium recoupment”.

Now here’s another, even more egregious example, from a roofer advising on insurance claims as a means to help people get a “free” roof. “We know Roofs and we Know Insurance Companies” they allege.

Check it out yourself at Get Free Roofs.com where the company describes its offer this way:

GET YOUR ROOF REPLACED BY YOUR INSURANCE COMPANY

• PAY NOTHING for our inspection
• PAY NOTHING for our detailed Insurance based estimate
• PAY NOTHING, unless we get you a roof replacement and then PAY ONLY your deductible.

They work for free…such a deal!

It gets better!

The site features charts from NAIC and actuarial firm Rollins Analytics, showing the rising cost of Homeowners insurance as a reason to file a claim…“You’re paying a lot for insurance–So Use It!”

And, they’re apparently experts at helping you do just that. I called and was told they are like public adjusters. They “…sit down with you and file the claim with your insurance company.”

As professionals who have completed insurance claims for over 2 decades, we will be able to inspect your property and tell you right away if we believe that you would be eligible to complete a claim. Our services are valued at over $1,600, which we complete at no cost to you. These services include the initial inspection, damage documentation, damage report, and all contact with the insurance company. We work with the desk adjuster, field adjuster, and engineering to complete the claim. Just a few of our services include:

·         Damage documentation

·         Report of damage for the insurance company

·         Produce a rendering of your roof to complete the claim

·         Become the point of contact for the insurance company for you

·         Contact the desk adjuster

·         Meet with the field adjuster

·         Complete all steps to put together your claim

·         Provide a free roof!

Anyway, you get my point.  This company, and too many others like it, appear ubiquitous–more here in Florida, apparently, than anywhere else.

To get a real handle on claims settlement practices as a means to lower costs for policyholders and provide better service to claimants, Robin Westcott’s panel (See Note #1 below) must first get a grip on how much contingency fees, AOB abuse, and solicitations like the one above are indirectly driving up costs.

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Note #1: The goal of the working group is to publish a comprehensive report addressing each agenda item either administratively or through proposed legislation.  Despite NAPIA testimony in New Jersey, the agenda  contains no item dealing with PA contingency fees. Item #4 deals with  Assignment of Benefits and public adjusting without a license. Item #9 might provide an opportunity for a broader discussion on a myriad of issues.

1. Adjusting & Investigating the Claim – Examinations Under Oath
2. Post-Claim Underwriting & Material Misrepresentation on the Application
3. Solicitation of Consumers within 48 – 72 Hours of a Loss and Policyholders’ Requirement to Mitigate Damages
4. Assignment of Claims and Unauthorized Adjusting of Claims
5. Insurers’ Right to Repair – Safeguards and Warranties for Consumers
6. Non-Renewal of Policies – Post-Claim but Prior to Repairs
7. Mortgage Company Withholding of Funds for Repairs for Loans in Arrears and Guarantee 100 Percent Replacement Cost
8. Mediation and Appraisal
9. Other Issues Identified by the Working Group

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