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Adjusters in Florida accused of fraudulent estimates

On Behalf of | Jan 5, 2023 | Insurance Law and Litigation

Florida is facing a property insurance reform crisis but there is also another problem that affects property owners. Several adjustors recently testified before a state legislative committee House that insurance carriers fraudulently changed their estimates.

Changing estimates

The Florida House Commerce Committee held a hearing on the insurance crisis reform bill and where witnesses also testified on fraudulent claim practices. These practices also led to plaintiff-initiated insurance litigation in Florida.

This fraudulent activity is not limited to residential and commercial property insurance claims. It could also impact automotive claims because independent adjusting firms sometimes review these claims.

An adjustor testified that insurance companies directed reviewers to change his estimates to repair roofs instead of replacing them. The insurers left his name on estimates to make it appear that he wrote this fraudulent estimate, which defrauded policyholders out of their valid property claim payments.

This activity is not limited to Florida. Witnesses also testified that this practice also takes place in Texas and Louisiana.

An adjustor who works in Florida and Louisiana claimed that he witnessed fraudulent practice several times in both states. Insurers, for example, redacted complete sections of his reports, which reduced repair costs by thousands of dollars.

The committee chairman met privately with adjustors after the hearing. Two adjustors gave him copies of reports they claimed were altered by insurance companies.

Lawsuits

A lawsuit was brought by a south Florida restoration firm against an insurance company. The firm claimed that insurance company personnel texted instructions to field inspectors to avoid making estimates of wind damage, to minimize damage estimates in hundreds of claims or to add false information.

A federal judge dismissed that claim in Oct. and ruled that state courts have regulatory jurisdiction over the insurance business. Another similar suit, however, is pending in Martin County.

A class action lawsuit may be filed against property insurers over adjustor reports that were allegedly altered. Adjusters also said there may be criminal charges.

Claimants may need assistance to assure that they obtain fair and accurate insurance payments. Attorneys can help assure that insurers meet their legal obligations.

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