Independent Adjusters Charge Florida Insurers with Doctoring Damage Estimates (article continued)

“Claims just aren’t getting paid now, and it’s not good for consumers or legitimate insurance companies,” he said, adding he’d rather not work for insurers who engage in the measures.

Mandell, of Haines City, FL, has been an adjuster since 2017 but was in construction for years, and said he knows construction costs and building codes. He said he became aware of the alteration issue when he adjusted a claim in Louisiana more than a year ago. The policyholder later called him, complaining his estimate had left out large amounts of damage from a storm. The homeowner sent him a copy of the report from the insurer, and Mandell said he was surprised to see his name on an estimate that was significantly different from the one he had submitted to the insurance company.

“I told them to hire an attorney,” Mandell said.

This year, the tactics seem to have become much more common in Florida, Mandell and Vinson told the Insurance Journal.

In one recent hurricane claim report, Vinson said he noted the entire shingle roof of a home was heavily damaged and needed full replacement. He documented the damage with more than 100 photos. But the altered report, sent by the insurer to the homeowner, had left the roof section out of the report altogether, lowering the repair estimate by some $30,000, he said.

“And that was with photo proof, mind you,” Vinson said.

The adjusters were three of dozens of people who spoke at the House Commerce Committee hearing Dec. 13. Several urged lawmakers to vote against HB 1A. The bill has been hailed by the insurance industry as it aims to end one-way attorney fees and outlaw assignment-of-benefits agreements in order to curb the huge amount of claims litigation in Florida.

Mandell and Vinson agreed Florida’s insurance market is in trouble, but they said insurers have themselves to blame, partly due to altered adjuster reports and low-balled payment offers.

“If they had just paid, as the estimates showed in the first place, there wouldn’t be all these other problems,” Vinson said.

“It makes things worse for everyone,” said Mandell. “The good insurance companies will be forced to adopt these same fraudulent practices in order to compete.”

Others at the hearing, and at a Senate committee meeting on Dec. 12, testified about other alleged tactics by insurers. Several homeowners and attorneys said some insurers have frustrated policyholders by sending as many as eight adjusters to look at a property after a claim. And carriers have required engineering reports in some claims, but have refused to provide those reports to the policyholders, speakers said at the committee meetings.

Democratic House committee members Dec. 13 offered 12 policyholder-protection type amendments to HB 1A. None of the amendments passed, and the bill was adopted without changes. By a vote of 27-13, the full Senate late Dec. 13 also approved the nearly identical Senate version of the property insurance bill, SB 2A.

The Florida Legislature’s special session on the insurance crisis was expected to conclude late Dec. 14 after the bills are voted on by the full House chamber.

We thank the Insurance Journal for reprint permission.

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