Whistleblowing Property Adjusters Confirm Fraudulent Property Insurer Practices

I thought about another title for this post: Florida’s Republican leaders heard firsthand how insurance companies are fraudulently underpaying claims and still sold out their constituents. Both titles are appropriate.

An Insurance Journal article, Independent Adjusters Charge Florida Insurers With Doctoring Damage Estimates, stated in part:

‘The insurance companies were directing file reviewers to change my estimates to repair the roofs rather than replace a totaled roof,’ said Ben Mandell, a licensed all-lines adjuster. ‘However, the insurer was leaving my name on the estimates in a fraudulent effort to make it appear that I had written this bogus estimate.’ The scheme was repeated over and over again, he said.

Another adjuster who works part-time in Louisiana also said that he has witnessed the practice numerous times in both states, with insurers redacting whole sections of his reports and leaving out thousands of dollars of needed repairs.

‘The problem is, they’re leaving our name on the estimates,’ adjuster Mark Vinson told the committee members. ‘When they send it to the policyholder, they (the policyholders) are under the impression that it’s a legitimate estimate, and it’s not.’

Adjuster Jordan Lee, who also works in Texas, said that insurance companies and adjustment firms have manipulated reports and deleted photographs and other key information in order to drastically limit payouts to policyholders.

…

Later Tuesday, Mandell told the Insurance Journal that several insurers have engaged in the practice in Florida and Louisiana. Vinson said that ‘most carriers’ in Florida and several in Louisiana have altered his reports, without his permission. Vinson said that Universal Property & Casualty Insurance Co., Florida’s second-largest carrier, behind the state-created Citizens Property Insurance Corp., was one of the most frequent perpetrators.

…

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 that 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.

Three weeks ago, an independent adjuster came to my office and showed me how adjustments to field reports were altered with a different carrier than the ones noted in the Insurance Journal article. According to this adjuster, a number of independent adjusters quit or were fired because of the practice.

The practice of altering field adjuster reports to reduce claims payments is becoming more prevalent as more insurance companies hire independent adjusting firms rather than make the adjustment with their own employees. The desk adjusters at the independent firms and the managers overseeing the operation for the insurance carriers conduct “collaborations,” which alter the estimates. They can remove photos and evidence of damage so regulators and others cannot question the altered estimate.

What did Florida’s Republican elected officials do after hearing this? As a registered Republican, I am embarrassed to say that they voted for the insurance company interests and have effectively doomed Floridians to more of the same treatment without recourse.

My Democrat friends ask why I support so many Republican candidates. Actions like this and the lack of courage make me wonder why as well.

As for the whistleblowing independent adjusters and other property adjusters who do not give into unethical claims management demands—BRAVO! You are licensed to follow the law and improper alteration of claims estimates is illegal.

We need greater protections for independent adjusters to expose unethical claims conduct as noted in
Do Independent Property Claims Adjusters Need More Legal Protection From Unethical Managers?

Thought For The Day

Courage is what it takes to stand up and speak; courage is also what it takes to sit down and listen.
—Winston Churchill