Claims adjusters say insurance companies are manipulating reports to avoid paying claims [Boss Insurance]

Claims Adjusters Say Insurance Companies Are Manipulating Reports To Avoid Paying Claims

Claims adjusters in the field speak out.

Several adjusters say insurance companies have manipulated their reports to pay homeowners less money or deny all of their claims.

An expert made the claim under oath during a deposition for a trial and since then others have told similar stories.

Hurricane Irma caused around $50 billion in damage in Florida in 2017, according to the National Oceanic and Atmospheric Administration.

Months after the storm, independent adjuster Rodney Buvens was hired by United Property and Casualty, also known as UPC, to assess a homeowner’s claim in Estero, Florida.

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“Our job is really to document the damage and provide an estimate,” Buvens told News 6.

Buvens testified under oath that he found evidence of damage from the windstorm and he recommended a full roof replacement, according to his deposition.

But that’s not what the owner has.

“We started getting indications from policyholders that they weren’t getting their estimates that we had been working on,”

After getting Buvens’ estimate, UPC sent engineers to the house who found no damage.

“They were using these engineering reports as a basis to deny or underpay these claims when there was clearly wind damage to these homes,” Buvens told News 6.

The owner’s claim was denied, leading them to file a lawsuit against Family Security Insurance, a UPC subsidiary.

And that led to the removal of Buvens.

“What we found was that they were taking our reports and either changing them without our knowledge and leaving our names on them, or they were asking us, telling us, ordering us to change those reports,” Buvens told News. 6.

Buvens testified that “his report includes language that was inserted by the office fitter that no wind damage was observed during the inspection.”

He also said it wasn’t the first time this had happened.

“There were a lot. There were hundreds that were changed,” Buvens told News 6.

Jordan Lee is also an independent expert who testified before a Florida House committee in December that insurance companies regularly change reports.

“They manipulated these documents without my approval,” Lee told lawmakers. “I believe carriers and adjustment companies are committing fraud by taking my estimates and those of other adjusters and manipulating them to reduce payments to policyholders.”

Rep. Bob Rommel, chair of the committee, responded.

“If insurance companies are engaging in fraudulent and manipulative behavior, it’s probably criminal,” Rommel said.

Mark Vinson also testified.

“I’ve also witnessed the change in estimates this year,” Vinson said. “And the problem with that is that they leave our names on the estimates. When they send it to policyholders, they feel like it’s a legitimate estimate based on the findings we found there and it’s not. »

UPC is now bankrupt, but they settled with the owners of Estero before the case went to trial, according to their lawyer.

A spokesperson for the Department of Financial Services – which investigates insurance fraud – said the department was investigating claims made in commission, as well as claims made by Buvens.

They also said that if anyone believes they have been the victim of insurance fraud, they should immediately report it to their Insurance Fraud Hotline at 1-800-378-0445.

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