Florida public adjuster says insurance companies are increasingly denying legitimate claims
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- Опубліковано 26 лис 2023
- The ABC Action News I-Team has been reporting on Florida’s growing property insurance crisis for months as part of our ongoing “Price of Paradise” series. We are now focusing on how a public adjuster could help you recover what you’re owed when it comes to filing an insurance claim. Public adjusters are insurance adjusters who work directly for homeowners instead of insurance companies. They charge a fee, which can be up to 20% of the eventual payout.
Ban insurance. It’s a total scam. If you’re deductible is as much as the claim along with crazy monthly payments, do away with it.
If you own your home with no leans (or insurable interests), Yes, you can drop your insurance coverage.
If you have a mortgage, you have no choice. Your home has to be insured.
Not when you have a house fire or a sudden water break .....
I agree
💯💯 Ban insurance they are just bunch of thieves robbing people and not doing the proper job.
Unlike the comment section, I don’t shed tears for insurance companies - this administration has dropped the ball on this issue
I totally agree
The Florida administration in the pockets of the insurance companies.
Most companies won’t even insure homes built before 2000 or so
2001 - 100 $60,000 homes in an area = $6,000,000
2023 - 250 brand new $300,000 homes in same area = $75,000,000
Hurricane comes in does some damage insurance companies feel the squeeze
Multiply this scenario all across Florida
Now do the math on their income for those same homes and then multiply it across all 50 states. They shouldn't feel any squeeze. That's why insurance is paid. And even if they do feel a squeeze, that's of no consequence to those who paid insurance every month and genuinely need the support of insurance. If I am forced to pay for a service, you damn well better provide that service when I need it.
Public adjusters are corrupt tools of the plaintiff bar. They have an incentive to produce grossly exaggerated estimates for a larger commission.
This comment is hilariously off base. I have a 90 day spreadsheet showing where claims sit before settlement and or appraisal with a public adjuster. On roughly 2 million dollars in claims that I’m currently working the carriers are trying to settle for 1/5th of where the claim ends up settling at after unbiased review from appraisers and umpires. And don’t even get me started on Xactimate price lists which are grossly undervalued to begin with. Ive worked as a vendor estimator for the carriers before and they’re completely out of line with their guidelines and underpayments, and most regulatory departments are well aware. Public Adjusters are the property owners only hope of getting a decent settlement these days.
Florida is a giant sandbar in the middle of the ocean. Plan accordingly.
EXACTLY
People building million dollar homes one the waterfront. No way the insurance companies can pay for all these waterfront homes. It doesn't take a economic major to figure that out.
Then they shouldn't be selling policies that they won't support
@@Tom-kn6sr, this. I heard it actually costs a lot, I guess they are able to cover.
@@Tom-kn6srsome people just don’t do their due diligence when buying insurance coverage. You can’t buy basic economy and expect first class. That just not how things work.
@@Dfgbuiiyyyybb I'm guessing that people building/buying million dollar homes aren't really looking for economy insurance. And that's kind of my point, insurance companies shouldn't be selling useless policies, they know what the house costs and where it is before they issue a policy, if their not going to back it up they shouldn't sell it. Thats fraud.
what happens when you buy expensive first class and barely get economy?@@Dfgbuiiyyyybb
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Insurance commission doesn't help
What does this have to do with the conversation? Besides, I know for a fact the insurance commissions have gone down since 2009, so they are working harder to make a living.
How much has the price of lumber gone up in the last 3 years? How much will it cost to replace your 20 year old house with todays new lumber cost? Now add in nails, shingles, wire, and everything else it takes to build a house.
Right here!!! Thank you! The cost of claim payouts the last 3 years have increased because of this. Insurance carriers including the one I adjusted for just laid off 2400! people
@Raputins_Rabbit I want to give you a thumbs up to agree, but I am hoping you still have your job.
Very helpful.. In california they've been very helpful in helping people get their claims settled. In California( For The People Public Adjusters)
They are greedy thieves
Theives
Insurance industry's about to tank, meaning one or two more big storms/fires/earthquakes/floods/droughts....
Did the PA pay you for this segment?
Well, when and if I get to retirement age, I'm retiring in coastal cities in Asia for way less than living in a regular city in the US, let alone Florida and actually enjoy life. Florida has become a shithole for many people. I'm sure Haiti is laughing at this.
That damage was not from anything recent. Its clearly a sinkhole or erosion from being that close to the water. Just because he doesnt like the outcome doesnt mean its incorrect. No insurance company benefits from denying legitimate claims. Whats not mentioned is that the Public Adjuster gets 10 to 20% of the money. So if it costs $50k to fix per your contractor and the PA takes 20%= well now your short 10k. Thats not paid by insurance
😮 wish I had one when a car went thru my foundation. still suffering
Oh that's rich. You mean the Public Adjusters that come through your house and at all kinds of things to the claim to cover your deductible? We talking about those adjusters?
Owned 2 different homes in Naples, Florida (1990-2014). Both very, very close to the coast. When you buy a home that close to the water you just have to accept that it may get flooded, blown away, etc. Just part of the deal. You have to accept the risk. I do not agree that FEMA (Taxpayers) should pick up any costs of damage resulting from natural weather occurrences. Insurance companies have been scammed for years by unscrupulous Contractors. All the litigation has created a business environment that is unsustainable. You live in a risky area, suck it up.
You are right! I think if someone has the money to build on the water, the should be self insured period. No taxpayer money bailing them out. Another option only insure these costal people for 25% of value.
Can’t believe ppl think that an engineer hired by the insurance company is going to decide in their favor 😂😂
Not if he wants to keep getting work lol 😂
If insurance company hires an engineer unfortunately you are going to have to hire one also and they are not cheap. They will be neutral to you since you are a one time client, it’s pricey but worth it if you want that claim to keep moving forward.
If the insurance company would do their work and not screw the insureds there wouldn’t be PAs and Attys, unfortunately they don’t. They wouldn’t have 70 million lawsuits if they would pay the claims from the beginning but they rather deny claims to then go cry to the Department of Insurance about poor me having all these lawsuits and change policy language that benefits insurance companies take away coverages and the only ones that get stuck with a big insurance company bill is the poor FL insured.
You want to get rid of the circus? make Florida a no insurance state and have the banks collect mortgage insurance on the home loans for the ppl that finance. Problem solved !!
What a load of shit. Insurance companies definitely hire neutral engineers and experts. You guys just prey on people and file frivolous lawsuits when you don't get your way. Not to mention the 20% you take from people is pretty predatory.
The key word PROBABLY that is not for sure. It just sounds like they are guessing!
We are waiting for a court date, to get our roof fixed. 😢
Public Adjusters as with shyster lawyers and unscrupulous homeowners cost everyone . End insuring homes close to water.
I'm a property adjuster this is absolutely incorrect lol holy crap don't believe what you see
I'm an independent consultant for a PA firm and it is 100% correct. Its probably outside of your periphery because as a property adjuster you have a maximum authority $ amount that you can write for... once it blows past that its taken off your desk for "losing control of the claim" State Farm, Allstate, Progressive, AAA, Farmers, Travelers.... all trying to pay 1/5th of a proper settlement on average... at least that's the case in my major market. Even the appraisers for the carriers are talking trash on the carriers these days... the industry is in a HORRIBLE state of affairs on the carrier side... I will concede there are some awful PA's as well... like anything, the property owner should educate themselves and vet their representation
An insurance policy is a contract that states what is covered and what is not. Oftentimes the insured and Public Adjuster believe any damage is covered by insurance. There is homeowners insurance and flood insurance these are separate policies; one does not provide coverage for the other. I cannot disagree that the insurance industry is broke as a whole. As an adjuster, appraiser, and building consultant I see the damage created by some roofers, and exaggerated estimates provided by many public adjusters. One has to realize money paid out in claims is supplemented by premiums that are the result of claim settlements and litigation costs. I just spoke with a PA today who stated the insured deserves a large settlement because they pay high premiums. (....and I deserve a new truck because I drive all the time!) As a homeowner, I assume responsibility for our own maintenance, so why should I pay for the neighbor who neglects his property and files a claim because of damage he failed to repair!
You have a surface level understanding of how adjusting works. PA’s hold a license to engage policy language to maximize your benefits per the policy. It is illegal for someone without a license to discuss policy language (other than the insured who owns the policy) so when your insurance co. says “we don’t pay for that” and “that’s not covered”, the only person who can legally verify that is the uneducated policy holder, or a licensed public adjuster - many of whom worked for insurance carriers but prefer to be able to sleep at night knowing they’re not screwing over property owners.
I've seen you PA's take 20% of a legitimately settled claim and leave the homeowner without enough money to repair their homes. You aren't the hero you pretend to be, you are greedy predators.
@@LOLatYOU422 So as a property owner you'd rather settle a claim directly with the insurance carrier for maybe 1/5th -1/3rd on average of what the actual repairs cost (I've seen major carriers Allstate, State Farm, Travelers, try to settle for less than 1/20th of real world costs )... rather than pay a PA 20% of a claim that's going to net you a 3-5X settlement amount on AVERAGE!? Don't quit your day job to go into anything math related. Maybe the carriers should be forced to pay the PA / appraisal fees so the property owner doesn't have to - I bet that would stop them from railroading claims into bad faith settlements, and entirely remove the need for PA's to even exist.... but no, sure, by all means blame the PA who's helping the property owner get what their owed because they're the only ones who can legally engage the policy... Even if you're going to point to bad PA's here or there, there are probably 1,000 terrible insurance adjusters per 1 bad PA... the odds and easily available data are in complete juxtaposition to your opinion. I bet every dollar you are a an adjuster for big box that regularly tells contractors "you shouldn't charge for this its the cost of doing business" "were not paying O&P due to lack of complexity regardless of the 9 independent trades on the estimate" "supervision is included in the overhead" "send me the building code, I've written 10,000 estimate and I've never seen this before" "we're not paying anything but Xactimate pricing" lol... you lose 100% of your appraisals... but you've been brainwashed by working for the carrier and reading a script of denials for the past decade so you think everyone else is the enemy of the claim. Wake up man!
@brandonm2381 PA's don't help people they only help themselves. If I had a homeowners claim that was being underpaid, I would just get multiple local contractor bids and send them to the carrier. I would get paid 100% of what I need to fix my damages and not have to deal with a slimy predatory public adjuster. I was at CVS the other day and I was talking to the cashier and he ended up telling me that he is a public adjuster but recent laws ruined his business. I laughed at him and told him he deserved to be working at CVS for preying on people who don't know better.
@@LOLatYOU422 best of luck doing it your way, sometimes turning in well documented bids is enough! I've gotten 100's of claims approved doing just that. For small residential claims less than $20k, you probably wont run into too much trouble... But it sounds like you've never dealt with an adjuster who only wants to pay for 1 elevation of siding that's discontinued after 2.5" hail destroyed the roof, skylights, custom bent aluminum fascia, window wraps, and all of the siding - citing all other damage is "mechanical" and railroading the claim into appraisal... I've had an adjuster tell me they disagree with code upgrades when a policy has coverage for ordinance and law... I've had an adjuster damn near force an appraisal on a 5 story commercial roof that they initially denied any coverage on, then offered minimal repairs under the deductible amount... After the PA got an engineer on site they wrote for $550k / full replacement. I could go on and on... Your average property owner will never navigate those issues, and most affluent owners simply don't have the time even if they have the know-how.
Meanwhile Florida Governor is shoe 👠 shopping !
Public adjuster's are scum. They submit over inflated and fabricated estimates (300k on a 50k claim), only to get denied because a PA doesn't know the policy; the 50k gets paid and the PA gets 10-15% for it. The homeowner gets screwed.
...this is especially true for flood. Heaven forbid a PA work both flood and homeowners, because then they try to claim the same damages on both policies, putting the insured in a bind, while they collect their 10-15%...
To any insured out there. It's up to YOU to know your policy. PA's are leeches and are only there to serve themselves.
Know. Your. Policy. Ultimately the responsibility is yours and yours alone.
There are laws and systems to protect you against unfair insurance companies, but nothing stops a PA from doing a poor job representing you.
I will say that engineering firms hired by the insurance company aren't great either though. Even if the original engineer has an opinion, it goes to committee "peer review" and often finds in favor of the insurance company. Check out Sandy and the law suits derived from that.
While I agree the educated homeowner is the ultimate asset in claims resolution, it sounds like you’re comparing a few bad apples. And if we’re talking bad apples, the insurance carrier has ONLY bad apples. Most PA’s used to work for carriers and got tired of lying and schilling for them, same with engineers. I’ve been doing insurance claims for almost 15 years, and the carriers are blatantly corrupt. I’ve seen them send claims to appraisal over law and ordinance LOL. Imagine being a desk adjuster knowing the policy has ordinance and law coverage and “disagreeing” with the LAW, and railroading the insured into the appraisal clause simply because the carrier wants to delay payment - I see it every day. PA’s are a huge asset to policy holders, and like anything else, homeowners should do their homework and vet their representation.
@@brandonm2381 oh I agree, carriers can be... Well, as you described. The problem is, PA's don't do, or have any authority to do, anything to help. They simply leech the 10-15% from the insured and for what. Making the claim take longer and getting no real additional payout that an educated insured could get for themselves, hence my advice to know your policy.
@@oll1998 PA's carry a license with the state to read and engage policy language, and the license requires continuing education hours in order to renew (its illegal to discuss policy without the license) and while they do charge a percentage, they are much cheaper than attorneys, and the PA contracts are written by the State Dept of Insurance. The OPAGGA (Office of Program Policy Analysis and Government Accountability) estimates that using public adjusters can help obtain payouts that are over 700 percent larger than what insurance companies would otherwise agree to pay.... I don't know anyone who, in their right mind, wouldn't happily pay 10-15% to 2x their settlement, let alone potentially 7x their settlement. If you're frame of mind is that PA's are leaches and they don't know policy, then you've either only interacted with a terrible one, or simply don't understand what they do in full context.
Public adjusters work against the public not for them.
@@brandonm2381 When I meet a pa familiar with flood insurance I'll let you know. :)
Every policy is different, get to understand yours and protect your home from damages, with reg. maintenance. Water doesn't get into your house during storms unless you have old windows, doors or roofs. Wind will push rain into cracks & crevices, not covered in your policy, chalk your windows and doors, inspect roofs for missing shingles. This is generalized info that holds true under all policies: No coverage for earth movement, shifting, settlement, etc... Waves crashing over the seawall often cause deck damage and remove a lot of soil during storms. It falls under rising water, which along with flooding & surge is not covered. People need to read their policies and ask questions from agents & carriers when they don't understand. Quit hiring a bunch of middle men like PAs who get paid by how LARGE the claim so they can be pretty self-serving, they truly are adding to our costs to our policies in FL. No one should need help on a property claim if they read policy language. Most carports and open Lanais like the couple in Clearwater have are not covered, they are not insurable for the most part. We are only going to bring down rates by removing the third parties from property insurance and people stop buying homes they cannot afford to maintain. Ask that PA how much he made in the last 5-years suing carriers and ask him how many times he made more money than the homeowner. Do research and stop asking people with financial interests to make reckless statements that drive up premiums. @FEDUPINFLORIDA
Especially with how they are building houses these days. And where! 🙄
You are correct! I began in this industry as an agent. I learned that people do not care about coverage until they have a loss. However, when they purchased the policy they elect to go with specific exclusions and a higher deductible. When a loss happens they fail to repair it and say the insurance company didn't provide enough money to cover it!
No, you chose a higher deductible, that was the choice of the insured.
That overhang is considered other structures and not covered in the policy. Read the policy.
@Bradimoose - that overhang is part of the dwelling bc it’s attached to the dwelling, which means the coverage is within the dwelling limit. Other structures are detached from dwelling like sheds, pools, retaining walls, fencing, docks, etc. Not to mention, a homeowners policy usually includes other structures coverage at 10% of the dwelling limit. Unless the loss is caused by flood, then other structures typically isn’t included on this type of policy… BUT still… it’s part of the dwelling.
Insurance company people have mouths to feed to. Wont someone please think about the children?!