Don't Trust Your Insurer

Do not accept your insurance company's claim determination without doing your own research and getting a second opinion. On Friday, ChipMerlin posted a blog on his website and the Insurance Law Journal published an article, both of which were about a lawsuit filed against United Property andCasualty Insurance Company ("UPC"). The lawsuit charges UPC and FKSInsurance Services and Property Loss Specialists with violating the RICO Act,breach of contract, fraud, and unfair trade practices.


The lawsuit, which is supported by sworn evidence states asfollows:


9. Instead of ensuring that field adjusters createdhonest, accurate reports to confirm that UPC's insured received an assessmentthat reflected their loss, Defendants specifically instructed desk adjusters tomodify the estimates created by field adjusters to decrease estimates in orderto ultimately decrease the amount of money UPC pays to its insureds when claimsare made under the insurance policies. In many circumstances, Defendantsinstructed field adjusters to modify reports to give UPC a "factual basis"to deny coverage altogether. Defendants pressured adjusters to create factualbases that were fraudulent in order to deny claims.
30.As this scheme has come to light, some field adjustershave stated under oath that UPC commanded them to add language to their reportwhich was inaccurate and outright false.


The allegations of the complaint are supported by thetestimony of a former adjuster for the Defendants, who stated that he wasinstructed to add "no wind damages were observed upon inspection" tomany of his reports. It further describes a pattern of wholesale denialswithout performing proper investigations. These allegations are supported alsoby a text message allegedly sent to adjusters working on UPC files, which canbe found below.

This text message appears to be instructing adjusters to setup the insureds to have their claims denied without performing a reasonable investigation based upon available information in direct violation of Florida'sBad Faith Statute.

It's important to note that this alleged behavior may not beisolated to UPC. If you would like to get to know how your insurance carrierallegedly treats its other insureds, you are in luck. Right on the ChiefFinancial Officers' website is a repository of Civil Remedy Notices of InsurerViolation ("CRN". These CRNs are complaints by other insureds statingwhat they believed happened in their claims, how they believed they werewronged, and which laws they thought their insurer violated. Anyone can search thesite for these complaints for free.

Before accepting your insurer's findings, you shouldsee what its other insureds are saying.

Here is a link to the searchable site.

Look up your carrier before you accept their denial orunderpayment. Do your research and get a second opinion. And if your insurerrefuses to do the right thing, contact a qualified attorney.

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