Call For Your Free Quote: 305-443-6321

Allegations of fraud against United Property and Casualty

Allegations of fraud against United Property and Casualty

A recent lawsuit filed in Florida alleges that the insurance company, United Property and Casualty, demanded that field adjuster’s reports be altered to ensure a denial or to reduce claims.

The lawsuits states in part:

29. Instead of ensuring that field adjusters created honest, accurate reports to confirm that UPC’s insured received an assessment that reflected their loss, Defendants specifically instructed desk adjusters to modify the estimates created by field adjusters to decrease estimates in order to ultimately decrease the amount of money UPC pays to its insureds when claims are made under the insurance policies. In many circumstances, Defendants instructed field adjusters to modify reports to give UPC a “factual basis” to deny coverage altogether. Defendants pressured adjusters to create factual bases that were fraudulent in order to deny claims.

30. As this scheme has come to light, some field adjusters have stated under oath that UPC commanded them to add language to their reports which was inaccurate and outright false.

Rod Buvens, a field adjuster acting on behalf of UPC through PLS following Irma, testified that UPC’s desk adjuster instructed him to add language into his report“ that no wind damages were observed upon inspection” at the property at issue, despite this language being categorically false based upon Mr. Buvens’ own inspection of a property. Relating to homes damaged by Irma, Mr. Buvens advised UPC’s desk adjuster, Josh DeMint, numerous times that the statement “no wind damages were observed upon inspection” was incorrect multiple times; yet, Mr. Buvens was still required to include the categorically false statement in his report at the demand and instruction of UPC.

Mr. Buvens testified that UPC demands its field adjusters remove items from an estimate, which ultimately results in UPC owing less to its insureds.

34. For example, Mr. Buvens testified that he was specifically instructed to remove portions of his estimate, which would have amounted to an additional $1,376.30 that UPC would have owed pursuant to the insurance policy. Moreover, if Mr. Buvens’ report and estimate were not wrongfully modified by UPC, the insured in this specific instance would have obtained a full roof replacement, which would have cost UPC thousands of dollars more pursuant to the insurance policy.

The American Policyholders Association (“APA”) was established to identify insurance fraud.

“The APA recognizes that at the time of loss, property owners rely upon the insurance companies and their agents to measure the loss to a property and determine what the insurance company is obligated to pay in benefits. The property owner and insurer have adverse interests in the determination of an insurance company’s liability. The APA studies the conflict of interest present in the adjustment process and monitors the systematic methods used by the insurance industry to determine policy benefits. The APA recognizes that insurance fraud occurs far too often by those obligated to pay for the loss.”

This type of behavior has occurred in the past as we saw engineering reports altered for the same reasons during Superstorm Sandy. Contact our office or call us at (305) 443-6321 for a free evaluation. We have a group of private adjusters, claims consultants, and top-rated attorneys on standby to assist you.