Under Florida law, it’s a third-degree felony for someone to produce a loss estimate for an insurance claim if they know the estimate contains false, incomplete or misleading information. The penalty is up to five years in prison. If the fraudulent amount is more than $100,000, it could be a first-degree felony with up to 30 years in prison.
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This is not just a Florida thing. It is routine for insurance companies to manipulate facts and policy language to deny and underpay insurance claims. Just last Thursday, my client’s denied insurance claim resulted in a $925,000.00 negotiated settlement. Two weeks before that, I settled another denied insurance claim for $534,000.00. So far this year, two and one half million dollars of insurance company denials have been reversed by my company, alone … and the year is not half over. And I’m just one guy. And Missouri doesn’t even get hurricanes.
The root of the problem can be found in a very unusual phenomenon where otherwise intelligent homeowners will enter into a binding contract worth hundreds of thousands (sometimes millions) of dollars without ever reading it. When it comes to the time for them and the party they contracted with to perform under the terms of that contract, they learn for the first time what those terms are and, as a result, they often find themselves trying to put the toothpaste back into the tube, so to speak.
Your home insurance policy is a contract. Have you read it?
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Way to go James. This is interesting. Thanks for helping people.
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That’s not as easy as it sounds. Reading through all the mumble jumble is one thing, completely understanding it is another.
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Indeed. This is something the insurance company will exploit in their favor. When it comes to the question of coverage, a “no” from your insurance company is in pencil, not ink. When it comes to what they initially agree to pay you, it’s an “estimate” - not a final number.
Unless you are the kind of guy who takes a blank 1040 to the IRS and asks them to fill it out and tell you how much income tax to pay, you never “file a claim” and ask the insurance adjuster to come to your home and tell you what they owe you. Under your contract, YOU have the duty to prove your loss. That means YOU prove that there is coverage, and YOU prove what it will cost to cure. YOU tell them what they owe YOU. If you need help, call in a pro … but don’t expect your insurance company to hold a gun to its own head and provide you with more than the minimum - if anything - that they can get away with. They consider it good business and responsible use of their funds to withhold as much from you as they can and they are happy to have you unaware of this and defer your duty to them.
State Farm just pulled out of California before wildfire season due to the inflationary cost of building materials. Even lowballing a claim as they are famous for would still be exponentially more than they are willing to pay for a fire loss in that state. Like a good neighbor, they dumped their customers and ran out of town. Insurance companies like to collect premiums, not pay claims.
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Good advice Jim. Thanks
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Jake wouldn’t do that. Would he?
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I agree. We are living in a time where people, govt. and corporations try to out clever each other and morality, common decency, duty be darned. They put their desire for profits over their customers… When it comes to contracts they’re increasing long, difficult to read and exclusive of many possible hazards you might expect. Also many times you don’t even see the contract until after you have paid for the insurance and there’s no option for negotiation anyway…
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Morality and all other relevant things pertaining to what you describe as human qualities has now been relegated to the machines and their AI which similar to human AI, just without all the feels.
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And just wait until AI takes control of our llegal system.
AI…that’s artificial idiocracy right…