After the passage of the great tort reforms to Florida’s insurance coverage legal guidelines in March, it has develop into clear that main modifications are coming to the state’s property insurance coverage market. Whereas the statutes handed primarily deal with stopping fraud by insured events, state legislators haven’t ignored the actions of insurers. 

On March 24^th, 2023, the identical day because the passage and quick implementation of HB 837, Florida Governor Ron DeSantis confirmed that the state’s Insurance coverage Regulation Workplace had opened an investigation into alleged fraud carried out by a number of insurers. This investigation is centered on a flood of experiences that people had been illegally underpaid or dropped by insurers trying to economize. 

Based on the allegations, it turned a typical apply amongst insurers within the state to amend adjuster experiences. Whereas amending experiences is typically crucial, the size and circumstances of those alterations far exceeded what could possibly be required. Public adjusters state that they’d submit experiences to insurers solely to seek out out their paperwork had been instantly amended to scale back the quantity the insurer must pay. 

That is supported by statements made by the insurance coverage trade watchdog, the American Policyholder Affiliation (APA). The APA has reported that some corporations reduce adjusters’ restore estimates by anyplace from 50-97%. This apply seems to be totally centered on saving the businesses cash on the expense of their prospects. 

Moreover, many people have had insurers drop their insurance policies, leaving them with out protection. Insurers can solely drop or refuse to resume insurance policies in particular conditions. The variety of dropped insurance policies seems to exceed all affordable estimates, suggesting that that is one other doubtlessly illegal cost-cutting measure.

What makes these practices even worse is the truth that insurance coverage charges have been skyrocketing statewide for years. Insurers are bringing in extra money than ever, but in line with buyer allegations, they’re violating contracts and state legal guidelines to economize. 

Whereas the investigation continues to be underway and outcomes haven’t but been introduced, the Insurance coverage Regulation Workplace could impose civil and felony penalties for fraud. Within the meantime, insured people who find themselves victims of insurer fraud can file claims to pursue compensation for what they’ve misplaced. 

Varieties of Insurance coverage Fraud Dedicated by Insurers

Insurers are held to strict requirements of habits as a result of they’ve vital incentives to be dishonest. They obtain month-to-month funds from their shoppers however solely have to pay out in the event that they approve claims. As such, it’s a well-known tendency amongst unethical insurance coverage corporations to disclaim or underpay claims to economize and enhance income. 

There are a number of ways in which insurers can defraud their prospects, similar to:

• Denying claims: An insurer could deny a declare that ought to be lined with out good motive within the hope that the shopper is not going to pursue the matter additional.
• Underpaying claims: Equally, an organization could make an illegitimately low settlement supply within the hope that the shopper will likely be determined for any assist they’ll get.
• Delaying claims: Unethical insurers will typically mix underpayments with delayed responses, hoping to place stress on the insured to simply accept the primary supply relatively than preserve pushing aside repairs.
• Altering adjuster experiences: Based on the allegations, corporations have begun altering adjuster experiences to help underpayments and denials of claims that ought to be lined in full. 
• Dropping insurance policies: If an insurer merely doesn’t wish to cope with a buyer’s declare, it might drop their coverage totally, with out regard for legal guidelines barring dropped insurance policies after hurricanes and different vital occasions.

Has Your Insurer Defrauded You?

In case you suspect your insurer is performing in dangerous religion, you don’t have to simply accept their habits. In case you discover the next issues, you might have grounds to take authorized motion towards the corporate to obtain the compensation you’re owed:

• Failure to speak: Insurers should promptly reply to claims and requests for data. They’re additionally required to offer clear and correct responses. In case you’re struggling to get a response, the corporate will not be performing in good religion.
• Pointless, vital delays: Equally, insurers must take immediate motion to analyze and approve or deny claims. If it’s been over a month and also you haven’t heard something, there’s an issue. 
• Lack of help for denials, underpayments, or dropped insurance policies: Every time an insurer denies a declare, it should present an inexpensive clarification as to why. It should additionally clarify why it has dropped a coverage or paid lower than the claimed quantity. Failing to present a solution is usually an indication of dangerous religion.
• Contradictory explanations of how your coverage works: In case you can’t get a straight reply from the corporate about what your coverage covers, it might imply it’s performing in dangerous religion and trying to defraud you.

All of those are indicators of dangerous religion insurance coverage which imply it might be time to seek the advice of a talented lawyer. 

What to Do If You Have Suffered Insurance coverage Fraud

You probably have had your coverage dropped, a declare denied, or acquired an insultingly low settlement supply, you might have suffered from dangerous religion insurance coverage fraud. In that case, you may get assist. Step one ought to be to debate your state of affairs with an skilled insurance coverage lawyer like these at The Skilled Legislation Group in Miami, Florida. 

Our skilled attorneys are deeply aware of the legal guidelines affecting Florida insurance coverage corporations. We perceive how unethical corporations attempt to exploit the folks they’re supposed to guard. We may also help you combat towards insurer fraud and dangerous religion all through Florida. Don’t hesitate to get assist when you have any questions. You’ll be able to name our agency at 954-266-0934 or attain out on-line to schedule a free case assessment. Get in contact in the present day to debate your state of affairs and uncover the following step towards holding your insurer accountable for fraud.