What happens when field adjusters have to choose between having a job and being ethical?
Field adjusters have an ethical duty to provide a service without bias, but more often than not, they are threatened to be replaced if they don’t alter reports to avoid including damage that is present.
In this case, the field adjuster was told to “play ball” or he “wouldn’t be working for UPC anymore.”
Despite having found storm-related damage, it was intentionally kept out of the report.
The desk adjuster from the Independent Adjusting (IA) firm directed the field adjuster not to perform a lift test to check for wind damage. Additionally, the field adjuster was instructed to remove damage estimates from his report. As if this was not enough, the desk adjuster also inserted language into the report stating, “that no wind damages were observed upon inspection.”.
Screenshot 1:
Screenshot 2:
Do you see the pattern present? The defendant, Family Security Insurance Company, INC, is doing everything possible to avoid paying for the property’s storm-related damages.
Despite the plaintiff having an account in good standing with the defendant – the plaintiff was being denied the compensation they were entitled to.
You can see from the field adjuster’s statement below that wind damage was indeed present on the property:
Is this a form of insurance fraud?
Absolutely. The plaintiff, in this case, is being denied the right to a fair and just insurance process. The claimant is rightfully attempting to obtain a benefit, and the insurer is knowingly denying the claimant the benefit they are due.
How was fraud committed? The field adjuster was instructed to remove damage from the report so the insurer could deny the claimant compensation.
The insurance company, the defendant, was manipulating the field adjuster to alter the report’s results so it would be favorable to them (the insurer) and not their customer (the claimant).
According to the field adjuster, the report should have included language indicating a full roof replacement is recommended. Yet, this was never included in the report.
Regarding other damages present, the field adjuster was instructed to remove “everything” from the report.
Screenshot 1:
Screenshot 2:
Why does this matter?
When an insurance claim is filed, every party involved has an ethical duty to uphold every policy, guideline, and law in place when performing their job.
In 2017, Hurricane Irma caused more than $50 Billion in damage. During the hurricane’s aftermath, many homeowners were left stranded with nowhere to live and no one to turn to. Their only option was to contact their insurance company only to be told they would not be receiving any compensation.
Devastating as this occurrence is, situations like this happen all the time.
The field adjuster stated he had been involved in over 180 similar cases, just like this one where he was directed to include something he believed to not be true in his report.
Screenshot 1:
Screenshot 2:
You need an attorney by your side with experience winning cases.
JT Law Firm fights for justice so property owners can stand a chance at receiving a favorable outcome so they can repair the damage to their property.
If you need help with your claim, speak with the property claim attorneys at JT Law Firm. There’s no cost or fee unless we win. Schedule your free case evaluation today.
Call us at 855-585-2997!
