When fighting for justice for one of his clients, Attorney John Tolley uncovered fraudulent activities connected to Family Security Insurance Company, a subsidiary of UPC.
The property damage claim, was being denied by the insurance company for “failure to promptly notify” the insurance carrier of the loss even though it was reported well within the requirements of Florida law. Upon further investigation, the true reason for the insurance company’s denial became clear.
Employees of FKS, the adjusting firm charged with handling this claim for the insurance company, were actively directing field adjusters to not write damages in their estimates and report they could not determine a cause of loss. This direction was at the behest of the insurance company.
The following image was taken from the deposition transcript where the field adjuster FKS coached on this particular case admitted to being coached and directed:
Instructions and orders like these violate ethical guidelines.
Adjusters are constantly instructed to regularly go against ethical guidelines by the insurance companies and their representatives:
Damage was present, yet a $0 estimate was created to cover repair costs.
The $0 estimate is in line with the field adjuster’s orders, and he admitted to creating this report with an outcome that not even he agreed with because he was ordered to do so. This “estimate”, if it could be called that, does not even include a scope of damages. When asked, the field adjuster said that a scope of damages estimate would have been included in the report if it were up to him.
In another case similar to this one, the field adjuster was told to “play ball” or he would not be working for them anymore. Field adjusters are often put into uncomfortable situations by their employers or by the insurance company and their representatives.
It’s difficult to infer the insurer ever had any intention of properly handling this claim when they did not even care to receive a scope of damages estimate. The scope of damages or loss document tells the insurer the type of damage the property received and the severity of the damage. Without this report, a claim cannot be approved or move forward:
Takeaway: It seems like insurance fraud has become an everyday practice for insurance companies, and they will go to great lengths to deny a claim.
If your property has sustained damage and your insurance company denies or underpays you, we can help. Speak with one of our attorneys today for a free case evaluation.
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