Recent lawsuits filed in southern Florida have accused two property insurers – Heritage Property & Casualty Insurance Co. and American Home Assurance Co. Inc. – of using inexperienced, unlicensed or unqualified adjusters to lowball damages claims.
A lawsuit filed in the 11th Judicial Circuit Court for Miami-Dade County provides documentation that Heritage had 4,803 Hurricane Irma claims that were handled by unlicensed adjusters. The Samari Lakes East Condo Association filed the complaint, alleging that the insurer should face punitive damages.
“Heritage hired unlicensed adjusters, refused to hire experts, refused to provide its adjusters and experts with underwriting documents showing the condition of the insured property prior to the loss, and weaponized litigation tactics by its naked allegations of fraud,” the lawsuit states. “And this is only what the plaintiff has been able to gather without discovery into (the) defendant’s general business practices.”
During Tropical Storm Eta in November 2020, 16.3% of the Heritage claims were handled by unlicensed adjusters, according to the lawsuit.
In a federal case filed in the Southern District of Florida, a representative of the owners of a mansion near Miami Beach alleged that American Home Assurance engaged “unqualified, inexperienced or untrained investigators,” including adjusters, as part of a strategy to lowball a damages claim made in response to property damage caused by Hurricane Irma.
“The … home was badly damaged by Hurricane Irma, and American Home on multiple occasions tried to reduce, delay and deny all or part of their recovery, including, among other things, by failing to conduct full and fair investigations at its own expense, and by generating incomplete, lowball estimates designed to pay less than what was contractually owed,” the attorneys for Michael Newman, the personal representative of homeowners Joel and Edith Newman, said in an amended complaint.
The Newmans’ claim was eventually resolved after multiple separate appraisal awards came in at an amount “dwarfing any estimates or offers” proposed by American Home, the complaint states.
“Upon information and belief, American Home encouraged its adjusters and claims investigators to save American Home money at the expense of its insureds through lowball estimates,” the plaintiffs’ attorneys said.
A jury in the Newmans’ case last month found that although American Home did not act in bad faith in handling their insurance claim, the insurer did violate the Florida Unfair Claim Settlement Practices Act. In turn, the jurors awarded the Newmans an amount equal to the interest on the alternative living expenses the couple paid after their home was damaged.
Heritage did not respond to a request for comment, but the Florida Association of Public Insurance Adjusters (FAPIA) stressed that unlicensed adjuster activity is not something that can be taken lightly.
“As a public adjuster, homeowner and a South Floridian myself, the allegations coming out of Miami are not frivolous and are quite concerning,” John Hornbuckle, the FAPIA president, told the Florida Record in an email. “Especially after catastrophic storms, insurers facing a large volume of claims often bring in independent adjusters from other states. Unfortunately, these adjusters are not licensed in Florida and may not be familiar with the laws and regulations of our state, which can result in claims being delayed, underpaid or denied.”
The FAPIA was also encouraged by the recent passage of Senate Bill 7052, which requires adjusters to provide their state license numbers during inspections and communications, according to Hornbuckle.
“The state always has our full support when it comes to investigating fraud and unlicensed activities,” he said.