Update: Florida CFO Bars Insurers From Altering Adjusters’ Reports Without Explanation

By | October 10, 2024

Almost two years after a group of independent claims adjusters alleged that insurers had deceptively altered their damage estimates and low-balled policyholders, Florida’s chief financial officer has issued an emergency rule barring similar actions in Hurricane Milton claims.

“Any move in a positive direction is a good thing,” said Mark Vinson, one of the whistleblowing independent adjusters who made the charges at a Florida legislative hearing in late 2022.

The rule, posted Wednesday evening just as Hurricane Milton’s eyewall made landfall near Tampa, prohibits desk adjusters from modifying field adjusters’ initial damage estimates – unless the revised report indicates all changes, provides a detailed explanation of why the changes were made, and includes the identity of the desk adjuster responsible for the revisions.

Another of the Florida adjusters who spoke up about the alleged insurer practices said the new rule is a partial victory but more needs to be done.

During disasters, it's imperative that our insurance professionals and consumers have the tools they need to file insurance claims accurately and quickly. By cutting through red tape before the storm hits, we can give vital guidance that will lead to a smoother claims process for policyholders. After the storm, I expect companies to be responsive to policyholders' needs and to provide the best customer service possible as we work to get people back on their feet. If you or a loved one has insurance questions or complications following Hurricane Milton, please contact my Insurance Consumer Helpline by calling 1-877-MY-FL-CFO (693-5236). -- CFO Patronis

“I thank (CFO) Jimmy Patronis for responding to the situation, to ensure that the companies do not change estimates or reduce prices that they’re not entitled to,” said independent adjuster Ben Mandell. “But we still would like them to move as fast to arrest the people that were responsible.”

The adjusters, all hired by insurance companies after Hurricane Ian hit Florida in 2022, have complained that after they turned in their inspection reports to claims management firms, the insurers made wholesale changes, reducing repair cost estimates by as much as 98% without a second inspection and without consulting with the field adjusters. All the while, the revised estimates that were sent to the insureds kept the field adjusters’ names and license numbers on there in a way that made it appear that they had endorsed the lower cost total, the adjusters said.

That prompted multiple, angry homeowners to blame the field adjusters.

Patronis’ office could not be reached for comment Wednesday night but a spokesman said earlier this month that an investigation into the adjusters’ claims is continuing.

Adjuster Mark Vinson at a Florida House committee hearing in 2022.

The emergency rule came less than two weeks after CBS News’ “60 Minutes” aired a segment on the adjusters’ allegations. That report has gained thousands of views and hundreds of online comments, suggesting it had an impact.

The head of one Florida insurer, Heritage Property & Casualty Insurance, blamed the altered reports on software that failed to show desk adjusters’ names. CEO Ernie Garateix also said that while some adjusters’ reports were revised downward, many other estimates were increased, benefitting insureds.

Patronis’ emergency rule should make a difference, adjusters said. But it also contains a requirement that Vinson and Mandell warned could limit their ability to provide accurate price estimates in some cases.

The rule notes that adjusters must use an electronic estimating program that is updated at least once a month. Xactimate, already the most widely used adjuster software, provides updates at least monthly, Mandell said. The CoreLogic Claims Estimate, formerly known as Symbility Mobile Claims, also is updated monthly, CoreLogic said.

Also, under the new rule, adjusters cannot tweak estimated prices. For example, Xactimate calculates roof replacement at a lower rate because it is based on a low hourly wage for roof demolition, or removal of old shingles. But in reality, most roof demolition work is done by a regular roofing crew, who are usually paid at a higher hourly wage than are general laborers/demolition workers, Mandell argued.

On the other hand, other brands of estimating software can produce lower overall cost estimates than Xactimate does, he noted.

Patronis’ order can be seen here.

Update: This article has been updated to show that CoreLogic’s estimating software is updated monthly.

Related: With Back-to-Back Storms, Insurers Now Facing Big Delays in Claims Adjusting

Top photo: Photo illustration generated by artificial intelligence software. (Adobe Stock)

Topics Carriers Florida

Was this article valuable?

Here are more articles you may enjoy.

Latest Comments

  • October 15, 2024 at 4:25 pm
    Jimmy C says:
    The desk adjuster should have changed the estimator or operator to their name. They were lazy and did not remove the company logo from the ESX file. Xactimate would also show ... read more
  • October 11, 2024 at 4:12 pm
    Parker says:
    I have served as a desk adjuster as well as in various levels of management with various carriers over my 30 year career, though never with Heritage, and I have personally nev... read more
  • October 11, 2024 at 7:43 am
    Barking neighbors dog says:
    What does one erroneous roof estimate have to do with the article? The specific claim you mention could have been removal of an extra 0 (zero). It's common to see initial esti... read more

Add a CommentSee All Comments (7)Add a Comment

Your email address will not be published. Required fields are marked *

*

More News
More News Features