In 2021, they alerted the FBI and Patronis’ office - which investigates insurance fraud. Investigators with the association, including a former prosecutor, felt Buvens’ statement in the deposition was legitimate. The association uses membership dues to report fraud by insurance companies and promote best practices among state regulators. Quinn, with the American Policyholder Association, was told about Buvens’ testimony from the lawyer handling the case, John Tolley. If the fraudulent amount is more than $100,000, it could be a first-degree felony with up to 30 years in prison. The penalty is up to five years in prison. Under Florida law, it’s a third-degree felony for someone to produce a loss estimate for an insurance claim if they know the estimate contains false, incomplete or misleading information. The company paid $117,000, including $19,000 in SFR Services’ legal fees, according to SFR’s president, Ricky McGraw. United Property and Casualty offered to settle the case. United Property and Casualty was “constantly changing claim-handling practices,” he told lawyers, saying he knew of more than 1,000 instances “where they asked licensed field adjusters to go against their statutory duties to handle claims in good faith with the policyholder.”īuvens said such instances included the insurance company “ignoring damages” and “removing estimates that the field adjuster wrote.” Orders to change estimates didn’t stop at that particular homeowner’s claim, Buvens said. He added that the claim director approached him about the deposition and told him to “play ball” or “I wouldn’t be working for (United Property and Casualty) anymore,” Buvens testified. The company did not respond to requests for comment. He said that they also told him to remove the $1,376.30 to repair the garage and remove debris.
When asked why he concluded that there was no storm damage to the home, Buvens said he was “told to put that in the report” by a desk adjuster working for United Property and Casualty and by the company that hired him. In 2020, lawyers took Buvens’ sworn deposition for the case. The homeowner’s contractor, SFR Services, sued United Property and Casualty on their behalf. He estimated repairing the garage and removing debris would cost another $1,376.30.īut the estimate that the homeowner later received from United Property and Casualty concluded there was no wind damage, and they were owed nothing. The ceiling had water stains consistent with storm damage, he originally determined. It was Quinn’s association that referred the case to Patronis’ office.īuvens saw that wind had damaged the roof. The initial response from state regulators reflects how officials pursue complaints of fraud by policyholders and their advocates but not complaints against insurance companies, said Doug Quinn, executive director of the American Policyholder Association. Patronis’ office has reopened Buvens’ case as part of a larger investigation into claims against United Property and Casualty, now insolvent. Three others spoke during the Florida legislative session in December. Four have given sworn testimony in civil cases, which can be used in criminal court. Since then, at least seven other adjusters for insurance companies have come forward saying their reports were similarly manipulated to pay homeowners less than their claim estimates.
A spokesperson for the head of the agency, Florida Chief Financial Officer Jimmy Patronis, said it was closed “due to lack of participation by witnesses.” Yet that claim was refuted by Buvens in repeated follow-up emails to his office. The case, which came out in a civil lawsuit, was reported in 2021 to the Department of Financial Services, the state agency that investigates insurance fraud.īut state investigators quickly dismissed the complaint without interviewing Buvens. Buvens’ 2019 case is the earliest known accusation that an insurance company manipulated a homeowners’ assessment to reject or lowball a claim, a potential felony under state law.
0 kommentar(er)
