Karen Schiffmiller, a leader and past president of the Florida Association of Public Insurance Adjusters, wrote the following note in response to an article, Miami homeowner charged with defrauding citizens by claiming old damage:
Why you should always ask questions. All Public Insurance Adjusters have a responsibility, when possibly representing a client, to do your due diligence and ask questions about any previous claims and damage to the property.
Always, always, always do the right thing! If you’re not sure if something is covered, or the damage looks like it̵
7;s been going on for a period of time, or the damage looks old, ask questions and do your homework!
The article noted:
Authorities in Florida have charged a Miami man — who has a long history of criminal and civil lawsuits to his name — with insurance fraud after investigators found about $300,000 in claims linked to pre-existing damage to his home.
Damacio Covon Green, 52, was arrested earlier this month after he claimed nearly $80,000 in damage to his Miami Gardens home from a backed-up sewer line in early 2021, according to the Florida Department of Financial Services. An adjuster from Citizens Property Insurance Co. found that the damage had occurred before the homeowner’s policy was written in 2020, the department said in a statement.
The disclosures in the 2021 claim led investigators to determine that $302,000 in earlier claims were for alleged damage that was old and had not been disclosed when the policies were dyed, a DFS spokesman said.
Best adjustment practice is to always determine the condition of the property before the loss occurred. Any adjuster will need to know this just to determine an actual estimate of the cash value of the damage. By doing so, issues of past insurance claims, damage from past events – repaired and unrepaired, and the amount of wear and tear on a property will always be investigated so that claims disputes and charges similar to the above can be minimized or avoided.
Is previously unrepaired damage always ruled out? In most cases the answer is “yes”. But I suggest the readers of this blog read this post again: Previous flood damage does not need to be repaired to have subsequent flood claims paid.
Today’s thought
We were criticized throughout that investigation for being too thorough, for taking too long. But time has shown the correctness of that approach.
– Ken Starr
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