Being a property owner in Broward County, you are sometimes vulnerable to property damage and possibly the need to file an insurance claim.
Recently I received a call from a property owner describing water damage to his property in Parkland, Florida, specifically in his kitchen where the loss occurred. He explained that he filed a claim three years prior for a similar plumbing leak, and was paid for his kitchen cabinets and the flooring. He did all the repairs except replace the flooring. He said the only new damage was to the flooring, not the cabinets. When You Should Not File An Insurance Claim My advice was not to file an insurance claim because he was already paid for flooring he did not replace. He said, “but this is a new leak”. I explained that the flooring damage was not “new damage” and that he could not be paid twice for something he didn’t replace from the first claim, and that he would be committing insurance fraud if he filed the claim. He was silent and I suggested that he replace his floor with the money he previously received from the insurance company and call it a day. The cost of Insurance Fraud is estimated to be more than $40 billion per year so this means the cost is placed on U.S. families in the form of increased insurance premiums. 3 Things Insurance Companies Look For 1. Past Claims - If you have submitted property damage claims in the past, the insurance company will review your claims history. If they notice patterns in the types of property damage claims you submit or how often you claim damage, this certainly raises a red flag. 2. Wider Claims History - As an extra precaution, insurance companies check data beyond their internal fraud detection systems. For example, some systems enable adjusters to match new claims to those that were part of earlier or multiple other claims. They can also reveal other red flags like Special Investigations Unit (SIU) activity. 3. Suspicious Loss Indicators – There are several Suspicious Loss Indicators that insurance companies watch for including:
Although not every claim matching these criteria is fraudulent, insurance companies may still want to investigate further. How Fraud Detection Works There are several analytical tools available that alert insurance adjusters to potential cases of fraud based on varying Suspicious Loss Indicators. They may use Special Investigations Units, private detectives, and even social media for the detection of insurance fraud. Was Your Insurance Claim Underpaid or Denied? Has your insurance company underpaid or denied your claim? Your past claims with that insurance carrier, your wider claim history, or even having one of the Suspicious Loss Indicator boxes checked could be to blame. Insurance claims are now, more than ever, a tedious and complex process. At Reliant Insurance Adjusters, we can help you through the complicated claim process and help you recover from your loss. Contact us today to schedule a no-obligation consultation and learn more about how we can help you.
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AuthorKaren Schiffmiller Archives
November 2024
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