The Louisiana Department of Insurance has taken the extraordinary step of filing an administrative action against a Texas-based law firm. I have been working in the first-party insurance claims business for over forty years. I have never seen anything like this.  

Continue Reading Louisiana Department of Insurance Accuses Texas-Based Law Firm of Fraud and Unfair Trade Practices

Insurance fraud is always wrong. It is especially wrong when the insurance company is defrauding its own customer. The American Policyholder Association (APA) has taken a bold step by hiring experienced insurance fraud investigators to review and investigate actions by insurance companies that are wrongful and fraudulent.
Continue Reading Is The Insurance Company Committing Fraud? Report It To The American Policyholder Association Professional Fraud Investigators

The same contractor that brought the RICO action against insurers allegedly “zeroing out” insurance claims before conducting investigations has filed a malicious prosecution lawsuit against a law firm that represented an insurer alleging fraud and misrepresentation committed by the contractor.1 The introduction to the malicious prosecution lawsuit filed this month states:
Continue Reading Insurance Defense Firm Sued For Malicious Prosecution After Fraud Case Dismissed

Florida insurance companies have been notorious for increasing rates and filing news articles at the start of legislative sessions that support their legislative propaganda efforts. The typical scapegoats are lawyers and contractors. Somebody from the Attorney General’s office and newspaper reporters should call the lawyers for a contractor regarding a complaint1 filed and follow with an investigation about a lawsuit which states:
Continue Reading Lawsuit Alleges Field Adjusters Stated Under Oath That Florida Based Insurer Commanded That Reports Be Altered To Reduce Or Deny Claims—Did Insurers Do This To Dupe Florida Legislators?

“Please do this, tell us that and please send us these documents.” Every day I hear this from potential clients, public adjusters representing policyholders, and restoration contractors asking what they have to do and provide. I often end up litigating the same issues in court. Insurance companies often leave the “please” out of the never-ending letters they send following a loss demanding information before paying money. Many insurance company adjusters seem a lot more allegedly concerned about thoroughly investigating a loss than they do about providing prompt payment.
Continue Reading California Policyholders Need to Cooperate with Their Insurers Following a Property Loss. What Does That Mean?

Steve Badger and I had a rematch debate yesterday at the TAPIA Conference in Kerrville, Texas.1 There were some topics that we agreed were “juicy,” with attorneys getting unilateral agreements for umpire appointments and other Texas attorneys winning cases and then being arrested. But I came across a pleading in a Florida lawsuit where Tower Hill claimed all kinds of fraud against a contractor and a “juicy” counterclaim was filed by the contractor against Tower Hill entities, its CEO and US Forensics.
Continue Reading Contractor Fights Back Against Tower Hill and US Forensic

Memorial Day usually finds millions of Americans traveling all over our great country. It is important that over this weekend, all of us take time to remember and reflect on the greatest sacrifice many made so we can enjoy our liberties. If your property burns down under suspicious circumstances, you may also want to remember and reflect on where you were and your activities as well because the insurance company claims representatives will be curious.
Continue Reading What Were Your Activities Over Memorial Day Weekend? A Quick Case Study on Post Loss Misrepresentations, Overvaluation and Arson

The new property insurance tactic to avoid payment and thereby delay or deny appraisal is to claim that the policyholder asked for too much and the claimed amount is fraudulent. A Florida case, American Capital Assurance Corporation v Leeward Bay at Tarpon Bay Condominium Association,1 which will be reviewed by the Florida Supreme Court, will eventually decide these issues.
Continue Reading Can Insurance Companies Avoid Appraisal by Alleging the Amount Claimed is Fraudulent?

My Red Bank colleague, Dan Ballard, and I recently gave a presentation about Misrepresentations & Mistakes at the 2020 Fall Conference of the Professional Public Adjusters Association of New Jersey (PPAANJ). During that presentation, I discussed New York case law providing that a homeowners insurance policy may be voided if the insured willfully and fraudulently places in the proof of loss a statement of property lost which the insured did not possess, or places a false and fraudulent value upon the articles which the insured did not own.
Continue Reading Incorrect Information Within Proof of Loss Not Enough To Void Insurance Policy