Auto-Owners has begun a sad trend of suing its insureds and alleging that the insured’s contractors and/or public adjusters are fraudulently inflating prices. Auto-Owners is levying these accusations even though its insureds’ contractors and/or public adjusters are also using Xactimate to estimate the costs of repair to reach a lump sum agreement. In taking this drastic step, Auto-Owners and its attorneys confusingly assert Xactimate results is fair and reasonable pricing for them, but results in fraud when its insureds’ contractors and/or public adjusters produce an estimate utilizing the same software. This trend is both shocking and concerning for Auto-Owners’ insureds.
Continue Reading Auto-Owners Utilizes Xactimate to Draft Claims Estimates, But Argues Fraud When its Insureds Do the Same

Steve Badger and Steve Patrick are really great at what they do—and both publicly do a lot in the field of properly insurance claims handling. Both have been outspoken about insurance fraud. In my recent post, Want A Hail Damage Claim Tip Which Helps Policyholder Recovery? Do Not Miss Friday At 2 With Chip Today, I noted the following:

‘Badger Traps’ will also be a topic with a big shout out to Steve Patrick for his upcoming seminar. The above photo is of Steve Badger and me. Yes, Steve Patrick has a warning about the smiling man next to me and what you have to be careful of when dealing with insurance companies about Overhead and Profit issues with contractors. Patrick’s seminar is gratis to American Policyholder Association members.


Continue Reading Badger Traps and How Contractors Can Avoid Being Accused of Insurance Fraud

It is not uncommon that a homeowner may suffer hailstorm damage and receive an actual cash value payment, but not make all the repairs before the next hailstorm hits. This is the situation that arose in Selective Insurance Company of South Carolina v. Sela.1
Continue Reading Insurer Acted in Bad Faith Where it Could Identify No Specific Misrepresentations Made by the Insured

Law360 published an excellent article, The Insurance Landscape For Phishing Claims Is Shifting,1 written by Jason Rubinstein and Jasmine Chalashtori. Their summary about the importance of coverage for these computer fraud claims and the need for brokers to discuss these risks with their business clients was highlighted at the end of their article:
Continue Reading Computer Fraud, Phishing, and Cyber Insurance Claims Pose Significant Risks and Coverage Issues

Drew Houghton heads up Merlin Law Group operations in our Oklahoma City office. I was speaking with him just before our holiday party about the American Policyholder Association combating fraudulent engineering reports harming policyholders as noted in, American Policyholder Association Makes Resonating Comments About Insurance Fraud Against Policyholders. Drew then told me about a recently filed Oklahoma class action where engineers were accused of sham reports to help prevent earthquake claims payments.
Continue Reading Engineers Accused of Sham Reports in Class Action

Douglas Quinn is the President of the American Policyholder Association (APA.). He was in Orlando last Saturday afternoon. The meeting was somewhat impromptu and had a number of leaders from the National Association of Public Insurance Adjusters.
Continue Reading American Policyholder Association Makes Resonating Comments About Insurance Fraud Against Policyholders

On October 2, 2019, the U.S. District Court for the Middle District of Florida ruled that a dispute between an insurance company and its policyholder should proceed to appraisal despite insurance company’s allegations that it had discovered what it called evidence of fraud.
Continue Reading An Insurer’s Potential Fraud Claim Against Insured Was “No Reason to Stop or Stay Appraisal,” Court Rules

Following a devastating loss to one’s home, as is the case throughout California due to recent fires and mudslides, the process of contacting your insurer to begin the rebuilding or repair can be complicated and daunting. Many are quick to begin the rebuilding and repairs immediately or as soon as possible. However, there are requirements in working with your insurer to properly rebuild or repair. If an insured fails to follow appropriate protocols, the insurer can not only deny coverage, but do so on the basis of fraud.
Continue Reading Don’t Expose Yourself to Fraud Allegations by the Insurer