THE NOT-SO-TRUTHFUL CLAIMS
Based on our experience, while most insureds file honest claims, there are few individuals that file not so truthful claims. In other situations, public adjusters may inflate the claims to increase the fee that they are being paid. The case in example is the recent arrest of Robert Eugene Leverett II, an Orlando, Florida public adjuster for insurance fraud.
According to the complaint against him, Leverett was hired by an Orlando motel to evaluate damage caused by a fire. But despite multiple experts who estimated the damage to be approximately $210,000, Leverett, who gets paid 10 percent of the claim payout, estimated the damage to be more than $650,000. Mr. Leverett claims that these charges are wrong and that he based his estimate based on the work of a professional engineering company, TLC Engineering, Inc. He also claims that the insurer and its forensic engineer intentionally underestimated the damages. We will have to wait on the results of this case, as it proceeds through the legal system.
Few months ago, we’ ve heard of the “Operation Leaky Pipes,” about a dozen Floridians who were intentionally damaging their homes with water damage in order to get the insurance payout. In yet another case, 22 homeowners were charged with either intentionally setting fires or causing flood damage in their homes, under the so called “Operation Fires and Floods”. A public adjuster was also involved in the latter case.
In a recent case we investigated, the insured claimed building envelop damage and kitchen ceiling damage from the winter 2013/14 storms. Our investigation revealed that the kitchen ceiling damage was caused by a plumbing leak that occurred prior to the storms. See Figure 1.
Figure 1: Damaged kitchen ceiling. Note the prior repairs as evidenced by the reinforcing tape. The insured claimed that the recent winter storms caused the ceiling damage and he wanted full building envelope investigation, ceiling replacement, and so on.
In another case, the insured claimed that his parquet floor was wrapped due to water infiltration from the winter storms. Our investigation revealed that his basement had chronic moisture problems and that the floor was incorrectly installed. See Figure 2 for fungi growth inside the window frame, providing evidence of long-term water intrusion problems. Our investigation revealed that the insured was washing down the exterior walls on a daily basis, contributing to the moisture intrusion problem.
FIGURE 2. Significant fungi growth and rotted wood on the interior side of the basement window. This suggests long-term water intrusion problems. The small amount of water that may have entered the basement during the winter of 2014 did not cause the warping of the wooden floors or the rotting of the window frame.
The typical not-so-truthful scenarios that our investigations reveal are damage claims that the insureds insist that were caused by recent floods or storm events while in reality these damages occurred over a long-period of time or were caused by past events.
Metropolitan Engineering, Consulting & Forensics (MECF)
Providing Competent, Expert and Objective Investigative Engineering and Consulting Services
P.O. Box 520
Tenafly, NJ 07670-0520
Tel.: (973) 897-8162
Fax: (973) 810-0440
E-mail: metroforensics@gmail.com
Web pages: https://sites.google.com/site/metropolitanenvironmental/
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We know you need to process damage claims quickly and knowing the facts is now faster than ever – within 24 hours of site visit. Our Pegasos Forensic Investigation Services (PFIS) feature:
· Expert Forensic Investigators on-site.
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· Fixed-Prices starting at $499 per chimney or roof inspection (volume discounts are also available). Flood loss assessments start at $999.0. HVAC equipment only inspections start at $299 for local (within one hour one-way drive) assignments.
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