Florida’s Insurance coverage Firm Fraud Investigations: A Disaster of Public Belief (With a Facet of Absurdity)


As an lawyer who has devoted my profession to representing policyholders, I’ve witnessed firsthand the challenges confronted by Florida owners, companies, condominium associations, and even authorities entities within the wake of pure disasters. Nevertheless, latest developments in Florida’s dealing with of insurance coverage firm fraud allegations have raised severe considerations concerning the efficacy of our regulatory our bodies and the potential erosion of public belief in our elected officers. And, as if the state of affairs weren’t regarding sufficient, latest interactions with the Division of Monetary Companies (DFS) have added a component of absurdity to this already troubling narrative.

The Whistleblower Dilemma

In December 2022, three unbiased claims adjusters testified earlier than the Florida legislature, alleging that a number of insurance coverage firms had systematically altered injury estimates on windstorm and hurricane claims, successfully underpaying policyholders. This testimony ought to have triggered quick and thorough investigations by the Florida Division of Monetary Companies (DFS). As an alternative, what adopted was a troubling sample of delays, inconsistencies, and, frankly, incompetence.

Two of those adjusters reported that they’d not been contacted by anybody from the DFS or any governmental investigative physique regardless of offering substantial proof to help their claims. This lack of follow-up isn’t just a bureaucratic oversight; it represents a basic failure within the state’s duty to guard its residents from potential fraud.

A Sample of Inaction (and Confusion)

The case of Ben Buvens, an adjuster who reported related allegations in opposition to United Property and Casualty (UPC) in 2019, additional illustrates this sample. Buvens’ criticism, filed with the DFS in 2021, was dismissed with out even an interview. Since then, no less than seven different adjusters have come ahead with comparable allegations, suggesting a systemic problem that calls for quick consideration.

In a twist that will be comical if it weren’t so regarding, I discovered myself within the place of getting to offer the DFS investigators with the whistleblowers’ cellphone numbers. The DFS stated they might not discover the whistleblowers. I wrote a put up, Are Florida’s Division of Monetary Service Investigators Competent or Merely Refusing to Examine Alleged Insurance coverage Firm, with an image of me with two of the whistleblowers and printed their cellphone numbers. Evidently regardless of gaining access to these people’ sworn testimony and call info, the DFS was unable to carry out even this fundamental investigative activity. One should marvel: if finding a telephone quantity is past their capabilities, how can we belief them to unravel advanced insurance coverage fraud schemes? Or is any person stopping the investigators from doing a immediate and thorough investigation?

The Function of the DFS (When They’re Not Chasing Phantoms)

The Florida Division of Monetary Companies, led by Chief Monetary Officer Jimmy Patronis, performs a vital position in investigating insurance coverage fraud claims. Nevertheless, the division’s dealing with of those latest allegations raises questions on its dedication to this duty – and its fundamental competence.

In a second of unintentional comedy that will be hilarious if it weren’t so alarming, the Chief of the Bureau of Investigation for the Division of Insurance coverage Agent & Company Companies filed a Bar criticism in opposition to me, alleging that I don’t have a Florida license to follow regulation. As somebody who has been a member of the Florida Bar since 1983 and has been working towards insurance coverage regulation on this state for 4 a long time, I discovered this accusation each baffling and deeply regarding. Had been they out to get me, or is that this simply an instance of incompetence in its skill to research, as I wrote in Chip Merlin Busted By Florida Insurance coverage Investigators!

The Impression on Public Belief

The gradual response to severe allegations, coupled with these shows of investigative ineptitude, has far-reaching implications for public belief in each the DFS and our elected officers. When customers understand that their complaints aren’t being adequately addressed – or worse, that the federal government officers accountable for addressing them are fumbling even probably the most fundamental duties – it erodes confidence within the very establishments designed to guard them.

Florida information stations like WINK Information and CBS Information Miami have been protecting points associated to Florida’s insurance coverage trade, together with the shortage of outcomes from investigations into fraud and misconduct. For instance, WINK Information reported on CFO Jimmy Patronis responding to their property insurance coverage investigation in February 2024 with extra guarantees however no outcomes.

In Florida Regulators Warned of Insurance coverage Firm Manipulations Years In the past, the Tampa Bay Occasions reported that state investigators rapidly dismissed a criticism about United Property and Casualty (UPC) in 2021 with out interviewing the whistleblower. No less than seven different adjusters have come ahead with related allegations since then, suggesting a sample of gradual or insufficient investigations from regulators.

The media is highlighting to the general public that the governmental investigatory our bodies aren’t totally nor transparently investigating this problem with the diligence that they appear to do with different issues of a better political precedence. This actually results in skepticism in the direction of regulatory our bodies. The general public questions the effectiveness and impartiality of regulatory businesses just like the DFS. Whereas voters might lose religion in elected officers who’re perceived as not prioritizing shopper safety or guaranteeing the competence of their departments, they actually lack confidence within the present system that oversees insurance coverage firms. It results in broader skepticism concerning the integrity of the insurance coverage market if wrongful actors aren’t considerably held accountable for dangerous acts.

To handle these considerations and rebuild public belief, a number of steps are crucial. The DFS should present clear, constant updates on the standing of ongoing investigations into these allegations. A radical evaluation of the division’s investigative processes is required to make sure that all complaints, whatever the goal, are dealt with with equal diligence and velocity. Elected officers overseeing the DFS ought to reaffirm their dedication to shopper safety and display this dedication by means of concrete actions. Higher transparency is required concerning the relationships between political figures, regulatory our bodies, and the insurance coverage trade to allay considerations about potential conflicts of curiosity.

As Florida continues to grapple with its property insurance coverage disaster, it’s extra essential than ever that our regulatory our bodies and elected officers display their dedication to defending customers.  The dealing with of those claims by the DFS and the shows of investigative incompetence characterize extra than simply particular person circumstances; they converse to the integrity of our complete insurance coverage regulatory system.

When our elected officers write legal guidelines taking away personal rights of motion and making it almost not possible to carry insurance coverage firms accountable for the injury they trigger from these dangerous religion practices, voters lose confidence in our elected leaders.

We should demand higher. Florida policyholders deserve a regulatory setting that prioritizes their pursuits and actively works to forestall and prosecute fraud and dangerous religion conduct by insurance coverage firms in opposition to them. Solely by means of swift, thorough, and clear investigations – performed by competent professionals – can we hope to revive public belief and make sure that our insurance coverage market operates pretty for all Floridians.

I’m scripting this as Hurricane Helene is punching Florida. These policyholders about to make Hurricane Helene claims ought to be assured that there are legal guidelines that they’ll implement to guard themselves when insurance coverage firms mistreat them. They need to have the ability to belief that their taxes will go to regulators who will probably be allowed to pretty and diligently maintain insurance coverage firms accountable.

We’re not simply preaching within the wind. I ask readers to affix these of us in encouraging and supporting these whistleblowers who will converse up when claims administration is performing wrongfully. We encourage readers to affix entities like United Policyholders and The American Policyholder Affiliation and help their efforts together with your time and cash. Help and vote for politicians who help policyholders and never these in mattress with insurance coverage lobbyists.

The trail ahead requires dedication, transparency, and a renewed deal with the elemental mission of policyholder safety. And maybe, alongside the best way, we are able to hope that the DFS learns methods to use a search engine successfully.

Thought For The Day

By no means doubt {that a} small group of considerate, dedicated residents can change the world; certainly, it’s the one factor that ever has.
—Margaret Mead



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