Florida’s Insurance Commissioner won’t say when and how insurers can alter estimates

TAMPA, Florida (WFLA) — Things are still not getting back to normal for the many Floridians who were hit hard by Hurricane Ian more than six months ago.

Many families struggle to navigate the confusing claims process and pay for home improvements.

8 On Your Side Investigator Mahsa Saeidi is pushing for state regulators to get answers to the process.

Last month, we alerted you to allegations made in a statehouse hearing.

In December, after Hurricane Ian, as thousands of Florida residents were still waiting for their insurance to arrive, three field insurance assessors appeared before the Florida Home Trade Committee and testified that their damage estimates had been altered.

Adjusters said their estimates were changed to reduce payments to hurricane victims.

“They need to stop changing our estimates and leaving our name on them,” said Florida licensed insurance appraiser Mark Vinson.

“There are some serious allegations,” said Mark Friedlander of the Insurance Information Institute. Mark spent 13 years at an insurance company in Jacksonville.

A few weeks later, two state investigations were launched.

8 On Sides you want to know when and how field custom estimates can be legally changed. As it turns out, though, Florida’s new Insurance Commissioner Michael Yaworsky isn’t going to answer that question.

Friedlander says that typically, when you file a claim with your insurance company, they assign a field appraiser to look over it and provide you with an estimate of your losses.

But the pitch administrator does not have the final say.

Ultimately, it’s the desk manager and the insurance company that make the coverage decisions.

So, when and how can the field adjustment estimates be changed?

“The guess is that the estimate was changed without the approval of the field administrator but the field manager’s name is still on the document, is it OK for me to do that?” asked investigator Mahsa Saeidi.

“That’s definitely not standard operating procedure in the property casualty industry,” Friedlander said. “If it has been significantly altered, for whatever reason, it would be inappropriate to keep the governing name there, without their approval.”

But not everyone agrees with Friedlander.

Another insurance industry insider told 8 On Your Side in the background that they could, and change field-adjusted estimates, on a regular basis, without approval.

So, to get a clear answer, we went to Yaworsky, the person in charge of managing insurance companies. We asked his office repeatedly to answer the question. They refused to answer directly. First, they sent us a link to the device for consumers, leading us to two pages that didn’t answer the question.

Next, they sent us the law for analysis, FS 626.9541 Unfair competition methods and unfair or deceptive acts or practices.

But considering this potentially affects every insurer and millions of Florida residents, it’s not the reporter’s job to interpret regulations, answer unresolved questions, and provide industry-wide guidance.

We’re not the only ones trying to find answers. State Senator Travis Hutson, sponsor of the Insurer Accountability Bill, wants to force insurers to detail who made the change in estimate and why.

The state does not accuse certain insurance companies of wrongdoing in relation to insurance adjusters’ claims.

If you have any tips for Mahsa, send him an email to [email protected]