CLEARWATER BEACH, Fla. — The ABC Action News I-Team has been reporting on Florida’s growing property insurance crisis for months as part of our ongoing “Price of Paradise” series.
We are now focusing on how a public adjuster could help you recover what you’re owed when it comes to filing an insurance claim.
Public adjusters are insurance adjusters who work directly for homeowners instead of insurance companies.
They charge a fee, which can be up to 20% of the eventual payout.
However after major disasters, they can play an important role in expediting the claims process, making sure homeowners are adequately reimbursed for damages, and helping both homeowners and insurance companies avoid costly litigation.
Legitimate claims reportedly denied
“The evidence is all right here. Just look at it,” public adjuster Joseph Ross said as we tagged along for a recent evaluation.
In the past, Ross has worked directly for insurance companies as an adjuster and has also worked as an independent adjuster, hired to evaluate claims during hurricanes, floods, tornadoes, and other widespread disasters.
“I’d go out there and assess the loss and give my recommendations for an estimate, write a report and send it up to their office, and they’d say ‘okay’ and pay the claim. I did that for 16 years and never really had much of a problem. Now, it’s different,” Ross said.
Ross said in recent years, legitimate claims are often denied based on reports from engineers hired by insurance companies to evaluate claims already handled by adjusters.
The opinions of licensed engineers supersede those of adjusters, who typically do not have an engineering background.
Ross said that led to some of his claims being overturned and led him to start working for homeowners rather than insurance companies as a licensed public adjuster.
Public adjusters measure and document policyholders’ losses and file claims with the insurance company on their behalf.
They are paid on contingency between 10% and 20% by the policyholder after the insurance company has paid the claim.
Did a sinkhole or erosion cause cracks and damage?
Ross was recently hired by a homeowner to evaluate damage to her Clearwater Beach home.
“That is dropping for some reason,” Ross said, pointing to a sagging part of the home’s roof.
He also noticed the patio was starting to cave in one corner.
Ross takes dozens of photos of cosmetic and more serious structural concerns, which he will use to produce an estimate.
He believes a leaking pipe under the home has caused erosion based on the pattern of damage to the walls and ceilings.
“It’s a covered loss. This happens. It’s nothing new,” he said.
But when the homeowner originally reported the damage to the insurance company, they sent out an engineer who ruled it was a sinkhole, which is not covered by her policy.
“If the engineer says it’s one thing and it’s going against the policy, well, then they’re not paying it,” Ross said.
Ross said no boring tests or ground penetrating radar were performed on the site to confirm a sinkhole.
Ross said dozens of homeowners have turned to him to help resolve Hurricane Ian claims going back more than a year.
“Most of the people I’ve been trying to deal with aren’t being paid anything,” Ross said. “They’ve had adjusters come out there…multiple. They’ve had engineers come out to their houses multiple times. “
Conflicting engineering reports
A Charlotte County homeowner lost 25 shingles and had significant damage during Hurricane Ian.
But a report from the engineer hired by his insurance company said, “The main problem with the roof framing is that the builder used green wood that was probably already slightly warped. Over time, as the wood dried, the warping became more exaggerated”
That home was built in the 1980s and had weathered several storms prior to Hurricane Ian.
A different engineer hired by the homeowner attributed the damage to “heavy wind and vibrations from Hurricane Ian,” saying in a report, ”This is a safety hazard and needs to be repaired.”
Ross is trying to help settle the claim before it ends up in court, resulting in a legal battle that could drag on for years.
Termites blamed for damages during a tornado
Ross said an engineer blamed insects, not a tornado, for damaging a Polk County home in 2020.
The tornado passed over the home, leading to structural damage to the Florida room.
The couple’s insurance company sent an engineer to the site to evaluate the claim, who found termite damage that had previously been undetected.
That was a policy exclusion that was used to deny the claim.
Mark Friedlander represents the Insurance Information Institute.
He said insurance adjusters are first responders who have done a great job processing thousands of claims from Hurricane Ian.
“In most cases, insurers acted with high levels of ethics and integrity in supporting their policyholders and paying legitimate claims that were filed for the storm,” Friedlander said.
Investigations underway
Ross said there are good insurance companies out there, but his customers generally are insured by them.
“Those would be the ones that we don’t ever deal with as public adjusters,” he said.
The Florida Department of Insurance has acknowledged opening investigations into insurance companies denying or underpaying legitimate claims associated with that storm.
“Certainly actions should be taken if it is determined certain companies weren’t following Florida’s regulations,” Friedlander said.
A 2010 study by the Office of Program Policy Analysis and Government Accountability found that homeowners who used public adjusters after hurricanes in 2004 and 2005 received payments from Citizens Insurance of 747% higher than those who didn’t.
That was the most recent report by that organization.
“We’re here so that if they don’t do what they’re supposed to, if the insurance company doesn’t take care of you, that’s where we step in,” Ross said.
The Florida Association of Public Insurance Adjusters has more information about hiring a public adjuster and has a link to help you find a public adjuster in your area.
The Florida Department of Financial Services, which regulates public adjusters, also has important information about licensing, fee structure and things you should consider before hiring a public adjuster.
If you have a story you’d like the I-Team to investigate, email us at adam@abcactionnews.com