New law prohibits insurance companies from altering claim estimates

The start of hurricane season is here, but many Southwest Floridians are still fighting their insurance companies about their Hurricane Ian claims more than eight months later. The Insurer Accountability Act aims to bring more balance between the consumer and the insurance industry.

Hurricane Ian left many Southwest Floridians with insurance claim horror stories. John Fuentes owns All Service Adjusting, a public adjusting firm based in Naples. He hears those horror stories day in and day out.

“They’re reporting things like ‘I’ve been grossly underpaid,” Fuentes added. “‘I didn’t meet my deductible’ is a very common one.”

And after taking deeper dives into some of those cases, Fuentes discovered some insurance companies changed their own estimates in order to pay his clients less. In one case, the insurer’s field adjuster said Fuentes’ client needed a new roof. Documents later showed a desk adjuster changed that to the roof only needed to be repaired so the homeowner only got about $11,000.

“They’re committing fraud. It’s a serious thing,” Fuentes said. “This homeowner was not made whole again.”

Independent adjusters warned state lawmakers about this issue prior to this legislative session.

“This fraud committed by some of the insurance companies is more widespread than any of us could have imagined,” one independent adjuster said to the Commerce Committee meeting during the second property insurance special session in December 2022.

Lawmakers responded by passing the Insurer Accountability Act. Governor DeSantis signed the bill into law Wednesday which makes it a crime for insurers to change adjusters’ reports without detailing who made the changes and why. They’ll also have to keep tabs on any edits made and preserve all versions of their reports. Finally, insurance companies will have to tell the state how they handle claims.

“They’ve gotta stop changing our estimates and leaving our names on them,” another independent adjuster said to the committee back in December 2022. “They are just taking stuff out for no reason.”

Struggling insurance companies will no longer be able to write new polices. Their higher ups won’t be getting any bonuses either. Mark Friedlander with the Insurance Information Institute said many of these provisions exist in many other states.

“It is, number one, consumer-focused,” Friedlander added. “Number two, it tightens regulations in many areas, particularly the claim adjuster situation. And three, it follows many of the best practices we see in insurance regulation in states across the country.”

Some argue the new law, which goes into effect July 1, does not go far enough. The part that would have required insurers to report how much money and fees go to their parent companies and subsidiaries did not make the cut. The American Policyholder Association (APA) wrote in a statement that it’s “disappointed that the clause requiring transparency in insurer profitability, including disclosure of excessive fees paid to affiliates in order to shift profits out of insurers, was removed from the bill. However, we are encouraged that Florida leadership is taking steps to hold insurers accountable to policyholders. The APA calls on Florida authorities to hold the insurance industry accountable by aggressively enforcing alleged violations of regulatory & criminal codes.”