New details emerge confirming state investigation into Heritage Insurance 

WINK News is breaking new details on a criminal investigation into an insurance company where customers claim they were left with wrecked homes after Ian and no money to rebuild.

WINK News reporter Claire Galt has confirmed the state is launching a criminal investigation into Heritage Insurance.

In a phone call Monday with Florida’s Chief Financial Officer Jimmy Patronis, he confirmed there’s a criminal investigation underway and that what he saw in a “60 Minutes” report the day before concerned him.

A couple who live in a North Port home ravaged by Hurricane Ian are victims again.

Forgive Jeff Rapkin if he’s angry: “I think they did it on purpose, and I think people are getting letters that say they’re not covered when they are. This is a con. That’s what this is. This is: make them go away at all costs. We’re not paying.”

He believes you’d be angry, too, if you’d suffered through what he’s suffered through since Hurricane Ian ripped off his roof.

And maybe you have suffered like he has?

Rapkin and his wife Ginny appeared on “60 Minutes” Sunday night to vent.

First, the hurricane ripped off his roof. Now, he claims his insurance company is ripping him off.

“60 Minutes” reported there are 50,000 Floridians fighting with their insurance companies 24 months after Ian.

Rapkin’s fight is with Heritage Insurance. He believes Heritage changed licensed adjuster Jordan Lee’s report.

Sharyn Alfonsi, “60 Minutes” reporter: “Did you put a dollar amount on how much you thought they were owed?”

Jordan Lee: “$231,368.57.”

Sharyn Alfonsi: “What did the insurance carrier come up with?”

Jordan Lee: “$15,469.48. so uh, quite a bit of difference.”

Sharyn Alfonsi: “Mmm, that’s not a difference of opinion.”

Jordan Lee: “No.”

Lee and other adjusters told their stories to state lawmakers, who, in turn, passed a new law in 2023. This law now protects Florida homeowners like the Rapkins.

Gov. Ron DeSantis said, “You can’t just disregard what the adjuster does. You actually have to have a clear, valid reason to be able to depart downward. That may not have been in place when Ian happened, but I know that particular company has faced fines in excess of seven figures from the State of Florida.”

State Senator Jonathan Martin said the law works both ways.

“If I’m fraudulently making a claim to my insurance company and claiming my roof was damaged when maybe I just went up there after the storm and ripped up some tiles with a hammer. That applies to me. It also applies to an insurance company if they’re lying when they’re dealing with the insured,” explained Martin.

“60 Minutes” said the state had opened a criminal investigation, but so far there have been no arrests.

Two years later, a blue tarp still sits on the roof.

A “Danger, Do Not Enter!” sign hangs on the stairwell above rusty, broken steps.

The Rapkins’ neighbor, Stanley Barret, said he feels for his friends.

“Like a disaster … It’s you spend your whole life saving for a home, and it’s taken away from you,” he said.

The governor referred to a million-dollar fine the state imposed on Heritage Insurance.

The company’s CEO sent a statement saying “60 Minutes” ignored the fact that Heritage acknowledged failures and is committed to making improvements.

The company denied it “altered damaged reports to deceive customers.”

The Rapkins have filed a lawsuit.

Heritage said because of that, it cannot comment on the specifics of the case.

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WINK’s Claire Galt reached out to Heritage about her story and the “60 Minutes” investigation. The company provided this response:

CEO of Heritage Property & Casualty Insurance Ernie Garateix said, “As we told 60 Minutes in a seven-page response to their questions, Heritage made many reforms and improvements following Hurricane Ian two years ago – including overhauling our claims software that now adds the name of any reviewer who works on the claim. The accusation by adjusters, via 60 Minutes, that we used ‘altered damaged reports to deceive customers’ is flat wrong. Third party field adjusters, like Jordan Lee, always have to collaborate with those higher up in their company on their estimates and the company Lee worked for during Hurricane Ian is no longer in business.”

Garateix continued, “60 Minutes also ignored the fact, even though we sent them the links and documents, that we signed an order with the Florida Department of Insurance Regulation following their investigation back in March of this year. This signed report also included a fine paid by Heritage where we acknowledged failures after Hurricane Ian and improvements we were committed to make. For example, we have already implemented a new claims system that tracks all names of those who work on claims. This change was also part of coming into compliance with Florida’s new insurance reform laws after Hurricane Ian, SB 7052, which we also sent to 60 Minutes to demonstrate that there had been industry-wide reforms to claims tracking in Hurricane Ian’s aftermath.

“It is important to point out that when we did our own review of Hurricane Ian claims following 60 Minutes’ outreach – using a random sample of 10,000 claims – we found that 4,162 of those were revised downward, 2,583 of them were revised upward and about 3,311 of them had no change from what the adjuster reviewed. This is further evidence that we work to pay every eligible claim.”

Garateix concluded, “We are not commenting on the specifics of the Rapkin case because it is an active lawsuit. However, we do want to stress that there are often legitimate reasons to repair a roof versus replacing a roof. In the case of Jordan Lee, records show that some of his estimates were revised downward by his adjustment firm because he would include screen enclosures, for example, that were not included in a homeowner’s policy. Additionally, third party adjusters are also paid based on a percentage of the claims they write. We are also aware of Jordan Lee being asked to collaborate by his employers at the third party adjustment firm and he would ignore that request for collaboration on his estimates. This meant the quality assurance process of that company would often have to continue on without Mr. Lee’s involvement in order to not delay the claims process.”

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BACKGROUND: A few of the key improvements Heritage Insurance made to enhance services since Hurricane Ian include:

• The expansion of the Claims Quality Assurance function to include 10 employees.
• The creation of a Governance and Compliance Director position to further ensure compliance with all state claims requirements;
• An expansion of the claims quality assurance process;The addition of resources to internal audit functions;
• The implementation of a new claims management software;
• The added requirement that field adjusters document the manner in which they provide the policyholder with a printed or electronic document;
• The modification of software to require the adjuster license number be included;
• The creation of automated reports to track compliance claim timeframes;
• The reformulation of our interest calculator on claims;
• The required validation of names and licenses of new third-party desk adjusters;
• The implementation of a new claims training program