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Disclosures of Prior Injury and Claims Presentation Accuracy Keep away from Claims Disputes | Property Insurance coverage Protection Regulation Weblog

Karen Schiffmiller, a pacesetter and Previous President of the Florida Affiliation of Public Insurance coverage Adjusters, wrote the next be aware in response to an article, Miami House owner Charged with Defrauding Residents by Claiming Previous Injury:

Why it’s best to all the time ask questions. All Public Insurance coverage Adjusters have a duty, when probably representing a shopper, to do your due diligence and ask questions if there have been any prior claims and injury on the property.

At all times, all the time, all the time do the precise factor! In case you are not sure if one thing is roofed, or the injury seems to be prefer it has been occurring for a time period, or the injury seems to be outdated, ask questions and do your homework!

The article famous:

Florida authorities have charged a Miami man – who has an extended report of prison and civil circumstances underneath his title – with insurance coverage fraud after investigators discovered that some $300,000 in claims had been linked to pre-existing injury to his house.

Damacio Covon Inexperienced, 52, was arrested earlier this month after he claimed virtually $80,000 in injury to his Miami Gardens house from a backed-up drain line in early 2021, based on the Florida Division of Monetary Providers. A Residents Property Insurance coverage Co. adjuster discovered that the injury had occurred earlier than the house owner coverage was written in 2020, the division stated in a press release.

The revelations within the 2021 declare led investigators to find out that $302,000 in earlier claims had been for alleged injury that was outdated and had not been disclosed when insurance policies had been inked, a DFS spokesman stated.

The perfect adjustment apply is to all the time decide the situation of the property earlier than the loss occurred. Each adjuster might want to know this simply to find out an precise money worth estimate of harm. By doing so, questions on prior insurance coverage claims, damages from prior occurrences—repaired and never repaired, and the quantity of wear and tear and tear to a property will all the time be inquired in order that claims disputes and costs much like the above will be minimized or prevented.

Is prior unrepaired injury all the time excluded? Usually, the reply is “sure.” However I recommend readers of this weblog re-read this publish: Prior Flood Injury Does Not Have to Be Repaired to Have Subsequent Flood Declare Paid.

Thought For The Day

We had been criticized all through that investigation for being too thorough, for taking too lengthy. However time has proved the correctness of that method.

—Ken Starr



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