When independent field adjusters told Florida lawmakers in December 2022 that they suspected insurance carriers were cheating their policyholders – predominantly homeowners – by underpaying them on Hurricane Ian claims, lawmakers and the state’s chief financial officer promised action. As the 2024 hurricane season begins in Florida, nearly 200,000 property owner claims have been closed without payment just from that single storm. And while some insurance carriers have been fined for their claims resolution practices, not one insurance company executive has been arrested and charged with criminal fraud. “I don’t want to see it get swept under the rug,” said Jordan Lee, an independent adjuster who is licensed in Florida and lives in Texas.Related: WESH 2 Hurricane Survival Guide 2024 He and two other adjusters brought the serious allegations of criminal fraud to Legislators during a special session in 2022 to address and help lower rising property insurance rates. The independent adjusters assess damage and document proposed claims with photos, measurements, and detailed estimates. They also put their names on those reports. The adjusters claim some carriers manipulated their claims, lowered them dramatically, and sent the payment estimates back to policyholders with the independent adjusters’ names on them as if they had written the company-edited payment estimate. The adjusters provided that documentation to WESH 2 Investigates, providing a “before” and “after” picture of how recommended roof replacements, for example, became roof repair recommendations and estimates, without the adjusters’ knowledge. At first, Lee said the state Department of Financial Services talked with him about the evidence he provided. Then, he said, an investigator called him last December and requested he come to Florida for an interview. It would have been the same day as his wedding. The investigator, he said, suggested calling back in early January. Lee said he called and left a message, and is still waiting for a callback.“It’s been six months since I called them," he said. "No callback. It’s not doing their due diligence to properly investigate.” The Department of Financial Services (DFS) is run by Republican Chief Financial Officer Jimmy Patronis. WESH 2 Investigates asked him if he believed the investigation will result in the arrests of any insurance company executives. “There’s good insurance companies. There’s bad insurance companies,” he said. He then quickly pointed out that after the Florida Office of Insurance Regulation (FLOIR) completed its “Targeted Market Conduct Examination Report” – a kind of audit of a carrier’s response to a major storm – of five insurance companies. Last month it fined them for improperly handling claims. The largest fine, $ 1 million, was assessed on Heritage Property and Casualty under “Consent Order 322312-24.” It’s believed to be one of the largest insurance fines by the state on record. Though it’s comparatively small, Heritage’s parent company, Heritage Insurance Holdings Inc, had revenue of $ 191 million in the first quarter of this year. In both the Market Conduct report and Consent Order, the FLOIR says Heritage failed to quickly respond to claims calls, pay claims in a timely manner, and make sure adjusters provided proper information to policyholders following Hurricane Ian. Patronis, who does not oversee FLOIR, and confines his investigations to those that may involve criminal conduct, added, “That (FLOIR) investigation led to, inconsistencies on how they took care of the Florida consumers that ultimately equated to a fine that took a million dollars out of their pockets. {Fox} But it was a fraud investigation. No crime was committed at least as far as you could tell? {Patronis} Again, criminal charges will be determined based on where there may have been laws that were broken.” It’s worth noting, Heritage Property and Casualty has donated $240,000 in campaign contributions to “Treasure Florida,” a Patronis political committee. The contributions were made between 2017 and 2022, according to the Florida Division of Elections campaign finance database. Patronis told WESH 2 Investigates he is considering running for governor in 2026, and since his re-election to the term-limited post of CFO, his political committee has raised more than $ 1.12 million. Doug Quinn, head of the American Policyholder Association, shared his thoughts on the pace of the criminal case thus far: "We strongly urge the DFS investigators and CFO Patronis to do the right thing, and aggressively chase down these alleged crimes," he said. "And where necessary make arrests and prosecutions.” Patronis’ office provided an additional statement regarding the criminal investigation:“The DFS criminal fraud investigation remains open and ongoing. Fraud investigators continue to conduct witness interviews to gather additional evidence and are working closely with state prosecutors to prepare the best possible case for presentation,” spokesperson Devin Galetta said. We asked if somebody should be arrested at the end of the investigation, adjuster Lee said, "I do.” As of April 22, according to FLOIR, 198,024 Hurricane Ian claims across Florida have been closed without payment – 49,044 remain open. In the nine-county central Florida region, 51,589 claims have been closed without payment, most in Orange and Volusia counties. And 7,998 remain open – as another potentially dangerous storm season approaches.
ORLANDO, Fla. —
When independent field adjusters told Florida lawmakers in December 2022 that they suspected insurance carriers were cheating their policyholders – predominantly homeowners – by underpaying them on Hurricane Ian claims, lawmakers and the state’s chief financial officer promised action.
As the 2024 hurricane season begins in Florida, nearly 200,000 property owner claims have been closed without payment just from that single storm. And while some insurance carriers have been fined for their claims resolution practices, not one insurance company executive has been arrested and charged with criminal fraud.
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“I don’t want to see it get swept under the rug,” said Jordan Lee, an independent adjuster who is licensed in Florida and lives in Texas.
Related: WESH 2 Hurricane Survival Guide 2024
He and two other adjusters brought the serious allegations of criminal fraud to Legislators during a special session in 2022 to address and help lower rising property insurance rates.
The independent adjusters assess damage and document proposed claims with photos, measurements, and detailed estimates. They also put their names on those reports.
The adjusters claim some carriers manipulated their claims, lowered them dramatically, and sent the payment estimates back to policyholders with the independent adjusters’ names on them as if they had written the company-edited payment estimate.
The adjusters provided that documentation to WESH 2 Investigates, providing a “before” and “after” picture of how recommended roof replacements, for example, became roof repair recommendations and estimates, without the adjusters’ knowledge.
At first, Lee said the state Department of Financial Services talked with him about the evidence he provided. Then, he said, an investigator called him last December and requested he come to Florida for an interview. It would have been the same day as his wedding. The investigator, he said, suggested calling back in early January. Lee said he called and left a message, and is still waiting for a callback.
“It’s been six months since I called them," he said. "No callback. It’s not doing their due diligence to properly investigate.”
The Department of Financial Services (DFS) is run by Republican Chief Financial Officer Jimmy Patronis. WESH 2 Investigates asked him if he believed the investigation will result in the arrests of any insurance company executives.
“There’s good insurance companies. There’s bad insurance companies,” he said. He then quickly pointed out that after the Florida Office of Insurance Regulation (FLOIR) completed its “Targeted Market Conduct Examination Report” – a kind of audit of a carrier’s response to a major storm – of five insurance companies. Last month it fined them for improperly handling claims.
The largest fine, $ 1 million, was assessed on Heritage Property and Casualty under “Consent Order 322312-24.”
It’s believed to be one of the largest insurance fines by the state on record. Though it’s comparatively small, Heritage’s parent company, Heritage Insurance Holdings Inc, had revenue of $ 191 million in the first quarter of this year.
In both the Market Conduct report and Consent Order, the FLOIR says Heritage failed to quickly respond to claims calls, pay claims in a timely manner, and make sure adjusters provided proper information to policyholders following Hurricane Ian.
Patronis, who does not oversee FLOIR, and confines his investigations to those that may involve criminal conduct, added, “That (FLOIR) investigation led to, inconsistencies on how they took care of the Florida consumers that ultimately equated to a fine that took a million dollars out of their pockets. {Fox} But it was a fraud investigation. No crime was committed at least as far as you could tell? {Patronis} Again, criminal charges will be determined based on where there may have been laws that were broken.”
It’s worth noting, Heritage Property and Casualty has donated $240,000 in campaign contributions to “Treasure Florida,” a Patronis political committee. The contributions were made between 2017 and 2022, according to the Florida Division of Elections campaign finance database. Patronis told WESH 2 Investigates he is considering running for governor in 2026, and since his re-election to the term-limited post of CFO, his political committee has raised more than $ 1.12 million.
Doug Quinn, head of the American Policyholder Association, shared his thoughts on the pace of the criminal case thus far:
"We strongly urge the DFS investigators and CFO Patronis to do the right thing, and aggressively chase down these alleged crimes," he said. "And where necessary make arrests and prosecutions.”
Patronis’ office provided an additional statement regarding the criminal investigation:
“The DFS criminal fraud investigation remains open and ongoing. Fraud investigators continue to conduct witness interviews to gather additional evidence and are working closely with state prosecutors to prepare the best possible case for presentation,” spokesperson Devin Galetta said.
We asked if somebody should be arrested at the end of the investigation, adjuster Lee said, "I do.”
As of April 22, according to FLOIR, 198,024 Hurricane Ian claims across Florida have been closed without payment – 49,044 remain open.
In the nine-county central Florida region, 51,589 claims have been closed without payment, most in Orange and Volusia counties. And 7,998 remain open – as another potentially dangerous storm season approaches.
