Tag Archives: Property Insurance

Favorable Third District Court of Appeals Decision

Favorable decision from the Third District Court of Appeal upholding Defendant’s Proposal for Settlement and entitlement to attorney’s fees in a case where the Plaintiff claimed that the declaratory relief count filed along with a breach of contract count invalidated the Insurer’s Proposal for Settlement.

To read the appellate decision, click here.

Comments Off on Favorable Third District Court of Appeals Decision

Filed under Fourth District Court of Appeals, Insurance

Jacksonville Roofer Facing Charges Related to Insurance Fraud & Failing to Begin Work

Jacksonville roofer and owner of Kinnecorps LLC, Roger Van Den Bosch, has been arrested and charged with insurance fraud, grand theft, uttering and failing to begin work. The roofing company has been under investigation since 2018 due to complaints from homeowners who signed Assignment of Benefits allowing their insurance companies to pay Van Den Bosch who in turn never completed the work.

Two other Kinnecorps employees, Van Den Bosch’s sister and girlfriend both face felony charges of uttering and knowingly notarizing a false document.

Click here to read the article.

Comments Off on Jacksonville Roofer Facing Charges Related to Insurance Fraud & Failing to Begin Work

Filed under Insurance Fraud

Exciting New Assignment of Benefits Law Passes

My Post (3)

H.B. 7065 passed last week and Governor DeSantis has promised to sign it!

This is great news for consumers and insurers alike. The law is designed to curb the onslaught of assignment of benefits cases, which have plagued the courts for the last five years. The new law has a lot of moving parts. It also creates many new opportunities for insurers to save money and prevent these “AOB” claims from reaching the litigation phase. Our firm can assist you in designing protocols to avoid some of the traps created by the new law. While the new law can save insurers money, it also presents new challenges for insurers by creating new responsibilities and deadlines. However, before discussing any protocols, one must understand the underlying new issues and responsibilities for all parties.

THE NEW AOB REQUIREMENTS

Under the new law, the assignees (AOB companies) will be required to do many things they previously did not have to contend with.

The assignees now will have to:

  1. Put their assignment in writing. This will eliminate the theory of “equitable assignments” sometimes pled and argued by the assignees and accepted by some judges.
  2. Both the assignee and assignor will have to sign the AOB. Again eliminating the “equitable assignment argument.”
  3. The AOB must allow for rescission under certain circumstances by the insured.
    • Due to the timeframes involved, this most likely will only come into play with roofs or restoration contracts.
  4. The AOB must be provided to the insurer within three business days after the date of which the assignment is executed or the date on which the work begins, whichever is earlier.
    • The statute also provides for very specific means of delivery of the assignment to the insurer.
    • Insurers still will need to inspect right away before any water mitigation is completed.
  5. The AOB must contain a written, itemized, per-unit cost of the services to be performed by the assignee.

The AOB must contain a specific 18 POINT UPPER CASE AND BOLD WARNING to the insured regarding the insured’s rights.

AOB COMPANIES PROHIBITIONS

The assignees will not be allowed to:

  1. Charge a penalty for rescission.
  2. Charge a “mortgage processing fee.”
  3. Have a penalty for cancellation of the agreement.
  4. Charge an “administrative fee.”
  5. Under “urgent or emergency circumstances,” the assignee may not receive an assignment of post-loss benefits under a residential property insurance policy in excess of the greater of $3,000 or 1% of the Coverage A limit under the policy.
  6. Assignments that don’t comply with this subsection are invalid and unenforceable.
    • Arguably any failures of the assignee to comply with the above provisions would provide the insurer a very sound affirmative defense, that the AOB is completely invalid and unenforceable.
    • This could potentially be a Motion for Summary Judgment issue as well.

NEW DUTIES FOR THE ASSIGNEE/AOB COMPANIES

Under the new law the assignees will now have to:

  1. Maintain records of all services.
  2. Cooperate with the insurer in the claim investigation.
  3. Provide the insurer with records and documents.
  4. Deliver the executed AOB within three business days.
    • A potential affirmative defense and Motion for Summary Judgment issue.
  5. Update the insurer with revised estimates.
  6. Perform work in accordance with “industry standards.”
  7. Submit to recorded statements and EUO’s pre-suit under certain circumstances.
    • A potential affirmative defense and Motion for Summary Judgment issue.
  8. Participate in appraisal and/or mediation under certain circumstances.

Additionally, assignees:

  1. Cannot modify managed care provisions under the policy.
  2. Cannot file suit until a written notice to initiate litigation has been served to the insurer.
    • The notice must contain certain information and has specific timing requirements.
    • A potential affirmative defense and Motion for Summary Judgment issue.

INSURERS NEW DUTIES

The insurers will also have some new obligations under the new AOB law.

The insurers now will have to:

  1. Have a provision in the policy for delivery of the AOB agreement.
  2. Respond in writing to the notice to initiate litigation within ten business days.
    • In the response, certain information must be present.
  3. Have procedures in place to respond to the notice to initiate litigation.

NEW POLICY OPTIONS FOR INSUREDS

Insurers may opt to provide policies in which the insured is not allowed to assign their rights under the policy to another. There are strict criteria which the insurer must follow in order to offer such policies. However, the price point will be lower, which will offer an incentive to most insureds to want to opt for this policy, rather than the one in which an AOB is allowed. Hopefully, this voluntary option selection by the insured will allow this provision to withstand any challenges in the courts.

I predict in the future most insureds will opt for these less expensive policies, which will allow insurers to pass the savings along to the consumers.

ATTORNEY’S FEES

The law also totally changes who will be considered the “prevailing party” for purposes of attorney’s fees, depending on an analysis of the judgment amount and the “disputed amount.” If the judgment is less than 25% of the “disputed amount” the insurer is entitled to an award of reasonable attorney’s fees. If the judgment is between 25% and 50% of the “disputed amount” no party is entitled to attorney’s fees. Only when the plaintiff (AOB company) receives a judgment of 50% or more over the “disputed amount” are they entitled to attorney’s fees.

This section dramatically changes the “risk/reward” structure previously involved in these cases. In the past, insurers have settled these cases, to avoid paying exorbitant attorney’s fees. There is a provision which states that the insurer can waive its right to fees under certain conditions if the insurer fails to inspect or provide authorization for repairs.

The statute also allows for potential attorney’s fees to the insurer if the assignee files a voluntary dismissal and then refiles a second case. Unfortunately, the statute gives the court discretion in this instance.

INSUREDS OBLIGATIONS

The new AOB law also codifies what probably was considered common sense and already law.

The insured must:

  1. Pay the deductible under the policy.
  2. Pay for any betterment ordered.
  3. Pay for any work done before any rescission by the insured of the assignment.

We believe we can help you predict the future strategies of the plaintiff’s attorneys, who are already plotting to exploit the perceived loopholes in the new law. Some may argue the law does not even apply to their clients. Some may file suit prematurely. Some will undoubtedly make constitutional challenges.

If you wish to have our firm present some protocols to help you navigate through this maze of new legislation, please contact us at info@roiglawyers.com.

This article is not intended to create an attorney-client relationship by offering this information, and anyone’s review of the information shall not be deemed to create such a relationship. The content provided is intended to provide information of general interest to the public and is not intended to offer legal advice about specific situations or problems. You should consult a lawyer with regard to specific law issues that require attention.

For additional information, please contact Jeffrey Tutan of Roig Lawyers at 954-354-1546 or by email at jtutan@roiglawyers.com. Jeffrey is a partner in the Deerfield Beach office of Roig Lawyers, head of the firm’s trial division and co-chair of the first party property division.

Comments Off on Exciting New Assignment of Benefits Law Passes

Filed under Assignment of Benefits

Miami-Dade Public Adjusters Facing Charges for Insurance Fraud Ring

Public adjuster Barbara Gonzalez and at least eight more suspects were arrested in insurance fraud ring in Miami-Dade. Gonzalez ran a public adjusting company Rubicon Group and the alleged ringleader of the fraud scheme.

Gonzalez’s charges include a $75,000 claim for fake water damage and repairs from a plumber that did not exist. She is also on the hook for three other false damage claims dating back to 2013.

Click here to read the article.

Comments Off on Miami-Dade Public Adjusters Facing Charges for Insurance Fraud Ring

Filed under Insurance Fraud

Florida Legislature Passes Assignment of Benefits Reform Bill

On April 24, 2019, by a vote of 25-14 the Florida Senate passed SB 122 that addresses AOB’s for residential or commercial property insurance claims and limits attorney’s fees related to AOB agreements. The Senate bill was a committee substitute for House Bill 7065, which passed the House on April 11, 2019. Governor Ron DeSantis is expected to sign the bill which would become law effective July 1, 2019. Click here to view the entire Bill: Florida SB 122/HB 7065

Contact us for more information or to discuss the implications of this significant change in Florida law.

Comments Off on Florida Legislature Passes Assignment of Benefits Reform Bill

Filed under AOB, Assignment of Benefits

Three Unlicensed Contractors Banned for Post-Storm Fraud

According to the Florida CFO Jimmy Patronis, three unlicensed contractors in Leon, Gadsden and Gulf counties have been banned from soliciting and conducting any work in Florida pending a full investigation. The Disaster Fraud Action Strike Team is investigating additional reports of potential fraud in Bay, Gulf, Washington and Leon counties. CFO Patronis is stressing the importance of verifying professional license information and whether the company has workers’ comp insurance before you hire a contractor.

Here’s a list of Tips to Stop Post-Storm Fraud:

  • Beware of Crooked Contractors.
  • Don’t Sign Anything.
  • Too Good to Be True? It Probably Is.
  • Beware of Door-to-Door.
  • Check a License.

Click here to read the press release.

Comments Off on Three Unlicensed Contractors Banned for Post-Storm Fraud

Filed under Fraud

Palmetto Bay Man Arrested for Insurance Fraud and Grand Theft

Carlos Guillermo Aponte of Palmetto Bay was arrested in September for three counts of insurance fraud and grand theft for allegedly defrauding Citizens Property Insurance Corp. The Department of Financial Services’ Disaster Fraud Action Strike Team (DFAST) investigated Aponte after receiving a tip about fraudulent invoices and false rental agreements with letters claiming lost of rent for more than $30,000.

Aponte could face prison time of up to 45 years and fines up to $45,000.

Click here to read the article.

Comments Off on Palmetto Bay Man Arrested for Insurance Fraud and Grand Theft

Filed under Insurance Fraud

Tampa Bay Roofing Insurance Scammers Busted in Connecticut

Carlton DeWayne Dunko and Frank Martin Pureber, once known for using their former company NBRC Construction in a roofing insurance scam that cheated nearly 100 Tampa Bay residents out of at least $632,000 have taken their talents to Connecticut.

After serving two years in a Florida prison and being placed on probation, Dunko and Pureber fled to Connecticut to start a similar operation, CTST Construction. Dunko was leading a sales meeting in Milford, CT when Florida fraud agents busted him. They have been found guilty of larceny and sentenced to a year in a Connecticut prison.

When Dunko and Pureber finish their Connecticut prison time, they will face trial for the alleged fraud they committed in Missouri with another roofing company, American Shingle and Siding.

Click here to read the article.

Comments Off on Tampa Bay Roofing Insurance Scammers Busted in Connecticut

Filed under Insurance Fraud

Pinellas County Sheriff Going After Unlicensed Contractors

Thirty people were arrested in a three-day sting to “flush-out” unlicensed contractors preying on property owners in Pinellas County. The sting produced at least 60 felony and misdemeanor charges against the violators. Operation Flush Out is Sheriff Bob Gualtieri’s third sting since October 2017.

A Tampa Bay Times’ investigation in 2017 revealed how the Pinellas County Construction Licensing Board preferred to punish unlicensed contractors with fines rather than pursue violations in criminal court. Contracting without a license carries a misdemeanor for first-time offenses and a felony the second time.

Pinellas County government took control of the agency on July 1st. Gualtieri launched the Construction Licensing Investigative Unit and trained deputies to investigate contracting crimes. The department’s previous stings in October and February netted more than 45 arrests and dozens of charges.

Click here to read the article.

Comments Off on Pinellas County Sheriff Going After Unlicensed Contractors

Filed under Insurance, Property Insurance

Florida Insurance Leaders Hope to Rein In AOB Crisis

The Florida insurance industry is hoping to put an end to its AOB crisis with education. Barry Gilway, president, CEO and executive director of Citizens Property Insurance Corp. says the key to slowing Assignment of Benefits (AOB) abuse in Florida is for the insurance industry to link AOB to its impact on the consumer and the premiums they are paying.

Insurance carriers from across the state have seen an increase in litigation due to AOB lawsuits from homeowners who work with unlicensed contractors who file inflated and fake claims on their behalf. According to the Florida Department of Financial Services, AOB lawsuits in Florida have increased from 405 to 28,200 between 2006 and 2016 with South Florida being the worst region for this issue.

Florida insurance industry leaders are hoping for a legislative fix with the new Senate leadership coming in next year.

Click here to read the full article.

Comments Off on Florida Insurance Leaders Hope to Rein In AOB Crisis

Filed under AOB, Property Insurance