What is contractor solicitation and how does it work?

Here’s the scenario: 

Contractor Offering Gift Card for Roof Inspection

You are approached at home (solicited) by a contractor who offers you payment or a gift card to conduct a free inspection of your roof. Upon completing the inspection, the contractor advises you of damage to your roof. 

Contractor Finds Roof Damage During Inspection

You have never noticed the damage but you trust the contractor as a professional. The contractor states that your roof is badly damaged and that you need a new roof. 

Contractor two thumbs up for insurance payment and communication promise

He states that your insurance company will cover the cost and there is no expense to you. He promises to communicate directly with your insurance company and handle the claim on your behalf.

Contractor asks you to electronically sign a document on a tablet

The contractor asks you to electronically sign a document on a tablet authorizing the work on your roof. The contractor scrolls to the signature area of the document and you sign.

Assignment of Benefits Document

 

Unbeknownst to you, you do not need a roof replacement; however, you have signed an Assignment of Benefits, a legal contract that transfers your insurance rights to the contractor. This authority allows the contractor to file an insurance claim on your behalf, receive direct payment of your insurance payouts, file a lawsuit against the insurance company and more. Because you signed the form electronically, you do not have a copy and do not know exactly what you’ve signed.

Invoice to your insurance company - very expensive

The contractor may charge the insurance company an unnecessary or inflated amount for the roof. 

Blue Tarp covering incomplete roof with damage showing

The contractor may never complete the work but is still able to be paid by the insurance company due to the requirement included on the contract you signed.

No communication allowed

The contract may also limit you from communicating directly with your insurance company, which means, if you have questions about the insurance claim, you will not be able to ask the company.

Contractor pointing happily to other houses in the neighborhood

Oftentimes, these fraudulent, possibly unlicensed, contractors target neighborhoods and take advantage of multiple homeowners. The contractor may complete the roof of one home to use as an example or proof to other homeowners.

This deliberate deception is insurance fraud perpetrated by a contractor = contractor solicitation fraud.

 

To learn more about contractor solicitation fraud and how you can protect yourself and your neighbors, review the components of Demolish Contractor Fraud: Steps to Avoid Falling Victim. 

 

What's Right and What's Wrong?

How to tell if a contractor is breaking the law:

 

WHAT'S RIGHT


 

WHAT'S WRONG


checkmark - yesRequire consumer to pay insurance deductible No

Waive an insurance deductible or offer services at no charge for filing an insurance claim

checkmark - yesAdvertise construction services to potential clientsNo

Mislead consumers using untrue or deceptive advertisements

checkmark - yesDiscuss, explain and offer a quote for construction or repair of property No

Negotiate or influence the settlement of an insurance claim on behalf of a consumer

checkmark - yesObtain a building permit from local officials, as required No

Construct or repair property without the appropriate permit or disregard local ordinances


View the complete list of permissible and prohibited actions by a contractor and the violations involved: Contractor Prohibitions

 

What constitutes fraud?

Fraud of any kind impacts both the victims and the industry its perpetrated against. Per the Insurance Information Institute, “insurance fraud is a deliberate deception perpetrated against or by an insurance company or agent for the purpose of financial gain. Fraud may be committed at different points in the transaction by applicants, policyholders, third-party claimants, or professionals who provide services to claimants.” 

How does fraud impact consumers and the insurance industry?

Insurance fraud costs more than $40 billion annually, which costs the average family between $400 and $700 a year in increased premiums. Insurance fraud tactics and schemes result in insurance companies paying higher negotiated settlements or paying additional costs to litigate these claims. Those expenses are typically passed on to consumers in the form of:

Insurance Rate Increase

Increased Insurance Rates

  • Florida has the 3rd highest property insurance premiums in the country - $3,643 average premium
  • Represent nearly 8% of all premiums written in the U.S.
Lack of Availability

LACK OF AVAILABILITY

  • Companies unwilling to insure homes:
    • Older than 15 years
    • Roof older than 10 years
    • Located in specific areas
  • Excluding coverage for specific damage
Mortgage Rate Increase

INCREASED MORTGAGE PAYMENTS

  • Increased insurance rates included in escrow account resulting in an increase in mortgage payments

 

 

When an insurance company pays a contractor for work, the homeowner expects the contractor to complete the work in a manner that is of high quality. If a contractor receives an insurance payment and abandons the job, intentionally does poor quality work or uses subpar materials, the contractor is committing insurance fraud. These acts of insurance fraud can impact you, as a consumer, significantly. If your home is left unfinished, you may have to pay out-of-pocket to complete or re-construct the repairs. Additionally, more damage can occur as a result of poor work or subpar materials used. An insurance company will not pay for the same damage twice - if you, or a third-party on your behalf, file an insurance claim for damage for a specific timeframe, the insurance company will not pay to repair that damage again.

Do your due diligence before hiring a contractor. Review Consumer Tips and Red Flags to decrease the likelihood of working with a contractor looking to commit insurance fraud.

Demolish Contractor Fraud: Consumer Tips
Red Flags: Protect Yourself From Potentially Fraudulent Contractors

You’ll also want to avoid unintentionally being involved in insurance fraud. Insurance fraud can be an intentional act, or you may unknowingly commit or be involved in fraud.

INTENTIONAL

  • Filing an insurance claim for...
    • Stolen property that was not taken
    • Hurricane damage that was not caused by a storm
    • Setting your home or property on fire
  • Inflating the cost of a damaged item
  • Allowing someone to use your insurance benefits for services
  • Falsely claiming to be injured in a vehicle accident
     

 

UNINTENTIONAL/UNKNOWINGLY

  • Your contractor files an insurance claim for damage that doesn't exist or for more damage than exists
  • Your vehicle repair company charges your insurance for new parts when used parts were installed
  • Your agent provides false information on your insurance application to obtain a better rate
  • A repair person replaces your windshield and charges your insurance company when there is little or no damage


 

Contact the Office of the Insurance Consumer Advocate

Office of the Insurance Consumer Advocate
200 East Gaines Street, Tallahassee, FL 32399
Phone: (850) 413-5923
Email: YourFLVoice@MyFloridaCFO.com

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