Adjusters claim insurance companies manipulate reports to avoid paying claims

State Department of Financial Services is investigating the complaints

Insurance field adjusters are blowing the whistle.

Several adjusters claim insurance companies manipulated their reports to pay homeowners less money or deny their claims all together.

One adjuster made the claim while under oath during a deposition for a lawsuit and since then others have come forward with similar stories.

Hurricane Irma did about $50 billion dollars’ worth of damage to Florida in 2017, according to the National Oceanic and Atmospheric Administration.

Months after the storm, independent adjuster Rodney Buvens was hired by United Property and Casualty, also known as UPC, to assess a homeowner’s claim in Estero, Florida.

[TRENDING: Become a News 6 Insider]

“Our job is really to document the damage and provide an estimate,” Buvens told News 6.

Buvens testified under oath that he found evidence of windstorm damage, and he recommended a full roof replacement, according to his deposition.

But that’s not what the homeowner’s got.

“We started getting indications from the policyholders that they weren’t being provided their estimates that we had worked on,”

After getting Buvens’ estimate, UPC sent engineers to the home who found no damage.

“They were using these engineering reports as a basis to deny or underpay these claims when there was clear wind damage to these homes,” Buvens told News 6.

The homeowner’s claim was denied, which lead them to file a lawsuit against Family Security Insurance, a subsidiary of UPC.

And it led to Buvens being deposed.

“What we found is that they were taking our reports and either changing them without our knowledge and leaving our names on them, or they were asking, telling us, directing us to change those reports,” Buvens told News 6.

Buvens testified that “his report includes language that was inserted by the desk adjuster that no wind damages were observed upon inspection.”

He also said it was not the first time it happened.

“There were many. There were hundreds of them that were changed,” Buvens told News 6.


Jordan Lee is also an independent adjuster who testified before a Florida House committee in December that insurance companies regularly alter reports.

“They have manipulated these documents without my approval,” Lee told lawmakers. “It is my opinion that both the carriers and the adjusting firms are committing fraud by taking my estimates as well as other adjusters estimates and manipulating them to reduce policy holder payouts.”

Rep. Bob Rommel, the chair of the committee, responded.

“If insurance companies are doing fraudulent, manipulating behavior, it’s probably criminal,” Rommel said.

Mark Vinson also testified.

“I also witnessed the estimates being changed this year,” Vinson said. “And the problem with that is, they’re leaving our names on the estimates. When they send them to the policy holders, they’re under the impression that that’s a legitimate estimate from the findings that we found there and it’s not.”

UPC is now out of business, but they did settle with the Estero homeowners before the case went to trial, according to their attorney.

A spokesperson for the Department of Financial Services — which investigates insurance fraud — said the department is investigating the claims made in committee, as well as the claims made by Buvens.

They also said that if anyone feels they have been the victim of insurance fraud, they should report it immediately to their insurance fraud hotline at 1-800-378-0445.

Get today’s headlines in minutes with Your Florida Daily:

About the Author:

Emmy Award-winning reporter Louis Bolden joined the News 6 team in September of 2001 and hasn't gotten a moment's rest since. Louis has been a General Assignment Reporter for News 6 and Weekend Morning Anchor. He joined the Special Projects/Investigative Unit in 2014.