Tackling Fraudulent Claims Tactics in Florida’s Insurance Landscape

Florida, a state frequently hit by hurricanes and natural disasters, has become a battleground against insurance fraud, spotlighting the dubious practices of some public claims adjusters and contractors. These entities have been found employing aggressive and deceitful strategies to access property insurance funds, with Operation Rubicon shedding light on staged water damage claims. This extensive investigation by the Florida Department of Financial Services and the Miami-Dade Police Department uncovered a scheme where water mitigation and restoration companies, along with public adjusters and insurance agents, manipulated Citizens Property Insurance Corp. and other insurers for over $600,000.

The fraud involved sending contractors to homes to fabricate evidence of water damage, with insurance agents playing a role by adjusting coverage or initiating new policies to support these false claims. This led to charges against nine individuals in 2019, with two more arrests following in 2022.

Similarly, roofing companies have been caught offering free inspections, only to intentionally damage roofs and then push for insurance-funded replacements. This led to four fraud charges in December 2023. In response, Florida legislators have enacted reforms over 2022 and 2023 aimed at curbing such exploitation. These measures include prohibiting assignment-of-benefit agreements, which often led to unnecessary litigation, and imposing restrictions on public adjusters’ practices.