Michele L. Levinson | Frost Brown Todd
In past years, carriers in states most affected by wildfires, notably California, have seen a significant increase in claims where the property sustains no significant “direct physical damage.” Meaning, the property itself was not directly impacted by the fire, yet the owner presented a claim for fire-related damages allegedly caused solely by the debris. While it is undeniable that some of these properties were close enough to sustain significant indirect damage due to smoke and ash, a great many others did not. And yet, the claims were presented anyway. The focus of this analysis is not on those properties that were significantly damaged, but those that were not. These claims typically involve a public adjuster and/or attorney and a homeowner who did not notice any damage, sustained no direct damage from the fire, and in many cases was not even aware that an insurance claim was unwarranted.
Historically, these entities would solicit property owners to present insurance claims targeted at removing contaminants from their property following either a wildfire or commercial property fire. Many a time, the property owner was not aware of any such damage, but the sales pitch was aimed at their fears that carcinogenic contaminants were in their home and the only way to remove it was to retain a contractor or cleaning company to present a claim to their insurance carrier. Once such an entity was California Recovery Group, or CRG. The unsuspecting homeowner would engage CRG, not knowing if there was any actual damage caused by a recent (or sometimes not so recent) fire.
What resulted were a multitude of these claims, some warranted, while others were not. In response to the unwarranted smoke and ash claims, the industry began involving the California Department of Insurance and National Insurance Crime Bureau (NICB) in their respective claim investigations. These very issues are specifically addressed in California Insurance Code section 15028(a), which states, “No person licensed as a public insurance adjuster shall do any of the following: (a) Use any misrepresentation to solicit a contract or agreement to adjust a claim.”
When one of your cases is in need of a construction expert, estimates, insurance appraisal or umpire services in defect or insurance disputes – please call Advise & Consult, Inc. at 888.684.8305, or email experts@adviseandconsult.net.