HomeInsuranceYearlong case of alleged insurance fraud in Florida closes

Yearlong case of alleged insurance fraud in Florida closes


WESH 2 Investigates has learned that one of the cases involving allegations of insurance company fraud, which may have led to underpayment of claims to homeowners following major storms, has been closed.The Department of Financial Services cited a lack of cooperation from witnesses. The decision to end that one case comes just one year after three men, Ben Mandell, Jordan Lee and Mark Vinson, put their reputations on the line at a state house hearing.The men, and later, five other independent adjusters, claimed insurance carriers were committing fraud to shortchange homeowners after Hurricane Ian and prior storms. Independent adjusters are often hired as subcontractors by insurance companies to conduct inspections and produce field reports. Those reports often recommend the replacement of roofs, siding, porches, etc., but the adjusters claimed the carriers and their claims supervisors removed photos and adjusted claims downward to underpay on claims. In many cases, homeowners didn’t know about it until the adjusters discovered it and called them. Some of those homeowners have filed lawsuits against carriers. “It is my opinion that both the carriers and the adjusting firms (who work for the carriers) are committing fraud by taking my estimates as well as other insurance adjuster estimates and manipulating them to reduce policyholder payouts,” Lee told House lawmakers on Dec. 13, 2022. Mandell provided WESH 2 Investigates photos and documents (underwriting report, photos, adjuster damage report, insurance company final report).He examined Hurricane Ian damage at one home and estimated the claim, mostly to replace the roof, at $40,468.54. But in the final report from the insurance company, which we are not naming because the state’s investigation is ongoing, the payment to the policyholder was $2,524.62. The company further left Mandell’s name on the final report, which he alleges to be a crime under Florida statute 817.234, addressing insurance fraud.Now, a year later, a spokesperson for the Department Of Financial Services, which is investigating those claims, tells WESH 2 Investigates no one has been arrested and charged, and the investigation is ongoing.Despite Chief Financial Officer Jimmy Patronis told WESH 2 in multiple interviews during the past nine months that his “team” is investigating the allegations, none of the adjusters we talked with say they’ve been called, emailed, or contacted in any way. “It’s really horrible what is happening to the people of Florida. The lack of integrity that people have is crazy,” Lee said.“It certainly rises to a level of incompetence that is beyond acceptable,” Mandell said. The state says it has just closed one of its cases involving independent adjuster Rod Buvens. He talked with WESH 2 Investigates last June. He told us that following Hurricane Irma, he provided proof that a now-insolvent insurance carrier doctored his claims to underpay homeowners.But after Buvens declined to respond to a subpoena to appear at a hearing last month, the state cited a lack of witness “cooperation,” and Patronis’s investigators closed that investigation.”The DFS investigator threatened to prosecute me when discussing the case against his boss, Patronis, adding to a long history of DFS intimidating and harassing whistleblowers,” Buvens told WESH 2 Investigates Tuesday.A Patronis spokesman, Devin Galetta, responded, “To have supposed witness of insurance fraud make allegations publicly yet refuse to speak with law enforcement is not normal, and if they do have credible information, it puts other policyholders at risk for fraud. This behavior brings into question the motives of some of these alleged witnesses.”As of Oct. 9, state records show nearly 200,000 Hurricane Ian insurance claims closed without payment.

WESH 2 Investigates has learned that one of the cases involving allegations of insurance company fraud, which may have led to underpayment of claims to homeowners following major storms, has been closed.

The Department of Financial Services cited a lack of cooperation from witnesses.

The decision to end that one case comes just one year after three men, Ben Mandell, Jordan Lee and Mark Vinson, put their reputations on the line at a state house hearing.

The men, and later, five other independent adjusters, claimed insurance carriers were committing fraud to shortchange homeowners after Hurricane Ian and prior storms. Independent adjusters are often hired as subcontractors by insurance companies to conduct inspections and produce field reports.

Those reports often recommend the replacement of roofs, siding, porches, etc., but the adjusters claimed the carriers and their claims supervisors removed photos and adjusted claims downward to underpay on claims. In many cases, homeowners didn’t know about it until the adjusters discovered it and called them.

Some of those homeowners have filed lawsuits against carriers.

“It is my opinion that both the carriers and the adjusting firms (who work for the carriers) are committing fraud by taking my estimates as well as other insurance adjuster estimates and manipulating them to reduce policyholder payouts,” Lee told House lawmakers on Dec. 13, 2022.

Mandell provided WESH 2 Investigates photos and documents (underwriting report, photos, adjuster damage report, insurance company final report).

He examined Hurricane Ian damage at one home and estimated the claim, mostly to replace the roof, at $40,468.54. But in the final report from the insurance company, which we are not naming because the state’s investigation is ongoing, the payment to the policyholder was $2,524.62.

The company further left Mandell’s name on the final report, which he alleges to be a crime under Florida statute 817.234, addressing insurance fraud.

Now, a year later, a spokesperson for the Department Of Financial Services, which is investigating those claims, tells WESH 2 Investigates no one has been arrested and charged, and the investigation is ongoing.

Despite Chief Financial Officer Jimmy Patronis told WESH 2 in multiple interviews during the past nine months that his “team” is investigating the allegations, none of the adjusters we talked with say they’ve been called, emailed, or contacted in any way.

“It’s really horrible what is happening to the people of Florida. The lack of integrity that people have is crazy,” Lee said.

“It certainly rises to a level of incompetence that is beyond acceptable,” Mandell said.

The state says it has just closed one of its cases involving independent adjuster Rod Buvens. He talked with WESH 2 Investigates last June. He told us that following Hurricane Irma, he provided proof that a now-insolvent insurance carrier doctored his claims to underpay homeowners.

But after Buvens declined to respond to a subpoena to appear at a hearing last month, the state cited a lack of witness “cooperation,” and Patronis’s investigators closed that investigation.

“The DFS investigator threatened to prosecute me when discussing the case against his boss, Patronis, adding to a long history of DFS intimidating and harassing whistleblowers,” Buvens told WESH 2 Investigates Tuesday.

A Patronis spokesman, Devin Galetta, responded, “To have supposed witness of insurance fraud make allegations publicly yet refuse to speak with law enforcement is not normal, and if they do have credible information, it puts other policyholders at risk for fraud. This behavior brings into question the motives of some of these alleged witnesses.”

As of Oct. 9, state records show nearly 200,000 Hurricane Ian insurance claims closed without payment.



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