Major Insurer's New Program Will Restrict Choice for Some Property Claims - NBC 6 South Florida
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Major Insurer's New Program Will Restrict Choice for Some Property Claims



    NBC 6's Myriam Masihy and Sandra Esquivel report. (Published Wednesday, Sept. 27, 2017)

    Edwin Torres is tired of his house being a construction zone.

    “I have no money to fix this,” he said.

    His problems started with a water leak he says was made worse by a contractor who was sent to fix it.

    “One of the main columns that is supporting the roof was carved into so much that it debilitated that column and now my roof is collapsing,” he said.

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    Now the City of Pembroke Pines is threatening to fine him $150 a day because the contractor did not get permits to do the work.

    “I feel sometimes that I have failed my family to provide them a safe home to live,” he said.

    Torres now believes the problem started because he agreed to allow his insurance company to choose the contractor rather than choose one himself. In exchange, Torres received a discount.

    “And these contractors, guess what?” he said. “They don’t want to keep me happy. They want to keep happy the insurance company.”

    Kathy Golt says she was out of her home for weeks after a contractor chosen by her insurance company did poor work and didn’t get permits following a problem with a leaky water heater. She hired a lawyer to help get her home fixed.

    “From day one, nobody has done the right thing on their part,” she said.

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    Neither Kathy nor Edwin used Citizens Insurance – one of Florida’s largest insurers. But in 2018, Citizens will have a similar program where they will choose a contractor to do repair work on claims involving water damage not caused during a storm.

    “At the end of the day, it’s the bottom line,” said Jimmy Farach, president-elect of the Florida Association of Public Adjusters, who expects to hear more complaints when Citizens implements the new program.

    “The insured have a right to have their own contractor – their own advocate that’s looking out for their own interest, and that’s being diminished,” Farach said.

    But Citizens’ president, Barry Gilway, told NBC 6 the non-profit insurance company turned to what’s called a managed repair program to control the cost of skyrocketing water claims that aren’t storm related.

    “We realize this program will be under a lot of criticism if we don’t provide high-quality service,” Gilway said. “In Miami-Dade, there is no other way to say it, there is a huge amount of fraud. A lot of the excess payments are going to attorneys and going to vendors that are overcharging for services.”

    According to Gilway, 92 cents of every premium dollar the company collected last year in Miami-Dade went to pay water claims.

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    “If we don’t take some action on that then the only alternative is to continuously raise rates,” he said.

    Citizens says policy holders will have a list of licensed and vetted contractors to choose from non-weather related water claims. You could choose your own contractor but could be limited to a $10,000 claim payout. The company says most customers never reach that cap on these types of claims. Citizens’ new program goes into effect in February and Gilway expects more providers to add programs like this, adding the entire industry is struggling to keep up with costs.

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