Quote:
Originally Posted by tophcfa
Cannot deny coverage, but can make coverage ridiculously unaffordable. How about making fraudulent roof claims a crime, and then correspondingly reducing insurance premiums for responsible homeowners?
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Fraudulent claims are already a crime. Many fraudulent roof claims occur when the homeowner signs an Assigment of Benefits Contract(AOB) and this enables the roofer to treat the claim as if he was the homeowner. I was in the insurance adjusting biz. If an insured and/or the roofer with an AOB contract makes a claim and the insurance company denies the claim, the insured or the rooger can file a suit. If insurance company loses, insurance company will have to pay the claim, their costs to defend the lawsuit and the attorney fees for the insured or roofer. If the insurance company wins the suit, they will have to pay their attorney fees and costs and can(in some circumstances) recover this money from the insured. This is rare. It is a losing propostion to fight these claims. I do not have the statistics, but do believe that the insurance company has to win a high % of the claims in order to come close to breaking even(they can never come close to breaking even)