When Heritage Insurance coverage determined to sue its former impartial adjuster, Jordan Lee, 1 it lit a fireplace that can nearly definitely illuminate way over it meant. I wrote in regards to the whistleblower stories that emerged after Hurricane Ian in Whistleblowing Property Adjusters Verify Fraudulent Property Insurer Practices. Unbiased adjusters alleged that their unique estimates have been secretly modified by insurers or their third-party directors earlier than being despatched to policyholders. I famous that these claims raised actual questions on transparency and ethics within the claims-handling course of.
Now, those self same points are transferring from information stories and regulatory testimony to the courtroom.
A Lawsuit That Attracts Its Personal Highlight
When Heritage filed its lawsuit towards Jordan Lee, I used to be stunned. Most insurers which have already weathered a regulatory effective and a few robust headlines relating to claims would like to maneuver on. Apart from these of us deeply fascinated by claims dealing with conduct, the general public and most within the trade produce other issues on their minds. The significance of the difficulty and info are inclined to fade. Heritage, nonetheless, selected to go to court docket. In doing so, it has opened the door to discovery on every little thing from its Ian claims-handling protocols to its 2024 consent order with the Florida Workplace of Insurance coverage Regulation, which carried a $1 million effective for claims-handling deficiencies.
Lawsuits are like searchlights. When you flip them on, you typically can’t management what will get illuminated.
The counterclaim Lee filed towards Heritage was nearly inevitable. As soon as Heritage went on the offensive with its lawsuit, it was clear Lee would reply by placing the corporate’s practices below authorized and public scrutiny over again.
What the Adjuster Alleges
Lee’s counterclaim tells a narrative that can sound acquainted to anybody following the post-Ian controversies. He says Heritage, via its third-party administrator TriStar, imposed procedures that pushed adjusters towards decrease payouts by proscribing overhead and revenue, requiring depreciation on roofs, favoring “restore over exchange” no matter code, and directing area adjusters to not stroll tile roofs, relying as a substitute on drone pictures or engineers recognized for locating “no harm.”
Maybe most placing, he claims Heritage and TriStar edited his estimates after submission, despatched the revised variations to policyholders together with his title nonetheless on them, and hid the adjustments from each the adjuster and the insured. He argues that this misrepresented his work and violated Florida’s moral requirements for adjusters.
These are critical allegations, however once more, allegations usually are not proof. They should be confirmed via proof, the identical method Heritage’s proof towards Lee should be confirmed. This lawsuit will now check whether or not these claims by all events will maintain up.
Heritage’s Public Protection
Heritage has pushed again exhausting in public statements. Its management says that edits to adjuster estimates have been a part of a normal quality-control course of designed to take away non-covered objects and guarantee constant outcomes. As proof, the corporate has even shared information from a evaluation of 10,000 Ian claims exhibiting that some revisions elevated funds, some decreased them, and a few have been unchanged.
Heritage additionally factors out that it has since upgraded its techniques to file who edits every estimate, a reform required by the 2024 consent order. In different phrases, Heritage’s place is that these weren’t acts of fraud or retaliation, however quite acts of regular oversight that it has discovered from previous operational shortcomings.
Anyone operating a corporation of any dimension can definitely admire that processes will not be good, or that sure people throughout the group will not be main others or performing correctly. Intent and motive are sometimes troublesome to discern with out nice transparency.
Why This Issues Past One Case
Regardless of the consequence, this case has already achieved one thing essential: it’s put a highlight again on post-catastrophe claims dealing with in Florida. Adjuster moral independence, desk enhancing, and insurer transparency usually are not summary points. These points straight have an effect on how a lot policyholders are paid and the way shortly they recuperate. The problems on this case are essential.
As I stated in prior posts, insurers can’t anticipate adjusters to behave as professionals whereas stripping them {of professional} judgment. If an adjuster’s title seems on a doc, that adjuster has the proper, and arguably the moral obligation, to make sure the doc displays their very own work. This case will check how the courts view that precept.
It’s value repeating: lawsuits and allegations usually are not proof. The reality comes out via proof. However as somebody who’s watched these disputes unfold for many years, I can let you know that Heritage might have reopened a difficulty most firms would have quietly left behind. The final time a serious insurance coverage firm did one thing like this, a secretive Jewish Legal professionals record grew to become public.
So, whether or not the corporate finally prevails or not, the invention course of itself will expose an ideal deal about how a minimum of one insurer dealt with Hurricane Ian claims. In that sense, Heritage’s lawsuit towards its personal adjuster might find yourself serving as an unplanned case research for all the insurance coverage trade. It’s also a reminder that when whistleblowers communicate honestly, typically the highlight shines brightest on those that struck the match.
Thought For The Day
“It’s error solely, and never reality, that shrinks from inquiry.”
— Thomas Paine
1 Heritage Prop. & Cas. Ins. Co. v. Lee, No. 2025-CA-002113 (Fla. Cir. Ct. – Hillsborough).
