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-   -   Insurance fraud? (https://www.askmehelpdesk.com/showthread.php?t=201435)

  • Apr 2, 2008, 06:54 AM
    aaalynn
    Insurance fraud?
    We have started a new company and are learning a lot!

    We are coming up against a competetor who tells the homeowner that they do not have to pay a deductable on damage! This company will bury the deductable and the home owner is being told they might even get cash back?

    Isn't this FRAUD? We were told that you always have to pay the deductable when you need to make a claim from storm damage to your roof!

    How do we compete with that? Is is legal to overinflate the claim - more than it should be?
  • Apr 2, 2008, 07:59 AM
    twinkiedooter
    Yes, this is fraud that the other company is doing. If you know the particulars on the deal, then call up the insurance company and tell them what the other contractor is doing. Insurance permiums are sky high - no sense this guy makes out like a bandit and the homeowner skates on his deductible and we have to pay for it.
  • Apr 2, 2008, 02:35 PM
    JudyKayTee
    Quote:

    Originally Posted by aaalynn
    We have started a new company and are learning a lot!

    We are coming up against a competetor who tells the homeowner that they do not have to pay a deductable on damage! This company will bury the deductable and the home owner is being told they might even get cash back?!

    Isnt this FRAUD? We were told that you always have to pay the deductable when you need to make a claim from storm damage to your roof!

    How do we compete with that? Is is legal to overinflate the claim - more than it should be?!


    I don't think it's illegal. If the estimate is, say, $1,000 (to use a figure) and your deductible is $200 your insurance company will pay $800 and you will pay the $200.

    If the company says it will waive the co pay the insurance company still pays $800. I don't see any damage to them. The insurance company always has the option of negotiating the price down or requesting other bids.

    Had your windshield replaced recently? They are giving GIFTS to people who use their services. Don't see any difference.

    This has gone on in the auto repair business for years and nobody has ever been able to pursue a criminal charge - you don't pay the full deductible or the auto repair company repairs an extra ding or two for no charge.

    Is it morally right? I don't know. Is it illegal - I don't think so. If the company bids the job at one price, the insurance company accepts - then I think the company can negotiate the co pay.

    Maybe someone in the insurance industry knows for sure - I only know my experience investigating claims.
  • Apr 2, 2008, 03:41 PM
    Fr_Chuck
    It depends if they are charging more for it, or if they are merely "eating" the cost out of their profit.

    If you are doing a job and you would normally make 3000 profit on the job, but you forgive 500 dollars of that debt without charging too much.

    So if their bid is 500 higher than your bid, then most likely they are dong fraud, if there bid is the same amount as yours but they just "eat" the deductabel as a loss of profit to get the job, that is different

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