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Inicio del Departamento | Inicio de Agentes y Agencias | Inicio de Insurance Insights

  Vol. 7 No. 4 July 2018

Noticias Útiles

CFO Jimmy Patronis: Hurricane Season is Here, Insurance Coverages You Didn't Know You
May Need for the 2018 Hurricane Season

HuracánOn the official start of the 2018 Hurricane Season, Florida Chief Financial Officer (CFO) Jimmy Patronis reminds Floridians of the importance of financial preparedness before the next storm. CFO Patronis warns that homeowners insurance policies contain limitations and exclusions and it is important to review your policy to understand your coverages.

"Last year, Hurricane Irma alone resulted in more than $8 billion in insured losses. If you haven't already, now is the time to financially prepare for the 2018 Hurricane Season," said CFO Jimmy Patronis. "Understanding your insurance coverage is a vital part of the hurricane preparedness process. Check your homeowners insurance policy and understand what is covered and what is excluded so that you have adequate coverage."

Homeowner's insurance policies vary from company to company. Here are eight insurance coverages you may consider for hurricane season:

Windstorm Coverage (if not included in your current homeowners policy).
Windstorm coverage may be excluded if you live in a wind pool area (generally within 1,000 - 1,500 feet of a body of water, such as the gulf or the ocean).

Flood Insurance (if not included in your current homeowners policy).
Flood coverage may be included in your current homeowners policy by endorsement, or a separate policy may be issued. This coverage is important to have even if you are not in a designated flood zone.

Food Spoilage.
Food spoilage is not always covered by most policies; however, if the coverage is included, most companies cover food spoilage due to a power outage caused by direct physical damage on the insured premises.

Sinkhole Coverage.
This covers sinkhole losses on any structure, including personal property. Coverage may be restricted to the principal building, as defined in the policy.

Additional Living Expenses/Loss of Use.
This provides for the "additional" expenses of living elsewhere due to a loss to the insured residence by covered damage.

Inflation Guard Endorsement.
This endorsement may be added to most policies and provides for an automatic percentage increase in coverage amounts to help keep your coverage aligned with current construction costs.

Replacement Cost Endorsement.
This pays up to the limits for the replacement of a damaged or destroyed home or property, without deducting depreciation. This is different from Actual Cash Value, which pays for the actual value of damaged items and does not consider depreciation.

Law and Ordinance.
This pays an additional amount to apply towards the cost to rebuild or repair damages due to the enforcement of any ordinance or law regarding construction, repair, or demolition.

Consumers should speak with their insurance agent or company to confirm the coverages on their policy as soon as possible. Once a storm develops, their insurance company may be under binding restrictions, and they may be unable to obtain a separate policy or add these important coverages to their current policy. Consumers should keep in mind that some property insurance companies offer flood coverage as an endorsement to the homeowners' policy, and typically there is a 30-day waiting period to obtain coverage through the National Flood Insurance Program (NFIP).

Those who have questions about their insurance coverage and how to financially prepare for the upcoming hurricane season are encouraged to contact CFO Patronis' Insurance Consumer Helpline by calling 1-877-693-5236 or visiting www.MyFloridaCFO.com/Division/Consumers/. The Helpline also provides consumers with a place to obtain contact information for their insurance company, verify the license of an insurance agent or adjuster and much more.

protect


Chief Financial Officer Jimmy Patronis Debunks
Top Hurricane Insurance Myths

During National Hurricane Preparedness Week's "Get an Insurance Check Up" day, Florida Chief Financial Officer (CFO) Jimmy Patronis reminded Floridians that now, more than ever, is the time to prepare for the 2018 Atlantic Hurricane Season. In his continued efforts to ensure Floridians are well-prepared, CFO Patronis has debunked the top myths and most common insurance-related misunderstandings when preparing and recovering from a tropical weather event.

"The 2017 Hurricane Season impacted virtually every county in Florida, with Hurricane Irma resulting in more than $8.6 billion in insured losses," said CFO Jimmy Patronis. "From property damage ranging from wind to flood, my office fielded more than 9,300 calls and received about 2,500 complaints stemming from the nearly 1 million insurance claims filed from Hurricane Irma alone. We recovered millions for Floridians, but found the majority of the complaints stemmed from a few common misunderstandings."

Realidades

MYTH 1: I already have homeowner's insurance, so everything on my property is covered and I'm financially prepared for the storm season.
FACT: All homeowner's insurance policies contain limitations and exclusions. Also, you may need a separate policy for windstorm or flood if these coverages are not included in your homeowner’s policy. It is important to review your policy to understand your coverages and exclusions.

MYTH 2: When an insurance company denies a claim, or provides an inadequate claim payment, I must pay out-of-pocket to cover any additional expenses from damages that occurred to my property.
FACT:
You should always get a second opinion to verify the cause of loss and/or the cost to repair or replace the damage.

MYTH 3: When contractors offer to waive my insurance deductible to provide repairs at a discounted rate, this is simply a kind gesture.
FACT:
Waiving the deductible or providing a discounted rate directly to you is a form of insurance fraud.

MYTH 4: An Assignment of Benefits (AOB) agreement is the only way to get immediate assistance for Floridians who have damage to their property.
FACT:
You do not need to sign an Assignment of Benefits to get your residence repaired, even for emergency repairs. You should make first contact with your insurance company by immediately reporting the claim.

MYTH 5: Insurance companies can take as long as they want to respond to an insurance claim filed by Floridians.
FACT:
Typically, insurance companies must acknowledge your insurance claim within 14 days from the date the claim was reported and they must pay undisputed amounts of your claim within 90 days from the date of damage.

MYTH 6: If my neighbor's property is blown into my yard and damages my own property, my neighbor's insurance will cover the cost of damage.
FACT:
The damage to your property is covered by your own homeowner's insurance policy, unless, you can prove your neighbor was negligent then the damage would be covered under their homeowner’s policy.

MYTH 7: My insurance agent is the only person I need to contact when filing an insurance claim.
FACT:
While you may call your agent, you should immediately report the claim to your insurance company. Most insurance companies have a toll-free claim number to report your claim.

CFO Patronis oversees Florida's Insurance Consumer Helpline (Helpline) which assists consumers with any insurance-related questions, concerns, or complaints they may have. Since taking office in July 1, 2017, CFO Patronis' Helpline has recovered more than $37.9 million for Floridians with $10.7 million stemming directly from inquiries related to Hurricane Irma. These are funds the consumer would not have recovered from their insurance company had they not reached out to the Helpline for assistance.

Consumers who have questions about their insurance coverage and how to financially prepare for the upcoming hurricane season are encouraged to call CFO Patronis' Helpline at 1-877-693-5236 or visit https://www.myfloridacfo.com/Division/Consumers/. The Helpline also provides consumers with a place to obtain contact information for their insurance company, verify the license of an insurance agent or adjuster and much more.

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CFO Jimmy Patronis' Division of Investigative
and Forensic Services Investigates Insurance
Fraud in Williams Murder Case

In light of the recent arrest of Denise Merrell Williams for her alleged involvement in the murder of Mike Williams following an investigation by state and local law enforcement partners, Chief Financial Officer (CFO) Jimmy Patronis announced he has directed his Division of Investigative and Forensic Services to investigate alleged life insurance fraud relating to Mike Williams' disappearance nearly two decades ago.

policeCFO Jimmy Patronis said: "As a result of the recent findings surrounding Mike Williams' death, I have directed my office to investigate whether or not his death was part of a scheme to fraudulently profit from his life insurance policies. As this case remains ongoing, we ask members of the community to come forward with any information they may have surrounding this case."

Members of the community who believe they have information surrounding potential life insurance fraud as it relates to this case are encouraged to contact the CFO's Fraud Tip Hotline by calling 1-800-378-0445. Callers can choose to remain anonymous and those who provide information that leads to a successful prosecution may be eligible for a cash reward.

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CFO Jimmy Patronis Releases Top 10 Most
Wanted Criminals

Most wanted

 

Continuing his work to crack down on insurance fraud, Chief Financial Officer Jimmy Patronis released his top 10 most wanted insurance fraud criminals and calls on local communities to help put these individuals in jail. Each of these criminals are wanted for different types of insurance fraud crimes, and with the community’s help these criminals can be brought to justice.

"Insurance fraud drives up the cost of insurance on all Florida families and businesses and the criminals behind this type of activity need to be put in jail," said CFO Jimmy Patronis. "An aware and engaged community bolsters our fraud-fighting forces. Insurance fraud is not a victimless crime and it's important we, as a community, protect each other from those who engage in fraudulent behavior."

The following individuals are wanted for various insurance-fraud related crimes:

Anthony Fitzgerald Phillips, last known address Fullerton, CA: Grand Theft.

Huberto Del Sol Puerto, last known address Hialeah/Miami, FL: Organized Fraud ($50,000 or More), False and Fraudulent Insurance Claims, Grand Theft (3rd Degree), Money Laundering, False Statement (Jurisdiction of Department of State).

Gabriel Sanchez, last known address Miami, FL: Racketeering.

William Brenes, last known address Hillsborough County: Fraudulently Presents a False Statement ($100,000 or more).

Jose Alexis Orellana Ramos, last known address North Lauderdale, FL: Organized Fraud ($50,000 or more), Grand Theft (1st Degree, $100,000 or more), Workers' Compensation Fraud (Over $100,000).

Joseph J. Beckford, last known address Carrollton, GA: False and Fraudulent Insurance Claim.

Bernardo Romero-Ortiz, last known address Orlando, FL: Workers' Compensation Fraud ($100,000 or more); Organized Fraud.

Roland Terencio Delgado, last known address Coral Gables, FL: Racketeering, Grand Theft (2 Counts).

Paul Emmanuel Pierre, last known address Orlando, FL: Racketeering, False and Fraudulent Insurance Claim.

Javier Lopez Rivero, last known address Miami, FL: Racketeering, Grand Theft, False and Fraudulent Insurance Claims.

CFO Patronis' Bureau of Insurance Fraud works to investigate alleged acts of insurance fraud, including licensee, healthcare, application, vehicle, homeowners, commercial, disability, arson, and life insurance fraud. CFO Patronis’ Bureau of Workers' Compensation Fraud investigates suspected criminal violations of Florida’s Workers' Compensation Laws and participates with multiple state agencies to prevent and prosecute unlicensed contractors, businesses employing workers without appropriate workers’ compensation coverage, employees who file false on-the-job injuries or exaggerate their injuries, and employees working other jobs while receiving workers' compensation benefits.

Members of the community are urged to assist CFO Patronis' fraud-fighting efforts by reporting any suspicious behavior to authorities. To report suspected insurance fraud, call 1-800-378-0445. Callers can choose to remain anonymous and callers who provide information that leads to a successful prosecution are eligible for a cash reward.

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Brandon Woman Charged with Public Assistance Fraud After Collecting $90,000 in Public Assistance Benefits While Earning Six-Figure Salary

Chief Financial Officer (CFO) Jimmy Patronis today announced the recent arrest of Nadia Caraballo, 41, after a public assistance fraud investigation revealed that Caraballo submitted false applications to the Department of Children and Families in order to qualify for Food Stamps and Medicaid assistance. As a result, Caraballo fraudulently obtained more than $93,000 in public assistance benefits.

"Public assistance fraud is not a victimless crime," said CFO Jimmy Patronis. "Every dollar taken by criminals who lie to obtain public assistance they are not entitled to is a dollar not going to a family or consumer who truly needs it. This type of activity is disgustingly unfortunate."

CFO Patronis' Division of Public Assistance Fraud identified that from 2012 to 2017, Caraballo completed and submitted annual applications indicating that she was unemployed and in need of supplemental nutrition and healthcare assistance.

The investigation revealed that Nadia Caraballo was employed by Citigroup Technology, Incorporated, from September 5, 2012 through at least November 1, 2017. Nadia Caraballo earned an annual salary of $110,000.00 to $139,050.00 and earned gross wages of $735,669.10 for the pay period of January 11, 2013 through October 20, 2017. Caraballo failed to report this information to the Department of Children and Families.

As a result of her actions, Caraballo fraudulently received $40,070.00 in Supplemental Nutrition Assistance Program (SNAP) benefits from January 2013 through October 2017 and $53,159.35 in Medicaid assistance from February 2013 through October 2017, for a total of $93,229.35 in assistance to which she was not legally entitled.

Caraballo was arrested February 22, 2018 by Hillsborough County Sheriff's Office and was charged with one count of public assistance fraud. Caraballo has been placed in an Extended Pre-trial Intervention program, disqualified from participating in the Food Stamp program and ordered to make full restitution to the state.

This case was prosecuted by the Hillsborough County State Attorney's Office, 13th Judicial Circuit.

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CFO Jimmy Patronis: $140,000 AOB Fraud Scheme Across Eight Florida Counties Lands Contractor
with Grand Theft and Racketeering Charges

toolsEl Oficial Principal de Finanzas Jimmy Patronis anunció el arresto de Timothy Matthew Cox, propietario de Nationwide Catastrophe Services, Inc. y Restoration Response Services, Inc., acusado de supuesto fraude de Asignación de Beneficios (AOB) que afectaron a 19 propietarios de viviendas en ocho condados de la Florida y un condado de Texas. Cox robó aproximadamente $140,000 para reparaciones en las viviendas relacionadas con daños causados por el clima tropical que nunca se hicieron. Como resultado de la presunta actividad de Cox, las viviendas de las víctimas sufrieron daños adicionales causados por otros fenómenos climáticos como el Huracán Irma.

CFO Jimmy Patronis said, "Criminals who prey on Florida families after a hurricane or tropical storm are some of the worst we see. This type of fraud has skyrocketed and impacts all Florida consumers. One of my first actions I took as your CFO was to create Florida's Disaster Fraud Action Strike Team to go after this type of fraud. With more than 100 ongoing investigations statewide, we are coming for anyone who takes advantage of our residents during vulnerable times."

CFO Patronis' Bureau of Insurance Fraud found that Cox and his team targeted Brevard, Clay, Escambia, Flagler, Orange, Osceola, Seminole and Volusia Counties and Tarrant County, Texas. These areas were impacted by tropical storms and hurricanes, and Cox pressured homeowners to sign an AOB contract to have damages repaired. Cox received $139,444.97 from the 19 victims and their insurance carriers. After receiving the insurance payments, Cox's team never started any of the work they were contracted to perform on the 19 homes. The payments made to Nationwide Catastrophe Services, Inc. and Restoration Response Services, Inc. were deposited into bank accounts controlled by Cox, who used the money for personal use.

Cox was arrested and booked into the Polk County Jail June 5, 2018. He faces multiple counts of grand theft and racketeering and could face up to 30 years in jail. The case is being prosecuted by the Attorney General's Office of Statewide Prosecution.

When consumers sign an AOB they are granting their contractor or restoration specialist with the right to negotiate the insurance claim directly with their insurance carriers. This allows the contractor or restoration specialist to receive the consumer's insurance benefits directly from the insurance carrier. Consumers who have experienced or witnessed this type of activity are encouraged to reach out to CFO Patronis' Fraud Tip Hotline by calling 1-800-378-0445. Callers can choose to remain anonymous.

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Disaster Fraud Action Strike Team Brings
$62,000 Insurance Fraud Scheme to a Halt

CFO Jimmy Patronis and the Department of Financial Services' Disaster Fraud Action Strike Team (DFAST) announced the recent arrest of Michael Christopher Hensley, owner of BOSC Insurance Company and Hensley Insurance Company. Hensley admitted to stealing $61,954 in insurance premiums between 2011 and 2018 in Orange County.

After an investigation by CFO Patronis' DFAST, it was revealed that Hensley solicited various commercial businesses to procure property and casualty insurance under both of his companies BOSC and Hensley Insurance. Hensley has had no active appointments on his license since 2010, making his licensed expired as of 2014 and unlicensed as of March 9, 2015.

After the impacts of Hurricane Irma, a commercial business property sustained extensive damage caused from the storm. The business owner attempted to contact his insurance agent, Hensley, for guidance on the claim process. After multiple calls and no response from Hensley, the owner contacted the listed insurance carrier on the Certificates of Insurance that Hensley had been providing the business with annually since 2012. An insurance representative with the listed company confirmed the business was not insured with them nor had he ever been insured with the insurance company. Upon this revelation, the owner of the business contacted the CFO's Orlando Field Office for assistance.

As a result of the investigation, Hensley admitted to collecting monthly insurance premiums payments from nine different commercial business and providing them with false Certificates of Insurance Coverage. Hensley went to various insurance company’s websites and made copies of their general liability policies. He would then take the companies information and transfer it to Certificates of Insurance and provide the fraudulent documents to the unsuspecting businesses as proof of insurance.

Hensley further admitted to using the money that he obtained from the victim businesses for his own personal benefits. Hensley was arrested April 6, 2018 by the Lake Mary Police Department and was booked into the Seminole County Jail on the counts of organized scheme to defraud and communications fraud, grand theft, misappropriation of insurance premium funds, unlicensed activity-MSB.

This case will be prosecuted by the Office of the State Attorney, 9th Judicial Circuit. Hensley could face up to 30 years in prison.

Investigators believe Hensley may have defrauded additional victims and encourage members of the community who have purchased property and casualty insurance from Michael Christopher Hensley, BOSC Insurance Company or Hensley Insurance Company to contact the Department of Financial Services' Insurance Fraud Hotline by calling 1-800-378-0445.

The Department's anti-fraud strike team consists of three teams that are working in areas heavily impacted by Hurricane Irma including South Florida, Miami-Dade and Monroe counties; Southwest Florida, including Lee and Collier counties; and Central Florida, including Polk and Orange counties. They are trained insurance fraud investigators with specialized knowledge of property and casualty fraud and workers' compensation fraud and to ensure that law-breakers are prosecuted to the fullest extent of Florida law, CFO Patronis is working directly with dedicated prosecutors housed within each of the respective State Attorney’s Offices.

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CFO Jimmy Patronis' Division of Consumer Services Donates 1,000 Financial Literacy Books for Kids

Florida's Chief Financial Officer (CFO) Jimmy Patronis announced the donation of 1,000 copies of "Sammie Learns to Earn," a financial literacy book developed by the CFO's Division of Consumer Services, to the Early Learning Coalition of the Big Bend in honor of Teach Children to Save Day on April 20. Teach Children to Save Day introduces children to smart money management and prepares them for major financial decisions ahead.

"A Federal Reserve report found that kids exposed to financial education ended up with higher credit scores than those who were not," said CFO Jimmy Patronis. "It’s never too early to start having discussions about the importance of finances with our children. We will continue to find ways to partner with similar organizations and local school districts to further educate our children about the importance of finances."

The "Sammie Learns to Earn" book shares the adventure of Sammie, the Savings Scottie, and teaches children how to save and budget their money in a fun and exciting way. For organizations wanting to partner with CFO Patronis' financial literacy initiative, please contact CFO.Patronis@myfloridacfo.com.

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El Oficial Principal de Finanzas Jimmy Patronis Anuncia Más Reducciones de Costos de Compensación por Accidentes de Trabajo para Negocios de la Florida

El Oficial Principal de Finanzas de la Florida, Jimmy Patronis, anunció hoy la implementación de reducciones adicionales en el costo de la compensación legal por accidentes de trabajo que le ahorrarán a las aseguradoras un estimado de casi $20 millones en 2019, lo cual permitirá a estas compañías aliviar los costos para las empresas de la Florida. Estas reducciones son resultado directo de la sólida gestión financiera del Fondo de Fideicomisos para la Administración de Compensación Legal por Accidentes de Trabajo (WCATF) y el Fondo de Fideicomiso para Discapacidades Especiales (SDTF), dos fondos a los cuales hacen aportes las compañías de seguros de compensación legal por accidentes de trabajo.

CFO Jimmy Patronis said, "Just last month, we announced that a 1.8 percent decrease in workers' compensation rates could mean a $79.5 million savings for Florida businesses. Reducing the cost of doing business for workers' compensation carriers by $20 million means additional savings could be passed on to Florida businesses, easing financial burdens. Anytime we can reduce the cost of doing business we should. Doing so supports our neighborhood businesses and ultimately, both our local and state economy."

Background:
Legislative changes in 1997 resulted in the SDTF being prospectively abolished and statutorily prohibited from accepting any new claims for dates of accident after December 31, 1997. However, in accordance with Florida law, insurers and individual self-insured employers continue to be assessed to fund a small number of older claims. Further, fiscally responsible management of the WCATF has allowed for assessment rates to be reduced.

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Legal Notices © 2018 Florida Department of Financial Services