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Avoiding Restoration Industry Scams to Save on Claims

July 18, 2008 Photo
Unexpected and unfortunate property-related emergencies occur around the country on a regular basis, causing policyholders an extreme amount of stress and vulnerability. Homeowners are often naïve when it comes to restoration, and can be scammed easily by a dishonest technician or company—which ultimately leads to higher claims costs. It is critical for insurance adjusters not only to make sure that property damage restoration needs are attended to quickly and efficiently, but also to educate homeowners on ways to avoid falling victim to restoration industry scams.

While many qualified, honest companies specialize in providing assistance during stressful property damage and mold situations, unfortunately some unskilled or unethical individuals will attempt to prey on home and business owners during property related emergencies. There are, however, specific steps adjusters can take to help agents and homeowners hire the right professional for the job. Adjusters also can help homeowners, who generally have little knowledge about mold and property damage clean-up, to recognize when a technician is or isn’t following correct procedures.

As an adjuster, you ultimately will help to reduce the amount of claims by educating yourself on ways to avoid restoration industry scams. Knowledge is critical to ensure that restoration services are accomplished and to avoid the risk of a service technician taking advantage of the policy holder or your company—both of which lead to additional costs. In addition, providing agents and policyholders with sound advice about avoiding scams can lead to increased policy renewals.

Following water, mold, fire, biohazard and other traumatic events involving property loss, many property owners experience a great deal of stress. Unfortunately, scam artists see this as the perfect time to prey on vulnerable property owners. This is particularly true when the damage follows a weather-related event.

However, there are several tips adjusters can offer their clients to help them avoid these scammers. They include:
  • To cover your bases, get a detailed written contract, especially if a down payment is required.
  • Get three written estimates for the work and compare bids—this will allow you to see if anyone is attempting to overcharge for the services.
  • Beware of contractors who try to rush you into starting service. If an offer is only good “now or never,” choose never and find someone else.
  • Never pay for work until it is finished and you are satisfied. An unprofessional service technician may not be motivated to do a thorough job if he is paid up front—or he may even neglect to finish the job, causing the need for a new company to come in and finish the work or fix a sub-par job.
  • Avoid paying with cash so that a clear paper trail and an indisputable record of payments can be made –especially if your insurance coverage does not cover the entire cost.
A recent investigative report that aired on KNBC in Los Angeles detailed an exposé that uncovered the improper conduct of several mold remediation companies. Each company pressured the homeowner by suggesting there was no need for an indoor air-quality hygienist to verify the presence of a problematic type of mold in his home. The mold they alleged happened to be an eye-line smudge on the baseboard, and each of the three mold “experts” told the homeowner to save his money on the air test and proceed directly into the remediation.

The average homeowner is not familiar with mold. Many believe common mold myths, such as the misconception that bleach will kill mold or that black mold is always hazardous. Dishonest service technicians easily can take advantage of the situation when mold appears.

If a mold technician is doing his job properly, he should identify the water source before the mold is evaluated since that is always the underlying cause of mold. In addition, the property owner should be offered the opportunity to consult with a qualified Indoor Environmental Professional (IEP) who can help evaluate the situation and will write the protocol that the remediation professional should follow.

It also is important for adjusters to note that it is impossible to determine the type of mold simply by looking at it. If a homeowner wants to know the specific type of mold present on his property, a sample must be sent to a qualified laboratory for evaluation. Industry standards, such as the EPA guidelines for mold remediation, allow the professional remediation company to deal with small areas of visible mold without the necessity of requiring an IEP. When the area of visible mold is larger, those standards suggest that an IEP become involved in the process.

Another tip to offer homeowners is to suggest that at the end of every mold remediation, regardless of the size of the restoration, an air sample be taken by a qualified mold testing company and sent to a laboratory for analysis.

There are also several things to look for that will reveal whether or not a technician is serving the best interest of the property owner, such as the use of scare tactics. If a technician claims that mold is hazardous before any testing has been done, he likely is using scare tactics to solicit extra services. For example, a dishonest service technician may spot black mold and tell a policyholder that the wall must be knocked down— creating the need for additional labor and a larger claim. Mold always should be tested before a technician makes any significant alterations to a location.

Failure to provide complete or useful information to property owners is another sign that a technician is not doing his job properly. The extent of the property damage and method of clean-up should be explained clearly and concisely. A list of service options also should be provided. Adjusters should warn policyholders to be leery of technicians who give biased and self-serving information and responses.

Adjusters should counsel homeowners to use companies from their local area whenever possible. This makes it easier to ask for testimonials from those who have used their services previously. A reliable company certainly will have a presence in the Yellow Pages as well as industry references available that can be contacted easily.

The best indication of trustworthiness is a history of ethical and professional service. In the absence of personal knowledge or experience, adjusters should take it upon themselves to research nearby companies and compile a list of reputable organizations.In general, restoration companies should be willing to accommodate the homeowner and adjuster to achieve the best possible outcome for all parties.

It’s important to remember that sometimes you can judge a book by its cover. Representatives should travel in company vehicles, wear branded uniforms and have business cards. They should be willing to answer all questions, and should have contact numbers that the homeowner can call if other questions or issues arise.

Service technicians also should have an accurate estimating program for the area and know how to use it.Accurate pricing is extremely beneficial to policyholders and adjusters because, regardless of the location, the customer or adjuster can be assured that the business is charging exactly the right price for the services provided.

While we like to give service technicians the benefit of the doubt, it is important to cover all of the bases when it comes to home restoration and remediation. Not getting it right the first time is costly and can result in a further escalation of losses and claims. Working with a reputable company that will restore conditions quickly and efficiently can help save money on claims, boost client referrals and increase policyholder renewals.
Mr. Will Southcombe, BA, MA, MBM, WRT, ASD, has a background in formal education, industry certifications, and more than 32 years restoration industry experience in the US and in Europe. He is the director of Technical Services for PuroClean Systems. He may be reached at wsouthcombe@purosystems.com.

About The Authors
Will Southcombe, BA, MA, MBM, WRT, ASD

Mr. Will Southcombe, BA, MA, MBM, WRT, ASD, has a background in formal education, industry certifications, and more than 32 years restoration industry experience in the US and in Europe. He is the director of Technical Services for PuroClean Systems.  wsouthcombe@purosystems.com

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CLM’s Insurance Fraud Committee identifies, analyzes, and offers education on emerging fraud schemes and tactics; monitors and reports on developments in case law, state fraud statutes and applicable regulations; collaborates with other anti-fraud industry organizations and associations; and seeks to provide amicus support in matters of importance in the fight against insurance fraud.

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