What is an “engineer’s report” ?
As I have said before, your insurance company is not your “good neighbor” and you are not in “good hands.” The insurance industry spends millions of dollars on advertisements and propaganda each year to convince you they have your best interests at heart. Unfortunately, for many insurance companies this is just not true. Their primary concern is not taking care of consumers it is taking care of their stockholders.
If you have suffered a loss to your home from fire, water, storm or mold requiring you to file an insurance claim, then your insurance company may have had your property inspected by a “professional engineer.” This engineer likely came to your home and was very nice. He may have struck up a friendly conversation with you discussing your home, previous repairs and the current loss. This professional engineer may have given you the impression your insurance claim was covered but the insurance company just needed to confirm a few things. You were probably surprised a few weeks later when you received a denial letter refusing to provide coverage for the loss and citing to the “investigation and report prepared by the engineer.”
The engineer’s report (if the insurance company even provides it to you) may appear very impressive. It will contain scientific and technical terms, cite to studies or articles, and offer the professional engineer’s opinion that the loss was caused by anything other than what would be covered under the policy. If it is a roof claim, then the loss will be caused by the “age of the roof”, “extended exposure to the elements”, “improper installation of underlayment”, or “improper flashing.” If it is a water damage claim, then the engineer’s report will likely state the damage was not the result of a “one time accidental occurrence” rather it was the result of “constant or repeated seepage of water that occurred over a period of time.” Coincidentally, you will find all of this language under the “Exclusions” section of your insurance policy. The insurance company now has the support it needs to deny your claim.
There is a good chance that the “facts”, the science, and the opinions contained in that report and relied upon by the insurance company are not accurate. In fact, they may be completely false or intentionally misrepresented. These facts and opinions are bought and paid for by the insurance company. If you do some background work on these so-called engineering firms, then you will discover they really do not do that much actual engineering at all. These engineers are not active in the field of engineering. They are not conducting studies, reviewing plans, or any of the tasks a typical structural engineer would. They may be a mechanical or chemical engineer. They may have no experience investigating the cause and origin of damages to a structure other than their work for insurance companies.
These “forensic engineers” make the majority of their money conducting investigations by and for insurance companies. Some firms make millions of dollars a year providing insurance companies with excuses to deny coverage for insurance claims. With millions of dollars at stake, do you really think this engineer is conducting a thorough, unbiased investigation of the loss. Or, do you think they know what the insurance companies want (to deny your claim) and are catering to their biggest customers.
After Superstorm Sandy devastated New Jersey, insurance companies, defense law firms and engineering firms conspired to falsify engineering reports to deny individuals the money they were owed under their insurance plans. In fact, engineering-fraud hearings were held in federal court in New York. The Vice President of Claims of the largest insurer in the National Flood Insurance Program (NFIP) took the witness stand. He was questioned whether he was aware of a systematic plan to falsify engineering causation reports to illegally deny honest insurance claims. He took the Fifth Amendment. Link
60 minutes ran a national story on this scheme as it related to Sandy; however, it was not unique to Sandy. This scheme dates back to at least Hurricane Katrina. While this involved flood claims, there is no reason to think insurance companies are not engaging in the same deceptive behavior for other non-storm related claims.
If you have “accepted” your insurance company’s denial of your insurance claim because it provided you with the opinions of a “professional engineer”, you should call for a complimentary review of the denial letter and engineer’s report. Under Florida law and your insurance policy, you have five (5) years from the date of loss to file a lawsuit to recover the insurance benefits you were wrongfully denied.
