Two independent claims adjusters in the Southeast have teamed up to create what they say is a quick, low-cost way for property owners to double-check insurance carriers’ damage estimates on claims.
They’re calling it “CarFax for property insurance claims,” referring to the site that checks for accident reports on vehicles. InsuranceClaim123.com, as it’s known, is a tool that could potentially have an impact on the way insurance carriers, lawyers and public adjusters do business.
The system uses a bit of artificial intelligence along with building-permit and other records, photographs and adjusters’ intuition to find possible oversights by insurance company adjusters, including missed property damage, inaccurate material prices, and cases in which insurers offer to pay only repair costs instead of full replacement value.
“We think homeowners can use this to negotiate with the carrier on the final amount,” said Ben Mandell, a former homebuilder and an independent adjuster since 2017. He has worked with fellow independent adjuster Mark Vinson to develop the InsuranceClaim123 system over the past year. Vinson, a computer science major in college, developed the website.
With the website, homeowners can alleviate that “gnawing feeling” that they’re not being fully paid for legitimate claims, Mandell said.
They say it works like this: Homeowners can upload their insurance company build-back estimates to the website. Within three to five business days, the site will provide a report, flagging items that Mandell and Vinson say probably should have been covered. Or it can confirm when a carrier’s report appears to be accurate.
The cost is $295 per report – a better deal than what a public adjuster or lawyer would charge to contest or litigate a claim.
As an example, Mandell provided a redacted report on a damage estimate from a major national carrier after a tree fell on a home. The insurer offered to repair a relatively small section of the roof and roof decking, plus 15 feet of fascia board and downspout—but not gutters.
The InsuranceClaim123 report contends that tree impacts “typically deform fascia, gutters, hangers, and downspouts together.” An attic inspection should also be done to check for damage to rafters and trusses. The insurer’s estimate of the number of new roof shingles needed did not jibe with the amount of plywood decking needed. New vinyl siding can’t easily be matched to old, and a larger section should be replaced, the report notes.
The scope of roof decking that needs replacing also suggests a larger amount of interior damage, and a full replacement of ceiling drywall may be needed in at least one room. The insurer should cover the cost of more insulation and paint, the report said.
The insurer’s report noted 67% depreciation, but the InsuranceClaim123 report argues that a typical depreciation is more like 15%. All told, the carrier’s estimate is $20,000 to $45,000 too low, the website posits.
Insurer advocates and public adjusters said it’s difficult to imagine how a system could arrive at an accurate damage estimate without physically inspecting a property. But the entrepreneurs said it’s all part of the “secret sauce,” which includes the adjusters’ own years of experience, property information, and up-to-date material costs—not unlike the process used by carriers’ desk adjusters when revising field adjusters’ reports.
“I really got into this by trying to reverse-engineer what the insurance companies were doing to reduce our estimates and build their reports,” Vinson said.
A licensed public adjuster in Texas, Vinson said he was able to access hundreds of redacted adjuster reports from a third-party administrator to use as a learning base for the system.
Mandell and Vinson will be familiar to many in the property insurance and claims industries. They are two of the three whistleblower adjusters who appeared at a Florida House of Representatives meeting in 2022 and accused a number of insurance carriers of deceptively revising their field reports and slashing damage estimates, all while leaving the adjusters’ names on the revised reports. The InsuranceClaim123 site, officially launched this month, includes video from CBS News’ “60 Minutes” 2024 report on the issue. The site already has so many requests for report that “it’s too many to count at this point,” Vinson noted.
Both Mandell and Vinson have worked as independent adjusters since 2017. A few insurance industry advocates have questioned some of Mandell’s roof reports, noting that Florida law now allows repair—not full replacement—of some roofs if a limited amount is damaged. And a review site that doesn’t physically inspect a home cannot always tell if a claim includes pre-existing damage, some have pointed out.
Mandell said that the system is needed now more than ever, as carriers and claims-adjusting firms hire younger adjusters with less experience, and as desk adjusters find new ways to reduce payouts.
“I mean, 87% depreciation on some claims—that’s ridiculous,” Mandell said.
It’s too early to tell what impact the 123 product may have on the insurance and litigation arena. Mandell said plaintiffs’ lawyers may want to use the system to help determine if a claim is worthy of litigation. The site will benefit public adjusters by letting them vet the validity of some claims before spending hours physically inspecting properties, he said.
But others argued that many homeowners are likely to turn to such a review site instead of public adjusters, especially if more carriers adopt policy endorsements that provide premium credits when insureds agree to refrain from hiring PAs. In the last year, at least four insurers have filed for Florida endorsements and at least one has been approved.
“I think this is probably one more nail in the public adjusters’ coffin,” said Scott Johnson, a Florida insurance educator and consultant who blogs regularly about the industry.
The Florida Association of Public Insurance Adjusters’ managing director, Nancy Dominguez, said association members have not used the 123 product and cannot provide an opinion on it. But, she added, a tool that analyzes uploaded data without inspecting the property and the policy cannot replace the judgment of an adjuster.
“A.I. may assist with preliminary review, but it is not a substitute for experienced, on-site claim representation,” Dominguez said in an email. “FAPIA supports responsible innovation while emphasizing that consumers are best protected when they have access to licensed professionals who can assess the full scope of a loss and guide the claim from start to finish.”
It’s also too early to know how InsuranceClaim123.com might handle suspected fraud by insureds, such as claims that appear to include pre-existing or non-existing damage.
“We’ll have to deal with that when we come to it,” Mandell said.
Related: ’60 Minutes’ Homeowners Ask Court to Force DFS to Divulge Heritage Probe Info
Topics
Carriers
Claims
