AOB Fraud and Abuse Worsening – ACT NOW

A report released today shows further increases in property insurance fraud and abuse, and warns of possible property insurance premium increases if steps aren’t taken quickly.

The Citizens Property Insurance Corporation report, which identifies an explosion of water damage claims and Assignment of Benefits (AOB) lawsuits, should serve as a wake-up call for consumers, job creators and elected leaders. The report clearly demonstrates that this suspicious activity is a pocketbook problem for Florida families.

Reforming Florida’s property insurance market, particularly as it relates to AOB, is a top priority of the Florida Chamber. We believe that property insurance reform will create a stable market that helps consumers find the best options at the best rates, and it will help make Florida more competitive.

The Florida Chamber, along with our Consumer Protection Coalition, is urging state lawmakers to head the warning of the Citizens report and pass meaningful reforms that end AOB fraud and abuse.

Sign the Petition

Visit www.FightFraud.Today and sign the petition urging lawmakers to take action.

Insurance Litigation, Assignment of Benefits Reform a Key Focus of Florida Chamber of Commerce’s Insurance Summit Oct. 26-28

 

Florida insurance officials and industry leaders will meet to discuss the state’s top insurance issues for the upcoming year

TALLAHASSEE (October 21, 2015) – State law that was intended to ensure a level playing field between consumers and their insurance companies in the handling of claims has instead evolved into a windfall for some trial lawyers, contractors and other vendors, according to a new report by the Florida Justice Reform Institute.

The report, Restoring Balance in Insurance Litigation, calls on state lawmakers to amend Florida law to curb abuse of one-way attorney fees and Assignment of Benefits, or AOBs. The one-way attorney fee statute allows trial lawyers to collect legal fees from insurance companies if they prevail in a claims dispute, but prevents insurers from recouping their legal costs if the court instead rules in their favor. Emboldened by the statute, plaintiffs gain negotiating power to inflate bills and gain attorney fees that are potentially unwarranted or disproportionate to any amount recovered.

Over time, the one-way attorney fee statute has become an incentive for trial lawyers, contractors and other vendors – often water damage remediation firms, roofers, or auto glass shops with aggressive marketing schemes – to file meritless lawsuits using Assignment of Benefits. AOBs are intended to allow contractors to work directly with insurers in getting paid for work performed, without having the policyholder put up repair money. However, some third parties are soliciting AOBs as a means of taking control of the policyholder’s benefits and then using that authority to inflate claims and file lawsuits, sometimes without the knowledge or consent of the policyholder.

The Institute’s report, authored by Mark Delegal of Holland & Knight and Ashley Kalifeh of Capital City Consulting – two Tallahassee-based attorneys with extensive insurance experience – will be presented during the Florida Chamber of Commerce’s annual Insurance Summit Oct. 26-28 at the Grand Floridian Resort in Orlando. The event attracts Florida’s elected officials, insurance regulators and private industry leaders to discuss the major trends and issues impacting Florida insurance consumers.

 

“Maintaining a healthy and competitive private insurance market is essential to ensuring Florida is an attractive destination for new businesses, capital investment and job growth, while also benefiting consumers with more choices in the marketplace,” said Mark Wilson, President and CEO of the Florida Chamber of Commerce. “Already, Florida’s lawsuit abuse climate is known as one of the worst in the country. Unfortunately, rampant Assignment of Benefits abuse is threatening to worsen our state’s legal climate and cost families more.”

 

The conference will include speaker presentations and panelist discussions on various insurance issues, including the property and casualty market, pricing and cost drivers, regulations, cyber security, medical malpractice and workers’ compensation. A key focus will be one-way attorney fees and AOB, as outlined in the Florida Justice Reform Institute report.

“This report is the first, hard look at how the growing use of AOBs is increasing costs and litigation,” said William Large, president of the Florida Justice Reform Institute. “Policyholders just want to be made whole for their losses, but with an AOB, vendors and their lawyers are incentivized to increase the claim’s scope of work and maximize profit and litigation fees.”

Assignment of Benefits abuse has become widespread in South Florida and is quickly spreading throughout Florida. State-run Citizens Property Insurance Corp. says lawsuits over water damage claims are the main reason why it is raising 2016 premiums in the tri-county region of Broward, Miami-Dade and Palm Beach counties. Without AOB abuse, the rates for Citizens policyholders would have gone down. In addition, data mined from the Florida Department of Financial Services’ Service of Process Unit shows that AOB lawsuits have grown by 16,000 percent since 2000, and currently represent about one-third of all insurance litigation.

 

“As these water damage claims are absorbed by the insurance companies, it’s going to result in an increase in everyone’s homeowner premiums,” said Bob Rollins, an independent insurance agent for the Beacon Group in Boca Raton. “The best answer is a legislative approach. We need a law that has some teeth in it.”

 

Bills to address AOB abuse were introduced during the last three legislative sessions but failed amid intense lobbying pressure from trial attorneys, contractors and vendors who use this scheme. Similar legislation is expected to be filed for the 2016 session.

 

“The one-way attorney’s fee was meant to benefit the insured. It was not meant to benefit third party corporate vendors,” Large said. “Until legislators clarify this principle, the problem will only get worse.”

 

During the conference, Chamber organizers plan to unveil an educational video about the risks of blindly assigning insurance benefits to a contractor or other third party. John Rollins, Citizens’ chief risk officer, and Angel Conlin, general counsel for the American Strategic Insurance Co., will also discuss AOB abuse and its impact on insurers and homeowners.

NOTE: Media are encouraged to attend. RSVP to Edie Ousley at eousley@flchamber.com.

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The Florida Chamber of Commerce is the voice of business and the state’s largest federation of employers, chambers of commerce and associations, aggressively representing small and large businesses from every industry and every region. The Florida Chamber works within all branches of government to affect those changes set forth in the annual Florida Business Agenda, and which are seen as critical to secure Florida’s future. The Florida Chamber works closely with its Political Operations and the Florida Chamber Foundation. Visit www.FloridaChamber.com for more information.

Florida Chamber Champions Healthcare Expansion and Lower Premiums During Central Florida Partnership Business Briefing

 

CEO Mark Wilson Says: Expand Healthcare and Give Us Our Eight Percent Back

ORLANDO, FL. (April 24, 2015) – Florida Chamber of Commerce President and CEO Mark Wilson today told a sold-out crowd attending the Central Florida Partnership Business Briefing that Florida should expand healthcare coverage and lower insurance premiums on the insured by finally ending the eight percent “cost shift”.

The Florida Hospital Association reports that hospitals currently “cost shift” about $1.4 billion of uncompensated care onto those who have health coverage – increasing premiums by about eight percent.

“At the Florida Chamber, we believe Florida has an opportunity to set the national example for expanding healthcare coverage while also lowering costs on Floridians and reforming Florida’s healthcare system,” Wilson said during the “Expanding Healthcare and Ending the Cost Shift Now” Business Briefing. “Simply put, expand healthcare coverage to more Floridians, and give us our eight percent back.”

Making Florida more competitive means making tough choices, and putting the long-term security of Florida’s future ahead of short-term fixes. Currently:

  • One-seventh of Florida’s economy is based on healthcare, and
    About 30 percent of Florida’s budget is consumed by Medicaid.

Worse yet, those numbers are growing – eclipsing Florida’s spending in crucial areas like education. As our state prepares to add six million new residents by 2030, it’s more important than ever that we get healthcare coverage right.

That’s why the Florida Chamber’s Healthcare Task Force, made up of volunteer business leaders from around Florida, developed a comprehensive Smarter Healthcare Coverage in Florida plan. It embraces expanding coverage and lowering costs, while achieving better healthcare outcomes and eliminating the $1.4 billion hidden healthcare tax that is “shifted” onto Floridians.

Smart solutions to further lower costs include reducing major cost drivers like:

  • Billions in healthcare fraud,
  • Inflated workers’ comp reimbursements,
  • Meritless lawsuits,
  • Allowing telemedicine to serve as an alternative healthcare delivery system, and
  • Enabling nurse practitioners to practice to their fullest potential.

“Most importantly, limiting the overall financial impact on the Medicaid budget to no more than 32 percent, and allowing a flow through of savings in the form of lower insurance premiums is a key component of the Florida Chamber’s plan,” Wilson added.

The Florida Chamber has championed a Smarter Healthcare Coverage in Florida plan throughout the legislative session. Wilson testified before the Florida Senate on more than one occasion, offered a 49-page comprehensive healthcare proposal as well as executive overview, and shared an educational video of Florida’s $1.4 billion hidden healthcare tax with employees throughout Florida.

Given that lawmakers remain far apart on their current budget discussions – a result of the House and Senate having different positions on healthcare expansion, the Florida Chamber is also recommending that lawmakers separate the federal funding of the Low Income Pool (LIP) from ending the cost shift. After securing LIP funding from the federal government, the Florida Chamber is hopeful that the Florida Legislature will return to the negotiating table to address the real opportunities in Florida’s healthcare arena – improving the quality of care, expand coverage, finally end the eight percent cost shift, protect taxpayers, reduce fraud and lower healthcare costs for Floridians.

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The Florida Chamber of Commerce is the voice of business and the state’s largest federation of employers, chambers of commerce and associations, aggressively representing small and large businesses from every industry and every region. The Florida Chamber works within all branches of government to affect those changes set forth in the annual Florida Business Agenda, and which are seen as critical to secure Florida’s future. The Florida Chamber works closely with its Political Operations and the Florida Chamber Foundation. Visit www.FloridaChamber.com for more information.