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January 8, 2025 26 mins

In episode 3 of the Win the Claim Podcast, attorney Dahlene Miller from United Law Group discusses the latest developments in property damage insurance laws and their impact on policyholders. Dahlene dives into the nuances of new estimate-writing requirements and the challenges arising from recent changes, including potential issues with insurance companies modifying claims post-submission.

She shares critical insights on the growing complexities for new law firms and public adjusters, how to effectively collaborate with contractors to avoid pitfalls, and the shifting landscape in Florida that might impact homeowners' rights. Dahlene also highlights emerging statutes aimed at holding insurance companies more accountable, offering a glimmer of hope for policyholders.

Want to learn more about how these changes could affect your claims? Listen to the full episode on Apple Podcasts, Spotify, or watch on YouTube for an in-depth look at these pressing issues.

Don’t miss out—tune in now!

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Episode Transcript

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(00:00):
Welcome to episode three of the Win the Claim podcast.

(00:04):
Today's guest is Dahlene Miller, an attorney at United Law Group,
known for her fierce advocacy in defending individuals and businesses against insurance company exploitation.
Dahlene, thanks for coming out. Thanks for speaking with us today.
Can you go into a little bit of what your law firm does specifically when it comes to property damage

(00:26):
and some of the new laws and how it affects policyholders?
Sure. So with the new laws that came out, there is essentially an executive order that came out at 5pm
when Hurricane Milton hit, ironically, signed by DeSantis,
that requires the modifications of the line item estimates to be issued
not just by the public adjusters, but more so for the insurance companies.

(00:50):
So a lot of people are of the opinion that this opinion came out
because of the fact that 60 minutes aired on an interview of the field adjusters
turning in their estimates to the insurance companies
and then the desk adjusters instructing them to change those light items.
So open fraud on the carrier part, something that we as public adjusters and attorneys get accused of all the time?

(01:11):
Exactly.
No, that would never happen with the carriers.
So what do you see being an issue with the new estimate writing requirements
and let's say new law firms or new public adjusters? How is that going to affect them?
I think it's just a matter of working in tandem with the contractors
because until we can get the bids and proposals showing the geographical areas

(01:35):
that have the market prices from the contractors,
we can essentially circumvent the issues that we'll have with the estimate writing
if we could get those from the onset, right?
So if we don't get those from the onset and have them provided to either the law firm or the public adjusters,
then the executive order would kick into place where we would essentially need to modify
and then explain to the insurance companies why we're modifying the estimates.

(01:59):
Correct. And I mean, the more that you have to explain and the more that you have to modify and revise,
the better chance it gives for them for an open denial or partial denial.
So I mean, obviously, exactumate instability are the two large ones that we use
and exactumate clearly states in their own white papers that this is an estimate of regional pricing.

(02:20):
These use onsite bid items for items that you find do not meet per unit
or per square foot or linear foot pricing.
I see it as being an issue that if a general contractor or a roofer can't get out a specific price per unit
in a timely manner, then it's going to affect me by, I have 30 days to provide the homeowner with some type of estimate.

(02:44):
If not, I breach contract and they have the right to cancel my contract.
So with the fact that they can cancel within 30 days of a storm and I have to provide an estimate within 30 days of a storm,
it kind of puts us in a precarious situation.
So I think working with contractors and roofers who are up to date on these type of laws is going to be a huge play in it.

(03:07):
So what type of law firm are you and what is your primary focus?
So we are a homeowners insurance claim.
We do handle residential but also commercial claims.
And our entire focus is the homeowners claims process,
whether that's from a business perspective on a commercial level or from the homeowners perspective.
Okay, so your first party defense.
Yep.

(03:28):
And how long have you been an attorney now?
Six years.
Six years.
And what have you seen over the past six years has been the main shift?
Do you think it's gone towards policy holders favor or away from policy holders favor in the state of Florida?
No, so for over 100 years we had legislation actually protecting the homeowners rights and the business owners for that matter.

(03:49):
And I was just having a conversation over lunch with an entity from Washington DC.
And Florida was unique in the sense that we had the statutory fee awards where we would actually be able,
if we had to recover the insurance proceeds for what was rightly owed to the homeowners for the insurance claims that they would make,
that as a way to reprimand these insurance companies, they would have to pay the homeowners attorneys if they even recovered one penny.

(04:14):
And so when I started practicing, that was the area of law that we had and the enforcements that we had,
instead of throwing these insurance companies in jail for the criminal actions that, let's be honest, they're doing.
On a daily basis.
On a daily basis.
For so many of us that are actually advocates of the homeowners, we have statutes outlining that if we do not follow these provisions,

(04:35):
they're third degree felonies. You know, they're not just misdemeanors and yet the insurance companies are not being held to the same regard.
They violated on a daily basis.
Right.
I mean, for example, we saw with Hurricane Ian, a lot of, well not a lot, but a few major insurance carriers go belly up in a lot of business
and their claims being turned over to FIGA.
For those of you who don't know that are brain new public adjusters or insurance adjusters,

(04:58):
and there's Matt Mahalan of BEI, we talked about him earlier.
So those of you that don't know is FIGA will only cover up to $300,000 worth of damage for residential claims.
That is all that they are legally responsible for.
They are a guarantee association.
They are not an insurance carrier or a reinsurer.
So if you have, let's say like in Hurricane Ian, some of the claims that we were dealing with, for example, one of our previous mutual clients had a seven figure loss on Captiva Island.

(05:28):
If his insurance company went belly up, then he would only have $300,000 worth of coverage.
So they're able to mismanage their funds and openly change estimates on a daily basis and go belly up.
And then those same directors and CEOs and C-suite executives are able to go and form a new insurance company the very next day and start the underwriting process all over again.

(05:50):
All over again.
And rinse and repeat over and over again.
But if you or I miss a filing deadline or if we misinterpret some policy language, the state seems, or I'm at least going to allege that they will crucify us.
They will.
And they will hold us accountable.
To the highest regard.

(06:11):
So I used to, that used to be my best selling point is, hey, listen, I've worked on your claim for the past three to five months.
We've gotten undisputed.
The insurance carrier doesn't want to do the right thing.
It's time to get an attorney involved.
And they're like, well, how much is that going to cost me?
I'm like, the great part is if you get a penny more than what you're offered, it's not going to cost you a dime.
And then as soon as that letter of rep went out from the law firm and the carrier council or maybe the desk adjuster that's in the litigation side took a look at the file.

(06:38):
They're like, man, we actually do owe more money.
We don't want to have to pay attorney's fees on top of this because we know we're going to lose in court.
Let me go ahead and settle that claim.
Now what I'm seeing is they're like, yeah, great.
Let's go to litigation.
Well, we're in the middle of appraisal.
I don't care.
Let's do examination under oath before we give our position on appraisal.
Well, that's not how that works according to Florida State statute.
Great.

(06:59):
Litigate us then because they know the average homeowner, if it's under $100,000 of a claim, that's not going to be worth it for them to litigate because it's going to cost them $30,000, $50,000.
Plus now they're paying the PA fee.
They're paying the law firm fee and they're having to go through eight months or a year.
And then they're getting dropped by their insurance carrier because they're not insurable because they have a damaged home.

(07:20):
So at this point, it's chess not checkers for the carrier.
The longer they wait, the late denied defend position, the better chance they have of them never having to pay a single penny.
So what are some of the ways that we can get around this new law and the attorney fee shifting?
So with the attorney fee shifting, it's really going to have to be a coherence of every entity representing the homeowner in tandem to be on board with making sure that there are other new statutes that are actually going to hold the insurance companies accountable.

(07:52):
Like what? What are some of those new statutes?
Some of those entail essentially a homeowner asking for an estimate off of the bat.
The insurance company has so many days now to produce that immediately upon the request of a homeowner.
And what happens if they don't produce that?
Then we would go into the avenue of what's called that faith.
So the lawyers at that point are able to file what's called the civil remedy notice and put them on reprimand for those actions.

(08:16):
It's the equivalent of essentially filing a complaint with the better business bureau.
And what you can do with that is then once we go to trial, if you prevail on the trial aspect, you're able to then recover additional monies for those bad actions because instead of showing, throwing these insurance companies in jail for these criminal acts and the fiduciary duties that they're going to do,
they're going to be able to make sure that they're not going to be able to do the fiduciary duties that they're supposed to follow.

(08:40):
They're able to then have punitive damages for that recovery process.
Yeah, and it hurts them more in the pocketbook than it does put in some CEO or some lonely desk address or in jail because they're going to go hire 20 more.
Exactly. So go out on bail.
I'm not sure on it, but what is the timeline from the time a homeowner requested from the carrier that they have to produce some type of estimate?
I believe it's 30 days.

(09:02):
Is it safe to say that's probably a breach of contract issue?
Well, that's where the bad faith action is going to be crucial.
So any of our public adjusters, any of our homeowners that are listening right now, any entities representing the homeowners, it's the documentation that's crucial because the standard is no longer negligence to prevail on a bad faith claim.
It's now intentional.

(09:23):
So you have to prove by one way or another, essentially that the insurance company completely intentionally ignored your requests for the homeowner's estimates from the insurance company in order to get the bad faith.
So how do we do that? We do that through documentation of paper.
We do that through phone calls and conversations that are being recorded with the insurance companies advising them that this call is being recorded.

(09:47):
And then through the deposition process, which with the details that we obtained from the public adjusters and any other entities involved, we're able to pigeonhole them into answering the questions of whether this was intentional or not.
And if it is, as they're going to claim unintentional, is there any recourse for a homeowner to get that claims information more readily available to them through the legal process?

(10:11):
Through the demand, you can do a demand letter and then simultaneously issue the civil remedy notice.
What that's going to do is prolong the period of when they have to submit it because to respond to a civil remedy notice, you have 60 days.
Otherwise, you are then found essentially culpable for not responding to it and any actions that are alleged therein.
So it limits the timeframe, but it also puts them on notice that they have these days and an additional time frame.

(10:36):
Now, you mentioned civil remedy notice. I know a lot of public adjusters out there feel comfortable writing civil remedy notices and we legally are allowed to.
I choose not to write civil remedy notice. I don't want to open myself up to that type of liability and I don't want it to be used against the policyholder if there's anything even remotely wrong with the language of the civil remedy notice.

(10:57):
At what point do you think they should be contacting your firm to at least get either a civil remedy notice or a demand letter or some type of deck action, you know, letter sent out?
Do you think it needs to be at the start of the claim or do you think it needs to be upon, like, say, first partial denial or open denial?
Because of the PAD faith changes in the legislation. It needs to be from the point when it was intentional.

(11:22):
So if you have an adjuster, for example, come out and I've had this happen and I will not name the insurance companies, but they will come out to an inspection after a hurricane loss.
They'll roll down their window. They'll look at the roof and they'll say, yeah, that's not covered. And then they'll drive away.
I mean, it's definitely not the big red elephant.
Exactly. So there's no way around the fact that that is intentional, that is not negligent at that point.

(11:48):
The insurance company had a fiduciary duty to do their investigation, their inspection, and instead of even putting so much as a ladder on that roof and getting out there, they literally rolled down their window and decided, yeah, we're just not going to cover this.
We're going to throw whatever exclusion applies to this homeowner's policy and then continue on with our claims process.
Yeah, delay, deny, defend.
Exactly.
And I mean, I'm seeing it more and more that the field adjusters and for those of you out there that know me, I don't argue with field adjusters.

(12:15):
90% of them have zero authority to settle the claim, let alone create coverage determination.
So there's absolutely no reason for me to argue with them on site.
I like to walk them into coverage.
But I've noticed more and more that the field adjusters are openly telling me, I'm going to write for this, but it's going to get denied.
And when I ask them why, they're like, well, I have certain standards that I can write for on the first inspection.

(12:38):
But ultimately the desk adjuster is going to find a way to deny it.
And when you ask them to put in writing, they're like, absolutely not.
Absolutely not.
You know, check around that though.
Yeah.
It's email, all of the conversation and then say, yeah, you know, to memorialize a conversation from earlier and then have them either openly deny it or to admit that essentially if you did have a conversation.

(13:03):
Yeah, it's a waiver of any contestation that you may have.
Yeah.
And an admission.
And fun fact I found if the homeowner has a ring camera or security system and it's clearly posted and I have pointed it out like, hey, just heads up, they bring camera, they have security cameras.
We are being recorded.
Then, and I have homeowner permission then recording both audio and visually is completely permitted or better yet.

(13:29):
If you set up on the road and public access and there's no expectation of privacy.
So you could go so bold as also wearing a body cam and advising them.
Yeah, correct.
I mean, depends how contentious it's going to get if it's, you know, if it's like a good neighbor, then I'm probably going to wear some type of body cam just for the pure fact of the adversarial miss that I meet with them on a daily basis.

(13:52):
So more to come, there's going to be a lot of changes coming out in the legislative this year.
We are in an election year.
A lot of homeowners are upset.
Elaine, Milton and Ian are all within the past three years and I think homeowners have had enough.
So if homeowners or policy orders want to reach out to you, how do they get a hold of you?
So they can reach us at United Law Group where based in Clearwater or you could just look us up at UnitedLawGroupofflorda.com.

(14:21):
We are not the entity associated with California.
There are two firms under that name.
So just to let everybody know.
Okay.
We are the establishment based in Florida, not in California.
All right.
Awesome.
I appreciate your time today.
And if you guys have any more questions, whether it's legal for her, Dahlia and her law firm or whether it's for new public adjusters or seasoned public adjusters and you want updated information on the state statutes and the requirements for estimate writing or for turning in certain documents.

(14:50):
Reach out to us.
We'll give you free advice and please wait for next month when we're going to put out another episode.
And thanks so much for joining us today.
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