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Great article explaining the Florida Insurance Marketplace

Dennis Maley does an excellent job of explaining the back end of how insurance companies operate and how they are able to be ever so profitable.  This is a great article that every Floridian should read!

Homeowner Insurance Problems Don’t Start With Citizens

Published Thursday, June 21, 2012 12:10 am

by Dennis Maley

This week, Tom Grady, the interim president of Citizens Property Insurance, the state’s “insurer of last resort,” made the rounds to portray private sector insurers as victims being squeezed out of the market by a big government program teetering on disaster. Citizens Property Insurance may well be a mess, but any honest conversation about solutions to Florida’s age-old insurance woes must begin with the private sector’s role in delivering us to where we are today.

Property insurance in Florida is a shell game, plain and simple. Insurers have been devising increasingly profitable ways to gouge property owners for years, and they’ve gotten it down to a science. While crying about Florida’s tight regulation and state competition, Grady and his friends fail to mention that the industry routinely hides profits in the unregulated and shockingly opaque business of reinsurance.

Reinsurance is insurance for insurance companies. It’s like a big-time bookmaker, whom smaller bookies can lay off risk to when they’ve got too much exposure on one side of a bet before a big game. Only, in this case, the little bookie is just a front for the big one, giving the appearance that the insurer is losing their hide when they’re really laughing all the way to the bank.

Reinsurance has almost no transparency whatsoever. Companies are set up offshore so that your insurer can send them outrageously high “reinsurance premiums,” ostensibly to hedge their risk and make sure money is available to pay your claim. This can account for more than half of your premium dollars and the portion of premiums that go to reinsurance payments on Floridian policies tripled between 2004 and 2009, according to an investigative report by the Herald Tribune.

While insurance profits are indeed regulated, reinsurance payments are an outgoing expense that the parent companies can do whatever they want with, including taking a profit. So, if the insurance company collects 100 dollars and keeps it, spending only 20 on claims and expenses, they might have to lower their rates – and certainly, aren’t going to be able to win the required approval to raise them. Therefore it’s no coincidence that unregulated “reinsurance,” often issued by the same corporation under a different name, has skyrocketed, allowing them to rake in tons of dough, while also giving the insurer a case to raise rates because of all the money they are “losing.”

Legislators know this, the industry knows this, and I am quite sure that Rick Scott and Tom Grady know this. Hell, the Herald-Tribune won a Pulitzer for exposing it. Yet here we are throwing legislative pity parties for the insurance companies, bemoaning the greedy homeowners who are getting over with their commie, state-owned insurance policies that are going to bankrupt us all. Meanwhile, no one is explaining why there was a $20 billion dollar gap last decade between what was collected in premiums and what was paid in claims, despite the worst historical decade on record in terms of storms. It must be all of that expensive reinsurance.

Here in Florida, we just ignore such details and press forward with whatever narrative suits the objectives of the industries that own our bought-and-paid-for government. This is after all, the state that thinks it makes sense to allow utilities to pre-bill customers for future nuclear plants that they may or may not build. These are both antitrust exempt, non-competitive industries. The deal is supposed to be, provide a critical service at a reasonable price and you’ll make a reasonable profit in return, without all of the uncertainties of a wide-open marketplace.

Instead, insurance companies and their legislators routinely act as though taxpayers are no more than a carcass to be picked over by greedy vultures. If it runs afoul of “the rules,” we just change or ignore them. As is usually the case, Floridians deserve better, but so long as they keep electing empty suits and industry shills, they’re unlikely to get it.

Dennis Maley is a featured columnist and editor for The Bradenton Times. His column appears every Thursday and Sunday on our site and in our free Weekly Recap and Sunday Edition (click here to subscribe). An archive of Dennis’ columns is available here. He can be reached at dennis.maley@thebradentontimes.com. You can also follow Dennis on Facebook and Twitter by clicking the badges below.

via Homeowner Insurance Problems Don’t Start With Citizens – The Bradenton Times – Free News for Bradenton, FL and Manatee County.

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Meet the Senior Public Adjusters at Claim Concepts

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Greg Roover, SPPA

Senior Professional Public Adjuster, President

Inspired by Personal Experience

Greg’s path to becoming a Public Adjuster was deeply personal. The Northridge Earthquake was a turning point, where his family’s experience with a public adjuster opened his eyes to the profound impact of this role. Greg embarked on a strategic career journey, motivated by a desire to help others as his family was helped. He honed his skills working for insurance companies as an independent insurance adjuster.

In 2006, Greg’s vision came to fruition with the founding of Claim Concepts. His insider knowledge, gained from years within the industry, and his passion for aiding others have been instrumental in the company’s success.

In 2025, Greg earned the Senior Professional Public Adjuster (SPPA) designation from The Institutes, the highest designation available to public adjusters. Awarded only to seasoned professionals who complete a rigorous course of study and examinations, the SPPA reflects Greg’s commitment to mastering every aspect of the claims process on behalf of the policyholders he serves.

Greg’s expertise is not just in his impressive resume but in the countless testimonials from those he has aided, reflecting his dedication to securing the rightful settlements for our clients.

Greg's Expertise Backed by Industry Accreditations

Morgan "Eric" Thomas

Morgan - Your Trusted Public Adjuster at Claim Concepts
Public Adjuster

From Adjuster to Advocate

Eric’s journey in the insurance world began in 1989, marking the start of a career defined by expertise and dedication. Fresh out of college, he jumped into the role of an independent adjuster, swiftly advancing to a general adjuster position at a major firm. There, Eric specialized in complex homeowners and commercial property insurance claims, showcasing his skill in navigating intricate scenarios. 

In 2001, his career took a pivotal turn towards the construction aspect of insurance. As the General Manager for a renowned Insurance Restoration Contractor, Eric oversaw everything from estimating to maintaining vital relationships with insurance companies. His profound understanding of insurance and construction led him to Claim Concepts, where he now thrives as a Public Adjuster. His unparalleled insight has been crucial in ensuring that our clients receive the settlements they genuinely deserve

Eric's Expertise Backed by Industry Accreditations

THE PROCESS

Our Proven Process Built on Precision, Leverage, and the Art of Resolving Complex Claims

Over many years, our team of seasoned professional Public Adjuster have developed a proactive claim management process to ensure our clients receive the proper settlement for their losses. We understand that proving your claim can be a daunting and time-consuming task, and we are here to alleviate that burden for you. Our goal is to make this process as seamless and stress-free as possible for you while ensuring that you recover the full and proper settlement for your loss that you need and deserve.

Step 1 - THE DISCUSSION

 Your Claim, Our Strategy – It all begins with a no-obligation, in-depth review of your claim. We know that by the time most clients reach us, they’ve already experienced confusion, frustration, or a settlement offer that simply didn’t feel right. We will review all claim documentation including estimates, letters, policy, photos, and any other relevant items. We will then work directly with you to map out the most effective path forward. Rest assured that we will only make an offer to work with you if we are confident that we will add value to your claim.

Step 2 - THE EVALUATION

Exhaustive Inspection & Document Review – Once we partner, our team immediately gets to work on your claim. We dive deep into your policy to ensure we fully understand how it applies to your specific loss, while carefully reviewing all existing estimates, photos and documentation. We then conduct an exhaustive, technology-driven inspection of the property using advanced field tools to document every aspect of your loss, ensuring nothing gets overlooked.

Step 3 - THE DEMAND

Estimate Preparation & Submission – We develop a comprehensive, line-item estimate utilizing industry-standard software, subjecting it to a rigorous three-tier review process covering field accuracy, technical precision, and compliance, to ensure nothing is missed. Once completed, we share it with you for your review, input and approval before submitting our entire claim package to the insurance company as The Demand.

Step 4 - THE NEGOTIATIONS

Expert Negotiation, Focused on Your Best Outcome – We stand strong on your behalf, skillfully negotiating for the resolution you need and deserve. When negotiations stall, we don’t back down, we guide you through your available dispute resolution options, to keep your claim moving toward the outcome you deserve.

Step 5 - THE RESOLUTION

Successful Resolution, Your Satisfaction is Key: The final step, this is what everything has been building toward. A fair resolution isn’t just our goal, it’s our standard. Our clients’ outcomes speak for themselves, and yours will too!

CLAIM QUESTIONS? WE HAVE ANSWERS

Peace of mind! We are here to represent you and your interest in the claim. Unfortunately, insurance companies often times deny claims that should be paid or do not pay enough money on a covered claim. This is not always the case and even when it is it may not be intentional. I know that most adjusters have the best of intentions but sometimes they may be inexperienced or simply trained to see things one way, the way the big insurance company wants it to be seen. As Public Adjusters our number one job is to get you the largest settlement available to you under your policy with the insurance company.

NO. Most states have laws stating that Public Adjusters are not allowed to represent the insurance companies. At Claim Concepts, we only represent the insuring public.

The public adjuster is employed by you, the insured. Their function is to represent your interests and ensure that you recover the proper settlement for all of your losses per the terms of your insurance policy. The insurance company’s adjuster works for the insurance company and is responsible to protect their interests throughout the claim.

Public Adjusters typically work on a contingency basis which equals a small percentage of any money recovered by the insurance company.

NO! This is NOT required under any policy that I have seen to date and I do not recommend it.  In the event of a loss it is best to employ a Reputable Public Adjuster that knows what the policy will cover and what it takes to get your property back to its pre-loss condition. Many contractors will provide you with a competitive bid to make repairs but not necessarily get your property back to its pre-loss condition.

Yes!  In most cases we can reopen your file with a supplemental claim. There are many factors involved. Give us a call and we will be happy to offer you a free claim consultation.

Not necessarily.  It is not recommended to file a claim every time you spill a glass of water as you may become classified as a nuisance claim maker. Property insurance is typically rated based on your area which is why all homeowner rates increased in Florida after the hurricanes, whether you filed a claim or not. The risk is more related to the area where your property is located and in commercial situations the use of the property.  However, it is known that there are databases where claim activity is logged and each insurance company may have their own stipulations based on claim activity of the individual or the property.  Ultimately, you buy insurance to protect you in the time of a loss.  If you are debating whether you should file a claim or not, please feel free to call and speak with one of our Public Adjusters about your particular situation, we are always happy to help.

Do not do anything before having a qualified Public Adjuster or Attorney take a look at your file. Depending on the way everything is written you may be agreeing to their offer by depositing the check. Please call our office and speak with one of our Public Adjusters about your particular situation, we are always happy to help in any way we can.