Contact Us (850) 438-4899

Blog

Why Is the Insurance Company Asking for Tax Returns in a Claim for Roof Damage? (So They Can Deny Your Claim)

Posted by Annie Dike | Jul 22, 2018 | 0 Comments

documents requested by the insurance company during claims investigation to deny claim

Have any of you ever received a request for documents like this from your insurance company?  This a REAL request the insurance company, Lloyd's of London, sent our client, a small business in Pensacola, in the case we recently tried that we want to share so you can understand what the insurance company is often REALLY doing when they claim to be “investigating” your claim. They do not play fair.  Instead, they set traps, like this one, in hopes you will make a misstep and fall into one of their traps so they do not have to pay your claim.  This was a claim over roof damage from the April, 2014 rainstorm and the insurance company is asking for bankruptcy records (#15), financial activity (#16), as well as tax returns three years prior to the storm (#17).  As a policyholder, you might find this request offensive because it has nothing to do with how your roof was damaged.  And, while we would agree, do you know what can happen if you do not produce documents or information requested by the insurance company?

What Could Happen If You Don't Meet the Insurance Company's Demands?

YOU COULD FORFEIT YOUR RIGHT TO COVERAGE UNDER THE POLICY.

It's true.  It's in the fine print of the policy the insurance company drafted in its favor.  There are all kinds of traps in the policy insurance companies have set for you that they hope you will trigger so they can deny your claim.  Insurance companies are very powerful.  They also lobby legislators and have had laws enacted in their favor, laws that allow them to deny coverage if you, the policyholder, do not file your claim in a certain amount of time, if you do not include certain information on your insurance application, if you make a mistake, or if you fail to produce something.  All of these things you may do inadvertently or unintentionally, but the policy and the law and the insurance company are all fighting against you.  This is why you need an insurance lawyer, who knows the games insurance companies play, and who knows how to make sure you avoid their traps and protect your right to recover the benefits you paid for protection. 

Mistaken Beliefs That Prevent Many People From Contacting an Insurance Dispute Attorney

We have seen many, many clients who have, unfortunately, had to forfeit coverage entirely, or recover less than they were entitled to because they waited to contact us.  Many clients hesitate to contact an attorney based on these two MISTAKEN beliefs:

  • I do not need an insurance lawyer because I only want what is fair; and
  • I cannot afford an insurance lawyer.

First, you can absolutely afford an insurance lawyer when you only pay if the insurance company pays you. Did you know that Florida law requires, in most circumstances, when you have to file a lawsuit against your insurance company and you win that—in addition to the insurance benefits the insurance company had already promised to pay you—they also then have to pay your attorney's fees?  We handle most insurance cases on a contingency basis, meaning you pay no attorney's fees if there is no recovery.  The only thing you can't afford is to trust that you don't need an insurance lawyer looking out for you because you only want what is fair.  You need an insurance lawyer, even if you only want what is fair, because the insurance company rarely plays fairly. While they tell you they are “investigating” your claim, sending an adjuster out to document damage, or asking for records or receipts, they are often trying to find everything they can and use everything they find to DENY YOUR CLAIM.  In the background, they are hiring experts (many of whom they have hired a hundred times before because their opinions are always favorable for the insurance company) to form opinions that allow them to say your damage is excluded. You likely cannot afford to hire your own expert, but we advance those costs on your behalf.  We will hire experts for you, experts who will conduct reliable investigations and render honest, reliable opinions.  You pay none of the costs we advance if there is no recovery. 

The Traps the Insurance Company Set For Our Client In This Case:

The case we recently tried, where we obtained a verdict from an Escambia County jury, is just another example of the traps the insurance company is trying to set for you and why our client's decision to hire an attorney early on helped him avoid those traps and make the insurance company pay. While claiming to be “investigating” our client's claim for the April, 2014 rainstorm, this is what the insurance company was really doing:

Lloyd's sent an engineer (from a company they have used hundreds of times to render opinions in their favor) who had no experience designing, installing or repairing flat, commercial rubber roofs to investigate a claim for damage to a flat, rubber roof, in hopes he would render an opinion that would allow the insurance company to deny coverage. 

Lloyd's engineer did just that.  He decided the day he was on the roof that the historic rainstorm, which dumped two feet of water in two days, caused NO DAMAGE to the roof; rather, all of the damage on the roof was pre-existing wear and tear, or if it was not, the damage was the result of faulty maintenance, faulty repairs, leakage, seepage, mold, anything that would fit into one of the fine-print exclusions in Lloyd's policy.

After receiving a claim package from the public adjuster hired by the small business totaling more than a million dollars to replace the roof and interior of this small business, Lloyd's chose not to talk to the public adjuster about his estimates or his calculations.  Instead, Lloyd's hired a national defense firm, that primarily represents insurance companies on coverage disputes, to send the 21-category document request shown in the image below, ranging from consumer complaints and citations for the business, as well as bankruptcy records, local, state and federal tax returns, and profit and loss statements from the owner.  We hope you're screaming: “What does this have to do with the roof?!”  The answer is: Nothing.  Lloyd's was playing games.

Lloyd's then demanded a second, more thorough inspection of the roof and interior seven months after the historic rainstorm and demanded the owner sit through a pre-scheduled Examination Under Oath.

If this small, family-owned business failed to meet ANY of these requirements, coverage could have been forfeited, on a claim in excess of a million dollars.  Of course, the letters sent to our client left that part out. Thankfully, the owner realized early on what he was dealing with, even before Lloyd's denied the claim, and brought in an insurance dispute lawyer to help advise him during the claims-handling process.  Impressed by our reputation representing policyholders only, never insurance companies, our client reviews and personal service, and our willingness to take on the cost and risk of the lawsuit without recovering anything unless they won, the family chose our firm, and wefiled a lawsuit against Lloyd's of London immediately after denial of the claim. 

Soon after TWW was brought in, Lloyd's accused the owner of committing insurance fraud so Lloyd's could avoid paying this legitimate claim. 

Using the very appraisal, real estate, foreclosure, and financial documents Lloyd's of London demanded the owner produce—none of which had anything to do with what happened on the roof the night of the April 2014, rainstorm—Lloyd's concocted an argument that the owner was in “such dire financial straits” that he saw an insurance claim as his “golden parachute” to save himself from complete financial destitution, a situation he has never found himself in, despite having survived the real estate crash in 2008 and the BP Oil Spill in 2010. 

 While we, as the policyholder's attorneys, are not allowed under the law to point to the financial motive of the insurance company, i.e., the money Lloyd's of London would save if it could avoid paying a million dollar claim, Lloyd's is welcome to, and happily did, point the finger at our client, telling the judge and jurors his only possible out in this case was to commit the crime of insurance fraud, a defense thankfully the jury saw right through. 

These are just some of the facts from the recent verdict we obtained for our client against Lloyd's of London that we wanted to share with you.  We hope some of the insurance tricks Lloyd's threw at us in this case show you the types of traps the insurance companies are often laying out for you in hopes they can trap you and avoid paying legitimate claims.  These are games you likely are not experienced at playing, games you may easily lose simply because you don't know what steps to take, what documents to produce, or what questions to answer to avoid forfeiting coverage on your claim, which the insurance company would love for you to do.

If this small business had not contacted us early on in this case it is likely the insurance company's bully tactics could have won the day and he would have not recovered any of the money he was owed under the policy. 

Make no mistake, when you file a claim, insurance companies often immediately go on the attack, and if you do not have a warrior fighting for you, it is likely, and far too common, that the insurance company will win.

Do Not Let the Insurance Company Trap or Bully You

If you are dealing with an insurance company on a claim, do not let these two hurdles—a belief that if you only want what is fair the insurance company will treat you fairly in return, and that you cannot afford an insurance dispute attorney—stop you from contacting an attorney who might mean the difference between whether you receive the insurance benefits you deserve when tragedy strikes or whether the insurance company's denial means the end for you.   

We know your rights. We know the law.  If an insurance company is requesting documents and information from you as part of its “investigation” of your claim, they may be gathering evidence and setting traps to snare you.  We know what to do, and we fight for you.  Read more about insurance companies' tactics and what types of requests from an insurance company should immediately prompt you to contact an attorney here.  The insurance company is not looking out for you.  They have a great deal of money and power and incentive to fight your claim. Do not let them win. CONTACT US anytime for a free consultation.

About the Author

Comments

There are no comments for this post. Be the first and Add your Comment below.

Leave a Comment

Free Consultation

We never charge any fee or cost for an initial consultation to explain your rights. If you’ve been injured in a car accident or have question about an insurance claim, contact us.

Menu