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Previously, insurance companies issued one check to the homeowner for a roof replacement.  Now they issue two checks.  One is called the ACV check and is given to you at the beginning.  The other is a depreciation check that is released upon proof that the job was completed.

Here’s what happens that you don’t know about!  When the contractor follows the law and submits the final invoices to the insurance company to release the depreciation check, the contractor has to disclose your full deductible amount along with any discounts he has given you to reduce the deductible.  The insurance company will then reduce the depreciation payment by the amount of the discount.  Therefore the contractor or the homeowner is paid less money.

The unethical roofers don’t disclose any discounts to the insurance company regarding discounts to get the full amount of the depreciation money.  THIS IS INSURANCE FRAUD!  And you could be charged with insurance fraud because of your roofing contractor!

Think about it this way … Do you think the insurance company is going to pay a penny more than needed to “fairly settle” your claim?  Of course not.  So where is the money going?  It’s either FRAUD or you’re going to get a BAD ROOF JOB!



For further information visit www.statutes.legis.state.tx.us​​ by clicking on the statehouse.



LAWS PROTECTING AGAINST INSURANCE FRAUD IN TEXAS

CHAPTER 27.  FRAUD BUSINESS AND COMMERCE CODE
TITLE 3.  INSOLVENCY, FRAUDULENT TRANSFERS, AND FRAUD
CHAPTER 35.  FRAUD


Sec. 27.02.  CERTAIN INSURANCE CLAIMS FOR EXCESSIVE CHARGES.

                    (a)  A person who sells goods or services commits an offense if:

(1)  the person advertises or promises to provide the good or service and to pay:

(A)  all or part of any applicable insurance deductible;  or

(B)  a rebate in an amount equal to all or part of any applicable insurance deductible;

(2)  the good or service is paid for by the consumer from proceeds of a property or casualty insurance policy;  and

(3)  the person knowingly charges an amount for the good or service that exceeds the usual and customary charge by the person for the good or service by an amount equal to or greater than all or part of the applicable insurance deductible paid by the person to an insurer on behalf of an insured or remitted to an insured by the person as a rebate.

(b)  A person who is insured under a property or casualty insurance policy commits an offense if the person:

(1)  submits a claim under the policy based on charges that are in violation of Subsection (a) of this section;  or

(2)  knowingly allows a claim in violation of Subsection (a) of this section to be submitted, unless the person promptly notifies the insurer of the excessive charges.

(c)  An offense under this section is a Class A misdemeanor.

 
Sec. 35.02.  INSURANCE FRAUD.  (a)  A person commits an offense if, with intent to defraud or deceive an insurer, the person, in support of a claim for payment under an insurance policy:

(1)  prepares or causes to be prepared a statement that:

(A)  the person knows contains false or misleading material information; and

(B)  is presented to an insurer; or

(2)  presents or causes to be presented to an insurer a statement that the person knows contains false or misleading material information.

(a-1)  A person commits an offense if the person, with intent to defraud or deceive an insurer and in support of an application for an insurance policy:

(1)  prepares or causes to be prepared a statement that:

(A)  the person knows contains false or misleading material information; and

(B)  is presented to an insurer; or

(2)   presents or causes to be presented to an insurer a statement that the person knows contains false or misleading material information.

(b)  A person commits an offense if, with intent to defraud or deceive an insurer, the person solicits, offers, pays, or receives a benefit in connection with the furnishing of goods or services for which a claim for payment is submitted under an insurance policy.

(c)   An offense under Subsection (a) or (b) is:

(1)  a Class C misdemeanor if the value of the claim is less than $50;

(2)  a Class B misdemeanor if the value of the claim is $50 or more but less than $500;

(3)  a Class A misdemeanor if the value of the claim is $500 or more but less than $1,500;

(4)  a state jail felony if the value of the claim is $1,500 or more but less than $20,000;

(5)  a felony of the third degree if the value of the claim is $20,000 or more but less than $100,000;

(6)  a felony of the second degree if the value of the claim is $100,000 or more but less than $200,000; or

(7)  a felony of the first degree if:

(A)  the value of the claim is $200,000 or more; or

(B)  an act committed in connection with the commission of the offense places a person at risk of death or serious bodily injury.

(d)  An offense under Subsection (a-1) is a state jail felony.

(e)  The court shall order a defendant convicted of an offense under this section to pay restitution, including court costs and attorney's fees, to an affected insurer.

(f)  If conduct that constitutes an offense under this section also constitutes an offense under any other law, the actor may be prosecuted under this section, the other law, or both.

(g)  For purposes of this section, if the actor proves by a preponderance of the evidence that a portion of the claim for payment under an insurance policy resulted from a valid loss, injury, expense, or service covered by the policy, the value of the claim is equal to the difference between the total claim amount and the amount of the valid portion of the claim.

(h)  If it is shown on the trial of an offense under this section that the actor submitted a bill for goods or services in support of a claim for payment under an insurance policy to the insurer issuing the policy, a rebuttable presumption exists that the actor caused the claim for payment to be prepared or presented.

We at Horisons have put this paper together to help educate you.  Laws have changed in the last ten years and it’s important that you are not fooled!

Educate yourself!  “Waiving Deductibles,” “Discounting Deductibles,” “Sign Allowances,” “Advertising Refunds,” etc. are all Against the Law in Texas!

You may not know about these new laws, BUT YOUR CONTRACTOR DOES!  And he’s asking you to commit fraud before he even begins the work!  Unethical roofing contractors are intentionally participating in illegal activity and tricking homeowners into committing felony insurance fraud crimes every day it Texas!

Make sure your roofer is accredited with the Roofing Contractors Association of Texas and others.

Listen to this unsolicited opinion we found on YouTube...Click on the YouTube picture.