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Legalease
Legalease, Lawyer
Category: Legal
Satisfied Customers: 14511
Experience:  15 years exp all aspects of general law
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I own a restoration company and recently did work for someone.

Resolved Question:

I own a restoration company and recently did work for someone. We signed a contract for $18,000, but insurance withheld a recoverable depreciation of approximately $4000. Upon invoicing the insurance company for the balance on the roof, the homeowner informed us she would be keeping the rest of that money for herself and we can't have it. As the insurance company will only pay out what she herself paid for the roof (less her $1000 deductible), would it be insurance fraud (a felony) for her to keep that money for other purposes?
Submitted: 9 months ago.
Category: Legal
Expert:  Legalease replied 9 months ago.

Hello there

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Unless there is something that you are not telling me here, then for her to keep money that is sent from the insurance company to pay for the remainder of a contracted repair, then YES, that is exactly what she will be committing if she keeps that money -- insurance fraud. Typically the best way to handle such a situation is to get in touch with the adjuster that you have been dealing with and reporting her actions to them -- usually the adjuster will then contact the owner and set the owner straight on what they must do with the money. If the adjuster refuses to assist then you should immediately file a contractor's lien on her property and take the matter into small claims court in the court nearest to the property location (you can sue in small claims court in Georgia for up to $5,000 without using an attorney and you can get the paperwork at the clerk's office of the civil court closest to the property). You can also take the matter to the local police but in many instances such as these they want the insurance company to make the first moves regarding insurance fraud criminal cases and if her insurance company is unwilling to get involved in that manner then you may have difficulties with the police assisting you. However, moving for an immediate property lien and into small claims court is within the items that you can do right away in this case and I suggest that you take those routes in order to catch that money before it is sent to her or before it is spent by her.

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MARY

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Customer: replied 9 months ago.

That is what I thought. I'm an honest guy with an honest company, never had this happen to us before. I have a great working relationship with the adjuster, but she has already called him every name in the book (She had an ACV policy and expected RCV benefits when we told her we couldn't do the roof for the ACV only. When he said no, apparently she got nasty.). She had to go all the way up the chain to get the money released as a "divine favor" exception so we could do her roof. To make a long story short, I made a bargain with her that if she paid her $1000 deductible then I would assume the risk of installing the roof whether they released the depreciation or not, with the contingency that it is mine if it gets released. The contract says $18200 and in a notes section "Owner's out of pocket expense not to exceed $1000 deductible." We even have a signed completion of work stating she is satisfied with the work performed.


 


As long is everything is well documented and "above board," is there any situation that would prevent this from being a fraudulent act on her part?

Customer: replied 9 months ago.

To clarify, she has paid the $18000 contract price LESS whatever the recoverable depreciation was. Between 4-5k.

Expert:  Legalease replied 9 months ago.

Josh -

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Have you received the full 18K ? If not, you are within your rights to get that payment. If you have received no advantage from the recoverable depreciation amount, then that is NOT your fault or problem -- your company is entitled to receive the full amount of the contract unless you agreed otherwise in writing.

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THANKS

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Mary

Legalease, Lawyer
Category: Legal
Satisfied Customers: 14511
Experience: 15 years exp all aspects of general law
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