The Free Roof? Think Again

Educate yourself before you commit Insurance Fraud!


“Waiving Deductibles” “Discounting Deductibles” “Sign Allowances”


IT’S ALL AGAINST THE LAW!

It is illegal in the State of Texas for your roofing company to pay your deductible, even partially


When a final invoice is submitted to the insurance company to recover depreciation does your roofing contractor show that you paid your deductable when in fact you did not?



Does your roofing contractor disclose to your insurance company how much of your deductable was covered/waived if not all of it on  a completion form to your insurance company?



When a roofing contractor follows the law and discloses on the final invoice, that the insured’s deductable was actually “COVERED”, “WAIVED”, or “DISCOUNTED”, then the insurance company would reduce the recoverable depreciation by the amount of the discounted deductible. Therefore the insured or the roofing company would be paid less money.



Maybe the roofing contractor uses an “ADVERTISING AGREEMENT” to trade for your deductable. Either way, if a roofing contractor follows the law and discloses that hundreds or even thousands less than the actual deductible, is collected then the insurance company would reduce the recoverable depreciation by the amount of the discounted or bartered deductible.




Example:


An adjusters written estimate for an insurance claim on a roof is estimated to be $11,000 to replace what was damaged. This is called the Replacement Cost Value or (RCV).



The Homeowner / Insured has an insurance deductible of $1,500.00 plus the Insurance company withheld $2,500.00 in Recoverable Depreciation. Recoverable Depreciation is money that will be paid back to the insured only when ALL the repairs are completed and the total cost of replacement is at least the full RCV amount or $11,000.



This means the insurance company’s first payable check or portion of “buying the roof” is $ 7,000.00. This is called the Actual Cash Value or (ACV). The Actual Cash Value is value of your property/roof after depreciation.



Along comes “Joe the Roofer” who only charges the Homeowner / Insured $9500.00 & Waives the full deductible amount or uses an advertising agreement.


“Joe the Roofer” then sends an invoice to the insurance company stating that they collected $ 1,500.00 from the Homeowner / Insured or that the total invoice to the insured was the full $11,000. (RCV)
 


“Joe the Roofer” is telling the insurance company they should release the remaining $2,500 in recoverable  depreciation.



The insurance company now thinks the Homeowner / Insured has satisfied their $1,500 deductible.



“Joe the Roofer” in this scenario got paid the initial $7,000 ACV check plus the recoverable depreciation check of $2,500 for a total of $9,500 to replace the Homeowner / Insured’s roof.



“Joe the Roofer” is happy and Homeowner / Insured is happy, because they just received a FREE ROOF and paid a lot less than they were supposed to (“hey, it’s OK; everyone does it, right?). WRONG IT’S A FELONY! For the Homeowner / Insured and “Joe the Roofer”!!!



On the other hand, if “Joe the Roofer”  were to send in a final invoice with the dollar figure of $9,500.00 total invoice charged to the Homeowner / Insured & NOT $11,000, then the insurance company would then back off their final check by the amount that “Joe the Roofer”  did NOT collect. 


“Joe the Roofer” in this scenario which is legal, got paid a total of $8,000 to replace the Homeowner / Insured’s roof.



This still is $3,000 less than a QUALITY roofing company should have gotten paid to replace the roof.



Do you think maybe that “Joe the Roofer” had to cut a few corners on your roof to make a profit?



Will “Joe the Roofer” be in business in one, two or five years from now when you have problems?



Fact: The very moment “Joe the Roofer”  sends off a false invoice showing a higher dollar amount collected then what was actually collected from Homeowner / Insured, then “Joe the Roofer”  has committed insurance fraud, if Homeowner / Insured signed that form then so have they.



Fact: If “Joe the Roofer”  provides an invoice (or receipt) to the Homeowner / Insured & the  Homeowner / Insured then signs it and faxes it to the insurance company, both parties have now committed insurance fraud, however the homeowner has also committed wire fraud AND they are also committing collusion (conspiring to perform an illegal act). …How nice; “Joe the Roofer”  has just dragged the homeowner down right along with them.

Fact: If a roofing company wants to pay you for placing a sign in your yard in the State of Texas, it is in fact considered a rebate since you actually received a betterment from your loss.


Would “Joe the Roofer”  pay the same amount $ as your insurance deductible to place a sign in a strangers yard, or someone’s yard that they are not re-roofing? If they are then please send them my way. This would be legal but it’s also not very likely.

It’s really quite simple:
 Find a QUALITY roofing contractor (Compassion Roofing & Remodeling) that has good references & that you think will provide you with the highest level of service and highest level of integrity. Let them negotiate the cost of your roof replacement and pay your full & legally required deductible. You are only required to pay your deductible: the insurance company will take care of the rest.

If you have a problem with your deductible, maybe the QUALITY roofing company can finance it. If not then maybe you need to rethink your premiums. A higher premium will mean a lower deductible, but YOU, the consumer, are the one who makes that choice.



Since roofing is by its very nature is dangerous and potentially deadly these kickbacks can be considered a first degree felony offense. At the minimum it’s a state jail felony. If you or “Joe the Roofer”  get caught doing it multiple times they can aggregate the charges.


All it takes is one angry neighbor, an insurance companies Special Investigation Unit to audit the insured, or the Texas Department of Insurance to investigate.
Click here for more information

Don’t do it, it’s not worth it!!!

If you don’t believe what we are telling you then please read for yourself…




See Chapter 35 Insurance Fraud Section 35.02(7)(B)


BUSINESS & COMMERCE CODE

CHAPTER 27. FRAUD 


§ 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.



Added by Acts 1989, 71st Leg., ch. 898, § 1, eff. Sept. 1, 1989.



PENAL CODE CHAPTER 35. INSURANCE FRAUD


§ 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.



Added by Acts 1995, 74th Leg., ch. 621, § 1, eff. Sept. 1, 1995.

Amended by Acts 2003, 78th Leg., ch. 605, § 1, eff. Sept. 1, 2003.


Amended by: 
Acts 2005, 79th Leg., Ch. 1162, § 4, eff. September 1, 2005.



§ 35.03. AGGREGATION AND MULTIPLE OFFENSES
(a) When separate claims in violation of this chapter are communicated to an insurer or group of insurers pursuant to one scheme or continuing course of conduct, the conduct may be considered as one offense and the value of the claims aggregated in determining the classification of the offense. If claims are aggregated under this subsection, Subsection (b) shall not apply. 
(b) When three or more separate claims in violation of this chapter are communicated to an insurer or group of insurers pursuant to one scheme or continuing course of conduct, the conduct may be considered as one offense, and the classification of the offense shall be one category higher than the most serious single offense proven from the separate claims, except that if the most serious offense is a felony of the first degree, the offense is a felony of the first degree. This subsection shall not be applied if claims are aggregated under Subsection (a).