When Floridians complain that an insurance company's claims adjuster is mishandling, lowballing or delaying claims, there's a less than 16 percent chance the adjuster will be disciplined.
When there's a complaint about a public adjuster - one who advocates for consumers - there's a 75 percent chance the state will crack down.
The Florida Department of Financial Services takes citizen complaints about adjusters, whether hired by insurance companies or policyholders, and decides which ones to investigate. State officials said they don't pick on public adjusters. It's possible more complaints against insurers' adjusters were resolved without requiring an investigation.
"A consumer complaint does not necessarily mean there was any wrongdoing by any party," Alexis Lambert, a spokeswoman for the department, wrote in an email. "Most complaints are resolved without having to open an investigation. For example, a consumer doesn't understand the process so they file a complaint but is then educated about the adjusting process and the complaint is closed."
The lopsided ratio of investigations of public adjusters concerns Bill Newton, of the Florida Consumer Action Network: "Consumers need access to reliable adjusters, so company adjusters should be investigated and disciplined the same way public adjusters are."
Barbara Zee, a homeowner in Delray Beach and board member of the Alliance of Delray Residential Association, said public adjusters should be held to a high standard because consumers hire them directly, but there shouldn't be such a disparity. "The influence ... insurers have over the people in charge of regulating is so much greater [that] it would be difficult for those numbers to ever come close," she said.
The claims adjusters
No matter who hires them, adjusters evaluate damage and estimate repair costs after a policyholder files an insurance claim. There are 47,040 adjusters on staff at Florida insurance companies, including those based outside the state; 29,022 independent insurance adjusters who can be hired by insurers to work on claims; and 2,602 public insurance adjusters, who are hired by policyholders. Of those licensed independent and public adjusters, only those appointed by an adjusting firm can estimate claims.
Public adjusters are generally allowed to charge 10 percent to 20 percent of a claim payout.
Most adjusters are licensed by the state after they take exams or complete required courses. Attorneys don't have to have a license to adjust claims, and an insurance company can allow agents and, in some cases, employees to adjust claims without a license.
The state received 246 complaints about public adjusters since February 2010 - compared to 69 against insurers' adjusters, according to the state's Department of Financial Services, which handles and looks into the complaints. Another state agency, the Office of Insurance Regulation, regulates and investigates insurance companies. It is funded largely by fees and fines from insurance companies, a fact that some say could give the state an incentive to punish insurers.
One reason there may be fewer complaints against insurance-hired adjusters: "Consumers may file a complaint against the insurance company rather than the individual adjuster," Lambert said.
The state received 27,138 claims-related complaints against insurers since 2008, Lambert said, adding they include those that may not have been substantiated. A spokesman for the insurance regulation office could not say how many were investigated.
Harold Weston, a professor at Georgia State University's Department of Risk Management and Insurance, said regulators may think more public adjusters need more oversight.
"Insurers have claims managers with control and responsibility over their ... adjusters. There are claims manuals to be followed ... and there is staff training. That's not to say company adjusters don't get the claims adjustment wrong sometimes. But there are a few levels of supervision that should correct many of the mistakes," Weston said.