HVAC Insurance Fraud on the Rise

07/06/2011 |


Next time your HVAC unit needs repair be sure to look into what you’re paying for. A recent study revealed that insurance claims submitted for damaged HVAC units were overpaid by 65% in the first half of 2011.

The study was undertaken by HVAC Investigators and went on to show that overpayment was a result of insurance providers who paid to replace the entire HVAC unit when only minor repairs were needed.

"Our research found that the average claim submitted to insurance companies was the result of an (owner) being told by an HVAC company that their unit was in need of a full replacement, when in actuality, a minor repair would bring the system back to pre-loss condition," says Damon Stafford of HVAC Investigators. "It becomes a self-fulfilling prophecy ... (owners) experience an issue, contact a local HVAC contractor, and in turn unknowingly file a fraudulent claim. That's in essence how the game has worked for the past 30 years."

According to the Insurance Information Institute, insurance fraud is the second most costly white-collar crime in the U.S., totaling more than $29 billion each year. Many insurance carriers unwittingly promote fraud by paying suspicious claims rather than fighting them. Often, insurers reason that it would be more cost-effective to pay these claims than to hire an expensive mechanical or electrical engineer to seek the truth.  

This challenge has given rise to niche companies like Stafford's HVAC Investigators, who utilizes local technicians across the country to assist with investigations of heating and air-conditioning claims. The firm's technicians charge hourly fees much lower than those of a typical engineer and provide recommended settlements.  

"We're excited about the positive impact we're having on the insurance industry," says Stafford. "When carriers understand that they can save, on average, somewhere between $3,000 and $4,000 per claim, they begin to grasp that this is something they should be paying attention to.”

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