by Guest » Sat Feb 18, 2006 10:21 am
My cousin Bob and another guy went for a long drive last Saturday evening and got struck by a rash driver from a distance. The bully escaped narrowly but was trapped later in the morning .The repair works for Bob would be somewhat around $4000. Bob's insurer had agreed to support him with aftermarket body parts for his vehicle, to which Bob's reaction was simple and stern. He did not want his insurer to provide him with aftermarket parts. He maintained that it was his insurer's job to collect the new parts from the tormentor. He had a hard time convincing the insurance representative till he revealed his other identity as an attorney.
Of late his insurance company has offered him new market parts, and also expressed their willingness to resolve matters soon. Could we ever look forward to a hassle-free world ?
Regards,
Blackberry
Of late his insurance company has offered him new market parts, and also expressed their willingness to resolve matters soon. Could we ever look forward to a hassle-free world ?
Regards,
Blackberry
Posted: Tue Jul 15, 2008 09:40 pm Post Subject:
It's not everyday that someone has the huevos grandes to man up against a big bully.
I agree... usually insurance companies just let these things slide. Glad you agree that someone is going to hold a shop accountable for commiting fraud. It's expensive but good to see that they are trying to help their insured's.Posted: Tue Jul 15, 2008 11:28 pm Post Subject:
What I am really surprised is that Progressive hasn't contacted you so you can settle this matter without them having to spend a million or two to beat down the honest business man.
Posted: Wed Jul 16, 2008 12:15 am Post Subject:
I guess your last few posts show how one person's statement can be ignored and the opposite told to someone else (which shows that hearing only one side of the story is no way to make an informed judgement).
That was exactly my point that EVEN Mike explained and explained and pleaded with this old man, but he didn't hear that...he heard what he wanted to hear then will undoubtedly repeat it...wrong...it happens all the time....what right do they have to even alledge fraud.
Tis my understanding that Progressive is ascerting that the body shop commited fraud in overcharging for operations, and not completing some operations that they did charge for...that my friend is fraud...I dont' know the guy or the shop, but I do know that Progressive initiated this suit, and you can bet your bippy that they wouldn't have spent this much money if they didn't have the facts to back that puppy up...we'll see what the jury says...that's all we can do.....and all invoiced parts were installed as per the shop's estimate,
Kind of like those computer programs your buddies sell on your 'trade sites' Mike? You know the ones that will actually perfectly duplicate a vendors invoice or tow bill, only the shop owner can put the prices in...I'm sure you know what I'm talking about, if not I'm sure I have the site around here somewhere...Did I ever tell you about the time, that a shop tried that number on me? I knew darn good and well that my parts prices couldn't be off THAT far...so I called the vendor yep the one who's letter head was at the top of the invoice, and had him fax me the 'real' invoice...guess who got a suit filed against them by their own vendor!but I fail to see how Progressive is using this suit to "send a message" to other shops. Progressive's message is DON'T OVER BILL OUR INSURED's
Actually google the suit, all you get is retoric about the counter suit, Progressive will not comment on the suit... :roll:It's not everyday that someone has the huevos grandes to man up against a big bully
Just what if the guy's a crook? You have to admit there are crooks in your industry...What if he is Mike? You gonna' come out guns a blazin' against him? Do you think it's right 'if' he overcharged by 10k? You don't know this guy neither do we....so lets just play a little game...'what if'? You gonna post on your favorite site what a scum bag he is? and then follow that with I'm glad Progressive took him down, we don't need people like this in our industry? Will ya' Mike will ya? Cause I want to read that post! Hell, I'll even comment on it!
beat down the honest business man.
See how do you know that? You friends with the guy? Or just all the propaganda you read? Seriously how can you make a statement like that without working for him? And knowing day to day what kind of a business man he is...????? Clarvoant?Posted: Wed Jul 16, 2008 12:39 am Post Subject:
Just what if the guy's a crook? You have to admit there are crooks in your industry...What if he is Mike? You gonna' come out guns a blazin' against him? Do you think it's right 'if' he overcharged by 10k? You don't know this guy neither do we
I will give him the same recognition I gave Mr Groebner from Allstate in Illinois that was on the take and is currently under house arrest for conspiring with 3 shop owners to be on those drp programs. Even his own industry wouldn't take him down, the federal government got him on tax evasion.
All crooks deserve their due, and all underpaying under indemnifying insurers deserve what they get as well.
That was exactly my point that EVEN Mike explained and explained and pleaded with this old man, but he didn't hear that...he heard what he wanted to hear then will undoubtedly repeat it...wrong...it happens all the time....
You are right Lori, if he had listened to me instead of the insurer that put his life in harms way, he would have never had to make the trip. He was fearful of not complying with an ignorant bullying appraiser.
Posted: Wed Jul 16, 2008 12:45 am Post Subject:
You are right Lori, if he had listened to me instead of the insurer that put his life in harms way, he would have never had to make the trip. He was fearful of not complying with an ignorant bullying appraiser.
EXACTLY..even though you told and told and explained and explained that nothing could/would happen he still didn't get it...honestly Mike I know there are some jerk adjusters out there, but I truly think this old guy misunderstood, it just makes zero sense. Especially for a lazy adjuster...Posted: Wed Jul 16, 2008 02:34 am Post Subject: Insurance adjusters
T and Lori, I think that insurance adjusters are right behind collision repair shops in this way. Let's take an expert repairer like Mike. No matter how many different ways his eperiences have lead him to choose the paint system, techs, equipment and materials that he has, with this current system, he shouldn't charge a consumer more than any shop in his market area is willing to do the job for. Isn't it similar with some ins. companies with their performance audits where your training and experience works against you? You know what I mean, some young kid who would sell out his own mother is lowering the bar. Will all claims departments be forced to become like the worst to survive?
Posted: Wed Jul 16, 2008 10:09 am Post Subject:
Let's take an expert repairer like Mike. No matter how many different ways his eperiences have lead him to choose the paint system, techs, equipment and materials that he has, with this current system, he shouldn't charge a consumer more than any shop in his market area is willing to do the job for
I agree but Dave, Mike doesn't agree with this logic...He thinks that HE should be paid more than the other shops in his area. He has said that time and time again...I think I know what you mean by this....
You know what I mean, some young kid who would sell out his own mother is lowering the bar.
And I agree (I think)...Will all claims departments be forced to become like the worst to survive?
We'll hope not Dave, just as good shops won't develope fraud as a habit...There is no doubt there are good and bad in both industrys as well as extremes in both, and of course that is where the spot light and media light shines brightest (to the extreme examples). We as a society don't enjoy reading about the terrific shops that repair vehicles free of charge for under priviledged, or the adjuster that worked all night to get someone in a house, car whatever...shame.Posted: Wed Jul 16, 2008 03:15 pm Post Subject:
agree but Dave, Mike doesn't agree with this logic...He thinks that HE should be paid more than the other shops in his area. He has said that time and time again...
I do not believe that I have made this statement or implied it. Not sure how you arrived at that conclusion. I have stated that in comparison to other related professions that all collision repairers and shop owners are adversely underpaid in comparison of similar skills.
Let's consider what insurance fraud may be.
The shop desires to charge for a service that was performed and was even allowed in the procedural pages to be a compensated procedure. But the insurer/appraiser claims his company does not recognize or pay for that procedure but relies on the same data used by the shop to calculate costs for repairs. The insurer uses the repair data information arbitrarily or picks and chooses out it desires to use the procedural pages.
The unethical shop simply does not perform the procedure or service even though the vehicle owner is owed pre loss condition by the insurer or does it for free.
The unethical shop may conspire with the appraiser to cost shift to cover a procedure so the appraiser does not break the company mandate of forbidding payment for a procedure and it showing up on an estimate or supplement, where the shop owner can later say, you have paid for this procedure or supplies before. The appraiser simply overpays a repair related item, or adds time elsewhere to cover the additional repairs. In essence, the insurer knowingly paid for something it knew would not be needed to cover something they chose not to document a record of payment for and the shop agrees as long as they got paid.
The ethical shop does not rely on the insurer paper work and documentation but prepares a repair invoice and estimate based on their professional expertise and bills the vehicle owner, possibly what Mr. Cacarro did in the case above for which the insurer is alledging fraud.
The ethical shop informs the vehicle owner of unpaid procedures or those that the insurer refuses to pay for and allows the insurer to inform the vehicle owner that they do not owe them for this procedure even though the shop recommends and states that it is necessary to complete the job or to restore to pre loss condition. The shop has no obligation to negotiate the vehicle owners contract of repairs or to tortiously interfere with the insurer. Since the vehicle owner contracts with the shop they must make the decision to pay for those repairs above their deductible and look to their insurer for reimbursement or simply not have those procedures done. Failure to pay for those repairs may put the insurer in a bad faith situation or breach of contract, possibly.
I would be willing to bet that many appraisers that post here would have to state under oath that they have negotiated and cost shifted in this matter with a shop owner. If the insurer estimate is a legal blue print for the repair and procedures were not performed they placed the shop owner in jeopardy of commiting fraud for negotiating in this matter.
Posted: Wed Jul 16, 2008 03:58 pm Post Subject:
Huh? Are you simply posting a few thoughts about what you think might have happened to cause Progressive to file suit? If so, it's really a pointless post as almost anything could have happened and it seems like you are greatly limiting your post... even including many opinions that the apprasier for the insurance company was in on the fraud.
This is not a criminal case, it's civil. So most likely the claim of fraud has to do with charges the shop submitted which they knew or should have known to be incorrect in some way.
Posted: Wed Jul 16, 2008 05:05 pm Post Subject:
Huh? Are you simply posting a few thoughts about what you think might have happened to cause Progressive to file suit?
Just asking what one considers cost shifting. Is it a fraudulent act perpetuated by whom?
This is not a criminal case, it's civil. So most likely the claim of fraud has to do with charges the shop submitted which they knew or should have known to be incorrect in some way.
At this point we do not know if the shop submitted any bill to the insurer or if the bill was submitted to their contracted customer. Where is the violation if a consumer wishes to contract with a shop that has more experience and certification that charges more than a prevailing rate determined by another party not contracted to or regulated by the insurer or Department of Insurance. Did the customer submit the balance of the underpaid to the insurer or did the shop negotiate directly with the seven letter folks. If he did bill the insurer directly, a court could presume that the shop was working for the insurer and the vehicle owner. Lot's of questions to be answered in due time that may clear some legal and contractual issues for shops across the country and perhaps serve as a basis for future enaction of state law or statutes.
What is the basis for correct charges of a private business that has no agreeement or contract with an insurer and is not regulated by the insurance industry?
Are list prices of parts, suggested list?
What if someone sells the list priced part for less? Are they in violation for changing the price?
Why are labor charges based on a non scientific, inconclusive labor rate survey that a state does not mandate by statutes?
Do you file a civil suit everytime you see Sears selling an item higher in price than the identical item at walmart?
Is there a state regulatory agency that determines the list prices a bodyshop can charge their consumers?
Does an policy of insurance state an amount that is the maximum they will pay for parts, labor and material and how is a third party or shop that contracts with a vehicle owner bound by that policy?
Why do they call them labor guides?
What if a business charges by the dollar instead of units?
What exactly is a unit?
How is it determined that the basis of units are accurate and who verifies?
What agency regulates that all bodyshops with varying overheads and cost of doing business must charge only a rate that an entity, not a part of that industry, determines?
Don't answer because you are paying the bill. You aren't paying the bill, the insurer is indemnifying the policyholder for a loss in which those funds are used to pay a contracted party for services. Or the insurer is paying a third party settlement based on a negotiation between the insurer and a shop that is not licensed to represent the damaged party in a civil settlement.
Shouldn't Applebees not be allowd to sell their hamburger for the same price as McDonalds and who is regulating them?
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