Insurance claim advice needed - Fast!

OK - some of you may have read about an unfortunate hit and run incident I was involved in back in Jan. If not, that background isn't critical. What is, is that there was a substantial amount that the body shop and my adjuster agreed on (Over $20K). Work was done, car was picked up, seemed like good work was done. The issue - when I finally went throught he itemized (4 page) list of the work and parts to be replaced, repaired, refinished, there was a substantial amount that was not done. Granted, the pieces estimated to be refinished, weren't damaged - but someone paid to have it done. When I asked if this was common practice - he said it was, because their hourly rate (body work) and that of the insurance companies significantly differ. Apparently, the mechanical hourly rate is OK and as such that componenbt of the esitmate is suppose to be accurate to what was done. My car is at the dealership right now assessing what was done and not done. Will get a call later today with an answer to what they are going to do. What would you do?

Sounds like Fraud...IMHO Did they slip the insurance adjuster some money to get the extra parts covered. Hmmmm, If it was my money that had to pay for the repairs, I would not be happy knowing this.

Yeah - I definately did not get the impression this was an oversight situation. Not going to name, names, (yet) but it is a very reputable shop - owned by a very reputable dealer group.

No, this is not how the game is played. If a part is listed for repair or replacement it should have been. You should ask to see the insurance companies estimate and parts list to compare the two. Next call should be to the insurance company as I am sure that they will be interested.

If there is a cost disagreement the repair shop should have brought it up with the insurance company BEFORE fixing the car. You are getting short changed by the repair shop. That's not very ethical. Bring it up with your insurance company.

As someone who's car is also in the shop, this isn't what I'm dealing with at all. The itemization was based on initial inspections and partial pull-aparts, and as new damage has been found supplements have been written up and submitted to the insurance company for approval prior to the work being done. There was certainly no guessing about what work would be performed and then not worrying about it later. No way. I'd be very suspicious if this were going on with my car.

The more I think about this more pissed of I'm getting. How do I know they didn't do $3K worth of work and billed my insurance company $26K!!! Just got off the phone with the shop and have put the fear of gawd into them. We'll see what happens. I truly have no idea what end game I'm after - not sure I could sleep well knowing I didn't do the right thing.

This is common fraud done by body shops. There is an initial estimate. Then once the car is taken apart, supplements are done, and paid for accordingly. The plan of some body shops is to "take all the money" regardless. For example. Insurance company says your fender is hosed, and they quote $350 for the fender and $200 paint/remove/replace. thats $550 in the pot, thats YOUR money. The body shop "fixes" the fender, and that may normally cost $200, but they take all $550, very common, and is illegal unless its disclosed. In fact, many "diminished value" claims are because body shops reduced the value by not doing work properly. Another tactic, going back to the $350 fender. An honest body shop will find this fender at wholesale cost. They will add a markup, usually 15-20% to it, and that is the price you pay. if that price is $320, then you essentially make $30 on the fender, because it was cheaper. if its $400, then the insurance company will need to pay more because the shop cannot get this part for the price they are paying, its treated as a supplement as well. I just went thru a whole insurance claim and got educated on this stuff quickly. My first body shop, was dishonest. Insurance company was paying me $1500 per headlight on my '00 halogen lights! i can buy halogen lights for $700 max. Yet they were going to replace my halogens for the full $1500. Every part they wanted the full amount. Rather than take their COST and add a markup, which is the honest way, they were working backwards, starting with the settlement amount. In the end, for the insurance settlement amount, I was able to fix all parts with new porsche parts, do a complete 02+ facelift, with xenons, harnesses, fender liners, parts that werent even damaged, and had enough in the pot so I only had to kick in a few thousand. Was a way to turn a bad situation into a postive one. Sounds like your getting the screws put to you man.

This is why all the big insurance companies are either in the body shop business or have approved shops. If the shop is running a scam the insurance company will cut their Ba... off and they will regret it. There is no normal scam in their request for additional un-forseen work and many times the adjuster will go back by the shop to verify.

Personally, I think you're better off currying favor with your insurance company by alerting them to your concerns, and letting them fight the fight with your body shop. The Ins. Co. has more power than you do.

Demand a kickback..........

Also any rate difference should be disclosed up front. My insurance company would pay 46/hr, but my shop wanted like 54/hr, so thats an 8 hour difference i could expect out of pocket.

I ordered all of the parts for my car myself. Took the insurance estimate and faxed it to a place I use. Obviously I can't be sure every part was actually used, but the body shop isn't getting anything extra. Signal - on the headlamps - I went through the same thing. Twice. The $1,500 price is for new whole lamps, but the $700 price is for the upgrade kit, which is essentially the same but requires some wiring work (my body shop took it to Sunset Porsche for the wiring and billed me $100 for it). I don't get this difference between the whole headlamp vs. upgrade headlamp, other than it is a way that Porsche is making a huge profit on, because the body shop/insurance companies just go off the replacement part, not the upgrade part. Glenn - how long has the work been done? My body shop kept my old parts for quite a while. Ask to see them. Say you want to check on something. Sounds to me like you got something fishy going on.

Do I not have the body shop by the *****? I know for a fact this shop is owned by the dealership and has charged retail for every part. $1650 for a rear rim. Standard allow, stock rim I can buy on eBay for $300. To a previous post - yeah kickback in the form of a supercharger, coilovers and an aero kit. That may make it easier to sleep at night - until the cops come knockin.

100% fraud. If they are an "approved" body shop from your ins company then think of it like health insurance. You pay a co-pay (ded. in insurance speak) and the body shop has a prenegotiated rate with the insurance company REGARDLESS what they normally charge. If you happen to be a doctor then this makes perfect sense, if you aren't think if about with this example.......if my wife (she's the M.D. in my family) charges $300 per appt but has a prenegotiated rate with the insurance company of $195, then that is all she gets. NOT the $300. That is the rate for "joe" off the street cash (private) pay. For my wife to charge the insurance company for the visit of $195 and "add" other services to bring it up to her $300 rate but never provide that service to the patient and is found out, she not only is removed from that insurance panel but prosecuted for FRAUD. You need to make this right.

I know I'd be asking an awful lot of questions. I suspect the body shop will get a little resistent at some point. Regarding the hourly rate charges, my body shop is the same thing. They are 'higher' than the market area and so the insurance company started out by paying the market area. I spoke with my person at length about this and she said they just keep giving the insurance company supplemental billings on the labor rates until they agree to pay for it, and if they don't then the body shop eats the cost. I told her I would pay the difference since I chose them and the amount really wasn't all that high compared to the total bill, and she said no, that they pressure the insurance company until they finally pay, or they (the body shop) eat the cost and take the lower rate.

I can't tell if you are comparing your completed repair to the initial estimate of work to be done .... or to the final bill to your insurance company. If the former, then there are bound to be differences, and your company's adjuster should be aware of the changes, both additions and subtractions, between initial and final work order. If the latter, then you are saying that your company was actually billed for work not done. That is fraud. I once ran into exactly that with a repair shop (major dealer) that was on my insurance company's list of "preferred repair shops". When I took the completed car, along with the final bill, back to my company's adjusting office and pointed out the fraudulent billing, they eventually kicked this company out of the preferred program, let the adjuster seek other employment, and bought my now-repaired car from me at the pre-accident value.

They billed to estimate and the insurance company has already paid. They don't reconcile after the fact - which I find astounding. I'd even say it leaves a very large door wide open for any company with an idea to abuse the system.

I didn't read all the responses, but read the first post. I have worked in claims for over 8 years - PM me if you want any advice/tips,/explanations. The price should have been agreed with the shop - which means they do the work on the insurance company estimate for that price - and thats it. If stuff wasnt done that was on the estimate from the ins co and the body shop was paid for it - there is a problem.

Agree with GunKata - insurance company would have agreed that the work on the estimate needed to be done, so if it wasn't, one of two things happened. Either you got screwed, or the insurance adjuster is in on it.

Fraud, pure and simple. Tell your insurance company - work paid for by them, was not done. They will take this up immediately for you.

This is common fraud done by body shops. There is an initial estimate. Then once the car is taken apart, supplements are done, and paid for accordingly. The plan of some body shops is to "take all the money" regardless. For example. Insurance company says your fender is hosed, and they quote $350 for the fender and $200 paint/remove/replace. thats $550 in the pot, thats YOUR money. The body shop "fixes" the fender, and that may normally cost $200, but they take all $550, very common, and is illegal unless its disclosed. If this is common, then there are some huge risk takers in Body Repair shops because the penalities for fraud are draconian. In MD the fines are extremely high and if the fraud is egregious enough, jail time is possible. Keep in mind that the Insurance company can conduct an audit of any proposed additional repairs that they are being asked to pay for, and Insurance adjustors have a reasonably good idea of when additional damage is likey to be found. If the adjustor is suspicious, all he has to do is to check out the damage at the repair shop before he authorizes the repair.

20/20 or dateline just did a thing on body shops a few weeks back, thats why I say this is a common scam. They even break stuff that isn't broken (hidden damage) and get supplements for it. They had video of these body shops guys taking hammers to cars, anyone see that?

I get it. I also get that there are unscrupulous people in every industry - while this one may have a higher propensity than say medical. What I find amazing is who did it this time. I'm not going to say who has done the work, as it may open me up to litigious issues, but let me say, 99% of the rennlisters here would have had no problem taking their car where I did. I'll keep you posted as to the response I get from the shop/dealer today. I'll base my next move on their position.

Yep...I saw it....

Plan A) If you talk to the insurance co, they're going to want some of their money back. Can't see how this can help you. Possibly more repairs will be performed but doubtful. Work not done will likely be deemed unnecessary and it will just result in a refund to a company that already has enough money. Plan B) If you talk to the body shop and make it well known that you will report it to the insurance co, they will probably bend over backwards to avoid going to jail for this clear cut case of insurance fraud. These guys do not want to be named in a fraud case. This plan has better chances of satisfying you.

Incorrect - it's the insurance company that has been defrauded, not the car owner They are contracted to fix your car as specified - and will also be going after the bodyshop on your behalf. Use your insurance company to do their job - do not engage the bodyshop further.