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Question DetailsAsked on 2/6/2017

Is it illegal to not give the contractor all the money paid out by insurance

Contractor bill for 86,000 to replace a roof and the roof did not cost that much because he added things he was going to do but did not do.

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Wow - $86,000 - assuming that doesnot have a factor of 10 error in it, must be slate on a mansion - or total roof and roof framing replacement for about 4000-8000SF house or so - or normal reroof on a MASSIVE mansion, because that is an incredible amount to pay for a reroof on a residence - normally more like $6-12,000 range for normal size house. Or are you talking a many-unit condo or apartment building maybe ?

IF he did not do all the work in the scope of work, and you are not going to demand that he do so, then the contract price needs to be renegotiated to reflect that change of scope - he certainly should not get full payment if he did not do all the work that payment reflects, even if it was agreed he would receive the insurance check.

And if there is a problem with this, and because of the issues below and the $ amount, you might well bring in an attorney on this to help negotiate with the contractor and the insurance company so they do not think you are scamming them. Especially if this is a normal house (pretty much anything short of a major mansion) and the bill was $86,000 just for a roof - it could be the contractor and the claims adjuster are in cahoots (happens far more often that it should) to run up the claim, with the adjuster getting a substantial kickback from the contractor. You do NOT want to get caught up in the middle of something like that.

And if a normal size house and not a LOT more work involved than you indicated, if you are disabled or elderly, this might be a fraud covered by elder fraud or similar laws.

On the insurance side - if all the work that needed to be done (and presumably was included in the insurance adjuster's estimate) was NOT done, then first they may not accept the job as properly done - meaning any future claim on the roof may be disallowed on the basis this repair was not done correctly - so a red flag for you there.

Also - they paid on the basis of a proper repair - if some work was left out which they included in their payment, then it is insurance fraud to keep those funds - so the claim adjustment needs to be revised to the work actually done, which then kicks back to the possibility of them saying they are not going to insure your roof against damage again - or possibly even deny the payment at all if you are not going to repair the roof as it should be and demand ALL their money back.

Generally speaking, and there are exceptions, at least in most states it is illegal to keep insurance money that covers work that was not done and paid for with the money, and is probably a violation of your insurance contract as well. That sort of thing can also lead to you having your policy cancelled for fraud, and being blacklisted by ALL insurance companies so you might not be able to buy ANY type of insurance - home, car, health, auto, etc.

Answered 3 years ago by LCD

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