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Is this Insurance Fraud?

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My father is being sued by a customer he served earlier this year. A giant tree branch fell through the customers house, and their insurance company has been paying for them to live in a hotel since then. We fixed up the house for them, about halfway through the contract after reframing and putting a new roof on. However, as their mortgage company was involved, it was taking too long for us to get paid. It took us 6 weeks to get two weeks worth of work done because of that. The customer was adamant about not sharing their mortgage company information with us preventing us from communicating directly with them to ensure prompt payment, and they also fought us on having a 3rd party arbitrator handle the mortgage company for us. So we walked off the job after finishing the work we were paid for up to that point.

Months later, we come to find out that the customer is now trying to sue my father for the $25,000 he was paid by the Insurance Company through the Mortgage Company claiming "Financial Hardship."

Is this insurance fraud? Or fraud in general? I mean, we definitely provided the work we were paid for, and I have before and after pictures and receipts to prove it, so I'm not worried. But can my father counter sue for fraud and defamation of character? If so, are there any CT General Statutes we can use to help us in court hearings?

Much appreciated.
 


adjusterjack

Senior Member
If your father has been served a summons and complaint he'd be a fool to try to handle this on his own without a lawyer. Does he have contractor's liability insurance? If yes, he should be reporting this claim to his insurance company.

I don't see him having anything to counter sue for, but he sure would have something to defend if he actually did get sued.
 
If your father has been served a summons and complaint he'd be a fool to try to handle this on his own without a lawyer. Does he have contractor's liability insurance? If yes, he should be reporting this claim to his insurance company.

I don't see him having anything to counter sue for, but he sure would have something to defend if he actually did get sued.
He just made the decision to get a lawyer to handle the case, actually. My father is no longer the business owner, but since he operated as a Sole Proprietor, he doesn't have limited liability and is being personally sued. However, I now own and operate the company. This decision was made before the summons was served.
 

adjusterjack

Senior Member
He just made the decision to get a lawyer to handle the case, actually.
Good.

My father is no longer the business owner, but since he operated as a Sole Proprietor, he doesn't have limited liability and is being personally sued. However, I now own and operate the company. This decision was made before the summons was served.
Likely irrelevant since he's being sued personally.

Months later, we come to find out that the customer is now trying to sue my father for the $25,000 he was paid by the Insurance Company through the Mortgage Company claiming "Financial Hardship."
None of that made any sense.

If you have the complaint in front of you, quote the allegations word for word.
 
If you have the complaint in front of you, quote the allegations word for word.
"On January 06, 2018 We (Plaintiff & Plaintiff's Husband) met with Defendant to discuss color of window and gutter for the house and to sign the contract. Defendant couldn't start job the until the mortgage company received all his documents from us. When all documents was received by the mortgage company Defendant received a certified check on January 23, 2018 for an amount of $12,510. Defendant still couldn't start the job until February 01, 2018 because his bank place a hold on the check because it was over $5000.00 which that is what he told us.

"Defendant at this time put his son in charge as the project manager of the job site. Roof guys started the job on February 01, 2018. Roofing guys couldn't read the blue print so they mess up but couldn't asked the project manager cause he wasn't on the job site for they to ask him about the blue prints so due to this the job got delay because the structure was done to the specs of the permit that was taken out which delay the job and then things need to be brought up to code.

"Defendant and his Son also delay the job because they wasn't using the $25, 019 to bring my home up to code Defendant left my room unfinished and walked off the job after calling me (Plaintiff's Husband) stupid on March 09, 2018. Defendant should pay us back $25,019 for are financial hardship that we suffer. David also never produce any receipts or invoices for any material or the money that we gave him."

There are no typo's in the above quotations. Aside from the removal of names, that is an exact rendition of the complaint. ...
 

justalayman

Senior Member
Is there truth to the allegation the roof was built improperly? Was it corrected (that would be at your father’s company’s expense)?

Was all the work in the contract for which your father recieved the $25,000 for completed satisfactorily?
 
Is there truth to the allegation the roof was built improperly? Was it corrected (that would be at your father’s company’s expense)?

Was all the work in the contract for which your father recieved the $25,000 for completed satisfactorily?
There is no truth to the allegation of the roof being built improperly. These people are not very good with spoken, or written communication. What happened was that the subcontractors made a mistake in reading the blue print when rebuilding the rafters for the ceiling, so I had to fix it myself. It was fixed, and then brought up to code according to the Inspectors demand. Everything was done properly. And yes, all the work for which my father was paid was done according to the contract. We were paid for 2 phases of work, and completed those 2 phases exactly as worded in the contract, with the exception of replacing a window and a gutter valuing about $750 in lieu of the fact that we needed to complete about $1000 of extra work on the roof in order for the roof to be installed properly and before the next bout of rain hit the next day.
 

justalayman

Senior Member
your Response isn’t clear. Was the contract completed? You said all work done was paid for and was done per the contract but you don’t say if the entirety of the contract was completed.

If so and it passed all required inspections, I don’t see the basis for the suit.
 
your Response isn’t clear. Was the contract completed? You said all work done was paid for and was done per the contract but you don’t say if the entirety of the contract was completed.

If so and it passed all required inspections, I don’t see the basis for the suit.
My apologies. The contract in it's entirety was not completed. The contract was written for 3 separate phases of work, each to be paid for separately. We Completed the first two phases of work, which is all we have been paid for. Phase 3 could not be completed because there was more work that needed to be done that was not accounted for, and their insurance company ignored us at every turn and never sent out an Adjuster to estimate the extra work, which needed to be finished BEFORE phase 3 could begin. This was one of several reasons we walked off the job AFTER giving them a Cease and Desist order with 10 days to comply.
 

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