Insurance Claim Guidance & Ethics

Policy Statement

Spartan Plumbing is committed to honest and ethical practices when dealing with insurance claims. We will provide accurate documentation of work performed and damages found, and we will never inflate, fabricate, or misrepresent claims.

Who This Applies To

All employees involved in insurance-related work, including technicians documenting damage, sales representatives preparing estimates, and office staff processing claims.

Ethical Standards — Non-Negotiable

We document what we find — we do not exaggerate damage to increase claim values

We invoice for work we actually performed — we do not add phantom line items

We do not coach customers on what to say to their insurance company

We do not recommend unnecessary work solely because insurance is paying for it

If asked by a customer to inflate a claim, we decline — politely but firmly

Procedure

When a Customer Has an Insurance Claim

Perform your normal diagnostic and assessment

Document all findings thoroughly with photos, measurements, and written descriptions

Provide an honest, accurate estimate for the required repair work

Insurance claim invoices may require additional detail — include itemized labor, materials, and specific scope of work

Submit the invoice and documentation to the office, who will coordinate with the insurance company

Documenting for Insurance

Take extensive photos: before, during, and after

Document the cause of the damage as accurately as you can determine

Note any pre-existing conditions separately from the new damage

Be factual and specific — avoid opinions or speculation about coverage

What Technicians Should NOT Do

Do not promise the customer that insurance will cover the work

Do not negotiate with the insurance adjuster — the office handles that

Do not accept payment directly from an insurance company — all payments go through the office

Do not provide multiple estimates with different amounts for the same work

Important Notes

• Insurance fraud is a crime in Ohio — it carries both criminal penalties and civil liability for the company
• This policy was identified as an ethical concern area — some practices needed to be clarified and corrected
• If you are ever pressured by a customer, contractor, or anyone else to misrepresent an insurance claim, report it to Josh immediately
• Being honest may mean some claims are denied — that is acceptable. Our integrity is worth more than any single job

Related SOPs

• Flood & Water Damage Emergency Response — documenting water damage for claims
• Payment Policy — payment handling for insurance jobs
• Service Call Process — standard documentation procedures