Insurance Claim

The Office of Insurance Regulation of the State of Florida released a statement about State Farm Insurance Company’s intent to leave the State of Florida. Commissioner Kevin McCarthy issued a consent order that ends the pending litigation between State Farm and the Insurance Commissioner’s office concerning State Farm’s plan to leave Florida’ property insurance market. State Farm will now continue writing business in Florida’s residential insurance market, and Citizens Property Insurance dodges a bullet that could have been fatal.

The Florida legislature established Citizens Property Insurance, the high risk pool, in 2002, in response to insurance companies that either went bankrupt, cancelled or pulled out of Florida because of repeated hurricanes. So, Citizens Property Insurance places the Florida taxpayers at risk for residential losses. Since 2002, storm after storm have struck Florida, nearly bankrupting Citizens. And Citizens is only one big storm away from ruin. So, when State Farm, the largest residential property insurer in Florida announced that they were leaving the state, the Insurance Commissioner’s office panicked.

This allowed State Farm to figuratively bend the Commissioner over the couch and have its way with him. Prior to State Farm’s announcement that they were leaving Florida, the company requested a rate increase of over 65% which was denied by the Commissioner. But rather than wave goodbye to Florida’s largest insurer, the Commissioner has granted the smaller...yet generous...rate increase of 14.8%. And, it is allowing State Farm to get rid of 125,000 policies that are arguably the highest risk policies they have on the books.

So, not only does State Farm get a rate increase on all policies, but it gets to keep its most profitable business and shove the riskier business off onto the taxpayers of the State of Florida. And for Citizens, 125,000 risky policies is better than 860,000.

You’ve got to admire that kind of moxy. State Farm, being the largest insurer in Florida, took full advantage of their market position and finally showed the State of Florida who is the boss. The regulators and the Florida legislature had little choice and no options but to give in to State Farm’s demands. The press release issued by the Commissioner’s office was a pitiful attempt to save face and spin the story to look like the Commish’s office was protecting Florida’s property owners.

Don’t you wonder if the terms of the consent order was what State Farm wanted all along?

Insurance claims are getting more and more complicated. Insurance companies are on a mission to increase their profits. That may mean that your insurance company will deny claims, delay claims and defend claims to beef up their bottom line.

The fabled management consulting firm of McKinsey and Company was retained a short time ago by three of the largest Property/Casualty companies in the world. That would be Allstate, Liberty Mutual and State Farm. McKinsey’s mission...as always...is to show companies how to earn more profits. Their final report recommended “The Three Ds”...defend claims, deny claims and delay claims.

All three companies have used this strategy aggressively to boost profits for their shareholders. Concurrently, all three have experienced higher than ever complaints of claims handling. Other companies have noticed the higher profits, and will likely follow suit.

I’m leading with that part of the story to show you that the claims experience you may look forward to...or have had...or are experiencing right now...is not a mistake, or an isolated incident.

So, what can you do when you have a claim?

First: understand that you cannot just trust the insurance company to take care of your claim for you. They are protecting THEIR money. The moment you file a claim, you become their adversary. If you allow the insurance company to handle your claim for you, you are a fool. They will cut corners and pay the absolute LOWEST amount possible to get you to sign a Full Release and close the claim. You will leave hundreds or even thousands of dollars on the table that you could have collected.

Second: just because you have a deductible on your insurance policy doesn’t mean that the deductible amount is all you’re going to have to spend. You need to realize that you might have to spend some extra money to collect the money you’re entitled to collect.

Like what?

- $50-$200 to have your attorney review ALL the documents the insurance company asks you to sign.

- $50-$200 to get an independent appraisal of your car if it’s been damaged.

- $50-$200 to get an independent restoration contractor’s estimate of your real estate property if it has been damaged. Many restoration contractors will do an estimate for free, but be prepared to pay for it.

- $50-$200 to have your attorney supervise your recorded statement with the adjuster.

- $50-$200 for an Independent Medical Examination if you are injured in an accident that was not your fault.

These are just a few of the claims expenses you should EXPECT to pay on your own behalf. Your policy states that it is YOUR RESPONSIBILITY to prove your claim.

But cheer up!! Spending a small amount of money to prove your claim will usually result in you collecting hundreds or even thousands more dollars in your claim settlement.

Worst Insurance Companies: The Top Ten Worst Insurance Companies in America

In 2008, the American Association for Justice released a 29-page report entitled “The Ten Worst Insurance Companies In America.” The report was the result of a comprehensive investigation of a blizzard of court documents, FBI records, state insurance department complaints and investigations, news stories from around the nation, and testimony and depositions from former insurance agents and adjusters. The final list includes companies that insure cars, homes, disability, health and life.

One thing that the report shows is that Allstate, State Farm and Liberty Mutual all hired famous management consultant McKinsey and Company to study how they could be more profitable. McKinsey came back with a strategy known as “The Three Ds...Deny, Delay and Defend.” All three companies have used this strategy aggressively to boost profits for their shareholders.

To read the report, go to: http://www.justice.org/docs/tenworstinsurancecompanies.pdf

The list is as follows:

10. Liberty Mutual

Not only has Liberty Mutual pulled out of Coastal states like Florida and Louisiana, but also Massachusetts, Rhode Island, Connecticut, Maryland and big parts of New York.

9. Torchmark

A variety of company subsidiaries sell burial insurance, cancer insurance, and life insurance. The company has been accused of selling minority customers higher priced products than white customers. Its sales tactics have attracted frequent lawsuits from regulators and policyholders.

8. United Health

This health insurer has a reputation for health care reimbursement rates that are so low and so delayed that doctors report patient health is at risk.

7. Farmers

Owned by Swiss insurance giant Zurich Insurance, Farmers is consistently near the bottom of homeowners and auto satisfaction surveys conducted by JD Power and Consumer Reports. As an example of their “profits over people” attitude, note that after the 1994 Northridge CA earthquake, Farmers instituted an employee program called “Bring Back a Billion.” This was an effort to save the company a billion dollars in claims settlements.

6. Wellpoint

Wellpoint is the nation’s largest health insurer, covering over 28 million people. They have been found to routinely cancel policies on pregnant women and chronically ill patients. In 2007, the California Department of Insurance assessed a $12.6 million fine against Wellpoint for “serious violations” in their claims procedures. Wellpoint was also sued by 800,000 doctors for underpaying claims.

5. Conseco

Long-term care insurance is Conseco’s forte. And that usually affects the elderly most. Conseco takes advantage of the calendar, knowing that if it waits long enough, many policyholders submitting claims will die before their claim is paid.

4. State Farm

The largest property casualty insurer in America, who has a long reputation for delaying and denying claims. State Farm has recently announced that it has pulled out of the Mississippi and Florida markets entirely. In 1999, after a giant Oklahoma tornado event, homeowners file a class action lawsuit against State Farm, alleging that the insurer widely undervalued homes. The jury ruled that State Farm had acted “recklessly” and “with malice” toward its own policyholders. And don’t get me started on how State Farm acted after Katrina.

3. AIG

The world’s largest insurer has had massive financial problems of late, with the Congress negotiating a Federal bailout of the insurer in Fall 2008. But besides that, AIG has developed a reputation over the years as a company that fights claims aggressively.

2. UNUM

This Chattanooga, TN based company is one of the nation’s leaders in disability insurance. UNUM has a long reputation for delaying and denying claims. If you want to read an infuriating book about this subject, read “Insult to Injury,” by Ray Bourhis. The author is an attorney that took on UNUM in court. UNUM is regularly the target of insurance department and media investigations for their claims handling tactics.

And...drumroll please...the AAJ choice for number one worst insurance company in America is....

1. ALLSTATE

The AAJ stated that the “good hands” of Allstate should be shown inside boxing gloves. According to the National Association of Insurance Commissioners (NAIC), complaints filed against Allstate were greater in number than most all of its major competitors. After Hurricane Katrina, the Louisiana Department of Insurance received over 1,200 complaints against Allstate, which is more than any other company. State Farm had over 700 complaints, and State Farm has the biggest share of the homeowners insurance market in Louisiana. Allstate embraces the McKinsey philosophy, “Delay, Deny and Defend.”

Allstate’s CEO Thomas Wilson summed up the strategies of all the companies when he said, “Our obligation is to earn a return for our shareholders.”

This week, State Farm Insurance Company, the largest private property insurer in the state, announced that they are pulling out of Florida after sustaining huge losses and being denied rate increases.

I am no fan of the games and scams of the insurance industry. Even though insurance makes our modern lives and way of life possible, it is fraught with problems. Insurance companies regularly mistreat their own customers. They delay, deny and minimize claims as standard operating procedure. But they also pay a lot of claims, too, and deserve to make a profit.

Into this environment come the insurance regulators of the 50 states. They try to protect the consumer. Their regulations swing from too much to too little, just like a pendulum. But, right now in Florida, the insurance regulators’ pendulum has swung to over-regulation. The regulators and state legislators have bungled the insurance marketplace in Florida, and consumers are going to get burned.

The Florida Department of Insurance has not produced evidence that the insurance market has failed, which might explain stiff price regulation in lieu of simply allowing competition in the marketplace to regulate premiums.

During the last 15-year period, Florida insurers have been unprofitable as a group. Dozens of insurers have stopped operating in the state. Simply denying rate increases does not benefit consumers. As insurers stop writing policies in Florida, reducing competition makes consumers worse off, with higher premiums and limited choices.

In response to insurance company exits since Hurricane Andrew, Florida legislators created Citizens Property Insurance Corporation (CPIC), an unprofitable state-run insurer that sells its policies below cost. This ridiculous pricing, paired with insurer exits, makes CPIC the insurer of over half of Florida's homeowners. Because CPIC is losing money, and owned by the state, these losses will eventually require taxpayers and consumers to bail out yet another insolvent corporation.

With State Farm’s departure from Florida, CPIC may end up insuring 80% of the homes in the state. CPIC is nearly insolvent right now. All it will take is one more major catastrophic hurricane to finish it off. However, it will be the Florida consumers and taxpayers that will be finished off when they are forced by the state legislature to bail out the state-run insurer.

The over-regulation of insurance companies was also recently shown in New Jersey. Just like in Florida, New Jersey lawmakers and regulators had over-regulated the car insurance marketplace to the point that insurance companies left the state in droves. New Jersey drivers found it nearly impossible to buy car insurance at any price. In 2003, the lawmakers and regulators regained their sanity and enacted reforms that brought back competitive pricing to car insurance. Rates are dropping and citizens can once again find affordable car insurance in New Jersey.

State regulators sometimes do more harm than good. Sometimes they get it right.