Are Florida Insurance Companies Really Losing Money? Are Investors Using Management Companies To Take Profits and Leave Little Surplus for Policyholder Claims?

An Order by the Office of Insurance Regulation shows one method some Florida insurers may use to “poor mouth” losses to the public and our legislators in Tallahassee while taking millions home through shell accounting techniques. Many of the smaller insurers operate as three corporations--the insurer, a managing general agent, and a holding company. It does not take a financial genius to figure out that investors and managers can siphon off profits by simply charging excessive fees through the managing general agent. The insurance part of the jointly owned enterprise then claims it cannot make any money for various reasons which we have been hearing about in the press and from some insurance lobbyists looking to raise rates and reduce benefits to policyholders.

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Down and Dirty with Neutral Evaluation of Sinkhole Claims

(Note: This Guest Blog is by Kristin Demers-Crowell, an attorney with Merlin Law Group in the Tampa, Florida, office. This is part of a series that she and fellow attorneys Donna DeVaney and Amy Boggs are writing on sinkhole issues).

Two weeks ago I wrote on the three ring circus that Florida’s statutory neutral evaluation of sinkhole claims has become. Fla. Stat. 627.7074. This follow up blog focuses on the “down and dirty” reasons why the process is unfair to policyholders.

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An Interesting Day in Tallahassee and Thoughts on the Pending Replacement Cost Coverage Legislation

The Florida legislature is a difficult place to navigate. The place is an adult maze, and it takes effort to find the right room. Possibly, the logistics are a warning to novice citizens such as me that actually try to have some small input regarding the laws we agree to abide.

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Representative Janet Long Gets a Hug From Chip Merlin

"You gotta be kidding me" is probably being repeated by many after reading the title to this post. I wrongfully wrote about Representative Janet Long without giving her an opportunity to explain her concerns and longstanding advocacy for policyholders when she worked as a Deputy Insurance Commissioner in a Florida Department of Insurance Branch office. Before the spotlight of politics and public life subjected her to criticism without an ability to fully explain the purpose of the laws she proposes, her job in the Florida Department of Insurance required her to talk with and help policyholders upset about every imaginable wrong that could possibly befall an insurance consumer. I should have been more diligent in my research of her before jumping to conclusions about the framework for her views in this very public blog.

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Policyholder Advocate Matt Gaetz Picks Up Endorsement From Jeb Bush

Matt Gaetz is running for a seat in the Florida House of Representatives. His chances of getting elected have become better since former Governor Jeb Bush provided his endorsement to Gaetz. Here is Gaetz commenting on the endorsement:

 

 

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A Confusing Oral Argument in QBE vs. Chalfonte Baffles the Florida Supreme Court Regarding First Party Bad Faith

Florida Supreme Court justices seemed as bewildered as I when policyholder's counsel explained last Thursday that he was not arguing a "bad faith" case. I will be the first to say that a "bad faith" case is really a lack of "good faith" case since the standard is whether the insurance company breached the obligation of good faith and fair dealing. While I understand what the very accomplished appellate attorney, Bruce Rogow, was trying to argue, I wish his argument had been more simple and to the point because he confused me. I am afraid he may have alienated the Court with his very esoteric argument about a good faith breach of contract issue in a first party insurance situation.

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Sinkhole Proposed Law Only Pays Policyholder 25% of Available Coverage--Lessons of How the Insurance Lobby Spins a Message

The poor policyholders whose homes cracked, popped, and dipped as a result of sinkholes induced by citrus farmers spraying their crops to prevent freezing damage should be happy it happened to them this year. Newly proposed anti-consumer sinkhole legislation would limit policyholders to 25% of their coverage limits for the most common sinkhole problems.

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Senators Mike Fasano and Rhonda Storms Come to the Rescue of Policyholders

The Florida Senate Banking and Insurance Committee has a number of very intelligent and very well meaning members. Two of them, Senator Rhonda Storms and Mike Fasano stood up yesterday to the insurance lobbyists who know little about insurance, but a lot about propaganda and politics. Full time and professional insurance lobbyists have one agenda--achieve their clients agenda. They have an army of lawyers, a ton of money, and their message is "spin" at its finest. No wonder so many public servants can get snowed by the misinformation and insurance industry proposed laws.

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Proposed New Senate Bill Filed: Policyholders Lose Prompt Replacement Cost Payments and Older Roof Insurance Coverage

If you are a policyholder, don’t expect prompt payment of replacement cost benefits and payments for damage to older roofs if Florida Senate proposed legislation passes. A proposed bill filed as a substitute that will be heard in the Florida Senate and Banking & Insurance this Wednesday was just released this afternoon. I have not had an opportunity to review it in detail, but a number of anti-consumer provisions are contained within this proposed legislation.

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The Florida Insurance Lobby Currently Controls the Rhetoric Regarding Public Adjusting in Florida

Julie Patel of the Sun-Sentinel published Battle Brewing Over Public Insurance Adjusters which was preceded by Florida Cabinet Tables Insurance Fee for Hurricane Claims: Fraud Suspected and a St. Petersburg Times article "State Delays Bond Sale for Hurricane Wilma Claims.” In each of these, the message from the insurance industry was clear:

The Florida Insurance Council, Property Casualty Insurers Association of America and the Florida Property Casualty Association issued statements Wednesday backing bills filed this week by Sen. Mike Bennett, R-Bradenton, and Rep. Janet Long, D-Seminole. They say public adjusters -- who represent homeowners in claims disputes with their insurer -- inflate claims, driving up costs for all policyholders.

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Everyone Must Participate In The Political Process

(*Chip Merlin's Note: This guest blog is by Frank Artiles, candidate for the Florida State House of Representatives)

“Determine never to be idle…It is wonderful how much may be done if we are always doing.”
      -Thomas Jefferson  

Thank you for hosting a Forum that informs and educates so many regarding insurance industry trends and concerns. I feel privileged to work in a part of the insurance industry dedicated to helping people. I am humbled that you have asked me to write about a topic that is so important and that I feel strongly about.

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Policyholders and Public Adjusting Under Attack in the Florida House of Representatives

Some public adjusters were calling me asking about the recent proposed legislation of Florida House Bill 1181. This extraordinarily anti-consumer legislation was filed by a Democrat, Janet C. Long. My impression is that this legislation is a potential nuclear bomb for policyholders and public adjusters.

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Are Insurers Stacking the Deck Against Florida Policyholders With Sinkhole Claims?

(Note: this Guest Blog is by Amy Boggs, an attorney with Merlin Law Group in the Tampa, Florida, office. This is a series that she and fellow attorneys Kristin Demers-Crowell and Donna DeVaney will be writing on sinkhole issues).

Carriers seem to be using the 2005 changes to sinkhole legislation to stack the deck against policyholders who are seeking adequate repairs for their property. There are two statutes at play that have emboldened carriers to force inadequate repairs on the policyholders.

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Adjusters Have Codes of Ethics: Florida's Are Significant and Need to Be Enforced

All adjusters, whether company, independent, or public, have significant ethical obligations in Florida. Indeed, these adjusters even have an obligation to turn each other into the Department of Financial Services. The failure to do so is, by itself, a breach of the adjuster’s ethical obligations:

(g) An adjuster shall promptly report to the Department any conduct by any licensed insurance representative of this state which violates any provision of the Insurance Code or Department rule or order.

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Sinkhole and Catastrophic Ground Cover Collapse Insurance in Florida

(Note: this Guest Blog is by Donna DeVaney, an attorney with Merlin Law Group in the Tampa, Florida, office. This is a series that she and fellow attorneys Kristin Demers-Crowell and Amy Boggs will be writing on sinkhole issues).

In 2009, the Florida legislature passed a law allowing Florida residents to opt-out of sinkhole coverage. The purpose of the law was to help insureds lower their yearly insurance premiums. The practical effect, however, has been that we now have many in this state who have insurance policies that effectively cover nothing in the event of sinkhole damage.

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Sink Appeals Public Adjuster Suit: Delay Possible For Miami-Dade County Public Adjuster Lawsuit

There are two active lawsuits with very good attorneys representing public adjusters who are challenging the 48 hour solicitation ban and the fee caps. The first one was filed in Miami-Dade County, as I reported in Florida Public Adjusters File Lawsuit to Overturn 48 Hour Solicitation Ban and Fee Caps. The second lawsuit challenging only the solicitation ban was filed in Leon County, as I reported in Second Public Adjuster Constitutional Solicitation Ban Challenge Filed. The later filed lawsuit seems to be moving along quicker; the first lawsuit has been delayed by a fight about venue.

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A Man of His Word: Unlike Other Flip Flop Politicians on Insurance Rates, Crist Sticks to His Promise

The Florida legislator is full of "flip flop" legislators that are reversing laws made in 2005 and 2006 which supported lower insurance rates and protected insurance consumers from unscrupulous insurers. Governor Charlie Crist ran on a platform of helping Floridians keep insurance rates down and he is sticking to that promise even as other politicians who once voted for such laws are now firmly supporting the opposite measures. These "flip flop" politicians are filing laws that would allow rates to go as high as the insurance industry can make them and laws that take benefits away from consumers following disaster. Crist seems to be standing tall against the insurance industry and for the people, unlike other politicians who are currently getting their responses and "speaking points" from insurance lobbyists.

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Consumer Advocates Call "Insurance Choice" Legislation Misleading

Three consumer advocates published a letter, Property Insurance Deregulation Too Costly, which claims that currently proposed Florida legislation calling for no regulation of insurance rates is bad for Floridians "because the average consumer does not have the resources or information to determine when a rate is excessive, the opportunity for the [insurance] company to abuse consumers exists." I agree, and for many more reasons than just that.

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Failure to Give Timely Notice: The Role of Prejudice in Florida

(Note: This Guest Blog is by Corey Harris, an attorney with Merlin Law Group in the Tampa, Florida, office. This is the sixth part in a series he is writing on post-loss duties).

In Florida, as in other states, failure to give an insurer timely notice of a loss can provide an insurer with a potential basis for denying a valid claim. Ideal Mut. Ins. Co. v. Waldrep, 400 So.2d 782, 785 (Fla. 3d DCA 1981). This can be a harsh result for policyholders, but, as I mentioned last week, some jurisdictions such as Florida hold that the late notice must prejudice the insurer as well.

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Mediation May Not be the Answer to a Best Alternative Insurance Claim Resolution Process Because it is Subject to Abuse

I appreciate all the comments to posts from readers with various perspectives on insurance coverage and the insurance claims industry. I read them all, try to respond when I can, and honestly consider the viewpoint of those writing. This morning, I came across a comment worthy of consideration by all of us regarding mediation and alternative approaches to insurance claims dispute resolution.

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Sean Shaw is a Refreshing and Intelligent Advocate for Floridians--We Deserve This Type of Representation

Why do so many of our politicians play to the lobbyists and support laws that harm the average person and voter? This is exactly what has happened with important laws sponsored by the insurance industry lobbyists and then proposed by Florida Senator Mike Bennett of Bradenton and Representative Bill Proctor of St. Augustine. These politicians and other Florida political leaders have sponsored a law that would allow insurance companies to raise the rates of Florida policyholders as much as they want. Indeed, the law they support allows for insurance companies to collude with each other, since it calls for the complete deregulation of rates. As the insurance industry is exempt from anti-trust regulation, based on a bargain it made with the federal government in which it agreed to state regulation of rates, the insurers would be legally exempt from all regulation. Is this stupid or what? Do the Florida political leaders supporting this law think people will be happy when their rates go up 100% in a couple of years, or is this just a payback to the insurance industry and their lobbyists funding certain political action committee dollars? Or, giving them the benefit of the doubt, do they really understand the issue?

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Policyholders Who Do Not Obtain Professional Claim Assistance Following a Loss May Be Foolish

The Florida Association of Public Insurance Adjusters’ (FAPIA) winter conference starts today. On its website is a link to a summary judgment motion filed in a lawsuit I noted in Second Public Adjuster Constitutional Solicitation Ban Challenge Filed. In the summary judgment was an amazing statistic that, if true, would certainly indicate that policyholders need professional help when dealing with their insurance claims:

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Appraiser Disinterest and Impartiality California Style

Barry Zalma writes some interesting and worthwhile property insurance coverage articles. While most of his work centers on insurance fraud, his recent article, "When is An Appraiser Disinterested?" has implications for consideration in Florida as well.

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Impressions Following the Alternative Dispute Resolution Roundtable

There are times when I am troubled about what I write on this blog. This is one of them. I know that many people are going to read this who have very different viewpoints. When a number of people tell you in advance that they look forward to what you are going to write, there is some tendency to write for the readers rather than having the courage to just place what is in your heart on paper. There is no way I can write about all my thoughts, but I will share points.

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Public Adjuster Lawsuit Challenging State's Cap on Fees and Solicitation Ban Survives Venue Change

In a widely read previous post, Florida Public Adjusters File Lawsuit to Overturn 48 Hour Solicitation Ban and Fee Caps, I noted how a lawsuit in Miami-Dade County challenged the fee cap and solicitation ban on public adjusters. The State challenged venue, and in a recent order, the trial court denied the change of venue.

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A Method for Keeping the Appraisal Clause in Property Insurance Policies Which Will Satisfy All Concerns

The appraisal clause should not be removed from Florida insurance policies. The concerns of insurers and policyholders can be addressed if we simply do two things:

1.  Mandate that the appraisal clause remain in all property insurance policies.

2.  Pass legislation which provides the safeguards for a fair procedure while allowing the parties to make the process as formal as they need to insure due process and still reflect the desire to avoid the time and expense of litigation.

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Florida Roundtable Appraisal Agenda Set

This Wednesday will be the Roundtable discussion regarding appraisal. It will be significant and I urge anybody with an opinion or interest to write to Sean Shaw, the Insurance Consumer Advocate. You can also watch the roundtable at WFSU Florida Channel and call into the conference at 1-888-808-6959 Code: 4132880.

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Florida Court Rules in Favor of Homeowner on Burden of Proof in Sinkhole Claim

Warfel v. Universal Ins. Co. of North America
No. 2D08-3134, 2009 WL 4640882
(Fla. 2d DCA, December 9, 2009)

The issue in this case was whether the amended sections of Florida Statute sections 627.7065, 627.7072, and 627.7073 (2005), which affected database information, testing standards, and reporting requirements for sinkhole claims, created a presumption that shifted the burden of proof to the homeowner to disprove an insurer’s expert’s opinion that damage was not caused by a sinkhole or whether it created a presumption that vanished once a homeowner produced evidence that a sinkhole damaged his or her property.

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Sean Shaw Has Full 2010 Legislative Agenda--Including Public Adjuster Issues

Miami Herald reporter, Bea Garcia, wrote a very important story, Tackling Contentious Insurance Issues, concerning Insurance Consumer Advocate Sean Shaw. It appears the Roundtable meeting I wrote about in Alternative Resolution Roundtable: Appraisal is the Hot Topic and Is There Any Chance that Appraisal Will Stay the Same in Florida?, is going to be an important last meeting before Shaw takes stances on how Florida legislators should deal with current insurance consumer issues:

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State Farm's Regulatory Resolutions and Concessions

In a post last September, State Farm Agents are Fighting State Farm for Economic Survival, I wrote:

"Again, for many different reasons, I hope McCarty and State Farm can work out a deal."

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Is There Any Chance that Appraisal Will Stay the Same in Florida?

Over the past several weeks I have had a number of public and private discussions with attorneys and public adjusters about the appraisal process. My post last week, Alternative Resolution Roundtable: Appraisal is the Hot Topic, had a comment from Mike Rump that I thought was worth sharing as this debate rages on:

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How Should Matching Parts of a Damaged Building Be Valued? Florida Valuation Issues, Part 9

(Note: This Guest Blog is by Michelle Claverol, an attorney with Merlin Law Group in the Coral Gables, Florida, office. This is the ninth in a series she is writing on valued policy laws).

Sometimes, if not most of the time, a covered peril will only cause partial damage to a structure. For example, let’s pretend an insured inadvertently drops an object on his tile floor and the object cracks a single tile. For the sake of argument, let’s assume that the policyholder has continuous tile throughout the house, and that due to the age and style of construction, a matching tile is no longer available on the market.

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Citizens Property Insurance Corporation is Shielded by Sovereign Immunity from Bad Faith Claims

In a blow to policyholders, Florida’s Fifth District Court of Appeals found that Citizens is not subject to bad faith lawsuits. The Court concluded:

In summary, we hold that Citizens is immune from first-party bad faith claims pursuant to section 627.351(6)(r)1. Likewise, we hold that Citizens is not subject to bad faith liability under section 624.155(1)(b)(1), as that statute is not applicable to it.

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State Farm Florida Withdraws its Plan to Leave the State and Agrees to Non-Renew no More than 125,000 Residential Property Policies

The Florida Office of Insurance Regulation (OIR) has entered a Consent Order today resolving the attempt by State Farm to leave the Florida property insurance market.

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Do Florida Legislators Think We Are Stupid?

Floridians currently have legislators that are in the pockets of and doing business for insurance companies. Virtually all states regulate insurance rates because insurance companies have been historically notorious for over charging customers following losses, as well as for under charging customers before declaring bankruptcy.

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While State Farm May Stay in Florida, Appraisals May Go

Julie Patel, of the Sun Sentinel, reported that Florida officials and State Farm appear to be working towards a mutual solution to keep State Farm selling property insurance in Florida:

Insurance Commissioner Kevin McCarty told the Florida Cabinet Tuesday that State Farm may not leave the state's property insurance market as planned and the state is developing a report card on insurers to help consumers and increase competition.

“We’d like them to be a good neighbor so long as they are a fair neighbor," Gov. Charlie Crist said about McCarty's prediction that State Farm will stay in Florida in a smaller form.

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A Recent Florida Court Decision on Subrogation

On Target, Inc. v. Allstate Floridian Ins. Co., as Subrogee of Anthony and Nancy Podorski
No. 2D08-4887, ___ So. 3d ___
(Fla. 3rd DCA October 30, 2009)

Nancy and Anthony Podorski hired On Target, Inc., a leak detection service, to locate a leak under the floor of their home. The On Target technician who responded presented Mr. Podorski with a two-page form titled “Customer Information Card and authorization to proceed with the work.” The Customer Information Card authorized On Target to find the leak, provided general information about the nature and extent of the services provided by On Target, and the indemnification provision at issue in this case:

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Florida Rates Are Rising--Not So Fast!

Last week, I made a statement in my post, Are Wind Mititgation Credits Killing Profits of Florida Insurers, that everybody is predicting insurance rates are going up . Then, the St. Petersburg Times ran a story, Citizens Property Rates Headed Up, or Maybe Down, Depending on Where You Live.

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Are Wind Mitigation Credits Killing Profits of Florida Insurers?

It is hard to imagine any Florida property insurers not making a killing in 2009. With no hurricanes or significant tropical storms, the most financially devastating peril was eliminated. Yet, over 100 Florida residential property insurers reported losses.

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Senator Fasano Defends His View Regarding Opting Out of Sinkhole Coverages

I wonder how our clients, the Leeds, would feel if they had purchased only catastrophic sinkhole coverage or no sinkhole coverage, rather than the normal sinkhole coverage required when they purchased their "all-risk" insurance policy. Their home slowly but surely cracked, drooped, and sank over several years before it was condemned. If they "saved" money on their premium as Florida Senator Mike Fasano successfully pushed for in legislation, they would have lost the entire investment on their home. They would also still owe money on the mortgage, possibly causing bankruptcy.

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"At War With The Weather" is a Must Read for Those Involved in the Debate of the Florida Property Insurance Market

My appointment by Florida's Governor Charlie Crist to the Citizens Mission Review Task Force afforded me the opportunity to learn about and have a small voice in the Florida insurance marketplace. At War With the Weather: Managing Large-Scale Risks in a New Era of Catastrophes is a significant academic work which our regulators and legislators must read and understand to fully appreciate the complexity of the property insurance issues in Florida and elsewhere. I wish it had been published while I was serving on that Committee. The historic lessons and current conclusions contained in this book are important to everybody living and working along Coastal areas.

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Associated Industries and Private Insurers Want Florida Policyholders to Pay as Much as Possible for Property Insurance

Florida Senator Mike Fasano, a public servant ever vigilant about consumers of regulated industries getting ripped by the amounts they have to pay for mandated services and products, forwarded a recent news article, “Group Backs Florida Property Insurance Rate Hike.” When the Florida legislators and Governor were concerned about the severe escalation of property insurance premiums following the 2004 and 2005 storm seasons, they froze the rates charged by Citizens Property Insurance Corporation. Governor Charlie Crist ran for elected office on a platform of preventing the severe escalation of such prices. At that time, many of Florida’s legislators ran their political campaigns suggesting they were no friend of the insurance industry that was raising rates in an extraordinary manner. While Governor Crist proved he is a man of his word by vetoing legislation which would have allowed major insurers to charge whatever they want, only a few elected legislators seem to remember the promises they made to their electorate. Associated Industries supports those politicians that are more concerned about insurers profits than the promises to their constituents—except when elections are around the corner.

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Florida's Third District Rules When a Bad faith Claim Can be Filed Following Appraisal

(Note: This Guest Blog is by Ruck DeMinico, Knowledge Manager with Merlin Law Group).  

In State Farm Florida Ins. Co. v. Seville Place Condominium Ass'n, Inc., No. 3D08-2538, ___ So. 3d ___ (Fla. 3rd DCA, October 14, 2009) Florida’s Third District Court of Appeal held that an insured could amend their complaint to add a bad faith claim after coverage was admitted by the insurer and an appraisal award had been entered, but before final judgment. 

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Second Public Adjuster Constitutional Solicitation Ban Challenge Filed

A lawsuit was filed in Leon County Circuit Court yesterday challenging the 48 hour solicitation ban on public adjusters. Last month, we posted Florida Public Adjusters File Lawsuit to Overturn 48 Hour Solicitation Ban and Fee Caps, reporting on the first of these two similar lawsuits. The second lawsuit is different in that it focuses solely on the 48 Hour Ban on solicitation, where the first challenges the fee caps enacted by the Florida legislature.

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Florida Insurance News Reports on State Farms Slow March to Leaving

Yesterday, Chad Hemenway, associate editor of BestWeek, reported that State Farm and Florida’s Office of Insurance Regulation jointly moved to delay the administrative hearing that will address State Farm’s move to leave Florida’s property insurance market.  The saga continues....

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Matt Gaetz is a Policyholder's Advocate Running for Public Office

Imagine if we had truly knowledgeable advocates for insurance consumers in our legislatures. Many politicians advertise they are for policyholders as election day approaches, but they refuse to push any agenda other than the insurance industry’s the rest of the time. In Florida’s past legislative session, Florida Senator Don Gaetz, sponsored three significant pieces of insurance consumer legislation protecting the rights of policyholders regarding the fair treatment of claims. The person helping to write that legislation, his son Matt Gaetz, is now running for the Florida House of Representatives and he deserves support from those who want strong laws protecting Floridians from slow, frustrating, and wrongful insurance claim handling.

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Sinkhole Case Trial Won For USAA Policyholder

Kelly and Craig Kubiak successfully presented a case to a jury this week involving a dispute with a long time USAA policyholder following a denial of her property insurance claim. The $245,000 jury verdict came after lengthy and contentious litigation with USAA. The opposing counsel and his law firm are one of the most successful in Florida. The most USAA ever offered in settlement to our client was fifty thousand dollars, so our client was thrilled and in tears following the jury’s verdict.

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Cooperation Clause Does Not Require the Policyholder's Slavish Obedience

It is curious how some insurance company claims managers allow their insurance defense counsel to treat their customers with an arrogant, demeaning tone, along with long requests for largely irrelevant lists of information following a loss. Any objection to the treatment is usually met with a threat the claim will be turned down for a failure to cooperate. The “threat” letter is usually in a similar tone requiring the policyholder to obey…or else. For insurance adjusters that do not act this way or allow their insurance defense counsel to do so, this treatment may shock you. Yet, many policyholder representatives see this as a growing trend in claims treatment following a loss.

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Florida Insurers Have A Strong Financial Incentive To Delay, Rather Than Deny, Claims

(Note: This Guest Blog is by Ruck DeMinico, Knowledge Manager with Merlin Law Group). 

The recent case of North Pointe Insurance Company v. Tomas, No. 3D08-2245, 2009 Fla. App. LEXIS 12505 (Fla. 3d DCA August 26, 2009), illustrates why many insurers who wrongfully fail to pay a claim choose to unnecessarily delay payment rather than out right deny them.

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Federated's Claims Handling Problems

(Note: This Guest Blog is by Kelly Kubiak, an attorney with Merlin Law Group in the Tampa, Florida, Office).

Some insurance companies feel that although they may not have investigated a Florida loss promptly during the time period Florida suffered successive hurricanes, the companies have an excuse due to the vast amount of claims.

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McCarty Claims State Farm Trying to Work Out Deal and Expects Property Insurance Rates to Go Up

I would pay to be a fly on the wall during the discussions the Florida Office of Insurance Regulation is having with State Farm regarding its withdrawal from the Florida property insurance market. As I noted in State Farm Must Love the Clash, many of us suspect that State Farm’s bullying and threatening tactics demonstrate that it does not want to leave Florida, but uses such tactics to get what it wants from Florida’s politicians and regulators.

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Florida Public Adjusters File Lawsuit to Overturn 48 Hour Solicitation Ban and Fee Caps

A lawsuit was filed by three public adjusting firms seeking to enjoin the State of Florida from enforcing the 48 hour solicitation ban and the fee caps public adjusters may charge to policyholders. The mastermind behind the lawsuit is lawyer turned public adjuster, Pat Catania of East Coast Public Adjusters. The lawsuit is not a surprise. Many public adjusters have been complaining that their business has been significantly impacted by these laws as insurance restoration companies act as surrogate public adjusters since the 48 Hour Ban does not prohibit insurance contractors from actively soliciting work from policyholders immediately after a loss.

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Tropical Storm Erika? - Rocco Calaci Gives His Plain-Talk Interpretation of the National Hurricane Center Bulletin

(*Chip Merlin's Note--Rocco Calaci has been a noted meteorology expert witness in the Katrina Legal Wars. After meeting him at a recent FAPIA Convention, I invited him to write a series of guest blogs. Click here to read his previous guest blogs)

(*Note from Rocco Calaci: I started issuing a "plain talk" interpretation of National Hurricane Center bulletins at the beginning of the 2008 hurricane season. I remind everyone that this is strictly a courtesy, I have no affiliation with any government agency, this is not a commercial service and the information is not for any type of decision. It is strictly FYI). 

***

There is an area of disturbed weather moving across the Atlantic and approaching the Lesser Antilles. This area may become Tropical Storm Erika in the next day or so.

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Prejudgment Interest Award Following Appraisal

Why do insurance companies get to play the float in some jurisdictions? After all, most regulations and good faith duties require prompt payment. Without penalties or awards of prejudgment interest, rules of promptness become meaningless because there is no accountability for claim delay.

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The Florida Insurance Industry Flexes Its Muscle

Where are our insurance consumer advocates? Are they publicly wanting to appear one way to get their constituents’ votes, but then voting another way behind closed doors? This is my concern, because otherwise the last bill placed before Governor Crist would never have appeared. My powerful, worthy, much richer, and able State Farm lobbyist, Mark Delegal and other similarly powerful interested insurance industry lawyers show how the insurance industry has already set out its agenda on the insurance consumers of Florida in a recent article:

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A Small Insurance Case May Cost Many Florida Public Adjusters Millions in Class Action Lawsuits

I once told an Allstate Insurance Company adjuster that if forced, I was going to sue over a very small matter, less than a thousand dollars, because it simply was not right that Allstate was taking “betterment” deductions on the adjustment of an automobile comprehensive coverage loss to a friend of mine. This small county court case eventually resulted in a significant class action settlement in Florida in excess of $20 million dollars. I have no idea why some insurance companies do not try to settle earlier and would rather wait until the information uncovered results in a bad situation getting worse. Unfortunately, unless the litigation fortunes of one public adjusting company changes dramatically on appeal, a seven thousand dollar fee dispute could cost many public adjusters millions in class action lawsuits.

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A Chronology of Public Adjuster Regulations Regarding What Florida Public Adjusters Can Charge

As this is being posted, I am providing an ethics seminar to Florida public adjusters along with Merlin attorneys Bob Reynolds and Michelle Claverol. This follows my earlier posts on the topic, Public Adjusters Sued in Class Action for Wrongful Conduct--Are Unauthorized Practice of Law Class Action Suits Next? and Public Adjusters Targeted by Lawyers for Overcharging Policyholders.

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Is Florida's Chief Insurance Regulator, Kevin McCarty, at Odds with Florida's Chief Financial Officer and Possible Next Governor?

Dan Luby of the Florida Insurance News forwarded a Blog, Alex Sink's Cold War with the Insurance Commissioner, by Gary Fine regarding a possible “riff” between Alex Sink and Kevin McCarty. I find this curious because the two of them are leading consumer advocates for policyholders. I have never found Bill McCollum, Sink’s opponent for Florida Governor next year to be a supporter of policyholders. He is clearly the insurance industry’s candidate. Yet, the Blog noted:

“Interestingly enough, Attorney General Bill McCollum - and Sink's likely rival for the governor's office in 2010 - praised McCarty's report, saying that Floridians should be "very pleased" with the amount of surplus lines coverage since it has helped decrease the need to have commercial coverage picked up by state-created insurers.”

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Protective Safeguard and State Farm Discounts Disappearing: The Fleeting Loyalty of Insurers to Customers

Two significant pieces of information show a continued trend in the property insurance business and suggests that insurance customers should not rely on the loyalty of their insurance companies. An article by Bea Garcia in the Miami Herald, Florida May Gut Discounts for Hurricane Shutters highlights the industry wide issues raised by State Farm’s requests to eliminate discounts and “recalibrate” the terms of previously granted discounts for measures taken to protect structures from hurricane damage.

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Catastrophic Sinkhole Coverage and the Problems of the New 2009 Florida Legislation

"Cheaper" insurance rates often mean far less coverage. In this world, you often get what you pay for. If there is ever a lesson to be learned about that, just ask those that live in the "Sinkhole Capital of the World," Pasco County, Florida. They can elect to get "Catastrophic Sinkhole Coverage" as ordinary coverage or get "Sinkhole Coverage" which is every bit as catastrophic where it counts--the ability to get back to where you started from--but covers damage from a slow moving sinkhole. The latter optional coverage is very expensive and covers Floridians from loss caused by most of the sinkholes that occur. The other coverage, which is much less costly, covers only very quick and substantial collapse sinkholes which happen once in a gazillion years to the properties owned by anybody. Guess which form the insurance industry wants to insure? BINGO!

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Merlin Law Group Hosting Public Adjuster Ethics Seminar Followed by a Political Fundraiser for a Public Adjuster Running for Public Office

Imagine if our legislatures had truly knowledgeable insurance consumer advocates. Do you think the insurance industry would have tried to pass laws in Texas and Florida that allowed insurance rates to unfairly rise or allow immunity for wrongful conduct after a loss occurs like TWIA is attempting in Texas?

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State Farm Criticized by News Leaders Regarding New Rate Increases

State Farm is a tenacious opponent. "If you at first you don't succeed, try, try again" is a motto which must be emblazoned in bold letters somewhere in its Bloomington, Illinois, headquarters. But, down in the Sunshine State, some are criticizing State Farm for its creative methods of raising rates.

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State Farm Bullies Texas and Florida with Power and Propaganda

I was going to write on the fascinating topic of errors and omissions aspects of 100 percent coinsurance penalties, but the response to yesterday’s Post, Should the Rust Family Stay in State Farm's Power and Ownership Given the Recent Record of Policyholder and Corporate Citizen Ethics, requires some follow up.

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Should the Rust Family Stay in State Farm's Power and Ownership Given the Recent Record of Policyholder and Corporate Citizen Ethics

State Farm lost its most significant claims case while Ed Rust Jr. was the "owner/manager" of State Farm. Ed Rust Jr. was the person who ultimately decided that thousands of State Farm policyholders would be underpaid or denied benefits in Mississippi. He is the chief corporate leader of State Farm Mutual, the corporation that allows its wholly owned subsidiary, State Farm Florida, to essentially lie about its financial situation. Everybody—especially Rust--knows that State Farm Florida is paying millions that would otherwise be profits to State Farm Mutual. I suspect a number of highly qualified agents and claims adjusters wonder why there has been no change in the top management for two generations. After all, in the United States, we believe in earning leadership rather than being born into it.

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Two Recent Florida Cases on Prejudgment Interest

In the last week, two Florida cases have been released which discuss prejudgment interest.

In Sunshine State Insurance Co. v. Davide, 34 Fla. L. Weekly D1422a (Fla. 3d DCA 2009), Florida’s Third District Court of Appeal held that when an insurer erroneously withholds a portion of a payment due, the insured is entitled to prejudgment interest on the amount not timely paid from the date the payment became due under the policy, not from the date the property was damaged. As I will explain at the end of the case summary, this case applies only to pre-2007 claims. On July 11, 2007, consumer friendly legislation took effect which would have provided Davide with a statutory right to interest from the date Sunshine received notice of the claim.

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A Common Law Remedy For Lack Of Good Faith And Fair Dealing Is Before The Florida Supreme Court

Yesterday, we filed an amicus curiae brief on behalf of United Policyholders in the Florida Supreme Court. This type of legal argument is often called a “Friend of the Court” brief because it is not filed by a party to the lawsuit, but it is filed by a person or entity with an interest in the outcome of the case. In theory, amicus briefs provide courts with information needed to reach the right decision. Usually, amicus briefs address the public policy or state or nation wide effects of a legal decision, while the parties to the case focus solely on how the outcome will affect them.

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Citizens May Eliminate Appraisal

Suppose you were not such a good person and tried to pay less than you owed on several debts. There was a process to resolve those debts, and you repeatedly lost and eventually had to pay the debts. What would you do? Well, if you are Citizens Property Insurance Corporation and its Board of Governors, you change the rules, looking for a different resolution process to avoid paying the debt and the publicity of underpaying claims.

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An Insurance Risk Manager Gives Fantastic Advice to Policyholders Getting Ready for a Potential Hurricane Claim

At the Greater Delray Beach Chamber of Commerce Hurricane Seminar this morning, Brent Winans of the Plastridge Agency gave a fantastic presentation, "10 Ways to Get Ready for a Hurricane Claim in 10 Minutes." Winans holds the coveted CPCU designation and is Vice President of Risk Management Services.

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Crist Makes the Correct "Consumer Choice"

Governor Charlie Crist just vetoed HB 1171, which was euphemistically titled the "Consumer Choice Bill."

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State Farm Tells Governor Crist It Will Not Leave Florida If Bailout Bill Is Signed

I do not know why the State Farm Florida President would write a letter to Governor Crist telling him State Farm will remain in Florida if Crist signs the bailout bill. Of course it would. What a competitive advantage a few large insurers would have over the rest of the domestic competition.

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Insurance Industry Does Not Agree on State Farm Bailout Law

The Insurance Journal ran an article, Florida Domestic Insurers Urge Veto of 'Dangerous' Deregulation Bill, which indicates a significant portion of Florida's insurance industry opposes State Farm, State Farm agents, and the other big insurers trying to get a competitive advantage from this legislation. The article outlined many of the competing views and stated in part:

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The Big Insurance Industry Propagandists Support the State Farm Bailout Bill

I received an email from a right wing group that has ties to the insurance industry. It is a call to lobby Governor Crist to support State Farm's bailout legislation. Every consumer group I know of has called the bailout another giveaway to the insurance industry at our expense. But the insurance propagandists are still pushing their illogical arguments.

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Crist Signs Surplus Lines Bill

Governor Crist has signed the flawed Surplus Lines Bill (HB 853) into law. The story was reported today by the Insurance Journal in an article, Gov. Crist Signs Florida Surplus Lines Regulation Bill:

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Common Law Good Faith Duty Before Florida Supreme Court

The issue whether Florida will join the majority of states recognizing an insurer's duty of good faith at common law is squarely before the Florida Supreme Court. In Citizens Property Ins. Co. vs. Louis Bertot, the Third District Court of Appeal noted the issue before it:

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Proposed Law Drops Sinkhole Coverage

One way to get cheaper rates is to buy an insurance policy that covers nothing. An article shows this is how the Florida legislature is tackling the insurance rate problem:

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Texas TWIA Bill Passes with Consumer Protections and Crist has Surplus Lines Bill

The Texas Windstorm Insurance Association (TWIA) has a new operations plan and laws that affect it, assuming Governor Perry signs the legislation. The good news for TWIA policyholders is that the consumer protections of Chapter 541 are still in place. The bad news is that I predict rates are going to increase substantially.

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Brad Ashwell States the Case to Veto the State Farm Bailout Bill

The Consumer Advocate for the Florida Public Interest Research Group,  Brad Ashwell, wrote a letter published in the Gainesville Sun calling on consumers to urge Governor Crist to veto the State Farm bailout legislation. He clearly explained how the bill will harm Floridians:

"The problem is that this bill would remove consumer protections by no longer allowing the OIR to protect Floridians from excessive or discriminatory rate hikes as Kevin McCarty and his office have successfully done time and time again.

If HB 1171 becomes law, major insurance carriers would not only be able to charge whatever they like, they would also be able to game the system by manipulating rates, quoting excessive premiums to coastal homeowners, then dropping those policies if they choose to so they can maintain and grow inland policies where there is less exposure. The lack of predictability this would create is exactly what we don’t need in a state with an already fragile and overstrained property insurance market.

And perhaps the most troublesome provision is that the bill would help further grow the surpluses of these larger insurers while preventing small Florida-based carriers from doing the same. In this way the bill aims to provide an unfair competitive advantage to larger companies by discouraging across the board competition with smaller carriers. This would ultimately harm consumers and businesses by fostering an insurance market offering fewer choices in terms of dependable insurers. It’s also important to recognize that there’s no guarantee these large companies will continue writing policies in Florida.

Rather than deregulating the market, which hasn’t worked out in the past, we should be working on policy goals that support a more competitive insurance market that provides consumers with more affordable options. In short, we need more Florida-based companies competing, not fewer large insurers who dominate the market, essentially holding homeowners hostage, charging any rate they choose."

He is right, and nobody disputes his facts. Proponents of the bill argue it gives consumers the “choice” to pay excessive rates if they want. The legislators who voted for the bill did so because of political pressure, without understanding the consequences, or because they like the incentives offered by insurance companies for their votes. Either way, the “choice” is just a way to justify this bad legislation.

The Politics of Insurance: Dinallo Resigns, Crist Hints of Veto and Texas TWIA Bill in Limbo

What happened to the time when a significant insurance coverage decision arrived and everybody in my line of work analyzed that topic for several years? Now, the insurance industry is writing so many new and differently worded forms, it is hard to rely upon case decisions as being of widespread significance. If a case decision is made which insurance companies want to avoid, they re-write the policy or the insurance industry lobbies legislators to change the statutory law "gaming" the insurance business to outcomes predetermined in the insurer's favor. Accordingly, I spend more time researching trends of politics. I also review insurance trade journals to contemplate how my policyholder clients may be impacted.

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A Couple of Interesting Insurable Interest Cases From Florida and Texas

Following up on Sunday's post, The Insurance Checklist--Insurable Interest and Address of the Risk, and while waiting for the politicians to decide how much our rates may go up in the following year, as indicated in yesterday's post, A Big Week for Texas and Florida Politics of Insurance, here are some cases that explain insurable interest.

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A Big Week for Texas and Florida Politics of Insurance

The Texas legislature has its hands full this week with an omnibus biill regarding TWIA. Florida Governor Charlie Crist has to decide whether to veto various measures regarding insurance legislation. Additionally, three federal bills were just filed which may impact the landscape of how insurance is made available and sold.

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Fasano and Crist Support Insurance Commissioner McCarty from Attack by Senator Mike Bennett

The politics of insurance is tough for consumer champions. The insurance lobby has many faces and methods of forcing its position. In Florida, the dirty campaign against those governmental officials who stand up to State Farm and the big insurance industry has begun in earnest. Florida has one of the most respected insurance commissioners in the country, Kevin McCarty. Mike Bennett, a relatively unknown state Senator, is attacking McCarty simply because McCarty voiced the opinion that Bennett’s insurance “choice” bill would hurt Floridians.

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QBE Insurance Company Bad Faith Case Moves Forward

Amy Boggs has an interesting case against QBE Insurance Company which has recently moved from the contract portion of the case to the claims practice a/k/a Bad Faith case. The condominium client we represent is The Dorsett House Condominium Association which was damaged from Hurricane Wilma. QBE Insurance Company insured many condominiums in Florida and has been the subject of much criticism. It recently lost a trial where the verdict on the contract damages was over $20 million.

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Matching of Property Damage is Statutory in Florida

Suppose some shingles on a roof are damaged, but not all. Does a policyholder get a hideous looking checkerboard roof which affects the value of the structure and possibly the neighborhood? If part of a carpet is damaged, is it patched leaving a new part slightly different looking in the middle of a room? Many of these issues never arise because many insurance companies pay to match, trying to maintain a happy customer. Some pay for only the damaged amount, and end up fighting with their customers.

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Florida and Texas Courts Have a Slightly Different View of Insurance Causation Burdens of Proof: Part I

Since last May, just before we opened our Houston office, I have been reviewing and pondering causation and burdens of proof found in Texas insurance cases. While writing yesterday's post regarding sinkhole coverage cases, I came across two Florida cases that demonstrate Florida’s view that policyholders truly have minimal proof requirements coverage under all-risk property insurance policies. Texas insurance case law does not follow this majority view. I will explain how they are different in two posts. Today will focus on Florida law. Tomorrow, I will provide Texas case examples and some practical suggestions so Texas policyholders do not get surprised at trial. I figure the insurance company adjusters and attorneys do not need any more help, so they get no suggestions.

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A Balanced Perspective Regarding the Politics of Insurance Legislation

I am an advocate for insurance policyholders. I am accountable to them. Our firm accomplishes the results they expect through a "can do" outlook, innovation and the timeless All-American mother of most success-- hard work.

I was imagining what it would be like to make a living as an insurance industry lobbyist. Lobbyists are usually lawyers or staffers that go by a title such as a "governmental affairs assistant." Some are the directors of various insurance trade organizations. Insurance companies measure their lobbyists’ accountability in a different way.

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Four Major Consumer Groups Call for Governor Crist to Veto Florida's Anti-Consumer Legislation

Imagine if the only way politicians could raise campaign money was from the people who could vote for them. Until that happens, the insurance industry, which is among the strongest lobbying powers, will continue to influence otherwise well meaning public servants into making laws serving only insurers. Thank goodness there are a few independent consumer-centered public service groups with expertise to take on the sophisticated and well funded insurance lobbyists and their lawyers.

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Florida Consumer Action Network Urges Veto of Unregulated Rate Hikes

The Florida Consumer Action Network (FCAN) has urged Florida Governor Charlie Crist to veto recently passed legislation that would allow insurers to raise rates without approval by the Office of Insurance Regulation. FCAN is probably Florida’s largest consumer action group. The Bradenton Herald quoted foes of the legislation who refer to the bill as "the State Farm bailout bill." I agree.

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Florida Insurance Legislation is Over for 2009--Maybe

Numerous newspaper articles have discussed this session’s bills which impact the insurance industry. The anti-consumer bill, which provides for deregulation of insurance rates, passed. I expect Governor Crist will veto that bill as was previously reported.

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Kevin McCarty Battles for Consumers and Against Higher Rates

Florida Insurance Commissioner Kevin McCarty is working tirelessly for fair treatment of insurance consumers. It is amusing that the Florida legislature may give into State Farm's bullying and even allow higher insurance rates, which McCarty says are unnecessary. Some of our legislators are pandering to State Farm and the Florida insurance industry by using the usual "word spin" games. Deregulating rates under the guise of "consumer choice" will simply lead to higher premiums.

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Surplus Lines Bill Moving Through the Florida Legislature

I wrote about surplus lines insurance companies in an earlier post, Surplus Lines Insurers, Sinkholes, and the Law of Mars. I explained how an attorney in our firm, Donna DeVaney, was able to get a favorable ruling in a sinkhole case involving a surplus lines policy due to a recent Florida Supreme Court case, Essex Ins. Co. v. Zota, 985 So. 2d 1036 (Fla. 2008).

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Does It Stay or Does It Go? State Farm's Assault on Florida

Most of the time, I battle large corporate insurers in David vs. Goliath like battles. I find it amusing that State Farm's attorneys are struggling in this fight, given State Farm’s enormous size and power. Today, State Farm's lawyers, lead by the very able Mark Delegal, are lobbying Florida's leaders on a very anti-consumer bill. This bill would allow State Farm to charge whatever rate it wants. Florida Governor Charlie Crist is reportedly prepared to veto such legislation.

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Surplus Lines Insurers, Sinkholes, and the Law of Mars

Surplus lines insurance companies are a different breed of insurance cat. They are not admitted carriers in the state in which they do business. Thus, most states have consumer protection laws specifically regarding how surplus lines insurance carriers can do business.

Surplus lines carriers are very important to the insurance marketplace. They will often insure the risks many admitted carriers find too risky or novel. For example, when a property owner buys surplus flood insurance or a complex Difference in Conditions policy, it is often sold through the surplus lines market.

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State Farm's, Allstate's and Nationwide's Concerted Agenda To Stop Competition And Insure Profits

Free enterprise is great until your competitors beat you. Dominant competitors may find it advantageous to combine interests to prevent new players from entering markets, destroying profit margins, and taking market share. It is amazing that there has not been more investigation and calls for transparency into the major personal lines insurance companies’ discussions and agreements which may reveal such a conspiracy. While anti-trust exemptions exist for insurance companies regarding sharing of loss data for rate making and other rate or form issues, there are no anti-trust exemptions for agreements that otherwise restrain trade and competition through collusion.

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State Farm's Power Play And Propaganda Ploy

State Farm is hard to figure out. They say one thing and often do another. When you finally get to the decision makers, there is usually some logic to why they do things despite disagreement from consumers or regulators. State Farm's announcement that it was leaving the Florida property market really has me wondering--"what's up?" From what I read and hear, I am not the only one.

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Responding to the Media About The Insurance Financial Crisis

The Tampa Tribune ran an editorial on January 12th regarding the Citizens Mission Review Task Force. As usual, I had something to say about their opinion, and wrote the the following reply, which was published in Sunday's paper:

Florida Dangerously Vulnerable

This is in response to the Jan. 12 editorial, "New Ideas Could Bring Sound Hurricane Coverage."

You raise some important points regarding the safety net of property insurance, and the Citizens Mission Review Task Force meetings also revealed issues that all Floridians must be made aware of.

First, dried up credit markets have left our current system dangerously vulnerable. In the event of a major hurricane season, it is unlikely that Florida would be able to raise the money needed to cover the debts of Citizens through bond sales.

Second, as you noted, Citizens rates are currently lower than being actuarial sound. Yet everybody wants rates to remain affordable. The task force recommended responsible, capped increases to prevent wallet shock.

Third, encouraging a private insurance market to replace those carriers that find Florida too risky is a viable long-term solution. The Legislature passed laws aiding and regulating these companies that often provide coverage at rates lower than Citizens, especially for policyholders who take advantage of the My Safe Florida Home program.

Finally, the best long-term solution is to harden structures. Yes, it is costly but offering premium discounts to homeowners who make improvements has to be encouraged, even if it takes a state and federal tax relief program too beneficial to pass up. That is something our federal and state leaders can start working on now.

We cannot afford to put our heads in the sand and hope Mother Nature will spare us for another season. We must act now for the long-term because there is no easy short-term solution to the very difficult situation we all face.

WILLIAM F. "CHIP" MERLIN

Tampa

The writer is founder of the Merlin Law Group and was appointed to the Citizens Property Insurance Mission Review Task Force by Gov. Charlie Crist in 2008.

The final meeting of the Task Force is scheduled in Jacksonville on Thursday, January 22nd. Our Report is due to the Florida Legislature by January 31.
 

Florida Cat Fund Credit Rating Drops

I recently wrote about the Florida Catastrophe Fund, and stories concerning its probable inability to pay claims if a major hurricane were to hit in the present credit market.   Rating agencies are catching on to the problem.  In a story buried at the bottom of the business section of the Tampa Tribune, AM Best warns that Florida's Catastrophe Fund would "run into difficulty" if a major hurricane hit.  The word "difficulty" could be "impossibility" if an Andrew-type storm struck metropolitan Dade or Tampa Bay.  The good news is that there are no threatening storms on the horizon, and we are getting later into the hurricane season so that a major storm is unlikely. Further good news is that the likelihood of a major hurricane striking those populated areas of Florida is remote.  However bad things always seem to happen at the worst time.  Thus, unless this credit crunch magically goes away, the probability of a bad storm striking the wrong place next year goes up because "stuff" happens at the wrong time.  Let's hope, for many reasons, that the credit market improves before next year's hurricane season.

Citizens Task Force Agenda

The agenda for the first Citizens Mission Review Task Force meeting this Friday is as follows:  Tampa Airport Marriott, Tampa International Airport, Tampa, FL Friday, October 10, 2008 Meeting: 10:00 am - 4:00 pm Conference Call Dial-in: 1-866-855-4989 Opening Remarks Scott Wallace - CEO, President & Executive Director - Citizens Representative Alan Hays Election of Chair and Vice Chair Susanne Murphy - Executive Vice President of Corporate Operations - Citizens 1. Sunshine Law Overview  Perry Cone - Senior Vice‐President and General Counsel - Citizens 2. Citizens Overview Susanne Murphy - ExecutiveVice President of Corporate Operations ‐ Citizens 3. Reinsurance in the Florida Market Private Reinsurance Kevin Campion, Benfield Florida Hurricane Catastrophe Fund Jack Nicholson, Senior FHCF Officer 4. Citizens Financial Overview Sharon Binnun, Chief Financial Officer - Citizens 5. Citizens' Rates Brian Donovan - Director of Actuarial Services - Citizens 6. Public Testimony 7. Future Meetings Adjourn The agenda does not say too much. That may be because there is no Chairperson yet to provide leadership. I don't understand why Citizens is running the agenda; my understanding is the Task Force is supposed to make recommendations regarding the role of Citizens in the future.  For some background information, here is a link to the bill creating this entity. There will be some obvious issues. These include:  1. Should Citizens be an insurer of "last resort?" Meaning that if a policyholder cannot get insurance in the private market, then Citizens is there as purely a backup.  2. Should Citizens charge rates that are not actuarially sound? The rates have not been so because of the public outcry following the 2004 Hurricane season.  3. Can Citizens help develop insurance markets by selling new insurance companies books of business?  These are public meetings, and they will be interesting to say the least. Florida is not the only state with the problem of having an insurer of "last resort," or something similar to Citizens because the private insurance market will not insure all risks. Stay tuned.

If The Big One Hits, Who Gets Stuck Holding The Bag?

[caption id="attachment_87" align="alignleft" width="68" caption="William Chip Merlin"]William Chip Merlin[/caption] Alex Sink may have been very wise to have paid Warren Buffet so much money for an option to have ready access to money if a major hurricane hit Florida.  (She paid Berkshire Hathaway $224 million for the option of borrowing $4 billion this hurricane season).  A recent St. Petersburg Times article highlighted the problems facing Florida should a major hurricane hit.  The bottom line is that the State could float bonds backed and paid for by every Floridian to cover the shortage of money to pay claims, but there are no of buyers to purchase them. I do not see this topic on the Agenda of the Citizens Mission Task Force for this Friday. I am certain it is a major concern for all and will come up. I am happy we are another week into October. Historically, the most severe hurricanes are over by now, as the waters start to cool and wind shear from the north becomes stronger. Let's hope a late hurricane such as Wilma or Opal does not visit us this year. I truly do not know if we can afford it.

And The Beat Goes On

[caption id="attachment_87" align="alignleft" width="68" caption="William Chip Merlin"]William Chip Merlin[/caption] Just when the lights are turned back on, roads cleared and the messes cleaned up from Tropical Storm Fay and Hurricane Gustav, here come the next two platinum hits on the 2008 Storm Charts. Tropical Storm Hanna cannot seem to figure herself out.  She will likely move along the Carolinas and up the Atlantic Coastline. Hurricane Ike is very, very troubling.  Already a category 4 hurricane, Ike is aiming for South Florida--the worst possible place to come ashore.  A category 4 hurricane that hits Dade or Broward county will cause unprecedented property loss.  Moreover, it would be a financial catastrophe to the state of Florida, as the legislature agreed to underwrite the hurricane insurance policies. I pray Ike goes elsewhere, and it is a long way from land. However, the initial models look bad.  Insurers and policyholders should prepare and plan for the logistical needs in the aftermath of what could be one of natures worst storms.

An Epic Storm

[caption id="attachment_87" align="alignleft" width="68" caption="William Chip Merlin"]William Chip Merlin[/caption] Can anybody remember another tropical storm path like Fay's?  The WeatherUnderground is an excellent site for the current status and history or Fay.  I have a deposition in the Port of New Orleans vs. FM Global case on Tuesday in New Orleans.  I am trying to figure out how to get there.
From an insurance standpoint, we are fielding calls from policyholders regarding various issues.  The hurricane deductible does not apply because Fay is not a hurricane.  A $250 deductible versus a 5% deductible of a $200,000 policy limit can make a big difference. Pools seem to be popping all over the east coast of Florida.  "Pool popping" cases can be difficult to collect upon because many residential policies specifically exclude losses caused by water exerting hydrostatic pressure on swimming pools.  Many people drain their pools to keep water from overflowing into the house.  Unfortunately, the reduction in weight and the severe pressures of water soaked into the ground literally causes pools to pop-up, destroying the pool. Rain water accumulating on the ground becomes surface, or groundwater, that is also often excluded as a loss.  Yesterday, a claims manager from a major insurer was in our offices and he predicted that many claims would be denied based on these exclusions.  I agree.  The contention will be what airborne water came into the home through the roof, walls, and windows versus surface water seeping into the structures under doors. Insurance controversies will never cease.  Following Katrina, we predicted the major fight was going to be wind damage versus excluded flood damage.  With Fay, I am pretty certain we can predict what many controversies will be before the adjusters start their work.

A Fantastic Regulatory Settlement

Allstate Insurance Company fought the law in Florida -- and the law won. After Allstate and its lawyers thumbed their noses at the Florida Office of Insurance Regulation's requests for documents and information earlier this year, Florida insurance regulators prohibited Allstate from offering new policies in Florida.  For anybody who watched the proceedings or saw the hearing on videotape, it was a disgusting display of corporate arrogance.  Allstate delayed and simply refused to provide answers to regulators, even though it was legally obligated to do so.  The Office of Insurance Regulation sanctioned Allstate, and the First District Court of Appeal has backed that decision.  It was the just and proper legal result. See Allstate Floridian Ins. Co. v. Office of Ins. Regulation, 981 So. 2d 617 (Fla. 1st DCA 2008). On Friday, Allstate acknowledged its wrongful conduct and agreed to a $5 million fine.  See Russell Ray, Allstate Settles Dispute, Tampa Tribune, August 16, 2008, at A1, available at http://www2.tbo.com/content/2008/aug/16/160012/na-allstate-settles-dispute/.  It also agreed to reduce rates and sell 100,000 new residential and condominium policies.  Congratulations to Insurance Commissioner Kevin McCarty; he oversaw a masterful job. The resolution still allows Florida to investigate Allstate's relationships with trade associations, reinsurers and rating organizations. This is extremely important because only the most naïve would believe that the major insurers in this state are not engaged in unconscionable conduct through these other entities. While the settlement is a great ending to a chapter of this investigation, the drama is far from over.

Tampa Tribune Calls For Explanation Regarding State Farm

The Tampa Tribune ran an editorial in today's paper regarding the forty-seven percent average rate increase request made by State Farm. Many editorials are not very helpful. This one is on point and I hope that our government leaders are paying attention. Here is the editorial in its entirety:
Big Insurer's Bid To Up Rates Scary Blow After Two Calm Years The Tampa Tribune Published: July 25, 2008 On its face, State Farm's request to increase rates for hurricane coverage by an average of 47 percent statewide is outrageous and unjustified. If so, it should be rejected. But if the company has based its application on a state-approved formula and solid numbers that don't export profits to its parent company, the implications are ominous after two storm-free years. If State Farm Florida really needs sharply higher rates to stay in business here, that means the state-sponsored Citizens Property may be even more underfunded than has been acknowledged. It could also be a warning that many of the smaller new insurers offering lower rates are gambling on good weather and might not survive a major storm. In Hillsborough, State Farm customers already pay rates about 20 percent higher than those insured by Citizens, according to the state's comparisons at shopandcomparerates.com. Yet State Farm in recent years reports having $1.20 in costs for every dollar it collected in premiums. The storms of 2004 washed away the company's surplus. Those numbers should be troubling to every policyholder. They suggest today's average rates of $2,000 statewide still aren't high enough. If rates really do need to increase about 50 percent to cover the actual risks, that means typical homeowners can expect to pay an extra $70 to $100 each month for property insurance. That's scary. Many lawmakers were quick to call State Farm's request unjustified. All Floridians should hope that a hearing Aug. 12 confirms that general suspicion. Congressman Robert Wexler is calling for a congressional investigation. The Democrat from Boca Raton says State Farm's rate increase is "not consistent with the realities of the conditions in Florida." We concur. But if State Farm's numbers do hold up, they will blow a hole in the Legislature's insurance reforms. Other insurers will be quick to ask for more. And even with higher rates, all ratepayers will remain at risk of paying even more if the statewide cost of storm repairs exceeds the cash available in the Florida Hurricane Catastrophe Fund. We know the state is paying $224 million for the right to borrow up to $4 billion from Berkshire Hathaway in case a major storm hits this year. But that's not half of it. The Legislature, in an attempt to keep rates low, has exposed the state to up to $28 billion in liability. Numbers that big should make all taxpayers nervous. What would make Florida breathe easier would be the return of a healthy private insurance market. An indicator that things are returning to normal will be an attempt by the big insurers to expand their market share. Just the opposite is happening. Winning a 47 percent rate increase is a sure way to lose customers. One bright spot among the many clouds is that the new, smaller companies have learned from others' mistakes. They are spreading their risks and not concentrating in a few counties, especially coastal ones. Every property owner and renter should hope the small companies are right and State Farm is wrong. If not, there are stormy financial times ahead, hurricanes or not.

Snookered Again

[caption id="attachment_87" align="alignleft" width="68" caption="William Chip Merlin"]William Chip Merlin[/caption] When will our legislature learn not to trust insurance executives and, especially, their lobbyists?  Maybe when we vote insurance-beholden legislators out of office. The Tampa Tribune, St. Petersburg Times and Miami Herald ran front page stories regarding State Farm's administrative request for an average rate increase of 47%.  At first I thought it was a mistake, until all three papers reported the same increase and the St. Petersburg Times indicated that some increases for existing rates could be 91%. Something is terribly wrong.  State Farm has increased rates for the past several years.  Supposedly, those rates were somewhat fair to State Farm and their policyholders.  Florida suffered zero hurricane losses the last two years.  State Farm, unless it is altering its books, has to be lake every other carrier in Florida over the past two years--raking in the cash.  They have collected very high premiums based upon catastrophes that never materialized. Possibly, State Farm was a lot smarter than Allstate, and simply waited a year to break the promise it made to the legislature.  Allstate got the great legislation it wanted, promised a discount, and then requested a forty percent rate increase, which lead to a full blown investigation of its practices.  Maybe the State Farm executives were a little smarter and simply waited a year. State Farm is one of the largest lobbying organizations in Florida and the United States.  The management wields a lot of power because it uses customer's premiums to influence regulators and legislators for laws that benefit State Farm, ofter to the detriment of its own customers.  It is all legal, and it makes good business sense for the executives of State Farm to influence social laws to its best economic interest. The question is how long we are going to alow this corporation to control the people we elect and have appointed?  Eventually, there must come a recognition that people, not corporations, are the reason laws are made and government exists.  When elected officials are asked if a policy or law helps the people and are commited to that function, these crazy situations will occur much less frequently.  Only arrogant corporations could expect to do what State Farm did this year and Allstate  did the reay before.  Are the people of Florida simply pawns in the schemes these insurance companies concoct to enough themselvelves.

Public Adjusters, Part Two

William \ Some of the interesting changes in the public adjuster trade are the increased requirements to obtain and maintain a license.  This past legislative year, the Florida Association of Public Insurance Adjusters (FAPIA) lobbied for and obtained an apprentice period as well as specific continuing education requirements for public insurance adjusters.  Some may be surprised that FAPIA pushed for this legislation, but there was an obvious need for it. In 2004, there were several hundred licensed public adjusters in Florida before Hurricane Charley set off a wave of storms, culminating with Hurricane Wilma in 2005.  The number of licensed public adjusters swelled to over three thousand in Florida.  While there was and is a need for policyholders to have experienced professionals assist them to establish the proper value of any significant claim, many of the new public adjusters had little experience, understanding, or training.  All one had to do to obtain a license was pass an open-book online test. I have met preachers, car salesmen, fitness trainers, and salespeople who became licensed public adjusters after the first storm of 2004.  The public suffers when inexperienced and inadequately trained people represent themselves as "professionals licensed by the state" to help consumers.  I do not begrudge anybody the opportunity to make a living in this field, but good adjusters have a tremendous amount of training gained over years of practice.  A thorough understanding of policy language, rules, laws, industry practices, construction estimating, building code knowledge, theories of coverage, financial issues, and adjustment techniques are learned through years of practice and diligent study.  Adjusting claims is serious business with serious consequences if not done right.  Could you imagine letting doctors practice brain surgery the day after they graduate from medical school?  This is essentially what Florida allowed; with some consumers unknowingly hiring "first time" adjusters. Accordingly, except for a minority of public adjusters that did not want any fee caps, the Florida public adjuster legislation was supported by FAPIA, NAPIA, the insurance industry, and the Citizens Property Insurance Claims Task Force.  (Of special note, the Citizens Task Force, which was formed to suggest legislation regarding Citizens' handling of claims, did not make one such suggestion, but was instead used by the insurance industry to make laws regarding other aspects of insurance.) My suggestion for those seeking to hire public adjusters is to look for the following:
  1. Reputation
  2. Membership in FAPIA and NAPIA
  3. Experience with the policyholder's type of claim
  4. Sufficient manpower
  5. Price
I include price because you usually get what you pay for.  Public adjusters typically charge ten percent (10%).  Many will charge less, but they may not work the claim as diligently and make up the lost value of one claim by settling in volume.  Ask for references.  The lowest priced adjuster is often not the best.  The highest may not be the best either.  Look for experience, reputation, and past results so you have a good sense of trust with the person you select as your representative.

Insurance Surcharge No Big Deal

William \ The Tampa Tribune and St. Petersburg Times ran front page articles regarding a surcharge being made to all policyholders in Florida.  The cost for a typical policyholder with a $1,000 to $1,500 premium is $30 to $40. This morning I spent nearly $90 to fill my car's gas tank.  Not that long ago, it cost about $60.  So, to put that insurance surcharge in perspective, many of us pay the same additional amount as the annual surcharge every week or so when we fill our gas tanks. The story did not deserve front page coverage.  What does deserve to be on the front page is an article informing people what the assessment would be if a Hurricane Katrina struck Miami, Ft. Lauderdale or Tampa.  The assessment would be hundreds, even thousands, of dollars tacked on to every auto, boat and homeowner's policy.

100,000 Policies Move Out of Citizens

William \ Kevin McCatry, of the Office of Insurance Regulation, announced that six fairly obscure insurance companies have taken the insurance for 100,000 risks which were previously underwritten by Citizens Property Insurance Corporation.  The good news for consumers is that their new insurance carriers are insuring them for the same or better coverage and for the same or better price.  What a deal!!  Or is it? As much as I have criticized large and mature property insurers such as Allstate, Nationwide, and State Farm, I always knew that they had professional claims management and could pay any claim.  Our experiences with smaller carriers vary.  Generally, claims management of small carriers is less professional, and their capabilities are extraordinarily stretched following a catastrophe.  Further, companies with little surplus (net worth in insurance terms) often come up with creative claims policies and decisions which invariably involve paying less than what is owed or extending the time for payment with excuse after excuse. For example, Southern Family and Atlantic Preferred were two companies that were part of the Poe Insurance Group that became insolvent following Hurricane Wilma in 2005.  The Poe companies were never strong financially.  The four 2004 storms caused a rash of bizarre interpretations of policy language, all favoring non-payment.  It got worse after Hurricane Wilma, and speculation was rampant that the claims personnel were given the customary "do not pay if you do not have to" orders from management. How valuable is insurance that is not going to pay promptly and in full?  How valuable is a deal for better coverage if the insurer is going to not have sufficient assets to treat the policyholder in good faith, with an eye towards payment rather than safeguarding the company treasury? Surplus is important to insurance companies and their customers because it shows the company's ability to pay unanticipated losses.  It is a value after you take away all the anticipated claims.  Insurance companies with big surplus have the financial means to do things right.  Those without big surplus often cheat to stay in business or are cheating on the level of service they provide to customers because they simply cannot afford to do things right. Hopefully, these smaller companies will find top notch methods of insurance operations.  But insurance is unlike any other business because the delivery of the insurance company's product often does not occur until years after the first policy is written.  Talk is often loose and cheap until the claim arrives; only then will anybody know how good of a deal these takeout companies really offered to Citizens' customers.

First Day of Hurricane Season and the First Named Storm is History

William \  Tropical Storm Arthur starts off the 2008 hurricane season with some early inning excitement.  In my line of work, I am always asked during the summer months how many hurricanes there will be and where they will hit.  The newspapers are full of stories from meteorologic prognosticators regarding these events.  I simply reply it is a guess:  the odds are a major hurricane will form in the Gulf of Mexico and there may be an Atlantic Coast hurricane as well.  The truth is nobody knows. But the fact that nobody knows does not mean that you should not be vigilant, especially along the Gulf Coast areas in June and July.  Arthur is a classic early season storm because generally, hurricanes will form only in the Gulf of Mexico early in the season.  Why?  The warm water temperature needed to form major storm systems is most favorable only in the Gulf of Mexico.  The entire Atlantic Caribbean area warms as the summer progresses. The Associated Press ran a story correctly noting that hurricane forecasts should not be the basis for bets.  It quoted Craig Fugate, the Director of Emergency Management in Florida, as stating that these early forecasts "are not useful at all."  Indeed, I believe that most people, having two years of dire forecasts which never materialized, will inevitably become complacent.  This is human nature. Instead, as indicated by the Insurance Information Institute, now is the time to make final preparations for the hurricane season.  The Institute lists five tips:
  1. Buy Enough Insurance;
  2. Buy the Right Insurance;
  3. Create a Home Inventory;
  4. Prepare an Evacuation Plan;
  5. Hurricane-Proof Your Structures.
Numbers one and two are easy enough.  Call your insurance agent and make certain you have high enough policy limits to rebuild your structure--brand new--to new codes.  Obtain Flood Coverage if you live even remotely close to a body of water--even if you are not in a flood zone.  For businesses, buy Business Income and, especially, Extra Expense Coverage.  Many businesses need off-premise power coverage. Nobody does number three.  I have yet to have a residential client who has made an inventory before a hurricane.  Businesses and governmental clients are not much better.  Indeed, some businesses have coverage for non-listed assets.  A before-loss videotape of structures and everything contained in them can be a big help for a number of adjustment reasons. Businesses cannot spend enough time going over a risk management operation plan in the event of a catastrophe.  Safekeeping of records, property and information is one aspect.  Making contingency plans to get back in business as soon as possible is crucial to the survivability of many businesses. Hurricane-proofing residential and business structures is the best thing that can be done.  Repair and maintain the exterior envelope of the building.  Trim trees and remove objects that can crash into structures.  Think about purchasing an alternative energy source if you have a business or can afford one for your home. As I have said before, if you do all of the above five steps, chances are nothing will happen to you.

New Insurance Companies Founded in Florida

William "Chip" Merlin Capitalism and economic venture are alive and well in the Florida insurance market.  The Florida Underwriter reported this month that over 1.7 million policies have been written by new insurance companies since the 2004 hurricane season.  As Allstate, State Farm and Nationwide retreat from the Florida property insurance market, these new insurance companies are accepting risks that would otherwise end up with Citizens Property Insurance Corporation. My initial reaction has been that this is a good development.  We need an infusion of new companies to take the place of the older established insurers that seem determined to leave the insurance business in an effort to safeguard all the surplus they previously made. The new economic premise of Enterprise Risk Management has led old lines carriers to get out of the alleged "risky" Florida insurance business to preserve the profits they made and enter other financial arenas--such as banking, life insurance, and pure investment.  It is refreshing to see new private insurers take the place of old line carriers in the property insurance market. This has not occurred without some governmental help and a fortuitous influx of money into the re-insurance markets.  The Florida Legislature passed legislation which allowed up to $25 million in matching funds to loan any insurer who was willing to write business in Florida.  At the same time, the re-insurance market has greater capacity to write business and the market has "softened" to afford lower rates to these newer carriers.  The bottom line is an influx of new carriers entering Florida and writing insurance policies where the old line carriers dare not go.  Florida is still far from being economically insulated should a major storm hit the state.  It is a Hurricane Katrina away from financial catastrophe.  Still, it is encouraging to see these new companies enter the market.  Hopefully, they will enjoy a number of profitable years to build their surplus ("surplus" is the net worth of an insurer) before faced with any widespread catastrophic losses.

Another Hurricane Season

June 1st starts another hurricane season.  USA Today quoted the Climate Prediction Center as saying, "there's no reason to think that break [from hurricanes over the past two years] will continue."  In short, they think the probabilities are good (or bad, if you think about it) that a few times this year somebody, somewhere, is going to get whacked along the coastal areas. There are several things people and businesses should do now to prepare and then to remember as the season progresses.  First, buy the proper insurance in case something really bad happens.  Many people think I am anti-insurance because I spend so much time filing lawsuits against insurance companies.  Not true.  If I were not litigating against wrongful claims practices for a living, I'd be selling the product. You need insurance.  If you are fortunate enough to be wealthy, you need it even more.  You need to spend time with your agent, go over the value of your possessions and the contingencies of what would happen to your life and business in the event of disaster, and insure for it. For instance, the National Flood Program has raised its limits.  We know from Hurricanes Katrina, Rita, and Dennis that "flood" (I almost feel like footnoting that word given all the litigation about the meaning of it) waters can extend seven to fifteen miles inland along some coastal areas.  Get coverage for the right amount now if there is even a remote chance of a flood.  The more valuable your property, the more you need the coverage and peace of mind.  Given the nature of chance, once you buy the coverage, the disaster will never happen to you. Second, ask your agent about "endorsement" coverages.  These coverages fill in the limitations and exclusions which most modern all-risk policies contain.  For example, many of our clients purchase "deductible buy down" coverage in order to lower the deductible because most policies now have large percentage deductibles if a hurricane strikes.  Agents should bring these to your attention.  It is our experience that most do not. Third, complete the structural "hardening" process you were planning.  A new roof, weather stripping, new windows, glass coatings, and such should be completed now.  The severity of most hurricane and windstorm losses can be significantly reduced by these improvements. Fourth, have a plan and stick to it.  Do not get stuck in a structure on top of a dining room table or crawling into the attic as waters are rising.  We had a client in the Pensacola area area film the surge waters, and it was quite disturbing to hear him sob as the water continued to rise several feet in his home. Finally, do not become complacent in a season where there are multiple warnings and no storm appears.  For example, Miami-Dade County refused to close as Hurricane Irene was heading north to strike Naples.  This was about the fifth "close call" of the season.  I was furious that morning because I had a hearing in downtown Miami and the judge did not cancell the hearing despite the fact it appeared that the hurricane was going further east and into the Everglades--right next to Miami.  I was driving in the outer bands of the hurricane an hour before the hearing, when the judge's secretary called in a panic and cancelled the hearing because the authorities closed all government buildings. The call was too little and far too late.  People rushing home from work were caught in a mess.  A powerline blew over at a flooded intersection not far from where I was.  Several people were electrocuted.  It all could have been avoided, but the "cry wolf" syndrome made the authorities complacent. Will a major hurricane hit this year?  I think so, but who really knows?  Do what you can and prepare.  There is peace of mind by doing so, and chances are nothing bad will happen anyway.  But just in case. . . .

Allstate Agents Victims?!!

Allstate Insurance Company has reportedly canceled or non-renewed more than 500,000 Florida property insurance policies over the last five years.  The decision to cut those policies was made by Allstate management.  Where were the insurance industry spin and propaganda people--often referred to as "spokespersons" of various insurance industry trade associations--to say that the victims of that decision were Allstate agents? The decision to raise the remaining Allstate policy rates an average of over 40%, after promising much lower rates to Florida government officials, was made by Allstate management.  Where were those insurance industry spokespeople to explain why Allstate management could lie to the Florida government?  The decision not to provide witnesses under oath to the Department of Insurance Regulation regarding honest compliance and to not provide the relevant documents required to answer questions was made by Allstate management and its lawyers.  Where were the spokespersons regarding that illegal conduct? Instead, the propagandists were actually successful in diverting attention away from Allstate's improper and illegal behavior by suggesting that Allstate agents were the victims of the order suspending Allstate's ability to write policies in Florida.  The insurance industry leaders and spokespeople never mentioned how wrongful Allstate's conduct was or that Allstate could have avoided the suspension entirely by simply being an honest and good corporate citizen.  They certainly did not want to mention that those "victims" voluntarily agree to work for a company that has slashed their income by ordering policies canceled. It is no wonder that the current Chair of the Florida Insurance Council is George Grawe.  Grawe is an in-house Allstate lawyer.

The Good Hands Gets the Iron Fist

It's about time.  For a decade, Allstate has refused to comply with discovery and court rules regarding its internal documents which demonstrate who, how and why Allstate redesigned everything in its claims program to simply pay less on claims. The Florida First District Court of Appeal issued an opinion which condemns many of the tactics Allstate and its attorneys have long used to thumb its nose at judges.  Anybody with the right to view the internal information explaining why Allstate has been changing its culture since it was spun off from Sears in the early 1990's has been stonewalled and shut down.  Indeed, a recent creative lawsuit has been filed in Montana against Allstate for abusing the legal process through such tactics.  (Simonsen v. Allstate) The Tampa Tribune and St. Petersburg Times have been closely covering this story since it started last fall.  They noted that the Office of Insurance Regulation was trying to find out why Allstate broke a promise of lower rates in return for Florida selling it undermarket reinsurance and taking on a greater share of the Cat Fund obligation in the event of a hurricane.  Well, Allstate went into what many of my attorneys so often see in civil proceedings---a complete shut down and refusal to tell the truth. An example noted by the Florida Appellate Court was when Allstate produced a witness that was supposed to have knowledge and documents to show which trade organizations Allstate belonged to.  Simple enough.  The witness acknowledged his purpose but did not have any documents.  Huh?  That's right.  Furthermore, Allstate has its attorneys do this all the time throughout the country in bad faith cases. Allstate has been a bad corporate citizen for a long time.  They consistently refuse to tell the truth and it is about time courts damn this type of behavior.  Everybody has to play by the rules--even multi-billion dollar corporations.

The 2008 Florida Legislation

Florida Chief Financial Officer Alex Sink has claimed that the recent legislative session was favorable to consumers of insurance.  It was, but it left a lot to be desired. While not noted as significant legislation, Senate Bill 2860 contains a renewed agenda concerning Citizens as a primary insurer versus an insurer of last resort.  Private market advocates should be happy to see a commission has been established to study this.  Personally, I think this is good and Florida should try to keep out of the insurance business as much as possible.  "Free enterprise" is important and while government has a significant role regulating insurance, there is a definite difference between being the regulator and the government being the operator.  To the extent possible, government should never compete with private business. Florida is allowing private insurance companies to borrow from the Citizens surplus in an effort to encourage private insurers to enter the Florida wind market.  I am not certain if this is good or not, but it is obvious that Florida is using its own capital to pay for new entrants into the property insurance business.  Again, the "free enterprise" proponents are winning the battle, although this is not truly "free enterprise" because government is giving loans to help. The bill also places restrictions upon an insurer's right to claim privileges to documents subject to an investigation by the Office of Insurance Regulation, raises administrative penalties for insurers guilty of trade practice violations, and allows lawsuits against insurers not paying undisputed claim amounts within ninety days. Interestingly, the Citizens Task Force that was authorized to analyze Citizens claims practices did not get any legislation passed regarding how Citizens handles its claims.  Amazingly, it did not even offer any such legislation.  Instead, it suggested with the help of the Florida Association of Public Insurance Adjusters, a bill which more stringently regulated public adjusters.  I view this bill favorable to public adjusters and the public.  The Citizens Task Force, however, utterly failed at its mission although there has been some good to come out of it--Citizens has a public forum where it can be called out on its continued wrongful claims practices.

Florida Senate Requires Fairness from Insurers

Moniker Florida newspapers (Tampa Tribune, St. Petersberg Times, Sun- Sentinel) reported on the recommendations of the Florida Senate Select Committee on Property Insurance Accountability, a committee formed in response to the insurance industry misleading Governor Crist and the Legislature about rates during last years legislative session.  Because of these misrepresentations Florida provided under-market prices for reinsurance and assumed greater risk in the event of a hurricane in return for lower rates.  The insurance industry then raised rates after getting the favorable legislation. The letter from the Committee to Senate President Ken Pruitt contains significant and progressive recommendations to help consumers.  A memorandum also indicated that the work of the Committee was not done and that the Select staff would be working with standing committees to help shape legislation protecting consumers. Finally, there appear to be some serious and well conceived changes to help insurance consumers.   The big insurance lobbyists were not pleased, and that is usually a sign that something has been done to help the insurance customers -- all most large insurers seem to care about is return on investment, even dishonorably like they did last year.  Even our governmental representatives have learned that you cannot trust big insurance.

Florida Reducing Hurricane Exposure

A year after the Florida Legislature and Governor Crist were duped by the insurance industry, legislation aimed at lowering the financial catastrophe of a major hurricane has been introduced to correct last year's mistake.  See HB 983.  Last fall, I spoke with Alex Sink regarding her concern that the collapsing bond markets could make it difficult for Florida to quickly raise money to pay for Catastrophe Fund obligations in the event of a hurricane.  Given the decrease in statewide tax revenues and the ever increasing credit strains caused in part by the sub-prime mortgage crisis, she has acted very prudently by supporting this legislation.  Obviously, if the state is picking up less of the insurance payments caused by a natural catastrophe, the insurance industry is picking up more.  Rates have to go up.  The question is:  How much?  The second question in an election year is:  If they go up a lot, are voters going to retaliate at the polls this fall? Of course, the State has an "out":  Citizens Property Insurance Corporations.  Citizens is a governmental entity "competing" against private insurers.  If it continues to charge lower rates, many policyholders and voters will be spared the increase.  Indeed, if the rates are limited to a 2 percent increase as reported in the Palm Beach Post, voter dissatisfaction probably won't materialize.  Nevertheless, the action by Sink and the Legislature was a step in the right direction.  We were a Katrina away from a major financial catastrophe, and this is a prudent step in the right direction.

Allstate Testifies Today

Moniker Allstate Insurance Companies are being called before the Florida Senate Select Committee to testify today and tomorrow regarding a number of issues, especially its rate filings.  I have publicy applauded this inquiry and those interested can read the Committee's filings on the internet. The issues are a little broader than just rates.  The letter to Allstate from Senators Atwater and Geller list claims history and profitability factoring.  I expect that the Core Claims Process Re-Design documents and processes will again be a matter of inquiry. The hearing should be interesting because something like this has never occurred.  Public inquiry with extensive press coverage regarding an insurance company's honesty of its operations is something that should have occurred long ago.

States Seek McKinsey Reports

Moniker The Tampa Tribune reported Friday that the Florida Department of Insurance is seeking McKinsey & Company consulting reports which are allegedly tied to an Allstate plan to underpay claimants.  These documents are at the heart of contention in a Colorado case where Allstate is being fined for not providing them, and also in a Missouri Department of Insurance investigation where Allstate is being fined $25,000 per day for refusing to cooperate with the state regulator's investigation.  I am seeking similar documents in an Indiana case in which Allstate has been already sanctioned and ordered to provide them. For over a decade, I have criticized Allstate's reliance on a claims program which appears to unethically calculate the value of an individual's bodily injury claim and not honestly disclose how Allstate arrived at its determination. The situation is analogous to an Emergency Hospital charging you too much and then not providing the details of the bill nor an honest explanation as to how it arrived at its numbers.  Allstate has understandably been reluctant to disclose its claims practice and expose itself to the Civil and Regulatory penalties that should accompany such a breach of the public trust and its knowing failure to act in good faith.  In case after case, Allstate simply refuses to fully comply with legal requests for the internal memoranda or ties up compliance through delay and stonewalling. The amazing aspect of the Department of Insurance request is that it has come so late after Allstate's claims processes were changed. The McKinsey documents were primarily generated over a decade ago, and I obtained them when I chaired a Bad Faith Litigation Group.  See, Mark Ballard, Allstate's Master Plan?, Nat'l Law Rev., November 9, 1998, at A1, (col.2).  One of my colleagues, David Berardinelli, wrote a book on this topic:  From "Good Hands" to Boxing Gloves - How Allstate Changed Casualty Insurance in America.  We suspect the most revealing documents are contained in management emails regarding the performance and profits of Allstate's claims programs.  In our experience, internal emails by management are more revealing than reports generated for display to many employees.  The Department should seek these in addition to the McKinsey documents.     It is refreshing that regulators are finally seeking transparency of Allstate's claims practice.  Still, one has to wonder why it has taken so long and if the Department is looking in all the right places.  They should visit our law office to obtain some of what they are seeking; we've had some, but not close to all, of these documents for 10 years.  Based on past experience, Allstate will not be in a hurry to provide anything which would expose how it treats its customers and which could expose it to further penalty or criticism.  It is unlikely Allstate will voluntarily allow a third party to challenge its claim that "you're in good hands with Allstate." 

Department of Insurance Gets Nothing from Allstate

Moniker  Allstate and other insurers are notorious for not complying with discovery seeking internal corporate documents which would expose corporate culture in bad faith cases.  From the news yesterday and today, it appears the Florida Department of Financial Services has learned the same lesson most policyholder attorneys have known for quite some time.
This controversy results from the 2007 laws granting insurers access to state sponsored reinsurance. The Legislature expected lower premiums in return, and this has not occurred.  Charlie Crist has been publicly critical as to why Florida was duped into this deal.The subpoenas issued to State Farm and Allstate were supposed to provide transparency on this.  Neither insurer has been quick to provide the internal documents. Our firm tried to obtain a copy of the subpoenas, but the Department would provide only the notice and refused to provide the list of requested documents.  To see the Allstate subpoena, click here.
 
 
State Farm's challenge to the Mississippi Attorney General may have emboldened Allstate.  They simply may be flexing their financial muscle. Allstate has an army of attorneys and lobbyists.  It has more money than most can imagine, and it certainly will not be eager to comply with requests that could lead to embarrassing revelations regarding how it operates to maximize profit.  So while this controversy is making front page headlines throughout Florida, Allstate's willingness to accept sanctions rather than to comply with Court requirements to disclose documents and comply with the rule of law seems to be business as usual.  See, Order Relative To Plaintiff's Motion for Sanctions, dated Sept. 17, 2004, Scroghan v. Wade and Allstate Ins. Co., (Bartholemew Cir. Ct., IN, 03C01-9909-CT-1317).

Changing The Focus

Moniker A year ago the news from Mississippi largely concerned insurance claims practices, trials, and significant settlements.  Except for the recent article of our firm's settlement of twenty two cases against State Farm, the media focus has been on alleged corruption of some policyholder attorneys, especially Dickie Scruggs.  Insurance industry leaders must be smiling because this news coverage has completely derailed efforts for meaningful claims practice reform and protective legislation for policyholders.  The sad truth is that all policyholders living along Coastal areas face exactly the same wind versus water fight with their insurers that happened in Katrina.  Indeed, in Florida, the revised Valued Policy legislation and recent Florida Supreme Court decisions make it inevitable that more Floridian policyholders will have to litigate these issues.  Maybe I should not complain, but there is a societal insurance problem along the Gulf and Eastern Coasts which is simply being ignored because the focus is upon corruption charges against Dickie Scruggs and others.  

Eventually the sad stories of policyholders not being paid, and the problems of insurers being allowed to change wording in their policies to make "all risk" coverage more like "your risk" coverage, will be played out again.  It is winter and hurricanes can seem a long time away.  The sensational stories of corruption and the falling economy are in the minds of everyone.  The insurance industry has once again escaped meaningful reform.  Meanwhile, we are still just a Katrina away from another insurance disaster because those that make policy have shifted focus to other matters without first correcting problems from the past.

Citizens Changes Course....Again

In January 2007 Governor Charlie Crist announced that Citizens was going to compete with private insurance companies. More recently however Citizens announced that it plans to give away a huge book (173,000 customers) of its business to other insurance companies; this seems a strange method of competing. Ten years ago, the Florida Windstorm Underwriting Association and the Florida Residential Casualty and Property Joint Underwriting Association drastically reduced their size following Hurricane Andrew by providing incentives for private insurance companies to assume policies placed with them. After Citizens was formed to take over the policies of those two entities, the previously minimalist role of Citizens as insurer of last resort changed to the largest property insurer in the state. Hopefully, this announcement is a turning point moving us in the direction of less government involvement in private industry. The expansion of Citizens was a rather bizarre socialist statement by our Governor, however, some, myself included, questioned what other options were available. I mean really what should the government's role be if private insurance companies are determined to pull out of a market or charge extremely high rates, some bordering on unconscionable? Perhaps our Chief Financial Officer has the secret formula to rate reduction with her proposal to reform the Cat Fund, but only time will tell. From my perspective, I suspect some private insurance companies are kicking themselves for missing out on the "turkey shoot" of high rates and no storms over the past two years. Eventually, the lure of extraordinary profit is hard to resist and those circumstances, along with additional capacity provided by similar thinking re-insurers may reduce the huge risk the taxpayers of this state have assumed by having Citizens as the largest insurer in Florida. I bet even Charlie Crist is smiling that Citizens is helping policyholders switch, rather than compete, for their premiums. Insurance is not the traditional business of government and thankfully we figured that out before we really had to pay the price. From the Desk of Chip Merlin, Esq.

Jeb Speech on Florida Insurance Too Little, Too Late

Playing before, and up to, an insurance industry crowd, former Florida governor Jeb Bush lobbed criticism at a solution to a problem he helped create. The problem is high insurance premiums and Florida's vulnerability to financial calamity if confronted with a Katrina type of event. It seems ironic that he can make money giving speeches about a mess he helped create. It seems even more ironic that the group he gave the speech to, the National Association of Mutual Insurance Companies (State Farm is a mutual insurance company), would give its "State Legislator of the Year" award to one of the most prolific anti-consumer legislators in Florida, Don Brown.Let's set the record straight, the hurricanes of 2004 and 2005 occurred while Jeb Bush was the Governor of Florida. He and the leadership of Florida allowed insurance companies to cancel and non-renew insurance policies at an escalating rate prior to Hurricane Charley. As a result, Citizens Property Insurance Corporation became more than an insurer of last resort and grew into a major insurer before the first 2004 storm hit. Before Hurricane Charley, there were no government initiatives to "harden" structures to wind damage, and Jeb Bush was the darling of developers building along the coastal areas in harms way of wind and water. During this time, Don Brown was an insurance agent by trade and a Florida House Representative with a strong propensity to support whatever the insurance industry lobby wanted as legislation. The large increases in insurance premiums and the historic growth of Citizens, now the largest property carrier in Florida, occurred while these men were leaders of the State. The populace was outraged because insurers drastically increased rates and many could find no insurance. Jeb Bush left newly elected Governor, Charlie Crist, and Chief Financial Officer, Alex Sink with a huge insurance mess. Whatever legislation Don Brown had supported with the backing of the insurance industry was not working by the time the legislature started meeting in 2007. So now Jeb Bush is criticizing the solution devised in January 2007. This is an easy sell to the insurance industry that wants to raise rates high enough so that there is no real gamble and one way or another they will make money. Don Brown and only one other member voted against Floridians taking on this risk in return for lower rates. The truth is that the citizenry of Florida has largely taken on the risk of hurricane loss that private insurers are not willing to. Whether this is good or not is open to debate. Despite the fact that I believe Jeb's Monday morning quarterbacking to be bad form and incorrect in some respects, he did manage to make a few good points during his speech at the NAMIC annual members convention:
  1. enforcement of building codes which harden structures to withstand hurricanes is necessary
  2. transparent premiums need to be tied to underwriting criteria so that better built homes receive better ratings for premiums
  3. premium discounts need to be more widely available for risk management improvements to property
Jeb probably should have initiated these policies while he was governor but failed to do so, I wonder why?

From the Desk of Chip Merlin, Esq.

Insurance reform flops: What now, start from scratch or mend fences?

In an interview with Victoria Langley, Alex Sink, Florida's Chief Financial Officer, weighed in on what she believes went wrong with Florida's insurance reform plans.  Part of the reform involved lawmakers putting an additional $12 billion dollars of taxpayers money into the states Catastrophe fund. This was supposed to allow insurance companies to reduce rates, however we're not seeing any real significant rate decreases, as a matter of many companies have filed for rate increases. Sink did not believe it was in the state's best interest to go back to the drawing board and start from scratch, but she did indicate that maybe we need to take back that $12 billion if it's not paying off.  She further suggests a need to remove insurance oversight from the State legislature, which may not be equipped to deal with highly complex financial decisions, and place it into the Florida Financial Service Commission.  Both views may have some legitimate basis. First, the rates are not going down. If Florida policyholders are not getting any benefit, why should the $12 billion remain in the catastrophe fund? Second, the legislature now has the State of Florida in the insurance business as a result of trying to appease the electorate outcry about high insurance bills. The result is that the State now controls the largest property and casualty company in Florida. Insurance laws are constantly changed as the legislature tries to improve and protect this insurance entity. The perilous result is that if a big hurricane hits, the rates of all Floridians will go through the roof as Citizens pays off the debts through assessments. This is all because a legislative body should not be in the position of running a capitalist insurance enterprise. Although a much anticipated OIR public hearing on State Farm's July 19 announcment of their plans to not renew some 50,000 residential policies in Florida, scheduled for tomorrow, Tuesday, August 14th, has been postponed. The hearing, whenever it takes place, may shed some light on why the enacted changes did not yield lower rates. A critical analysis of the internal motivations and political strategies employed by State Farm and similarly situated insurance carriers is required to provide transparency to the process and see whether this is an industry that has any semblance to one that should be trusted.

How do we escape Florida's financial insurance catastrophe?

Following the passage of recent insurance legislation, I wrote an op-ed piece for the St. Petersburg Times noting that Floridians are now a Hurricane Katrina away from financial disaster. Recently, the St. Petersburg Times and Miami Herald have run stories finding that our elected politicians have also come to the same conclusion.  The July issues of both the Florida Underwriter and a supplement to Business Insurance ran cover stories detailing the problems of Florida's resolution to its insurance rate crisis.It is curious how many politicians seemed to put off the "day of reckoning" realization. The growth of Citizens and the immediate demands of their electorate to reduce insurance rates seemed a far smaller problem in the winter than a hurricane which may or may not happen until sometime in the future. With hurricane season here, the realities are upon them and the folly of the new legislation is obvious. No one can change the financial outcome of a hurricane now. Florida has rolled the dice, assuming we are lucky this season; the significant issue is what we are going to do about it in the coming months. How about we start by reducing the size of the bet? Currently, Citizens is reported to insure more than $400 billion of property risk, with the probable maximum loss exceeding their surplus by $20 billion or more.  Instead of being an insurer of last resort as it was thought of until 2004, the new mandate is to compete; this has to stop. Citizens is a governmental entity that is charging below market rates or rates it acknowledges are not actuarially sound. In a free market country, why are we allowing the government to unfairly compete? This is all the more surprising since it was a Republican legislature that pushed this measure, providing a governmental entity with an unfair advantage over private insurers. If Citizens goes broke because its rates are too low or its capacity is not enough to pay claims, it merely charges everybody in Florida for its debt. No private insurance company enjoys such a bankroll. If a private insurer operated like that they would be financially ruined. As a result of this expansion and unfair competitive advantage many private insurers are leaving our market. Karl Marx and socialists everywhere would be proud of the current legislative mandate for Citizens. The government has no business "competing" with private insurers? No other industry has such governmental competition. All that having been said it seems that the first step to getting us out of this financial mess is to stop expanding Citizens. From the Desk of Chip Merlin, Esq.

Florida officials are gambling with citizens' money

CFO Alex Sink and Governor Charlie Crist are still new to their elected jobs; this was obvious from statements made by Sink in her interview with the Miami Herald. In one statement she astonishingly relates that it wasn't until last month, while driving along Ft. Lauderdale's Condo Canyons, that she realized how vulnerable Citizens Property Insurance Corporation and its insureds are in the event of a significant hurricane. She and Crist, among others are clearly annoyed that the hoped for lower insurance rates have not materialized and are calling for an explanation and investigation. The important issue to note here is that if the chief guru of finance did not appreciate how a major hurricane could impact every taxpayer in Florida and the Governor does not trust the insurance industry, then how can they advise and educate their constituents about our insurance crisis; it appears that they are as much in the dark as we are.What is the Country's fourth largest property insurance carrier? Citizens Property Insurance Corporation. In Florida, it is the largest. It now collects over $3 billion in premiums each year. It insures more properties which have the highest probability of damage than any other insurer. It issues over 1.3 million policies. Citizens has over $400 billion of insured exposure. If a major hurricane, like Katrina hit Florida, Citizens could owe an estimated $15 to $30 billion dollars. So what's wrong with that picture? Citizens Property Insurance Corporation has only a fraction of this money in its coffers. If it were a private insurer, it would be in bankruptcy. Even more importantly, if that major hurricane should hit, Citizens can seek money from virtually every policyholder (not just Citizens policyholders) and taxpayer in Florida to make up for this shortfall. Each Floridian could be a Hurricane Katrina away from annual payments of $1000 or more for atleast five years to pay for the shortfall. Dennis Ross, a Lakeland legislator who is very experienced with insurance, refused to vote for the S.B 2498, which expanded Citizens potential customer base, for fear of increased financial exposure to all Floridians. He claimed that the relatively small and uncertain premium reductions compared to the very real gamble that a major hurricane would not hit, did not justify passage of legislation. So far, he is right about the premium reduction. Pray that he is not proven completely correct. What caused this mess? First, Citizens is not really an insurance company, it is a government behemoth. When rates have to go up to reflect the expected amount of losses, people complain to elected officials who turn around and write laws to force Citizens to knowingly charge less premiums than it should to pay claims. This happened in the 2007 legislative session, Citizens policyholders have below market and actuarial rates because the legislature passed a law allowing this. Why did the rates go up and why were people complaining so vehemently to their elected officials? Two main reasons exist for this: 1. Approximately two thirds of the rate increases between 2003 and 2006 were the result of property value increases and rising construction costs. Property values and construction costs increased mostly as a result of the real estate boom and historically low interest rates and so the value to be insured had to be raised to accommodate increased costs to repair or replace damaged property. For example, if you owned a car valued at $5000 in 2003, it may only cost $250 to insure. But, if in 2006, that same car were worth $12,500 and the body shops doing repairs to it increased their costs by 50 per cent, the cost to insure that car would certainly more than double. As property values increased during that time so did property taxes. Property owners were upset because they did nothing to their properties but the "overhead" costs of owning the property significantly increased. They complained to the government to do something. 2. Extraordinary catastrophes in 2004 and 2005 rocked the insurance markets and reinsurance capacity. Florida had unprecedented losses. Those losses have an actuarial impact. The experience history of payments mandated a rise in premiums. While there is much debate about the proper rate, nobody disputes that the loss data from the hurricanes supported a need for some increase in rates. The problem was further exacerbated by the fact that many carriers could not find affordable reinsurance or enough reinsurance to offset the risk of a future catastrophe. Recently there has been a flood of investors into the reinsurance market following the very profitable 2006 year and reports are that reinsurance rates are falling, but the failure to find reinsurance at rates anywhere close to pre- 2004 premiums caused many insurers to cancel policies or leave the market entirely. Floridians were mad as hell about not only having rates raised, but many did not have insurance at all. They complained to their legislators who did something. Unfortunately, if a major hurricane hits, those same complaining Floridians will learn that what our legislators did was wrong. They took a huge gamble at the expense of the citizens. Everyone living in Florida, or insuring property here, is going to be outraged at the bills they are going to receive and have to pay. As our elected officials are realizing the losing bet they've placed, they are scratching their heads wondering if they should fold, let it ride, or double down. It looks like there is no need to hit the casino, Floridians are gambling right now with hurricane season in full swing. You can gauge how you are doing by watching The Weather Channel. From the Desk of Chip Merlin, Esq.

State CFO Alex Sink discusses Florida's property insurance plan

Two weeks after Alex Sink was sworn into office as Florida's new chief financial officer, lawmakers embarked on a 10-day special session to come up with ways of lowering insurance rates and providing some respite for the state's beleaguered homeowners. "I was still trying to find the ladies room," recalled Sink during an interview with the Miami Herald last week. The end result of the special session was the expansion of the Florida Hurricane Catastrophe Fund to $28 billion, allowing insurers to buy less expensive back-up insurance. This special session, in conjunction with more recently passed insurance legislation expanding Citizens, came with promises of savings to policyholders, with rate cuts averaging 20 percent or so.  Six months later, the promised savings have not materialized -- as a matter of fact in recent weeks atleast five homeowner insurance groups have filed requests for rate increases.  With more requests for rate increases inevitable, Sink, Crist, and other state officials are left questioning the viability of Florida's plan to reduce property insurance premiums.

Regulating insurance regulators without a paper trail

It was recently reported by Paige St. John that the Florida Department of Financial Services is not keeping complete copies of consumer complaints (civil remedy notices) and insurance company responses. Instead, the Department's legal staff has determined that according to section 624.155 of the Florida Statutes they are only required to maintain two documents.  One is the civil remedy notice and the other is the report of the disposition.  Any other documents received (i.e. attachments, responses, etc.) are not part of their statutory duty pursuant to the Florida Sunshine Records laws or section 624.155 to be retained and are being discarded. Legal counsel having differing opinions about how to interpret the law is not new. What is significant was that the reporter, Ms. St. John, indicated that candidate Alex Sink promised to use such records to help regulate claims conduct by insurers, however elected official Alex Sink has a different use for those records---creating trash.  Why would the elected regulator allow formal complaints of insurer misconduct and company responses to be destroyed? I cannot fathom one reason why such a practice would help consumers. The CRN law was enacted in 1982 to provide Floridians a means to redress insurer misconduct. Further, it allowed for the then Department of Insurance to help determine whether systematic practices of insurer misconduct existed. Only cheating insurance companies have anything to fear from this law. Orwell's classic novel, 1984, warned of the dangers of the government re-writing history. His Ministry of Truth was charged with destroying accounts harmful to a regimes policies so that it could create the history it desired. Florida's Sunshine laws have protected this State for decades from these practices by preventing Florida's elected and appointed officials from destroying records they made and received in the course of their business. What practical reason could an insurance official that has a regulatory responsibility to oversee the insurance industry have for destroy potentially damaging documents regarding the conduct of insurance companies? Some may speculate that the reason is to prevent embarrassment or penalty to the insurance companies that are not playing fair. Possibly, Alex Sink will make an executive decision to stop the destruction of these documents. Possibly she will go a step further and require staff members that are supposedly regulating the insurance industry to actually use the documents as proof of wrongful practices. While the newly appointed Consumer Advocate for the Department of Insurance, General Milligan, has been a breath of fresh air for policyholder interests, one has to wonder what Alex Sink is thinking and whether the people working with her have a clue and desire about how to effectively regulate insurance companies. From the Desk of Chip Merlin, Esq.

Florida seeks help to cover catastrophe fund

According to Florida Today, Gov. Charlie Crist is quietly considering hedging Florida's gigantic hurricane bet, and with it raising the odds homeowners will get socked with a bailout bill. A draft report shows state financial advisers are considering spending $670 million to buy $6 billion in protection for the Florida Hurricane Catastrophe Fund. The state fund sells discount storm coverage to insurance companies and in turn is backed by Florida consumers who would pay for any deficits caused by storm losses. The losses are paid with special charges on insurance premiums.

Fla. Task Force on Citizens' Claims Handling to Meet in Pensacola

Florida Chief Financial Officer Alex Sink is convening the third meeting of the legislatively-created task force on Citizens Property Insurance Claims Handling and Resolution. The meeting will be held June 13, from 2 p.m. - 8 p.m. at Hagler Auditorium, Building 2, Room 252 on the campus of Pensacola Junior College, 1000 College Blvd. in Pensacola, Fla. Click here for the schedule of future task force meetings.

Florida Supreme Court hears oral arguments in VPL case

Florida Farm Bureau Casualty Insurance Co. issued a homeowners insurance policy to the Coxes. The policy excluded any losses caused, either directly or indirectly, by flood or water damage of any kind.  The Coxes' home sustained extensive damage caused by Hurricane Ivan and was determined to be a total loss due in large part to flood damage and in lesser part to wind damage. The Coxes demanded coverage, and Florida Farm tendered $12,000 for the windstorm damage. The Coxes declined the payment. In the ensuing litigation, the trial court found that under Mierzwa v. Florida Windstorm Underwriting Association(877 So. 2d 774 [Fla. 4th DCA 2004]), "if it is found that a carrier has any liability at all to the owner [of] a building damaged by a covered peril and deemed a total loss, that liability is for the face amount of the policy." Florida Farm Bureau appealed to the 1st District Court of Appeals, which held that under Florida's 2004 Valued Policy Law (VPL) Section 627.702 Florida Farm was obligated to pay out policy limits if any wind-related damage had occurred to the homeowners' property.  The court noted that although the VPL section had been amended so that the statute does not apply where the loss was caused in part by a covered peril and in part by a noncovered peril, the amendment was not applicable in this case because it specifically prohibited retroactive application to claims filed prior to its effective date, which was June 1, 2005. Despite this second loss, the Florida Farm Bureau certified the following question to the Florida Supreme Court: Does Section 627.702(1) of the Florida Statutes (2004), require an insurance carrier to pay the face amount of the policy to an owner of a building deemed a total loss when the building is damaged in part by a covered peril but is significantly damaged by an excluded peril? The Florida Supreme Court granted review with oral arguments.  Click here to watch a webcast of the oral arguments, which were heard yesterday, June 7th.

Do we build or flee in the face of catastrophic frequency and severity?

June 1st was the first day of hurricane season and already the Florida Coast has been hit by its first tropical storm (Andrea).  If predictions from NOAA are correct we are in store for a very busy 2007 hurricane season and preparedness is at the forefront of everyone's minds. Governmental entities throughout the Gulf Coast are making final preparations for implementation of catastrohe plans. In Florida, many are taking advantage of the State's sales tax holiday and purchasing various and sundry items in preparation for the hurricane which may never come. Many policyholders are reviewing their policies to make sure that they have adequate coverage and worrying about what would happen if a Katrina event struck close to home. Last week, a long time client with a nearly $70 million property called regarding a major problem; the property budget would not allow them to purchase enough coverage, including code upgrade coverage and excess flood coverage. They could afford one or the other, but not both. Their insurance agent said they should buy both, which seems the wisest course of action, but they could only afford to purchase one. I had the sinking feeling the many less affluent property owners are also having to decide which additional peril coverages they can afford; that is if they are even aware that their policies do not cover a wide array of perils,1 including flood damage.  Our client opted to purchase the excess flood coverage because the property is on the beach and renovations were recently completed. The one lesson from Katrina which owners of property along the water should remember is that flooding is your most obvious risk of total destruction. Further, even if wind causes most of the damage, risk carriers generally opt to blame the flood waters for the damage, so buy flood coverage, it pays. I also met with a very large developer and owner of retail space. The type of policyholder that most would think the insurance brokers and companies fawn over, but not in this market. This corporate risk manager had the same worries about finding quality, affordable insurance coverage as any other homeowner. This risk manager purchased layered coverage, this is where various insurance companies insure the properties, but for for different "layers" of damage. In effect there are multiple policies covering the same property but at different amounts of loss.  The problems are myriad with "layered coverage." The first is that the various policies inevitably have different language which affect how much is paid and what the duties of the insurer may be. Usually, the higher layer insurers will agree to conform their policies at the time of underwriting to the same terms as found in the lower levels of coverage. But, that is not always the case, particularly in the current market.  The current trend is that many insurers are making "take it or leave it" offers of coverage. In this tight capacity market, the insurer is in a far stronger position to dictate not only price, but terms of coverage.  The capacity problem may be resolved in the future, but for now, it is a sellers market for those involved with insuring property in catastrophe prone venues.  Frequency and severity of loss have everything to do with our current insurance situation. The catastropic frequency and severity of hurricanes from 2004 to 2006 was off the charts. And, the severity of loss (the average amount paid per claim) was  extraordinary as well.  Combined, these lead to historic losses in a relatively small catastrophe prone area. Like bookies looking for the sure bet, insurance companies are simply looking to place bets where fewer losses occur. As these private insures flee the coasts, state insurers of last resort are left to fill the void, in some instances with less than satisfactory results. The long term answer is not easy and will not be cheap.  People are determined to continue living close to beaches and water. Recognizing and accepting this fact, we must start to deal with the upfront cost of building more structurally sound and "hurricane resistant" structures.   1 A recent NAIC survey found that 33 percent of U.S. heads of household, who own a home and have homeowners insurance, incorrectly believe flood damages would be covered by a standard homeowners or property and liability policy, despite extensive media coverage on Hurricane Katrina victims whose claims were denied because they lacked flood insurance. From the Desk of Chip Merlin, Esq.

Citizens asks for time limit on claim disputes

Facing criticism for thousands of 2004 and 2005 hurricane claims still open, Citizens Property Insurance seeks to rein in the lawyers and freelance adjusters it alleges are whipping up disputes in order to pocket large fees. Chip Merlin, of the Merlin Law Group, warned against limiting the rights of homeowners to contend with what he said are ''statistical issues'' at the state's largest property insurer.  Read more... Is this part of Citizen's ongoing effort to improve policyholder and applicant services?

Lakeshore Club Damage Appraised At $40 Million

Since the centers of three hurricanes passed virtually overhead in 2004, residents of the sprawling Lakeshore Club Villas condominium complex have lived in a sort of insurance-induced purgatory.  Lakeshore's insurer, Philadelphia Indemnity Insurance, put repair costs attributable to the storms at a few hundred thousand dollars, while the homeowners association put the figure well above $30 million.  This week a team of appraisers, including a representative of the insurer, tabulated total storm damage repair costs at about $40 million.  Chip Merlin, an attorney for Lakeshore, said he is happy with the appraisal, but is concerned about the potential reductions based on interpretation of policy. Read more from Billy Townsend of the Tampa Tribune....
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Claims practices--what really concerns insurance companies

Insurance is a business based on trust. If the public does not trust that you will pay claims promptly and for what is owed your business will flounder.  Fair value assessments and prompt payments aren't just expected by policyholders, it is required by every State insurance code. How this is going to happen is rarely open for public debate. Until now.... Citizens Property Insurance Corporation is no longer an insurance company under Florida law. It acts like one, is subject to most of the insurance code, but it is the creation of the government and is the government....whatever that means. The practical regualtory effect is that Citizens is subject to the Florida Public Records Act and supposedly is transparent regarding its rate making and claims settling practices. A very novel idea in the private insurance market where secrecy is the normal state of affairs. The Citizens Property Insurance Corporation, a non-insurance company, is being scrutinized for it claims practices from Hurricanes Charley through Wilma. It's history is awful, but it claims to be reforming. Only time, and public participation in meetings convened by the Task Force on Citizens Property Insurance Claims Handling and Resolution, will tell.  Click here for my presentation on Policyholder Perspective of Citizen's Claim Culture presented at the Task Force's second meeting held today, June 4th, 2007.  All that having been said, all this talk about transparency with Citizen's begs the question of why public regulators do not require the same transparency of "for real" and "for profit" insurance companies. Simply, if the insurance industry is so honest and fair dealing, why should they be worried about having their claims culture exposed in the public forum as Citizens is doing? From the Desk of Chip Merlin, Esq.

Fla. Plaintiffs Settle with State Farm on Hurricane Damaged Screen Enclosures

A Broward County Court has approved a class action settlement on behalf of more than 12,000 State Farm Insurance policyholders in Florida who will receive 100 percent of the damages they requested in a $6.8 million settlement of claims filed last year in which they alleged the insurer refused to pay replacement costs of screen enclosures damaged by Hurricanes Katrina and Wilma, attorneys for the plaintiffs announced. Read more....