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.
Continue Reading..."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.
Continue Reading...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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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.
Continue Reading...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.
Continue Reading...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.
Continue Reading...(*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.
Continue Reading...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.
Continue Reading...As you read this post, consider these life lessons:
You can’t always get what you want
But if you try sometimes, well,
You just might find you get what you need
and
Continue Reading...DON QUIXOTE
Hand over that golden helmet!BARBER
But this is a shaving basin!DON QUIXOTE
Shaving basin! Know thou not what this really is?
The Golden Helmet of Mambrino!
When worn by one of noble heart, it renders
him invulnerable to all wounds!
(to the Barber whacking the barrel with his sword)
Hand it over!Thou Golden Helmet of Mambrino,
With so illustrious a past,
Too long hast thou been lost to glory,
Th'art rediscovered now at last!
Golden Helmet of Mambrino
There can be no hat like thee!
Thou and I now, ere I die now,
Will make golden history!BARBER
(aside to Sancho)
I can hear the cuckoo singing
In the cuckooberry tree...
Amy Bach and others with United Policyholders provide a longtime and steadfast consumer protection organization devoted solely to the interests of policyholders. With extensive experience and appreciation of how much legislation can impact insurance coverage and claims, Bach provides a unique perspective with expertise on a national level concerning insurance policy and insurance regulation. Policyholders need more Amy Bachs to counteract the extraordinary coordinated efforts by insurers to make laws and regulations one sided in the insurers favor.
Continue Reading...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.
Continue Reading...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.
Continue Reading...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.
Continue Reading...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?
Continue Reading...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.
Continue Reading...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:
Continue Reading...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."
Continue Reading...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.
Continue Reading...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.
Continue Reading...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.
Continue Reading...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.
Continue Reading...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.
Continue Reading...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:
Continue Reading...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:
Continue Reading...“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.”
"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!
Continue Reading...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?
Continue Reading...Amy Bach of United Policyholders commented on yesterday's post, The Obligation of Good Faith Claims Handling and Policyholders' Perceptions of Why it Does Not Happen, She wrote:
Continue Reading..."As usual, great point Chip. I helped write and pass a law in California that allows claimants to obtain claim related documents during the adjustment process. We tried to get a similar law passed in Louisiana after Katrina - and I've been thinking this would be a good concept to work on exporting nationwide...."
The Florida legislature passed a law prohibiting Public Insurance Adjusters from soliciting business within 48 hours of a loss. Obviously, the lobbyists for the insurance industry were overjoyed with this law’s passage because it effectively allows the insurance companies and the insurance restoration industry to set the tone of the adjustment, without the typical policyholder having access to professional help.
Continue Reading...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.
Continue Reading..."Should I Stay or Should I Go?" I imagine the State Farm claims employees and agents must be playing these classic lines from The Clash over and over. According to an article in yesterday's South Florida Sun-Sentinel, there is some speculation State Farm wants to stay and may try to politically strong-arm Florida into allowing it.
Continue Reading...There is no place for fraud by a policyholder or public insurance adjuster when reporting a loss to an insurance company. At this week's Florida Association of Public Insurance Adjusters (FAPIA) summer conference, our law firm emphasized this message. Like insurance company and independent adjusters, public adjusters are bound by ethical standards. I was happy to see that the FAPIA leadership made ethical and professional behavior a prominent theme of discussion at the conference. Both policyholders and the insurance industry can benefit greatly from increased emphasis and enforcement of public adjuster professional and ethical standards.
Continue Reading...Governor Charlie Crist just vetoed HB 1171, which was euphemistically titled the "Consumer Choice Bill."
Continue Reading...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.
Continue Reading...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:
Continue Reading...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.
Continue Reading...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:
Continue Reading...Have you ever visited one on one with an elected legislator for more than 30 minutes? I have a number of times, and the results are mixed. Yesterday, I had a surprisingly pleasant and rewarding experience talking with Mike Fasano, a Florida Senator.
Continue Reading...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:
Continue Reading...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.
Continue Reading...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.
Another day, another twist as the TWIA / Windstorm bill winds its way through the Texas legislature.
In its latest incarnation, the Windstorm bill, now found in HB 4409, does not contain the language that would have stripped consumers of the ability to bring an action under Chapter 541 against Texas Windstorm Insurance Association (TWIA) for wrongfully denying or delaying payment of claims.
Continue Reading...There has to be a better way for Texas to make laws. Well meaning people who become legislators generally want to make things better. It is obvious that the Texas legislature is not functioning in a way that allows good intentioned people to make good law.
Continue Reading...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.
Continue Reading...An article in the Austin American Statesman, Late surprise: Windstorm insurance passes, provides insight regarding the ethics of some in the Texas legislature. Most would agree that laws and rules are to be followed, but maybe that does not apply to the Texas Senate:
“By Senate rules the vote was to have occurred before midnight Wednesday, but a Senate sergeant at arms unplugged the clock at the back of the Senate just before midnight.
By a 27-4 vote, senators voted to amend House Bill 4409 to include the provisions of Senate Bill 14, that was passed in April to address the looming crisis in the Texas Windstorm Insurance Association.
“This is our last hope to be able to work on this issue,” said state Sen. Mike Jackson, R-LaPorte, the Senate sponsor of the House legislation.
For nearly a half hour, during the debate on the issue, the Senate clock read 11:58.”
Our understanding is that the anti-consumer language is not included, but the version on the Web site has the bad language and struck the consumer protections. It is buried at page 47 of 84 of the pdf version. We will keep those in Texas posted on the bill.
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.
Continue Reading...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.
Continue Reading...After reading what actually passed, the House Committee seems to have struck all of the Senate language concerning 2210.552, and then added a new subsection (on page 36 of its 51 page bill) which reads :
SECTION 40. Section 2210.552, Insurance Code, is amended by
adding Subsection (e) to read as follows:
(e) Notwithstanding Subchapter H, Chapter 74, Government
Code, or any other law, an action brought under this section may not
be transferred by the judicial panel on multidistrict litigation.
Maybe the calls and messages paid off. Maybe policyholders just got lucky. The important activity for now is to make certain that legislators know to keep it this way.
Stay tuned for developments.
The legislative process has been called something akin to watching sausage being made. In Austin last night, it was very old and molded meat as the ingredient. The story was reported by the San Antonio Express News:
Continue Reading...This morning’s post, Proposed TWIA Law Smacks Hurricane Ike Claimants, deserves follow-up and some suggestions for action. I am no politician, but I encourage everybody to participate in our process of government. It is the American way, and I am convinced that many positive changes happen because some of us speak our minds about important matters.
Continue Reading...Why do some elected representatives kick the people who voted for them and pander to insurance companies? Tina Nicholson forwarded me a bill that has passed the Texas Senate that guts all consumer protections for TWIA policyholders.
Continue Reading...Imagine – all kinds of legislation, hand in hand with lobbying and political positioning, just in time for the start of hurricane season on June 1. A couple of recent news stories point out the possible direction that several key measures may be heading.
Continue Reading...A former insurance defense attorney called me yesterday, asking if I would represent him and his wife in their sinkhole insurance dispute. While he oversaw many sinkhole matters from the insurance company's position, I guess he knows that a lawyer who represents himself has a fool for a client. His call to me is part of a trend, sinkhole loss calls to our Tampa office have been on the rise. Last week, the St. Petersburg Times ran a front page lead article, Geologists Worry About Drought's Effects on Sinkhole Season. The insurance coverage available, various statutory changes, caselaw, science, and repair of sinkhole losses make these cases fairly complex. Extreme rains or droughts seem to make sinkholes more frequent.
Continue Reading...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.
Continue Reading...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.
Continue Reading...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.
Continue Reading...As I noted in a blog post last week, House Bill 853, legislation intended to exclude surplus lines insurance carriers from an entire Chapter of the Insurance Code, was poised to pass both chambers of the legislature -- with only the hope that time would run out before they could agree on the wording.
Continue Reading...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.
Continue Reading...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.
Continue Reading...Richard Dietz, a former claims supervisor with Farmer's Insurance Group, has taken to the airwaves to confess the sins of his former employer, co-workers and himself. His video is being broadcast in the state of Washington in support of a consumer protection referendum which would provide financial penalties for insurers that wrongly delay or deny claims.
Continue Reading...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).
Continue Reading...Most insurance opponents find it amusing when I explain how many places I have been in a week. If they only knew how many matters I have "touched" in a day they would fully appreciate how hard I work to protect policyholders. This morning at breakfast, a Zurich attorney asked about my daily schedule and I responded as I normally do, that I am "busy." The truth is that I was up at 5:45 am, in Tampa, flew to Destin, Florida, and picked up a client which lead to strategy on her case, then on to New Orleans where I met with new potential clients, met with the Zurich counsel, went to a Condominium Conference, worked on the paperwork of a seven figure hotel settlement, etc.,---- I am in the "muck" of insurance disagreements and want to help, which is why you should listen to the following suggestions.
Continue Reading...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.
Continue Reading...The April 6 Edition of BestWeek ran a story, Insurers Have Faith in 'Bad Faith' Victories, which indicates insurance companies are winning the legislative battle against consumer protection statutes. The story notes that the insurance industry's lobbying propaganda claims that consumer protection statutes make insurance more costly at a time when people can least afford it.
But how affordable is "cheap insurance" that does not pay or pay on time?
Insurers are using the premiums paid by their customers to sponsor pro-insurance industry laws that do not hold insurers accountable when they wrongly delay or deny payments. The same premiums pay for lobbyists to do everything they can to defeat proposed legislation that provides meaningful remedies to customers who have been harmed by an insurer's shoddy claims practices.
Last year, Washington passed laws that made it unlawful for insurers to "unreasonably" deny insurance claims, and allows treble damages when an insurer does so. The Washington Insurance Commissioner stated "the law is encouraging insurers to be more responsible."
What those insurers want are consumer protection laws with no teeth. They want illusory laws that mandate "good faith" claims handling without meaningful accountability. That type of law would be akin to prohibiting murder, but not giving the police the power to make an arrest.
Honest insurers and those that act in good faith should have no problem with strong consumer protection laws. Those companies already play by the rules. The only reason insurers would lobby against strong consumer protection laws is because they want to cheat their customers. This forces otherwise good and honest carriers into dishonest practices so they can compete. A legal system that fails to hold entities and people accountable for breaking rules is tantamount to a society without rules.
If you love dealing with your group health insurance bills and claims, you will be overjoyed with the new legislation proposed in Congress allowing property insurance companies to apply for a Federal Charter. This proposed legislation is the most unfair and anti-consumer federal legislation filed in recent years.
Continue Reading...We all know that the insurance industry is one of the biggest lobbyists around. However, as Brian Albright’s recent article, New legislation challenges ‘bad faith’ claims practices, notes, New Jersey, Connecticut and Montana are considering legislation that significantly improves consumers’ legal rights against insurers who act in bad faith. Colorado is considering legislation that could prohibit insurance companies from rewarding employees for making claims determinations against their customers. Let’s hope this is a trend, and that legislators throughout the country find the integrity to enact similar legislation.
Mark Phillips recently posted a comment in Surplus Lines Insurers, Sinkholes, and the Law of Mars, which would probably terminate his employment as an adjuster for telling the truth if he were still an Independent Adjuster:
Continue Reading..."I handled numerous loss adjustments for a South Florida MGA broker who had arranged his own "excess surplus lines" authority overseas. Due to this flexible "hand-shake" authority and with his own customized and approved manuscripted policy designs, he was actually controlling the underwriting data and policy issuance. He was bold and daring enough to "check off" certain boxes misrepresenting building characteristics and histories inaccurately on applications, so that, at time of loss investigation he could promptly deny coverage when it was noted in the adjusting routine that certain building events and maintenances had not occurred as were required to be validated in order to acquire the policy coverage and issuance. He could thus accurately void the contract on grounds of misrepresentation, and have the underwriting questionnaire in the file to back up the denial. His incentive was of course to sustain his flexible contract arrangement and limit his loss ratios, thus enriching his commission contingencies. Worth noting is that many of the insureds represented a class of Hispanic consumers who had no ability to know what was authentically being stated on their final application and were thus caught by surprise when struggling to communicate in English, back to me the adjuster, that they had not confirmed certain property realities that had been "checked off" on their application.
Another compromised policyholder left at the curb."
Recently, our firm has been questioned about the appraisal of Hurricane Ike claims. Appraisal is an informal process which determines the monetary amount of disputed damage claimed under a property insurance policy. Questions have come from policyholders and public adjusters regarding a variety of issues.
Continue Reading...Mississippi State Senator David Baria admitted that his proposed legislative bill of rights for policyholders is "dead." Mississippi S.B. 2196 would have eliminated anticoncurrent causation exclusionary language from property insurance policies. The Mississippi Senate Insurance Committee failed to act on the bill, thereby killing any attempt to enact a bill of rights.
Unlike other states, the insurance industry dominates Mississippi's Republican party. Accordingly, I was not surprised when the Mississippi Senate killed the bill. Until the Mississippi Republican party frees itself of the very anti-consumer mind set of insurance industry lobbyists or Mississippi changes the balance of power back to the Democratic party, it will be very difficult to achieve meaningful insurance reform there.
Mississippi Insurance Commissioner, Mike Chaney, has his own regulatory version, which is supported by the insurance industry. Julie Pulliam, the director of public affairs (a lobbyist manager) for the American Insurance Association thinks Chaney's "Policyholder Bill of Rights" strikes the right balance. The one thing I have learned from going head to head in politics with the insurance industry is if they think something is the "right balance," then it is bad for policyholders.
It appears that the insurance lobby may have a friend in Mike Chaney. It is obvious they have strong allies with the Mississippi Legislature. It is a shame that some of the nicest people and many lifelong friends have leaders so committed to helping an industry forcefully against their long term economic interests. It makes little common sense. But again, that's politics.
"Merlin is just on a 'fishing expedition' seeking these emails, your Honor." Similar phrases are argued by insurance counsel all the time when our firm is trying to get to the truth of what happened and, just as important, why something happened. In today's manner of doing business, the truth of many disputed matters is best found in emails. The contemporaneous history of emails between individuals is often the best record of the logic and thought processes leading towards action and decision. If I were representing insurers with corrupt or wrongful claims practices, I would argue against turning over those emails as well---why would anybody hide emails that proved innocence?
A recent Order in Citizens for Responsibility and Ethics in Washington v. Executive Office of the President, highlights why emails are so important. The Court stated:
"I have always begun with the premise that, as just indicated, the emails that are said to be missing are the very heart of this lawsuit and there is a profound societal interest in their preservation. They are, after all, the most fundamental and useful contemporary records of the recent history of the President’s office. If Napoleon was right when he said that he did not care who wrote France’s laws if he could write its history, then the importance of preserving the e-mails cannot be exaggerated." (emphasis added)
Modern insurance companies operate through emails. Company goals, management initiatives, discussions, reflections on performance, actions and history of activities are substantially recorded in emails. Judges in insurance disputes should quickly and, as a matter of routine, dismiss the "fishing expedition" arguments by insurance company attorneys. It has been our experience that many insurers, knowing what those emails say, are much more inclined to discuss settlement and quickly resolve cases when insurance company emails are discoverable. If judges in insurance disputes do not permit acces to emails, there is far too great a temptation for insurance companies to re-write or sanitize a claims history.
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.
Most people do not look at their insurance policy until loss or damage forces them to. And most will agree that trying to find confirmation of coverage is not as easy as expected. Typically, insurance policies are very long and the various coverage provisions and exclusions can be confusing and sometimes ambiguous.
This scenario became glaringly apparent in the aftermath of Hurricane Katrina. Many policyholders found themselves in a very uncertain world, trusting solely on their relationship with their insurance carrier only to be denied coverage based on an exclusion they had never heard of. And oftentimes worse, many policyholders did not receive many benefits under their policy because their insurance adjuster did not inform them of the coverages and benefits available to them.
In an effort to prevent this unnecessary chaos in the future, several Mississippi lawmakers have recognized the importance of legislation to ensure that the citizens of Mississippi are aware of their rights as policyholders and informed of any exclusions in their policies that would be cause for denial of coverage. Unfortunately, these measures have not yet made their way to the Governor.
The Mississippi lawmakers started back in Session on January 6, 2009. We are in the process of preparing and pitching an Insurance Modernization Package to our lawmakers that will include, among other measures, a Policyholder Bill of Rights and other important legislation that will provide for timely payment of claims and penalties for noncompliance and unfair trade practices.
So far, this has proven to be an uphill battle in Mississippi, but one worthy of pursuing. The citizens of Mississippi are not insisting on anything that the insurance carriers are not already obligated to do in many other states across the nation.
In the typical, hospitable Mississippi fashion, Mississippi has focused on the needs of their business guests first. As Mississipians rebuild their beautiful coast, they are acutely aware of the need for a fair and balanced co-existence with their insurer. It is now time to focus on the needs of the citizens of Mississippi.
Stay tuned....we are in for a promising year!
There are some fights where you simply cannot sit on the fence. You have to choose what you stand for, who you want to help, and fight for what is right versus what is wrong.
You know that the people supporting you are "good" and the other guys--those that support cheaters and do not want to be accountable for their broken promises-- are simply "bad."
We have that fight going on in Mississippi as indicated in a story filed by Anita Lee. The Mississippi Policyholder Bill of Rights needs to be in legislation and regulation. It needs teeth. It needs to be enforced. Deborah Trotter has been leading our efforts to get something passed that is not a watered down form over substance piece of paper.
The problem is the insurance companies are very powerful "bad guys" when it comes to legislation giving their customers an even hand. Insurance companies are not people. They are mere fictitious entities filed under law. They do not breathe, bleed nor die. They can, and have, accumulated more money than most of people can imagine. By law, these fictitious paper entities are supposed to serve a public purpose. They agree to abide by laws required under licenses for which they voluntarily apply.
In Mississippi, there are people who will be "bought off" by the insurance companies. They are the insurance company lobbyists, lawyers, publicists, and employees that will do everything they can to prevent laws and regulations that support the rights of the insurers' customers. The insurers will influence patronage of bad public servants through donations and money. They have done this for a long time and have many supporters dependent on the largesse spread by the insurance support industry. These are the "bad guys."
This fight is not about the interpretation of a law or contract. It is not about how much an insurance rate should be or a lawsuit about whether a promise or duty has been violated.
This is a fight, like so many in different venues, where people are simply trying to make laws that force insurance companies to uphold promises and duties owed to the people that are to them, the customers. There can be nothing wrong with making laws that hold insurance companies accountable for breaking contractual promises and duties they agreed to abide by when getting their licenses.
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:
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.
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.
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.
Tuesday was a rather interesting day. Our firm helped win a $4.6 million dollar judgment for a panhandle Condominium Association last year. Citizens Property Insurance Corporation did not pay, as usual, but appealed. I argued the case [Citizens Property Ins. Corp. vs. East Pass Towers II Condominium, No. 1D07-2727 (Fla. Dist. Ct. App. oral argument Jan. 22, 2008)] for our client in Tallahassee, met with the Association representatives, and then made my way up the hill to the State Capitol where the Select Committee on Property Insurance Accountability was meeting.
One of firm's lobbyists briefed me on the schedule and introduced me to some of the panel members I had not previously met. We wondered if the media attention and articles (Tom Zucco, No Auto for Allstate, St. Petersburg Times, January 17, 2008, at A1; Jerome R. Stockfisch, State Bans Allstate From writing any New Policies, January 17, 2008, Tampa Tribune) following last week's 0ffice of Insurance Regulation hearing would cause more attention to be focused on these proceedings. Given the media in attendance and the articles in this morning's papers (Jerome R. Stockfisch, Panel Begins Insurance Investigation, Tampa Tribune, January 23, 2008; Michael Sasso, Secretive Allstate File Could Show 'Bad Faith', Tampa Tribune, January 23, 2008), we are certain there is great interest regarding these investigations that would provide some transparency to the insurance industry's tactics to raise rates and lower claims payments.
The panel consists of Florida Senators. While it is in vogue to criticize our politicians, most are truly trying to make laws and policy that make our lives better. With the public outcry regarding extraordinary increases of insurance rates following the 2004 and 2005 hurricane seasons, they worked to find a solution to ease the burden of rate increases and policy considerations. The plan was for Florida to assume a greater risk in the event of a catastrophe and sell re-insurance to the insurance industry at lower than market rates to help lower premiums and provide capacity so cancellations would decrease.
The average residential premium was expected to decrease approximately 19%. Instead, many carriers sought increases. Allstate sought a 46% rate increase. This "duping" of the legislature and insurance regulators is what created the current investigations by the Office of Insurance Regulation and this select committee.
J. Robert Hunter has long studied and criticized many activities of the insurance industry. He is an actuary by trade, a former insurance commissioner, and serves as the Insurance Director for the Consumer Federation. Florida Insurance Commissioner Tom McCarty asked Hunter to testify about the "duping" and alleged misinformation generated by insurance industry trade associations.
Hunter provided a lengthy report: "Property/Casualty Insurance in 2008: Overpriced Insurance and Underpaid Claims Result in Unjustified Profits, Padded Reserves, and Excessive Capitalization", J. Robert Hunter, January 10, 2008. He detailed and provided evidence that the insurance industry has made significant profits and continues to do so despite providing alleged propaganda trying to demonstrate otherwise.
My impression of his testimony is that insurance company executives try to hide true profits being made to keep rates as high as possible. Hunter essentially indicated that insurance company management lied in its filings and practices. At one point, he called the activities possibly "illegal" when Senators were questioning if criminal activity occurred.
From experience, most honest people and corporate representatives openly discuss and show documents when authorities demand answers and proof of activities. Dishonest people and entities hide and try to avoid directly answering the same because guilt would be admitted. Anybody watching Allstate answering and avoiding production of requested information last week during the Office of Insurance Regulation hearing has to have an impression that Allstate is hiding something really bad.
In his report, Hunter specifically indicated that the Consumer Federation of America recommends that consumers avoid Allstate, if possible, because it has a history of anti-consumer behavior. Id. at 29.
As all this was being played out, I noticed the room was also full of insurance company attorneys and lobbyists. Most policyholders would be amazed to learn how much their own insurance companies spend in lobbying dollars to make and encourage anti-consumer efforts. The irony is that the policyholder's premiums are used to finance these activities. Modern insurance companies have the policyholder's money financing an army of attorneys to protect the insurance company with little regard to the policyholder's interest.
Accordingly, the efforts by those such as Robert Hunter, the Florida Senate, and the Office of Insurance Regulation should be applauded. It is high time that insurance executives are called to testify and provide documents demanded by regulators. If they have nothing to hide, they should be happy to provide truthful and complete disclosure. From past experience, nobody should be holding their breath that this will happen anytime soon.
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