Tag Archives: Claims Handling

Claims Handling Requirements by State – Tennessee

As promised in my recent post regarding the Gatlinburg fires, today we are looking at the claims handling guidelines provided by the Tennessee code. The Tennessee code has general requirements that require insurance carriers to develop standards and practices for the prompt and proper handling of claims in the Unfair Claims Settlement Practices Act.1… Continue Reading

Florida Hurricane Matthew Claims – Payment of Undisputed Amounts

States differ regarding the time frame required for a first-party property insurance carrier to pay undisputed amounts on a claim. In Florida, for a residential first-party property insurance claim, the carrier is required to pay undisputed amounts within 90 days after receipt of notice of the claim, if these three things have occurred:1 The insurer … Continue Reading

Incentive Pay to Lower Insurance Claims to Policyholders Still Exists

The recent Wells Fargo calamity of opening customer accounts without permission underscores how financial incentives can promote unethical behavior by employees on the front line of servicing customers. I was asked by a reporter involved with stories of the recent Tennessee wildfire whether insurance companies offer incentive pay to their claims managers.… Continue Reading

State Farm Operation Guidelines Regarding Wind and Hail Damage to Composition Roofs

Insurance companies routinely have instructions for their claims adjusters on how to adjust various types of losses. State Farm has some of the most detailed claims guidelines in the industry. I have often stated that for first-party claims, relevant claims guidelines should also be provided to the policyholders who suffer losses. Why not?… Continue Reading

Insurance Company Lawyers Called “Dogs on a Leash”

The CBS 60 Minutes documentary, The Storm After The Storm, called insurance company lawyers, "Dogs on a Leash." It raised the question whether insurers should be held accountable for acquiescing to unethical and wrongful misconduct by their own lawyers. Lawsuits naming insurance company lawyers and law firms for their complicity with aiding wrongful underpayments to … Continue Reading

Kieserman Appointed to Lead FEMA Superstorm Sandy Investigation of WYO Claims Handling

My father was in the United States Coast Guard and eventually rose to the rank of Rear Admiral. So, I was happy to learn that FEMA’s Craig Fugate appointed a distinguished former Coast Guard Officer, Brad J. Kieserman, to investigate what has been going on regarding WYO insurance claims practices. Here’s an official, and good … Continue Reading

Hailstorm/Windstorm Claims? Challenges For The Policyholder? Two Points Going Hand-In-Hand These Days

If you are a Public Adjuster or Roofing Contractor working in the property damage insurance claim industry, you no doubt have been seeing more and more hailstorm/windstorm claims in recent years. In researching some of the many issues surrounding these claims for my presentation at the recent Windstorm Insurance Conference, several challenges seemed to consistently … Continue Reading

Georgia Unfair Claims Handling

I recently received my license to practice law in Georgia and a common question I am asked is whether the insured’s claim is being handled in “good faith” by the insurance carrier and whether an action for unfair claims handling is appropriate.… Continue Reading

“You Want What!?” – Why Insurance Companies Must Provide Clear Explanation Behind Document Requests

If you have ever had an insurance claim or negotiated a loss on behalf of a property owner, you would probably agree that one of the most frustrating aspects of the claims investigation process is the virtually endless set of documents requested from the insurance company. Finding and sending all the documents can take days, … Continue Reading

Insurer to Pay $327,400 in Fines for Late Investigations of Super Storm Sandy Claims

On May 22, 2014 Naragansett Bay Insurance Company (“Naragansett”) signed a Consent Order with the New York State Department of Financial Services (DFS) agreeing to pay a civil penalty of $327,400 and to enact substantial capacity upgrades for its failure to timely perform adjuster inspections on numerous properties damaged by Super Storm Sandy.1… Continue Reading

Adjusting Hailstorm Damage Insurance Claims from Photographs

Insurance adjusters are taught to investigate coverage and evaluate damage. Good faith performance requires that this be done in a prompt, thorough, and honest manner. Most adjusters are taught to document what they see in the field through photographs, video, and the collection of evidence. Good faith also requires that the adjusters undertaking this important … Continue Reading

State Farm’s ACE Program

I have previously blogged about the decisions coming out of the United States District Court of Arizona in the Barten v. State Farm case. Recall, my Barten blogs have largely concerned State Farm’s corporate profit augmentation programs, whether the programs are called ACE or something else. Well, good orders just keep coming out of the … Continue Reading
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