State Farm advertises extensively to promote an image of providing "Good Neighbor" service. Since many insurance companies have a less than sterling reputation, this marketing strategy is important. So, when ABC News has a headline that reads, State Farm Faces Criminal Investigation Over Hurricane Claims, you can bet executives at State Farm’s home office are asking its claims department, "what the heck is going on?"

The news report is fairly straight forward:

State Farm Insurance, the nation’s largest home insurer, faces a new criminal investigation in Texas related to how it handled potentially tens of thousands of hurricane claims there, ABC News has learned exclusively.

Gregg Cox, who leads the public integrity unit of the Travis County District Attorney’s office in Austin, confirmed to ABC News his investigators recently launched the probe after reviewing newly released communications from top State Farm managers in Texas. Some of the same communications have led to lawsuits by customers who say they were defrauded by State Farm Lloyds, the Texas subsidiary of the larger insurance company.

The documents in question relate to an alleged cover-up by State Farm management related to its denial of consumer insurance claims for a common type of roof damage that occurs during high wind events and hurricanes.

What is the common issue? It is the damage that occurs when roof shingles rise during a windstorm. As noted in The TWIA Roof Damage Memo: Checking Basic References to Resolve Adjustment Questions, Internal Texas Windstorm Roofing Claims Memo Explains Damage is Not Covered and Roof Repair Methods Prove TWIA is Wrongly Denying Roof Claims, TWIA executives got in trouble with the same issue.

A recurrent problem I find is that insurers spend a lot more time trying to come up with justifications for why damage is not covered rather than conducting thorough and fair investigations. I wrote about this problem with roof claims in "InspectAPedia"–An Interesting Reference Website Regarding Building Inspection and Repair Including a Discussion of TWIA. The post is a refresher on roof damage investigation from the standpoint of the insurer and noted:

While reading his article, I kept imagining how the insurance company may try to use a more thorough investigation to find causes leading to the loss other than just windstorm and then raise the anti-concurrent clause exclusion as a means to escape liability. But, that is another topic.

It looks to me as if this criminal probe may address the problem with State Farm.

  • An uplifted or detached shingle would never be accepted by a material manufacturer during a warranty inspection. Nor would a competent engineer, roof consultant or architect believe that debonded shingles are acceptable. I hope those who defrauded are brought to justice and those who were denied coverage are properly compensated!

  • careroof

    I don’t have any other words to appreciate this post other than I am really impressed.

  • Wendy

    Oh I just had the second inspection of my roof done for hail dmg. My shingle roof is covered, but the adjuster stated, NONE of the damage on my flat roof is caused by hail and therefore it was not covered. So pictures and estimates are being sent to my agent. If that is not covered, I will be hiring a public adjuster and if need be it will go to court.