Insurance company property claims manuals are often sanitized to prevent criticism. They contain general and often give vague instructions to claims adjusters. The actual instructions are often provided in verbal meetings with claims managers, which may have PowerPoint presentations, email claims bulletins, and other non-specific documents which are not placed in claims manuals. Why don’t market conduct examiners and departments of insurance investigators ask for these types of documents when investigating insurance company claims practices and conduct?

Continue Reading The Heritage Insurance Company Hurricane Ian Quality Assurance Field Update—Why Don’t Insurance Departments and Market Conduct Examiners Ask For These Documents?

The answer to this post is very complex. But I want to publish one redacted example which shows how the claims management of independent adjusters seem more concerned about pleasing the insurance company bottom line rather than properly adjusting the claim as required by law:

Continue Reading Why Are Property Insurance Claims Being Underpaid and Independent Catastrophe Adjusters Leaving the Field?

I have been working on a number of active State Farm lawsuits involving its claims practices. My research came across a recently filed class action lawsuit in December alleging systemic racial discrimination in its claims processing.1 The press release to the lawsuit indicated the following:

Continue Reading State Farm Accused of Systemic Discrimination in Class Action Lawsuit

The property insurance claims industry is increasingly turning to independent adjusters rather than company adjusters. The number of independent adjusters calling, texting, and literally confessing to me about unethical conduct has exploded over the last few years. My thought is that insurance companies are hiring independent adjustment firms and then placing financial pressure on those entities to reduce claims severity. Insurers trying to make their financial claims goals will simply hire a competitor of the independent adjusting firm if those numbers are not met. Those independent adjustment companies, in turn, have their claims managers place more emphasis upon closing claims for less than what is owed—damn regulatory ethics requirements and good faith treatment.
Continue Reading Do Independent Property Claims Adjusters Need More Legal Protection From Unethical Managers

Steve Badger is an excellent insurance company advocate. While I poked professional fun at our latest debate in last week’s post, Steve Badger Was Rope-A-Doped By Chip Merlin!, Badger raised the following questions to the audience:
Continue Reading Do Insurance Companies Compete Based Upon Claims Payments? More Thoughts About Steve Badger Being Rope-a-Doped

Steve Badger, insurance industry guru and advocate, admitted that one of the first things he does every single day is read this blog—while he is on his morning toilet after pouring his morning coffee. You may be there right with him. But few would admit it, especially in front of an insurance industry audience that is the insurance industry’s General Counsel.
Continue Reading Steve Badger Was Rope-A-Doped By Chip Merlin!

A news report about a presentation at the Property Loss Research Bureau (PLRB) made this remarkable omission from a person teaching other property insurance adjusters, claims executives, and their attorneys:
Continue Reading Independent Adjuster Leader Admits that Adjusters Tell Engineers Not to Place Opinions in Reports that Increase the Claim Value