Imagine if you were responsible for overseeing Florida’s insurance regulations and a subordinate came to you with a problem:
“Boss, we have so many complaints about insurance companies mistreating policyholders coming into the complaint telephone line that the entire staff only has time to take the calls and log the complaint. We do not have anybody left to follow up on the complaint. What do we do?”
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:
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
In a Puerto Rico Hurricane Michael case involving a Zurich Insurance Company providing a policy to a Louisiana policyholder, an alleged delayed payment resulted in attorneys for Zurich arguing that they could delay owed payments for various excuses. The first issue was what a proof of loss meant under Louisiana law.
Continue Reading Proof Of Loss is Different Under Louisiana Law—Should You Be Insured by a Slow and Underpaying Insurance Company?
Property which simply wears out or is damaged by rot is never covered, right? That is what most insurance company adjusters and attorneys will say. Indeed, they will defiantly state something like: “This is a property insurance policy and not a maintenance contract.”
So, what happens if the damaged portion of the property cannot be repaired because the underlying property has pre-existing rot or is simply worn out?
Continue Reading Repairability of Damaged Portions of a Structure: Is Rot or Wear and Tear Always Excluded?
Insurance claims adjusting is not easy business. Quality adjustment which vets claims quickly and gets the money to policyholders fairly, promptly and fully is challenging work. I have repeatedly indicated this in numerous blogs.
Continue Reading Two Views Of Claims Management: Prompt and Full Payment vs. Overpayment Caused By Fraud
One of the most offensive examples of insurance company claims managers losing their ethical way is when they demand that their insureds risk life and limb to immediately investigate their roofs after a hail storm. Most insurance policies require “prompt notice” of loss. But, does the insurance company ever warn its customers they must risk their lives to climb on their roofs or pay money for somebody else after every hail storm?
Continue Reading Prompt Notice of Hail Damage—What is It? Why Do Insurers Fetch Their Lawyers to Claim Non-Compliance? Should Insurers Expect Their Insureds To Dangerously Climb Roofs When OSHA Regulations Prevent Their Own Adjusters From Doing the Same?
Property claims adjusters are supposed to promptly evaluate damage, investigate coverage, and provide full benefits to policyholders. Adjustment is about giving the customer the service promised and paid for when the policy was purchased. This service is not paid with "indemnity dollars," but with insurance company claims expense dollars, which insurance companies must spend to make certain their policyholders are promptly and fully receiving benefits.
It’s no secret that Citizens Property Insurance Corporation routinely treats policyholders like numbers on a page. Despite its title as the state’s largest property insurer, Citizens consistently gets the most complaints from policyholders, earning a reputation as the worst property insurance company in the state — and in a state like Florida, that’s really saying something.
Continue Reading Policyholders Routinely Burned by Citizens Property Insurance Corporation
Insurance companies and insurance industry advocates consistently point to insurance fraud as a reason for higher insurance premiums. But, if insurance fraud is such a problem, why are property insurers still reaping massive profits? With profits like these, is there really justification for consistently raising premiums?
|
Revenues |
Profits |
|||||
|
Rank |
Company |
Fortune 500 rank |
$ millions |
% change from 2009 |
$ millions |
% change from 2009 |
|
(mutual) |
37 |
63,176.7 |
2.8 |
1,762.8 |
129.9 |
|
|
(stock) |
7 |
136,185.0 |
21.1 |
12,967.0 |
61.0 |
|
|
17 |
104,417.0 |
1.2 |
7,786.0 |
N.A. |
||
|
82 |
33,193.0 |
6.8 |
1,678.0 |
64.0 |
||
|
89 |
31,400.0 |
-1.9 |
928.0 |
8.7 |
||
|
106 |
25,112.0 |
1.8 |
3,216.0 |
-11.2 |
||
|
117 |
22,383.0 |
-9.4 |
1,680.0 |
N.A. |
||
|
127 |
20,265.0 |
-2.3 |
959.0 |
33.9 |
||
|
145 |
17,946.1 |
2.2 |
2,637.4 |
-12.7 |
||
|
164 |
14,963.3 |
2.7 |
1,068.3 |
1.0 |
||
|
168 |
14,621.0 |
3.5 |
1,288.0 |
128.4 |
||
|
185 |
13,319.0 |
2.3 |
2,174.0 |
-0.4 |
||
|
285 |
8,527.7 |
-2.0 |
279.2 |
-35.2 |
||
|
358 |
6,491.8 |
0.6 |
487.1 |
89.6 |
||
Continue Reading Insurance Company Profits Soar Despite Alleged Insurance Fraud “Epidemic”