I recently deposed corporate representatives from American Family, Auto Owners, State Farm and Allstate Insurance Companies and received the following admissions from some of those corporate representatives:

  1. the independent adjuster (often catastrophe adjusters) failed to follow key aspects of the insurers’ own claims handling guidelines;
     
  2. the independent adjuster failed to properly document the claims file, including failure to enter log notes regarding investigation of the claim;
     
  3. refusal by the independent adjuster to consider additional evidence submitted by the homeowner regarding the property damage claim;
     
  4. there was zero oversight the by insurer’s claim file manager, including no supervision of the independent adjuster;
     
  5. the claims manager failed to have any meaningful participation in the claim and failed to ensure the claims file was properly documented.
     
  6. the independent adjuster made an on site coverage determination and informed the homeowner in-person of the denial of coverage– without prior review of the claim or any supervision by the insurer’s claims manager.


Continue Reading Insurers’ Pattern And Practice Of Hiring Independent Adjusters Known To Have Previously Disregarded Insurers’ Claims Handling Guidelines

Property Casualty 360 posted a story by the Associated Press, describing the continuing saga of Louisiana Citizens Property Insurance Corporations’ Hurricane Rita and Katrina claims.

Continue Reading With $100 Million on the Line, Louisiana’s State Run Insurer of Last Resort is Turning to the U.S. Supreme Court

Louisiana Citizens Property Insurance Company has settled a state class action case, Press v. Louisiana Citizens Fair Plan Property Insurance Corp., for failing to fully pay overhead and profit to insureds. The proposed settlement, for $23 million, covers claims from Hurricanes Katrina and Rita.


Continue Reading Louisiana Citizens Property Insurance Loses Overhead & Profit Case

The Galveston Island and Bolivar Peninsula slab cases are settling. There was an agreement between the Texas attorneys that nothing would come out in the press until the clients signed the agreements. Since even the Texas Windstorm Insurance Association (TWIA) participated with a press release, I assume that the gentlemen’s confidentiality agreement to wait on telling everybody publicly that a settlement has been reached, even before clients have signed the releases, no longer applies. The vast majority of my clients have only received letters from our firm, and I am awaiting final figures from TWIA so that we can consummate the deal. I hope everybody is not optimistically jumping the gun.


Continue Reading Texas Windstorm Insurer Settles 2,400 Hurricane Ike Slab Claims

The oil spill attorneys advertising for a mass of clients and recent advertisements in Texas regarding Hurricane Ike claims, seem to indicate that all my colleagues always win, and win big. Nothing could be further from the truth. The truth is that if you are going to trial or push for what should fully be paid, at least one party to the litigation will lose and, sometimes, lose after a lot of money is offered to settle. Everybody loves to talk about their wins. Losses happen, and I am reminded of that bitterness and horrible feeling of injustice every now and then.


Continue Reading Policyholders Do Not Always Win or Settle for Big Bucks

Jay MacDonald, of Bankrate.com, read a number of our posts and interviewed me regarding insurance coverage issues pertaining the BP Oil Spill. In his insurance blog post, Will Homeowners Insurance Absorb Oil?, he noted a number of my observations concerning the major issues facing policyholder insurance claims resulting from the BP Oil Spill:


Continue Reading Will Homeowner Policies Cover Oil Spill Claims?

On Bloomberg, I gave a television interview regarding the legal and financial aspect of claims and lawsuits which are being generated as a result of the BP Oil Spill. Lost profit and business interruption claims and disputes are not novel to those of us with commercial first party insurance claims experience. Every Sunday, Michelle Claverol, in our Coral Gables office, posts about lost profit cases, which often involve complex accounting and economic issues. The BP Oil Spill is causing an epidemic of these financial loss claims, which will largely be brought as third party claims under the Oil Pollution Act of 1990.


Continue Reading The BP Oil Spill Causes an Epidemic of Claims

The Destin beach’s white sugar sand was in full glory yesterday. While flying back to Tampa and looking down on the crystal blue water and the most gorgeous stretch of beach in the United States, I told Corey Harris that such beauty and fun is being wasted because of fear caused by the oil spill. A funny YouTube video about the current threat of oil and dragons makes the point:
 

https://youtube.com/watch?v=11hGx8eMi_M%26hl%3Den_US%26fs%3D1%26rel%3D0%26color1%3D0x2b405b%26color2%3D0x6b8ab6
Continue Reading Dragons Attacking Gulf Coast Beaches are a Bigger Menace Than the Oil Spill

The tragedy of loss of human life and damage to the environment when discussing the BP Oil Spill cannot be overstated. The important role that accountants and business interruption experts will play helping prove financial loss cannot be overstated either. Experienced professionals like Bob Glasser, noted in yesterday’s Are Lawyers Pandering for BP Oil Spill Clients Going to Get Sued for Malpractice in Follow-up Class Actions? A Guest Blog Regarding Business Claims By Bob Glasser Explains and Guest Blogger Bruce Smith, who wrote The Forensic Accountant’s Role In Business Interruption And Business Income Claims, should be in high demand from businesses and entities that lose revenue and income as a result of this oil spill. Attorneys presenting these lost income claims should consider hiring such individuals as consultants and financial expert witnesses.


Continue Reading Accountants and Business Interruption Experts Will Play an Important Role Recovering BP Oil Spill Income Loss Claims