Wait a second here: 99% of claims settled, most lawsuits no longer in contention, $40.6 billion dollars paid, 1.7 million claims. Sounds like overall the industry did a pretty decent job. Sure, there’s some whiners out there but if you take 1.7 million insurance claims (regardless of exposure) I’m sure you’ll find quite a few dissatisfied customers with very loud voices.
With a few mishandled claims exceptions – to be expected considering the magnitude of what had to be dealt with – the industry should be proud of what it accomplished given the nature and scope of the disaster.
Now, it’s 2-years later… it’s over. Quit your whinning and begging for handouts. Get to rebuilding your cities, your lives, and yourselves. No more Oliver Twists asking for more.
You’re cut off. We’re revoking your “Woe Is Me” membership card. We all face adversity in life. People in residential fires have lost everything and don’t take 2-years to rebuild or don’t need FEMA trailers. Get on with it.
You can stop patting yourself on the back also. What a joke. The vast majority of claims (probably over 90%) were simple wind to shingles and resulting water damage as far north as Memphis. Yes, it is very easy to get simple wind claims right, but State Farm and Nationwide got 100% of their claims of wind vs water wrong and yes there are still thousands of mishandled claims still out there. A better percentage comparision would be what percentage of the wind vs water claims were properly settled from the start and how many are settled now.
I am both glad and saddened at the same time for all of the people who were either misled or misinformed about insurance coverage in prone ares.
This is a huge problem and usually lies in th lap of the underwriter. Yes people chose to remove coverages from their policies because they can’t afford the costs but it all stems back to the point I made on where the money collected from Insurance Companies ends up.
I agree with pay for performance but again nobody[CEO,CFO] I know is worth 11.66 million in pay for a year.This money could be distributed to the victims of storms instead of turning to the government to bail out people.
Large insurance companies ahve reinsurance to bail their butts out if the losses they suffer exceed X amount of dollars so think about it.
Adjuster Joe you’ve got a following brother.Their are a lot of people sick and tired except the few that reap the financial gains from manipululating the data they have.
Maybe a better way of looking at the percetnage of closed is to compare how claims were handled when the insured had proper coverage (and I am specifically saying both Wind and Flood) verses when the insured only had Wind coverage.
I suspect that the people who had proper coverage had their claims settled much closer to their expectations and on a much quicker basis.
Okay… let’s start with your numbers. You say thousands… should we say that’s 3000? 4000? Let’s go 5000. That’s .3% of the total claim volume according to this article. A .3% defect rate on something of this magnitude is unfortunate but just about unavoidable unless companies flew over the catastophe area with the back door open on a C-130 and just pushed barrels of money out.
Most of the debate has centered around how much the company was responsible for paying on wind damage when the entire structure was a loss due to flooding. When the house isn’t there anymore the adjuster had to make the determination if wind pushed it off the foundation or if flood waters were responsible.
Thankfully the courts reasonably interpreted that a flood caused by levee failure is still a flood. Some debate centered around storm surge, yes. Was it wind driven water, thats a matter of interpretation.
As for 100%… that sounds highly unlikely. Where are you getting that figure from?
are still thousands of mishandled claims still out there. A better percentage comparision would be what percentage of the wind vs water claims were properly settled from the start and how many are settled now.
Call Michael Moore ask for help…. Maybe he will do a story about State Farm.
I am truly sorry you cannot comprehend the written word, ANON. You continue to try to compare apples to a bushel of grapefruit.
1. State Farm admitted they denied all slab cases. An admision to denying all does equal 100%. They lost and now are trying to lowball final settlements.
2. You try to lump settled cases hundreds of miles inland with slab cases. The insurance industry (even State Farm, except in OKLA where tornados hit and they attempt the same expert engineer tricks they use for Katrina claims) gets simple wind losses right every day. The vast majority of the Katrina claims are just that, simple wind claims over fifty miles from the coast. To compare closing those with the more difficult ones with real questions is absurd.
G: Okay… you want my story? Here’s a brief version:
Lets see… when I was a child my house burned down because of an unattended cigarette… we were properly insured and rebuilt. At the time I was living with my grandmother who was on a fixed income but managed to maintain adequate homeowner’s insurance to protect against that.
I drive a 7 year old Dodge Intrepid that was near totalled in an accident shortly after I purchased it… it was repaired because I caried proper insurance.
I was hospitalized a few years back but that was taken care of (as was my recent dental visits) becuase I carried appropriate insurance.
Two winters ago the gutters on my house as well as my roof were heavily damaged by ice dams and snow/ice weight. Both were repaired by my insurance company because I carried adequate insurance coverage.
My ex-fiancee required extensive medical treatement for “women’s issues”… at the time we weren’t able to afford insurance but we were able to “work off” the accumulated medical bills by working multiple minimum wage jobs.
While working myself through college I lived on Ramen Soup, popsicles, and saltine crackers pilfered from the caffeteria so that I could afford tuition.
Don’t assume to tell me who I am, what I drive, how cold my heart is, etc without knowing me or where I come from. You don’t know the first thing about me or my experiences. I’ve never had “nice things” like expensive cars, toys, etc. I’ve worked hard to get where I am and have saved money by living in my means, doing without luxuries, and realizing the importance of some things over others.
How dare you!
Your comments are disgusting and cold-hearted.
I’m not greedy… I’m a realist. I’m not out of line but I’m also not a socialist. There’s no work? Bull! I’ve heard plenty of people complain about the number of illegals rebuilding New Orleans… can’t find a job… buy a hammer and start bidding. These people have had two years… that’s enough. Even the savior of the depression knew people needed to work… that’s what WPA was all about. If there’s no work, move, take a look at NE-Ohio… that’s why everyone is running as fast as they can.
Don’t assume to know who or what I am because you don’t.
Next you’ll be telling us how to defeat terrorism. Why? Only because you slept at a Holiday Inn Express last nite and “feel” qualified.
Did you stand in the mud like I did? If you did, how can you deny a flood carried all but the slab away?
Further, anyone who makes a generalization with 100% estimate is a fool.
Step right up, Joe, you’ve earned it.
It does not matter whether the claim is for a little roof damage or a total loss, it still counts as a claim. The insurer still has to investigate it and close it, even if it is not a covered loss.
Settled does not mean everyone is happy, it means there is no dispute between the insured and the insurer as to the final settlement. The insured may still be mad because he/she did not get the money they had hoped for, but the claim is settled.
If you can’t agree on these two points, without ranting about State Farm and how they are such an evil company because they did not get 100% of the claims exactly right, then your opinions mean nothing to me.
You must live your life in constant misery due to your unrealistic expectations of 100% perfection.
P.S. You need to keep an eye on the developments in Nationwide v. Leonard. It seems the Fifth Circuit Court of Appeals heard arguments on Monday dealing with the anti-concurrent causation clause. You stated some time ago that Judge Senter had ruled it null and void and that was the end of it. Apparently not!
adjusterjerk is a total legend in his own mindHe can’t comprehend and he can’t explain. All he gives is blinding hate against SF with no logic or reason. I have said this over and over about adjusterjerk (besides him being a serial sexual harrasser) and that is that he has told me (and the rest of you) nothing and added irrelevance.
reading adjusterjoe is a excellent study in extremism. reading his rants you can get a feel for muslim extremism to the western world. he has no ablity to ratainalize and attempt to understand others views. his hatred is absolute to the point of being a fanatic with a suicide belt. life cannot be good for someone with that much hate.
I figured it out… he’s right with the 100% figure. It just takes the creative numerology approach used to decode the secret conspiracy behind September 11th.
If you take the total volume of claims (approximately 1.7 million claims according to this article), then subract all the claims outside 50 miles from the coast, then subrtact all the people who had adequate flood protection, take that number and subtract all the people who didn’t experience a total “slab” loss, subtract from that all the people insured by companies other than State Farm, multiply that by 666 to represent the actual evil of State Farm, then divide it by 4 (obviously, for B-U-S-H) you’ll end up with a 100% figure. Yeah, you may also have to divide it again by the square root of negative pi – don’t forget to cary the one.
Nothing like piling on. Unless each of you has more than 10 years in the claims business and have personally worked a catastrophic claims event like a hurricane,I suggest you lighten up.
Joe’s perspective is coming from that of the adjuster. These people are the “first responders” so-to-speak, and are the face of the insurance company to those in need. I can tell you from personal experience that they spend time away from their families and live in lousey conditions to help those in need. They aren’t in the boardrooms and high level meetings and don’t want to be. And for those of you who do nothing but bash insurance companies, who do you work for and what contributions have you made recently to improve things?
Having worked as a catastrophe adjuster for regional and national P&C carriers, I’m proud of the job they do. Insurance policies never cover everything. People are personally responsible for understanding what is, and what isn’t covered. I’m shocked that nobody has bashed the local agents on this. They’re the ones who sold the policies and should have educated their clients.
If you think the industry is so bad, I suggest you focus your time and energy on making a positive difference. Where would society be without insurance companies? In the end, if you can find a place where things are handled better, perhaps you should consider re-locating there.
I hope you never experience a disaster that requires an insurance response. But if you do, I’d be willing to bet your experience with your company and adjuster will be a pleasant surprise.
Truth is 90% of those whining about not being covered were fully aware that they needed flood coverage. However, many lived in areas that had NEVER SEEN FLOOD WATER BEFORE FROM ANY CAUSE. That does not change the FACT THAT WIND DAMAGED HOMES BEFORE THE WATER!!!!! These people just find it hard to believe that they were and are offered NOTHING FOR WOIND DAMAGE. State Fram and Nationwide made the corporate decision to DENY any wind damage on contract clauses THEY KKNEW would be struck down. I have said it before, they could have saved a lot of grief and money and paid reasonable wind damage on first call and it would all be behind them now. They chose the usual State Farm path of go to h*#@ if you don’t like our way.
All I can wish for you is to loose everything and feel the pain these people have felt. How does one “get on” with their life when it has blown away…have you been to where Katrina hit? We just came back from the area and had a difficult time finding a gas station or even a grocery or pharmacy. These people not only lost their homes but their places of business. You can’t “get on” with you life if you no longer have any income. You are nothing but a greedy selfish and heartless person. I’d like to know what adversity YOU have faced in your measly life….what did you get a scratch on your Jaguar. Your comments are disgusting and WAY out of line!
I am tired like everyone else. Tired of the whining, tired of the insurance rates, tired of hearing the SF vs. Ins’d #4055. To me, here’s the bottom line.
People make choices in life, but unfortunately people are not trained to deal with the consequences when their choice turns out poorly. Case in point, underinsurance in the Gulf states and EVERYWHERE else!
I live in New Orleans and I ride around appalled at what I see. Here’s the catch. A lot of what is still bad was bad before, it’s just that people lived there then. A lot of people didn’t have insurance or not enough not because they did not have the money, but because they made a conscious decision NOT to buy it. And with the programs that have come about from the chaos caused by Katrina, WHY SHOULD THEY BUY IT FOR NEXT TIME? The system here is set up to protect those who make a choice to be irresponsible. Some people get up and go to work every day to earn a living to support their family with a decent lifestyle. We don’t all ask anyone for anything. We pay our bills and we have the best insurance we can buy. It is our choice to be responsible and there are a lot of our type out here.
Do you think that someone actually made up these New Orleans t-shirts that say things like, “I stayed for Katrina and all I got was FEMA money, a New Cadillac, and a plasma TV”? That really happened! The money is here. There is more money now than there ever has been before. FREE money to those who can prove that they did not have enough insurance money to pay for their damages. First of all, there are ridiculous numbers of people taking advantage of this program. For instance, I know someone who had plenty of money to rebuild bigger and better from insurance money, but somehow managed to get Road Home money that he just used to pay for his daughter’s wedding. What? How does that happen? And then consider that there are so many people who cannot be responsible for thousands of dollars in their pockets dedicated to go toward reconstruction of their homes. Another brilliant decision by our government–“Let’s just give everyone their Road Home money and too few stipulations.” Give a drunken homeless man $10 and watch him go buy his next drink. Irresponsibility is just that, and unfortunately it breeds more of the same.
Will Katrina happen again? Probably so. And by the way, the outcome will be the more of the same. People don’t change. You have those you are responsible and those who are not. Those who work hard and earn their lifestyles and those who take from everyone else. It’s just the way that it is.
So those of you who worked here, thank you for your tireless dedication. Insurance companies who didn’t pay what they should, well, that’s nothing new it happens in every catastrophe, but shame on you. Those insurance companies who did pay what you owed, well, that’s what you’re supposed to do. Those of you feeling sorry for the people who haven’t picked up the pieces, look harder–there are a lot of poor souls here, but there are many “Poor pitiful me” souls pulling the wool over a lot of people’s eyes. Katrina was a horrible thing, but this city will never die. People look at the destruction and filth appalled. This was a dirty city before and even with all of the newness that has come from the storm; just give it time–we’ll make it ugly too. Welcome to New Orleans.
Your post appeared to be in response to mine. Here I am trying to be nice and light and you come on like the Jack%&^* you usually are with your constant whining about State Farm. Do you know that most businesses and society in general have changed to new names for old things. Associate for employee and so forth. Probably a symptom of political correctness. As far as I know most companies have changed various terms including insured. Big deal. Now rant some more about State Farm. I don’t know or care about State Farm. If they are bad players, the courts should stick them good. If not, shut up.
My company has always had higher losses in the Midwest. The states in the Midwest just generally don’t take the idiotic approach of a Florida to insurance regulation.
Your the worst kind of conservative. First you complain about people who whine. Then instead of debating the issues at hand…with logic and reasoning (which there is plenty to back your position), verbally attack the person who was trying to illustrate a completely valid point. Then when someone defends the a person who was verbally attacked and turns the personal attack on you, all you do is whine about how hard your life is and that you had to Ramon noodles to go to college.
I am sorry. I am sick of this BS conservative crab “that I made all the right decisions and struggled but I managed to succeed by my hard work.” Who built that school that you went too? Who provided that Farm Subsidy to make your Ramon so cheap? Who regulates the insurance industry to make sure you get what you pay for? And if the Insurance industry can’t pay… The answer is the Government brought to you by the people, for the people.
If you want to post on here stay away from the personal attacks (I do see the Irony-but I did not mean to berate your person just your argument style). Lets stick to the issues because a lot of people have good things to say and the personal attacks’ just denigrate the debate.
I tried every way I could to tell you that there was noting directed towards you. The only objection I have with your posts is your ambivolence towards a cancer on our industry (phrase borrowed from John Dean), State Farm.
It is your don’t care about State Farm attitude that allows them to give our industry a bad name. Moreso it is those that blindly support them that hurt us.
You know Joe, It’s people like you and I that are in close contact with the consumer when they have the terrible experience of suffering a loss. This is the time when the shortages in coverage and the denials of things that are not relative have to be conveyed to the consumer and we take the punches.
Then you read how much profit a company makes and it angers some of us to no end.
I’ll give you an example: I know a single male that has clean driving record excellent credit and a great job but because he is single he pays double the amount on auto premiums than if he had married.This makes no sense at all nor does the credit rating.
The lobbyist for insurance companies have our politicians in eating from their hands because of campaign contributions and the like. This is B.S.The politicians are elected by their constituants not the large corporations and they should nbe looking out for the consumer but they have become so corrupt with money the oposite occurs. I know state legislators and they have told me time and time again about the same old same old.
I have no preference towards ANY insurance company and if you read some of my earlier posts and dialog that has gone on over this topic you will certainly realize that.
I think the entire system needs revamping everyone in insurance works their tales off to do their jobs and perform on as professional a level as possible all the while the the top level execs have their chronies making and tailoring words and phrases that the average public doesn’t understand. This is what causes people to choose the lowest rates and lack of coverage.
Some agencies,not all, are to blame but on the other hand some insurance companies charge outrageous premiums for reasons that only they can comprehend.
I can tell you have first hand knowledge in the southern quadrant of the country and YOU know best what issues are at hand in those areas.
Again Best wishes to you and I applaud the dialog we’ve had on this particular subject.It has given me some insight as to how agnets think which I have never ecperienced before and it DOES leave a fowl odor in the air AGAIN this is not all agents.
I’ll say this again everyone needs to make a living and some are more fortunate than other and some have worked harder than others but don’t blame that on the little guy.
With the exec bonus’ I’ve seen I think it’s an injustice to the people of this country and me being one person can’t do anything about it but try and get people to see the side of the industry I’ve experienced.
Thanks to all for your input!
Don’t try logic with the insurance company haters who post on this site. It never works. There are some people who really think business is evil, insurance companies are more evil and people who make more money than they should(?) are evil. They can’t be convinced.
Nobody: It is many times it is me that you are at odds with and I have never stated the insurance companies make too much money, only that they have a problem fairly and equitably settling claims within the policy and its legal obligations. I make my living exclusively from insurance companies and have for over 25 years. The only money issue I have with insurance companies is that they do not pay adjusters enough. The vast majority act with integrity and honesty. There are two or three that want to do things their own way regardless whether it is right or wrong. They hire only adjusters without expeience and indoctrinate them into their philosophy so they might perpetuate their game.
Partially true and I do pay cash.I save up to buy what I can afford on the petty salary I make and to the guy with the Ramen noodles there are plenty of joibs and work out there if you want to make minimum wage or you have connections to get your foot into a door at a decent paying company.
I feel sorry for you if you’ve gone through all that. I do have a heart if you were referring to me.
I am an adjuster as well not as many years as Joe but close by the way Joe your comments are right on target again.
I’m ending it on this note.I really don’t mean any disrespect to anyone who has worked hard to get to where they’re at.
I am sick and tired of hearing how little money insurance companies have or how they have to raise premiums when every single one of them has posted massive financial gains in the few years even with paying out for CAT damages and executive bonus’
Yes I am bitter at the Corporate part of this Country.Yes I think the officers make to much in bonus money and wake up those very people are making plans with people overseas to send your job there to if they can.
I wasn’t responding to anything you have said. Chrome and someone else posting seem to think that anything paid above what they think is acceptable is wrong. You and I don’t always agree on things, but I respect your knowledge and views.
For the record I would like to correct you.
A policy holder takes out a policy to be indemnified should they suffer a loss.
They should be paid what they are owed..a fair equitable settlement based on the declarations of their policy.
No more No less!
As a State Farm policyholder/owner, I am glad that they had the integrity to deny claims relating to their concurrent causation clause…i.e. living by the terms of their policy and not bowing to emotional appeal/slander of Scruggs group.
I know what my policy covers and what it doesn’t. I don’t want my rates going up because some two-bit judge decides that the policy should cover things that were not intended to be covered and were not rated for in the premium calculations.
Most exclusions in a policy are there for specific reasons, either the coverage is better provided for elsewhere (NFIP for example)or because the cost of including coverage for that issue would be cost prohibititive. The concurrent causation clause exists to eliminate the gray area between a covered event & a non-covered event. Explain to me exactly how an adjuster is supposed to be able to determine the correct indemnification of the wind portion of a slab claim. Explain how the actuaries are supposed to include that data into the rate calculations.
Abslutely, according to the terms of the legal contract. The are entitled to no less and no more. Too many people think they are entitled to payments that are not covered in the contract. If the companies don’t pay what the customer is entitled to they should be punished. If the companies pay more than they should under the contract they are poor business people.
The concurrent causation clause was struck down due to being ambiguous and against public policy. To deny something which is clearly covered in one section (wind) which is impossible to be independently discerned from another peril, just b/c the second event occurs, is fraudulent and a weak attempt to get out of contractual obligations. These are claims that other companies have paid for years and is against public policy. State Farm knew the concurrent causation clause was not enforceable, if litigated, but chose to do so anyway. Take this scenario. A dwelling has wind damage today and before the adjuster can get out, tonite the house falls into a sinkhole. Under the theory of concurrent causation, the claim would be denied in all states but FLA and CALIF. (Feel free to correct me if there are otehr states where sinkholes are possibly covered).
Joe, I hope you weren’t trying to respond to something you think I said with this post. I know nothing about this coverage or exclusions and have never commented on it. All I have ever said is that we all need to abide by the contract. Pay if it is covered, don’t pay if it isn’t. If the court says it’s covered in the end, that’s fine with me. I’m staying out of any technical arguments where I have no expertise. I wish a few other posters would, but they are entitled to an opinion regardless of my opinion of their opinion since this is an opinion post.
Nobody: The post was more at those like State Farm Policyholder and others who want State Farm to abuse INSUREDS.
BTW, from the inception of insurance, persons owning a policy have always been refered to as INSUREDS. In the last 10-15 years State Farm has begun the use of the term POLICYHOLDER. Are the afraid to admit the person owning the policy is an INSURED????? The policy itself refers to INSUREDS rather than policyholders. This makes them appear to go into the process with a bias against the INSURED. Again Nobody, if the shoe don’t fit, don’t try to wear it. No harsh comments directed at you if not discusssing your words.
Some interesting comments Joe.
I’ll have to follow up with your explanation of the policy holder versus insured.
I DO know that FL and California are some of the toughest states for Insurance Companies as well as Wv,Ny and De.
Most companies are focusing on the Midwest states to tap for money now however because of this years weather maybe there has been a change in strategy?
It would be intersting to find something on findlaw surrounding this information.
Joe, Nationwide’s concurrent causation language is the subject of an appeal in MS (Leonard v. Nationwide). Concurrent causation language has not been struck down everywhere, as your post seems to infer. Do you know for a fact that this language/issue has been tried in every jurisdiction? This is not a sarcastic question. I’m curious to know what you know about this subject in states other than OK, MS & LA.
Using your example of wind damage followed the next day by a sinkhole. If a non-covered event follows that closely to a covered event (wind), the home is still a total loss. How can ANY adjuster determine how much wind damage there was? (Again, no sarcasm here.) How can the policyholder be indemnified for the wind loss when they themselves cannot prove the damages that arose from the wind damage? Situations such as this are the basis for concurrent causation language, isn’t it?
This leads into the recent 5th Circuit Court of Appeals ruling on VPL (Valued Policy Laws), which attorneys and policyholders have been using to rape carriers (ALL carriers) when there are concurrent causation issues. Is it OK for policyholders to get full value of the policy/property when the a portion of the loss was caused by a non-covered event even if the covered event did not total the property?
I’m not going to debate bonuses, pay, profits, etc. I am just trying to understand your position on why it is OK for policyholders and attorneys to interpret the policy way beyond what was ever intended, but it is not OK for carriers to rely on the approved wording in a policy to deny a claim.
As far as concurrent causation, I have worked claims all over the US and the only times I have ever run across it was in hurricanes and as far back as 1994 in Hurricane Opal, concurrent causation was not applied. The courts sometimes do use good sense. I repeat from my earlier post; Why should a legitimately owed claim be able to be denied in its entirity just because another loss occurs? I paid losses in FLA in Opal with “CONCURRENT CAUSATION.” The courts look at the past and what has been universally accepted, ie “public policy” and use it in their rulings. If it has been a common practice in the past, why should State Farm now be able to unilaterally remove coverage?
The engineers tell us that they can “GUARANTEE” (and SF accepts this as gospel) that all of the damages were from flood to allow State Farm to escape from any exposure, so why can’t they determine a reaonable wind damage from examining adjacent property? How can they guarantee the dwelling was destroyed by flood and not wind? Was there a wind meter at the dwelling where the loss occurred? Was ther a measuring device at the dwelling for flood levels? Just think about it; why are engineers infalable when their answers are on the side of the carrier and not questioned? The allegations, apparently borne out by actual engineer reports in this instance, are that when the reports support the insured, the carrier has them changed. I have read some of the actual reports and understand why the carriers are being questioned in court. The engineer’s work in Katrina was very shoddy. When it helps the carrier the engineer is a hero and makes good money, but when it favors the insured, it is a different story. He is not called back again.
The only place where I ever heard of the valued plicy being wrongly applied was in FLA. It was quickly corrected by the legislature. You should check the valued policy statute in MS and LA as neither has wind as a covered peril for valued policy to kick in. Alabam has no valued policy statute. As far as a recent ruling on Valued Policy on the 5th Circuit, I am not familiar, but I would suggest that if that is the case, it is due to the carrier not proving their case, ie SHODDY ENGINEER REPORTS. If this case originated from Louisiana, they have some strange jurispurdence such as direct action, no full spousal immunity, assumed negligance if the loss eminates from your property and many others.
You did not really answer my questions. I used your examples on concurrent causation (the wind damage & sinkhole). You responded that you have only seen the concurrent causation clause applied in hurricanes. Why then did you use wind and sinkhole as an example. I also asked how an insured can prove what was covered vs. non-covered damages, again based on your example. You did not answer that.
As to the 5th Circuit decision on VPL, it is a New Orleans case, arising out of Katrina. Oh, by the way…it is in favor of State Farm. It is not a case where State Farm did not prove their case or relied on engineer reports. It is a case where policyholders are seeking the full value of their destroyed home where there was wind & water damage from Katrina, despite the fact that water is not covered under the policy. The 5th Circuit upheld 2 circuit court decisions holding the VPL does not apply when the loss arises out of covered & non-covered perils.
There is an article in yesterday’s Times Picayune on this case.
Sam: I am baffled by your response. You wrote as follows:
This leads into the recent 5th Circuit Court of Appeals ruling on VPL (Valued Policy Laws), which attorneys and policyholders have been using to rape carriers (ALL carriers) when there are concurrent causation issues. Is it OK for policyholders to get full value of the policy/property when the a portion of the loss was caused by a non-covered event even if the covered event did not total the property?
This suggests that the court has wrongly applied valued policy. But now you state the courts got it right. Where is the arguement? WE agree valued policy should not apply in this case and the court got it right. Lawyers daily file lawsuits for things they want but don’t get.
As far as answering your questions, I answered them fully. You misread my example as I used a simialr timeframe as occurred in the hurricane. The wind occurred duing the day and later that nite, the sinkhole occurred. The wind from the Hurican preceded the flood by several hours, same scenario.
Finally read my post. Engineers are GOD when they support the insurance industry and are not to be questioned. If they are so good, they can certainly determine raesonably how much wind damage occurred if they can “GUARANTEE” it was all flood water. The industry many times cuts off tehir nose to spite their face.
I can think of one more example of concurrent causation with flood. The Houston, TX floods of early 90’s when the oil piplne burst and the oil slick caught fire and burned the buildings from the flood line up. I think the oil company paid those claims though and let the carriers of the hook. The uncovered loss came first (flood) and then fire. Obviously the flood caused severe damage, but the homes could be built back. When the fire burnt the dwelling from flood line up, the buildings became non rebuildable from a covered loss. Should State Farm be able to tell the homeowners they will pay nothing in this scenario b/c of flood damage?
If the policy has concurrent causation language approved for use in that state by that state’s insurance department, then YES…the policyholder should not be paid.
I am very glad you have absolutely nothing to do with real policy, however, you must be a State Farm employee as you spout their line perectly. Do you understand the legal theory of “public policy” and not being able to go arbitrarily attempt to go against it? Do you not know that anything which can be construed as the least bit ambiguous is to be interpreted as being in the favor of the person who did NOT draw the contract? If you did not want the truth and the correct answer, why did you ask the question?
You asked a yes or no question; I gave you a yes or no answer. Your question did not refer to ambiguity, public policy, case law, precedent or other factors that vary by state & jurisdiction.
Do not presume to guess where I work, what experience I have in the industry or with policies. Your presumptions are wrong.
Posted On: August 9, 2007, 12:32 pm CDT
Posted By: Sam
Comment:
You asked a yes or no question; I gave you a yes or no answer. Your question did not refer to ambiguity, public policy, case law, precedent or other factors that vary by state & jurisdiction.
It is foolish to talk with someone that lives in a make believe world as do you. Our entire discussion is predicated upon our existence in the real world, so to act as though we live in your lala land where insurance carriers can abuse insureds at will, with no checks, is plain ole dumb.
It took me a while but I know fully know who and what you are.
Sam,don’t you just love Adjuster Jerk, as someone once named him? Sorry, I know I said I wouldn’t read his stuff any more, but his hate of State Farm is so intense and myopic that he is laughable. Anyone who comments on his personal subject is a State Farm sympathizer. His posts give me a comedy release every day. He says the same thing over and over and over and over and over and over, you get the idea. Sam, your balanced posts are intelligent and appreciated by me and probably all the others abused by Joe for the longest time. Ok, Joe, time to accuse Sam and me of evil intent.
Nobody, thanks for the compliments on my posts…I try to be reasoned and reasonably intelligent.
Joe, me thinks you have a bit of a politician in you. You talk out both sides of your mouth to support your opinion (yes, opinion). I read posts almost daily, and have previously posted with you. You do not seem to want to debate facts, because when facts support something in opposition to your opinion, you resort to personal attacks.
You two guys obviously are on the denying side of claims irrelavent of what a court rules in favor of or not.
Hauling in engineers to determine evidence to deny coverage of a loss is a last ditch effort to deny what is rightfully owed on large payouts.
An (insured) is entitled to fair and equitable settlement based on the declarations within the policy in a reasonable amount of time.
The insured either buys more coverage than they need if they can afford it or they buy just enough to cover them if they are devastated.These are the people that are denied coverage the most.
I don’t see any agents saying to an potential client that they shouldn’t buy a house in this area. It is prone to flooding,hurricanes,snow,hail or whatever may be the case.No you sell them a policy and when it comes time to collect on it you give them a song and dance of how this and that is not covered.
An insurance policy is or was considered a contract of utmost good faith.Has that changed? This is obviously not the case anymore based on Sam and Nobody’s statements.
Please let me know so that I can go to my agency and cough over some more money for some high positioned person or agent working on commission to line their pockets more so.
I’ve always said an insurance policy doesn’t tell you what it covers only what it doesn’t.
What adjuster joe keeps saying to you is right on the money and YOU guys don’t want to accept the reality of it.
Instead you turn rude and unprovoked comments and insults.
If SF tries to screw the policy holder obviously they will win by hiring people to represent their cause after all they’ve taken the average persons money for premium payment.The average person doesn’t have the time or the money to fight large companies in court.
It’s good thing people like adjuster joe and myself are around to help try and resolve a claim fairly otherwise more people would be screwed.
Again,the insurance company should pay what’s owed nothing more nothing less.
Sam – just give up on adjusterjerk. The old coot is a total loser and a nutter. I also need to add that the guy is a serial sexual harrasser. This “man” lives with blinders on his eyes and ears and can not and will not listen to anything anyone has to say UNLESS it is in 100% agreement with his thoughts and opinions. Joe always seems to offer nothing and add irrelevance to any topic/discussion/post/etc. Sam, now watch adjusterjerk come on here and talk bad about me cause I am a woman. He does it all the time to all women on this site.
Your LIES and PERSONAL ATTACKS get old. I have never personally attacked you or anyone else. I have never accused you or anyone else of being a child molesterer as you do me. The sole reason you and/or Jewel are part of any discussion due to your total and complete ignorance of insurance and nothing else.
You are apparently unable to read. Let the courts decide. It’s in their hands. Unless you are a judge in addition to being an adjuster you have no say in any of this. All I have ever said is let the courts decide. It’s in their hands. If State Farm is wrong they will be punished. Where is the ambivalence there? I will no longer read or respond to your idiotic rants about this company. You need mental treatment.
It seems obvious to me that chrome and adjusterjoe are public adjusters. That would explain their hatred of State Farm and other large carriers.
Don’t they make a living by trying to increase the amount of a claim to cover their 10% to 15% commisions? Maybe I’m wrong.
I handle claims based on the policy language, state law, and the damage present. I do not handle claims based on how I think a court will interpret the policy if the insured sues.
Wrong. Not a public adjuster. If you do not use jurisprudence in your deliberations then you end up, as does State Farm, with bad faith suits out the wazoo. I have zero bad faith claims in my career. You must have many annually.
My living comes directly from the insurance industry. I do not hate the industry. I do have a distrust for State Farm as they have exhibited a proclivity to abuse their insureds and in the casualty market they routinely deny and refuse to investigate legitimate claims. State Fram is responsible for more anti-insurance industry case law than all other companies combined.
Thank you Mark for pointing out the purpose of the policy. Pay what is owed.
Chrome, you are making assumptions about me, just as Joe did. Please don’t. You are wrong.
I do not purposely set out and look for a way to deny coverage for any claim. I look for every way possible to provide coverage to the policyholder based on the policy language. Sometimes, there is no coverage. If there is a dispute about the policy language, I look to case law AND seek the opinion of coverage counsel in that jurisdiction. I, like Mark, pay what is owed under the policy and have NEVER blindly denied a claim as suggested by a few posters. Nor have I ever hired an engineer to look for a way to deny coverage, nor encouraged an engineer or other expert to fabricate evidence.
Joe, I have provided several facts, cases and articles to you that dispute your position. Instead of continuing what is a futile argument with you, I chose to discontinue posting. You accused me of ‘taking my marbles and going home’. Well, that is my prerogative.
You may want to read the entire 5th U.S. Circuit Court of Appeals’ opinion regarding the various issues on which Nationwide appealed. It’s not perfect, but it does overturn Judge Senter’s ruling on Nationwide’s anti-concurrent causation clause.
Here is a link to David Rossmiller’s blog, which has links to the AP story and the actual opinion in PDF format.
Wait a second here: 99% of claims settled, most lawsuits no longer in contention, $40.6 billion dollars paid, 1.7 million claims. Sounds like overall the industry did a pretty decent job. Sure, there’s some whiners out there but if you take 1.7 million insurance claims (regardless of exposure) I’m sure you’ll find quite a few dissatisfied customers with very loud voices.
With a few mishandled claims exceptions – to be expected considering the magnitude of what had to be dealt with – the industry should be proud of what it accomplished given the nature and scope of the disaster.
Now, it’s 2-years later… it’s over. Quit your whinning and begging for handouts. Get to rebuilding your cities, your lives, and yourselves. No more Oliver Twists asking for more.
You’re cut off. We’re revoking your “Woe Is Me” membership card. We all face adversity in life. People in residential fires have lost everything and don’t take 2-years to rebuild or don’t need FEMA trailers. Get on with it.
You can stop patting yourself on the back also. What a joke. The vast majority of claims (probably over 90%) were simple wind to shingles and resulting water damage as far north as Memphis. Yes, it is very easy to get simple wind claims right, but State Farm and Nationwide got 100% of their claims of wind vs water wrong and yes there are still thousands of mishandled claims still out there. A better percentage comparision would be what percentage of the wind vs water claims were properly settled from the start and how many are settled now.
I am both glad and saddened at the same time for all of the people who were either misled or misinformed about insurance coverage in prone ares.
This is a huge problem and usually lies in th lap of the underwriter. Yes people chose to remove coverages from their policies because they can’t afford the costs but it all stems back to the point I made on where the money collected from Insurance Companies ends up.
I agree with pay for performance but again nobody[CEO,CFO] I know is worth 11.66 million in pay for a year.This money could be distributed to the victims of storms instead of turning to the government to bail out people.
Large insurance companies ahve reinsurance to bail their butts out if the losses they suffer exceed X amount of dollars so think about it.
Adjuster Joe you’ve got a following brother.Their are a lot of people sick and tired except the few that reap the financial gains from manipululating the data they have.
New Orleans should’ve stayed under water!
No that’s a time bomb waiting to go off.
Below sea level and they are rebuilding.Where’s the sanity?
Maybe a better way of looking at the percetnage of closed is to compare how claims were handled when the insured had proper coverage (and I am specifically saying both Wind and Flood) verses when the insured only had Wind coverage.
I suspect that the people who had proper coverage had their claims settled much closer to their expectations and on a much quicker basis.
Okay… let’s start with your numbers. You say thousands… should we say that’s 3000? 4000? Let’s go 5000. That’s .3% of the total claim volume according to this article. A .3% defect rate on something of this magnitude is unfortunate but just about unavoidable unless companies flew over the catastophe area with the back door open on a C-130 and just pushed barrels of money out.
Most of the debate has centered around how much the company was responsible for paying on wind damage when the entire structure was a loss due to flooding. When the house isn’t there anymore the adjuster had to make the determination if wind pushed it off the foundation or if flood waters were responsible.
Thankfully the courts reasonably interpreted that a flood caused by levee failure is still a flood. Some debate centered around storm surge, yes. Was it wind driven water, thats a matter of interpretation.
As for 100%… that sounds highly unlikely. Where are you getting that figure from?
are still thousands of mishandled claims still out there. A better percentage comparision would be what percentage of the wind vs water claims were properly settled from the start and how many are settled now.
Call Michael Moore ask for help…. Maybe he will do a story about State Farm.
Call Anita Lee at the Sun Herald ask her about State Farm. And see how great your personal jurisdiction is.
The only way Michael Moore would do a story is if it got him in the lime light.
Bottom line is that many people did not carry the proper insurance and unfortunately it came back to bite them.
I am truly sorry you cannot comprehend the written word, ANON. You continue to try to compare apples to a bushel of grapefruit.
1. State Farm admitted they denied all slab cases. An admision to denying all does equal 100%. They lost and now are trying to lowball final settlements.
2. You try to lump settled cases hundreds of miles inland with slab cases. The insurance industry (even State Farm, except in OKLA where tornados hit and they attempt the same expert engineer tricks they use for Katrina claims) gets simple wind losses right every day. The vast majority of the Katrina claims are just that, simple wind claims over fifty miles from the coast. To compare closing those with the more difficult ones with real questions is absurd.
G: Okay… you want my story? Here’s a brief version:
Lets see… when I was a child my house burned down because of an unattended cigarette… we were properly insured and rebuilt. At the time I was living with my grandmother who was on a fixed income but managed to maintain adequate homeowner’s insurance to protect against that.
I drive a 7 year old Dodge Intrepid that was near totalled in an accident shortly after I purchased it… it was repaired because I caried proper insurance.
I was hospitalized a few years back but that was taken care of (as was my recent dental visits) becuase I carried appropriate insurance.
Two winters ago the gutters on my house as well as my roof were heavily damaged by ice dams and snow/ice weight. Both were repaired by my insurance company because I carried adequate insurance coverage.
My ex-fiancee required extensive medical treatement for “women’s issues”… at the time we weren’t able to afford insurance but we were able to “work off” the accumulated medical bills by working multiple minimum wage jobs.
While working myself through college I lived on Ramen Soup, popsicles, and saltine crackers pilfered from the caffeteria so that I could afford tuition.
Don’t assume to tell me who I am, what I drive, how cold my heart is, etc without knowing me or where I come from. You don’t know the first thing about me or my experiences. I’ve never had “nice things” like expensive cars, toys, etc. I’ve worked hard to get where I am and have saved money by living in my means, doing without luxuries, and realizing the importance of some things over others.
How dare you!
Your comments are disgusting and cold-hearted.
I’m not greedy… I’m a realist. I’m not out of line but I’m also not a socialist. There’s no work? Bull! I’ve heard plenty of people complain about the number of illegals rebuilding New Orleans… can’t find a job… buy a hammer and start bidding. These people have had two years… that’s enough. Even the savior of the depression knew people needed to work… that’s what WPA was all about. If there’s no work, move, take a look at NE-Ohio… that’s why everyone is running as fast as they can.
Don’t assume to know who or what I am because you don’t.
Next you’ll be telling us how to defeat terrorism. Why? Only because you slept at a Holiday Inn Express last nite and “feel” qualified.
Did you stand in the mud like I did? If you did, how can you deny a flood carried all but the slab away?
Further, anyone who makes a generalization with 100% estimate is a fool.
Step right up, Joe, you’ve earned it.
adjusterjoe,
It does not matter whether the claim is for a little roof damage or a total loss, it still counts as a claim. The insurer still has to investigate it and close it, even if it is not a covered loss.
Settled does not mean everyone is happy, it means there is no dispute between the insured and the insurer as to the final settlement. The insured may still be mad because he/she did not get the money they had hoped for, but the claim is settled.
If you can’t agree on these two points, without ranting about State Farm and how they are such an evil company because they did not get 100% of the claims exactly right, then your opinions mean nothing to me.
You must live your life in constant misery due to your unrealistic expectations of 100% perfection.
P.S. You need to keep an eye on the developments in Nationwide v. Leonard. It seems the Fifth Circuit Court of Appeals heard arguments on Monday dealing with the anti-concurrent causation clause. You stated some time ago that Judge Senter had ruled it null and void and that was the end of it. Apparently not!
Check out http://www.insurancecoverageblog.com/ for the opinion of someone more smarter than I is…
Defeating Terrorism
By: adjusterjoe
Step one… get rid of State Farm
The End
Been there, I have been working hurricanes for over 20 years and yes I did work Katrina and am familiar with the Mississsippi Coast. Bring it on.
adjusterjerk is a total legend in his own mindHe can’t comprehend and he can’t explain. All he gives is blinding hate against SF with no logic or reason. I have said this over and over about adjusterjerk (besides him being a serial sexual harrasser) and that is that he has told me (and the rest of you) nothing and added irrelevance.
Does kind of make one wonder about his self stated credentials, doesn’t it?
reading adjusterjoe is a excellent study in extremism. reading his rants you can get a feel for muslim extremism to the western world. he has no ablity to ratainalize and attempt to understand others views. his hatred is absolute to the point of being a fanatic with a suicide belt. life cannot be good for someone with that much hate.
I figured it out… he’s right with the 100% figure. It just takes the creative numerology approach used to decode the secret conspiracy behind September 11th.
If you take the total volume of claims (approximately 1.7 million claims according to this article), then subract all the claims outside 50 miles from the coast, then subrtact all the people who had adequate flood protection, take that number and subtract all the people who didn’t experience a total “slab” loss, subtract from that all the people insured by companies other than State Farm, multiply that by 666 to represent the actual evil of State Farm, then divide it by 4 (obviously, for B-U-S-H) you’ll end up with a 100% figure. Yeah, you may also have to divide it again by the square root of negative pi – don’t forget to cary the one.
Very well said! A claim is a claim is a claim. You pay premium for coverage they should pay what they owe period!
To All:
Nothing like piling on. Unless each of you has more than 10 years in the claims business and have personally worked a catastrophic claims event like a hurricane,I suggest you lighten up.
Joe’s perspective is coming from that of the adjuster. These people are the “first responders” so-to-speak, and are the face of the insurance company to those in need. I can tell you from personal experience that they spend time away from their families and live in lousey conditions to help those in need. They aren’t in the boardrooms and high level meetings and don’t want to be. And for those of you who do nothing but bash insurance companies, who do you work for and what contributions have you made recently to improve things?
Having worked as a catastrophe adjuster for regional and national P&C carriers, I’m proud of the job they do. Insurance policies never cover everything. People are personally responsible for understanding what is, and what isn’t covered. I’m shocked that nobody has bashed the local agents on this. They’re the ones who sold the policies and should have educated their clients.
If you think the industry is so bad, I suggest you focus your time and energy on making a positive difference. Where would society be without insurance companies? In the end, if you can find a place where things are handled better, perhaps you should consider re-locating there.
I hope you never experience a disaster that requires an insurance response. But if you do, I’d be willing to bet your experience with your company and adjuster will be a pleasant surprise.
Joe is absolutely correct!
But think Joe the bonus’ will be lower next year if they don’t play games!
Well said!
Truth is 90% of those whining about not being covered were fully aware that they needed flood coverage. However, many lived in areas that had NEVER SEEN FLOOD WATER BEFORE FROM ANY CAUSE. That does not change the FACT THAT WIND DAMAGED HOMES BEFORE THE WATER!!!!! These people just find it hard to believe that they were and are offered NOTHING FOR WOIND DAMAGE. State Fram and Nationwide made the corporate decision to DENY any wind damage on contract clauses THEY KKNEW would be struck down. I have said it before, they could have saved a lot of grief and money and paid reasonable wind damage on first call and it would all be behind them now. They chose the usual State Farm path of go to h*#@ if you don’t like our way.
People don’t carry the proper insurance because they can’t afford the outrageous rates by the insurance companies!
All I can wish for you is to loose everything and feel the pain these people have felt. How does one “get on” with their life when it has blown away…have you been to where Katrina hit? We just came back from the area and had a difficult time finding a gas station or even a grocery or pharmacy. These people not only lost their homes but their places of business. You can’t “get on” with you life if you no longer have any income. You are nothing but a greedy selfish and heartless person. I’d like to know what adversity YOU have faced in your measly life….what did you get a scratch on your Jaguar. Your comments are disgusting and WAY out of line!
I am tired like everyone else. Tired of the whining, tired of the insurance rates, tired of hearing the SF vs. Ins’d #4055. To me, here’s the bottom line.
People make choices in life, but unfortunately people are not trained to deal with the consequences when their choice turns out poorly. Case in point, underinsurance in the Gulf states and EVERYWHERE else!
I live in New Orleans and I ride around appalled at what I see. Here’s the catch. A lot of what is still bad was bad before, it’s just that people lived there then. A lot of people didn’t have insurance or not enough not because they did not have the money, but because they made a conscious decision NOT to buy it. And with the programs that have come about from the chaos caused by Katrina, WHY SHOULD THEY BUY IT FOR NEXT TIME? The system here is set up to protect those who make a choice to be irresponsible. Some people get up and go to work every day to earn a living to support their family with a decent lifestyle. We don’t all ask anyone for anything. We pay our bills and we have the best insurance we can buy. It is our choice to be responsible and there are a lot of our type out here.
Do you think that someone actually made up these New Orleans t-shirts that say things like, “I stayed for Katrina and all I got was FEMA money, a New Cadillac, and a plasma TV”? That really happened! The money is here. There is more money now than there ever has been before. FREE money to those who can prove that they did not have enough insurance money to pay for their damages. First of all, there are ridiculous numbers of people taking advantage of this program. For instance, I know someone who had plenty of money to rebuild bigger and better from insurance money, but somehow managed to get Road Home money that he just used to pay for his daughter’s wedding. What? How does that happen? And then consider that there are so many people who cannot be responsible for thousands of dollars in their pockets dedicated to go toward reconstruction of their homes. Another brilliant decision by our government–“Let’s just give everyone their Road Home money and too few stipulations.” Give a drunken homeless man $10 and watch him go buy his next drink. Irresponsibility is just that, and unfortunately it breeds more of the same.
Will Katrina happen again? Probably so. And by the way, the outcome will be the more of the same. People don’t change. You have those you are responsible and those who are not. Those who work hard and earn their lifestyles and those who take from everyone else. It’s just the way that it is.
So those of you who worked here, thank you for your tireless dedication. Insurance companies who didn’t pay what they should, well, that’s nothing new it happens in every catastrophe, but shame on you. Those insurance companies who did pay what you owed, well, that’s what you’re supposed to do. Those of you feeling sorry for the people who haven’t picked up the pieces, look harder–there are a lot of poor souls here, but there are many “Poor pitiful me” souls pulling the wool over a lot of people’s eyes. Katrina was a horrible thing, but this city will never die. People look at the destruction and filth appalled. This was a dirty city before and even with all of the newness that has come from the storm; just give it time–we’ll make it ugly too. Welcome to New Orleans.
Your post appeared to be in response to mine. Here I am trying to be nice and light and you come on like the Jack%&^* you usually are with your constant whining about State Farm. Do you know that most businesses and society in general have changed to new names for old things. Associate for employee and so forth. Probably a symptom of political correctness. As far as I know most companies have changed various terms including insured. Big deal. Now rant some more about State Farm. I don’t know or care about State Farm. If they are bad players, the courts should stick them good. If not, shut up.
My company has always had higher losses in the Midwest. The states in the Midwest just generally don’t take the idiotic approach of a Florida to insurance regulation.
Anon,
Your the worst kind of conservative. First you complain about people who whine. Then instead of debating the issues at hand…with logic and reasoning (which there is plenty to back your position), verbally attack the person who was trying to illustrate a completely valid point. Then when someone defends the a person who was verbally attacked and turns the personal attack on you, all you do is whine about how hard your life is and that you had to Ramon noodles to go to college.
I am sorry. I am sick of this BS conservative crab “that I made all the right decisions and struggled but I managed to succeed by my hard work.” Who built that school that you went too? Who provided that Farm Subsidy to make your Ramon so cheap? Who regulates the insurance industry to make sure you get what you pay for? And if the Insurance industry can’t pay… The answer is the Government brought to you by the people, for the people.
If you want to post on here stay away from the personal attacks (I do see the Irony-but I did not mean to berate your person just your argument style). Lets stick to the issues because a lot of people have good things to say and the personal attacks’ just denigrate the debate.
I tried every way I could to tell you that there was noting directed towards you. The only objection I have with your posts is your ambivolence towards a cancer on our industry (phrase borrowed from John Dean), State Farm.
It is your don’t care about State Farm attitude that allows them to give our industry a bad name. Moreso it is those that blindly support them that hurt us.
Do the math Einstein. If the rates and prices dont support the claims, who pays?
Pay cash for your stuff and you dont need property insurance , or start your own insurance company since its so easy to make money
You know Joe, It’s people like you and I that are in close contact with the consumer when they have the terrible experience of suffering a loss. This is the time when the shortages in coverage and the denials of things that are not relative have to be conveyed to the consumer and we take the punches.
Then you read how much profit a company makes and it angers some of us to no end.
I’ll give you an example: I know a single male that has clean driving record excellent credit and a great job but because he is single he pays double the amount on auto premiums than if he had married.This makes no sense at all nor does the credit rating.
The lobbyist for insurance companies have our politicians in eating from their hands because of campaign contributions and the like. This is B.S.The politicians are elected by their constituants not the large corporations and they should nbe looking out for the consumer but they have become so corrupt with money the oposite occurs. I know state legislators and they have told me time and time again about the same old same old.
I have no preference towards ANY insurance company and if you read some of my earlier posts and dialog that has gone on over this topic you will certainly realize that.
I think the entire system needs revamping everyone in insurance works their tales off to do their jobs and perform on as professional a level as possible all the while the the top level execs have their chronies making and tailoring words and phrases that the average public doesn’t understand. This is what causes people to choose the lowest rates and lack of coverage.
Some agencies,not all, are to blame but on the other hand some insurance companies charge outrageous premiums for reasons that only they can comprehend.
I can tell you have first hand knowledge in the southern quadrant of the country and YOU know best what issues are at hand in those areas.
Again Best wishes to you and I applaud the dialog we’ve had on this particular subject.It has given me some insight as to how agnets think which I have never ecperienced before and it DOES leave a fowl odor in the air AGAIN this is not all agents.
I’ll say this again everyone needs to make a living and some are more fortunate than other and some have worked harder than others but don’t blame that on the little guy.
With the exec bonus’ I’ve seen I think it’s an injustice to the people of this country and me being one person can’t do anything about it but try and get people to see the side of the industry I’ve experienced.
Thanks to all for your input!
Don’t try logic with the insurance company haters who post on this site. It never works. There are some people who really think business is evil, insurance companies are more evil and people who make more money than they should(?) are evil. They can’t be convinced.
Nobody: It is many times it is me that you are at odds with and I have never stated the insurance companies make too much money, only that they have a problem fairly and equitably settling claims within the policy and its legal obligations. I make my living exclusively from insurance companies and have for over 25 years. The only money issue I have with insurance companies is that they do not pay adjusters enough. The vast majority act with integrity and honesty. There are two or three that want to do things their own way regardless whether it is right or wrong. They hire only adjusters without expeience and indoctrinate them into their philosophy so they might perpetuate their game.
Partially true and I do pay cash.I save up to buy what I can afford on the petty salary I make and to the guy with the Ramen noodles there are plenty of joibs and work out there if you want to make minimum wage or you have connections to get your foot into a door at a decent paying company.
I feel sorry for you if you’ve gone through all that. I do have a heart if you were referring to me.
I am an adjuster as well not as many years as Joe but close by the way Joe your comments are right on target again.
I’m ending it on this note.I really don’t mean any disrespect to anyone who has worked hard to get to where they’re at.
I am sick and tired of hearing how little money insurance companies have or how they have to raise premiums when every single one of them has posted massive financial gains in the few years even with paying out for CAT damages and executive bonus’
Yes I am bitter at the Corporate part of this Country.Yes I think the officers make to much in bonus money and wake up those very people are making plans with people overseas to send your job there to if they can.
I wasn’t responding to anything you have said. Chrome and someone else posting seem to think that anything paid above what they think is acceptable is wrong. You and I don’t always agree on things, but I respect your knowledge and views.
For the record I would like to correct you.
A policy holder takes out a policy to be indemnified should they suffer a loss.
They should be paid what they are owed..a fair equitable settlement based on the declarations of their policy.
No more No less!
As a State Farm policyholder/owner, I am glad that they had the integrity to deny claims relating to their concurrent causation clause…i.e. living by the terms of their policy and not bowing to emotional appeal/slander of Scruggs group.
I know what my policy covers and what it doesn’t. I don’t want my rates going up because some two-bit judge decides that the policy should cover things that were not intended to be covered and were not rated for in the premium calculations.
Most exclusions in a policy are there for specific reasons, either the coverage is better provided for elsewhere (NFIP for example)or because the cost of including coverage for that issue would be cost prohibititive. The concurrent causation clause exists to eliminate the gray area between a covered event & a non-covered event. Explain to me exactly how an adjuster is supposed to be able to determine the correct indemnification of the wind portion of a slab claim. Explain how the actuaries are supposed to include that data into the rate calculations.
Abslutely, according to the terms of the legal contract. The are entitled to no less and no more. Too many people think they are entitled to payments that are not covered in the contract. If the companies don’t pay what the customer is entitled to they should be punished. If the companies pay more than they should under the contract they are poor business people.
The concurrent causation clause was struck down due to being ambiguous and against public policy. To deny something which is clearly covered in one section (wind) which is impossible to be independently discerned from another peril, just b/c the second event occurs, is fraudulent and a weak attempt to get out of contractual obligations. These are claims that other companies have paid for years and is against public policy. State Farm knew the concurrent causation clause was not enforceable, if litigated, but chose to do so anyway. Take this scenario. A dwelling has wind damage today and before the adjuster can get out, tonite the house falls into a sinkhole. Under the theory of concurrent causation, the claim would be denied in all states but FLA and CALIF. (Feel free to correct me if there are otehr states where sinkholes are possibly covered).
Joe, I hope you weren’t trying to respond to something you think I said with this post. I know nothing about this coverage or exclusions and have never commented on it. All I have ever said is that we all need to abide by the contract. Pay if it is covered, don’t pay if it isn’t. If the court says it’s covered in the end, that’s fine with me. I’m staying out of any technical arguments where I have no expertise. I wish a few other posters would, but they are entitled to an opinion regardless of my opinion of their opinion since this is an opinion post.
Nobody: The post was more at those like State Farm Policyholder and others who want State Farm to abuse INSUREDS.
BTW, from the inception of insurance, persons owning a policy have always been refered to as INSUREDS. In the last 10-15 years State Farm has begun the use of the term POLICYHOLDER. Are the afraid to admit the person owning the policy is an INSURED????? The policy itself refers to INSUREDS rather than policyholders. This makes them appear to go into the process with a bias against the INSURED. Again Nobody, if the shoe don’t fit, don’t try to wear it. No harsh comments directed at you if not discusssing your words.
Some interesting comments Joe.
I’ll have to follow up with your explanation of the policy holder versus insured.
I DO know that FL and California are some of the toughest states for Insurance Companies as well as Wv,Ny and De.
Most companies are focusing on the Midwest states to tap for money now however because of this years weather maybe there has been a change in strategy?
It would be intersting to find something on findlaw surrounding this information.
Joe, Nationwide’s concurrent causation language is the subject of an appeal in MS (Leonard v. Nationwide). Concurrent causation language has not been struck down everywhere, as your post seems to infer. Do you know for a fact that this language/issue has been tried in every jurisdiction? This is not a sarcastic question. I’m curious to know what you know about this subject in states other than OK, MS & LA.
Using your example of wind damage followed the next day by a sinkhole. If a non-covered event follows that closely to a covered event (wind), the home is still a total loss. How can ANY adjuster determine how much wind damage there was? (Again, no sarcasm here.) How can the policyholder be indemnified for the wind loss when they themselves cannot prove the damages that arose from the wind damage? Situations such as this are the basis for concurrent causation language, isn’t it?
This leads into the recent 5th Circuit Court of Appeals ruling on VPL (Valued Policy Laws), which attorneys and policyholders have been using to rape carriers (ALL carriers) when there are concurrent causation issues. Is it OK for policyholders to get full value of the policy/property when the a portion of the loss was caused by a non-covered event even if the covered event did not total the property?
I’m not going to debate bonuses, pay, profits, etc. I am just trying to understand your position on why it is OK for policyholders and attorneys to interpret the policy way beyond what was ever intended, but it is not OK for carriers to rely on the approved wording in a policy to deny a claim.
Posted On: August 8, 2007, 8:34 pm CDT
Posted By: Nobody Important
I don’t know or care about State Farm.
I just read them like they are written.
Sam:
As far as concurrent causation, I have worked claims all over the US and the only times I have ever run across it was in hurricanes and as far back as 1994 in Hurricane Opal, concurrent causation was not applied. The courts sometimes do use good sense. I repeat from my earlier post; Why should a legitimately owed claim be able to be denied in its entirity just because another loss occurs? I paid losses in FLA in Opal with “CONCURRENT CAUSATION.” The courts look at the past and what has been universally accepted, ie “public policy” and use it in their rulings. If it has been a common practice in the past, why should State Farm now be able to unilaterally remove coverage?
The engineers tell us that they can “GUARANTEE” (and SF accepts this as gospel) that all of the damages were from flood to allow State Farm to escape from any exposure, so why can’t they determine a reaonable wind damage from examining adjacent property? How can they guarantee the dwelling was destroyed by flood and not wind? Was there a wind meter at the dwelling where the loss occurred? Was ther a measuring device at the dwelling for flood levels? Just think about it; why are engineers infalable when their answers are on the side of the carrier and not questioned? The allegations, apparently borne out by actual engineer reports in this instance, are that when the reports support the insured, the carrier has them changed. I have read some of the actual reports and understand why the carriers are being questioned in court. The engineer’s work in Katrina was very shoddy. When it helps the carrier the engineer is a hero and makes good money, but when it favors the insured, it is a different story. He is not called back again.
The only place where I ever heard of the valued plicy being wrongly applied was in FLA. It was quickly corrected by the legislature. You should check the valued policy statute in MS and LA as neither has wind as a covered peril for valued policy to kick in. Alabam has no valued policy statute. As far as a recent ruling on Valued Policy on the 5th Circuit, I am not familiar, but I would suggest that if that is the case, it is due to the carrier not proving their case, ie SHODDY ENGINEER REPORTS. If this case originated from Louisiana, they have some strange jurispurdence such as direct action, no full spousal immunity, assumed negligance if the loss eminates from your property and many others.
You did not really answer my questions. I used your examples on concurrent causation (the wind damage & sinkhole). You responded that you have only seen the concurrent causation clause applied in hurricanes. Why then did you use wind and sinkhole as an example. I also asked how an insured can prove what was covered vs. non-covered damages, again based on your example. You did not answer that.
As to the 5th Circuit decision on VPL, it is a New Orleans case, arising out of Katrina. Oh, by the way…it is in favor of State Farm. It is not a case where State Farm did not prove their case or relied on engineer reports. It is a case where policyholders are seeking the full value of their destroyed home where there was wind & water damage from Katrina, despite the fact that water is not covered under the policy. The 5th Circuit upheld 2 circuit court decisions holding the VPL does not apply when the loss arises out of covered & non-covered perils.
There is an article in yesterday’s Times Picayune on this case.
Sam: I am baffled by your response. You wrote as follows:
This leads into the recent 5th Circuit Court of Appeals ruling on VPL (Valued Policy Laws), which attorneys and policyholders have been using to rape carriers (ALL carriers) when there are concurrent causation issues. Is it OK for policyholders to get full value of the policy/property when the a portion of the loss was caused by a non-covered event even if the covered event did not total the property?
This suggests that the court has wrongly applied valued policy. But now you state the courts got it right. Where is the arguement? WE agree valued policy should not apply in this case and the court got it right. Lawyers daily file lawsuits for things they want but don’t get.
As far as answering your questions, I answered them fully. You misread my example as I used a simialr timeframe as occurred in the hurricane. The wind occurred duing the day and later that nite, the sinkhole occurred. The wind from the Hurican preceded the flood by several hours, same scenario.
Finally read my post. Engineers are GOD when they support the insurance industry and are not to be questioned. If they are so good, they can certainly determine raesonably how much wind damage occurred if they can “GUARANTEE” it was all flood water. The industry many times cuts off tehir nose to spite their face.
I can think of one more example of concurrent causation with flood. The Houston, TX floods of early 90’s when the oil piplne burst and the oil slick caught fire and burned the buildings from the flood line up. I think the oil company paid those claims though and let the carriers of the hook. The uncovered loss came first (flood) and then fire. Obviously the flood caused severe damage, but the homes could be built back. When the fire burnt the dwelling from flood line up, the buildings became non rebuildable from a covered loss. Should State Farm be able to tell the homeowners they will pay nothing in this scenario b/c of flood damage?
If the policy has concurrent causation language approved for use in that state by that state’s insurance department, then YES…the policyholder should not be paid.
I am very glad you have absolutely nothing to do with real policy, however, you must be a State Farm employee as you spout their line perectly. Do you understand the legal theory of “public policy” and not being able to go arbitrarily attempt to go against it? Do you not know that anything which can be construed as the least bit ambiguous is to be interpreted as being in the favor of the person who did NOT draw the contract? If you did not want the truth and the correct answer, why did you ask the question?
You asked a yes or no question; I gave you a yes or no answer. Your question did not refer to ambiguity, public policy, case law, precedent or other factors that vary by state & jurisdiction.
Do not presume to guess where I work, what experience I have in the industry or with policies. Your presumptions are wrong.
You are obviously one of the blind followers, with only one perspective.
Posted On: August 9, 2007, 12:32 pm CDT
Posted By: Sam
Comment:
You asked a yes or no question; I gave you a yes or no answer. Your question did not refer to ambiguity, public policy, case law, precedent or other factors that vary by state & jurisdiction.
It is foolish to talk with someone that lives in a make believe world as do you. Our entire discussion is predicated upon our existence in the real world, so to act as though we live in your lala land where insurance carriers can abuse insureds at will, with no checks, is plain ole dumb.
It took me a while but I know fully know who and what you are.
Sam,don’t you just love Adjuster Jerk, as someone once named him? Sorry, I know I said I wouldn’t read his stuff any more, but his hate of State Farm is so intense and myopic that he is laughable. Anyone who comments on his personal subject is a State Farm sympathizer. His posts give me a comedy release every day. He says the same thing over and over and over and over and over and over, you get the idea. Sam, your balanced posts are intelligent and appreciated by me and probably all the others abused by Joe for the longest time. Ok, Joe, time to accuse Sam and me of evil intent.
Nobody, thanks for the compliments on my posts…I try to be reasoned and reasonably intelligent.
Joe, me thinks you have a bit of a politician in you. You talk out both sides of your mouth to support your opinion (yes, opinion). I read posts almost daily, and have previously posted with you. You do not seem to want to debate facts, because when facts support something in opposition to your opinion, you resort to personal attacks.
Have a nice day. I’m outta here!
Sam:
Your response to the truth is a common one. “I have no answer for the truth so I will take my marbles and go home.”
When you have any facts on your side, please feel free to elucidate!
You two guys obviously are on the denying side of claims irrelavent of what a court rules in favor of or not.
Hauling in engineers to determine evidence to deny coverage of a loss is a last ditch effort to deny what is rightfully owed on large payouts.
An (insured) is entitled to fair and equitable settlement based on the declarations within the policy in a reasonable amount of time.
The insured either buys more coverage than they need if they can afford it or they buy just enough to cover them if they are devastated.These are the people that are denied coverage the most.
I don’t see any agents saying to an potential client that they shouldn’t buy a house in this area. It is prone to flooding,hurricanes,snow,hail or whatever may be the case.No you sell them a policy and when it comes time to collect on it you give them a song and dance of how this and that is not covered.
An insurance policy is or was considered a contract of utmost good faith.Has that changed? This is obviously not the case anymore based on Sam and Nobody’s statements.
Please let me know so that I can go to my agency and cough over some more money for some high positioned person or agent working on commission to line their pockets more so.
I’ve always said an insurance policy doesn’t tell you what it covers only what it doesn’t.
What adjuster joe keeps saying to you is right on the money and YOU guys don’t want to accept the reality of it.
Instead you turn rude and unprovoked comments and insults.
If SF tries to screw the policy holder obviously they will win by hiring people to represent their cause after all they’ve taken the average persons money for premium payment.The average person doesn’t have the time or the money to fight large companies in court.
It’s good thing people like adjuster joe and myself are around to help try and resolve a claim fairly otherwise more people would be screwed.
Again,the insurance company should pay what’s owed nothing more nothing less.
Sam – just give up on adjusterjerk. The old coot is a total loser and a nutter. I also need to add that the guy is a serial sexual harrasser. This “man” lives with blinders on his eyes and ears and can not and will not listen to anything anyone has to say UNLESS it is in 100% agreement with his thoughts and opinions. Joe always seems to offer nothing and add irrelevance to any topic/discussion/post/etc. Sam, now watch adjusterjerk come on here and talk bad about me cause I am a woman. He does it all the time to all women on this site.
Mary:
Your LIES and PERSONAL ATTACKS get old. I have never personally attacked you or anyone else. I have never accused you or anyone else of being a child molesterer as you do me. The sole reason you and/or Jewel are part of any discussion due to your total and complete ignorance of insurance and nothing else.
Whoa, don’t see where Jewel or Rosie, for that matter, have checked in. Would welcome their comments, though. You better relax before you pop a fuse!
You are apparently unable to read. Let the courts decide. It’s in their hands. Unless you are a judge in addition to being an adjuster you have no say in any of this. All I have ever said is let the courts decide. It’s in their hands. If State Farm is wrong they will be punished. Where is the ambivalence there? I will no longer read or respond to your idiotic rants about this company. You need mental treatment.
It seems obvious to me that chrome and adjusterjoe are public adjusters. That would explain their hatred of State Farm and other large carriers.
Don’t they make a living by trying to increase the amount of a claim to cover their 10% to 15% commisions? Maybe I’m wrong.
I handle claims based on the policy language, state law, and the damage present. I do not handle claims based on how I think a court will interpret the policy if the insured sues.
Wrong. Not a public adjuster. If you do not use jurisprudence in your deliberations then you end up, as does State Farm, with bad faith suits out the wazoo. I have zero bad faith claims in my career. You must have many annually.
My living comes directly from the insurance industry. I do not hate the industry. I do have a distrust for State Farm as they have exhibited a proclivity to abuse their insureds and in the casualty market they routinely deny and refuse to investigate legitimate claims. State Fram is responsible for more anti-insurance industry case law than all other companies combined.
Thank you Mark for pointing out the purpose of the policy. Pay what is owed.
Chrome, you are making assumptions about me, just as Joe did. Please don’t. You are wrong.
I do not purposely set out and look for a way to deny coverage for any claim. I look for every way possible to provide coverage to the policyholder based on the policy language. Sometimes, there is no coverage. If there is a dispute about the policy language, I look to case law AND seek the opinion of coverage counsel in that jurisdiction. I, like Mark, pay what is owed under the policy and have NEVER blindly denied a claim as suggested by a few posters. Nor have I ever hired an engineer to look for a way to deny coverage, nor encouraged an engineer or other expert to fabricate evidence.
Joe, I have provided several facts, cases and articles to you that dispute your position. Instead of continuing what is a futile argument with you, I chose to discontinue posting. You accused me of ‘taking my marbles and going home’. Well, that is my prerogative.
To All – Have a Nice Day
Sam:
You have provided zero FACTS; only your blind support of carriers whose main intent is to defraud insureds.
AJ,
You may want to read the entire 5th U.S. Circuit Court of Appeals’ opinion regarding the various issues on which Nationwide appealed. It’s not perfect, but it does overturn Judge Senter’s ruling on Nationwide’s anti-concurrent causation clause.
Here is a link to David Rossmiller’s blog, which has links to the AP story and the actual opinion in PDF format.
http://www.insurancecoverageblog.com/archives/first-party-insurance-nationwide-v-leonard-fifth-circuit-upholds-anticoncurrent-cause-provision-as-unambiguous.html