I wish I could say I am shocked by the insurance company\’s actions, but sadly, we went through the same thing with \”Mutual of O…\” flood insurance after Hurricane Isabel in Maryland 3 years ago.
We still have not received what we paid for and are still struggling with the financial and emotional effects.
You depend on the insurance companies to help you in this time of desperation, and all they do is fight you and do everything they can to avoid paying on policies that you purchase for disasters like floods.
Insurance companies can easily rebound after this, since it\’s only money.
Mutual of O… insurance has ruined our lives.
You keep hoping someone will do the right thing. These women deserve a medal for having a conscience. Do you insurance companies remember what that is?
Depends on the company – State Farm & Allstate are some of the worst. I applaud these 2 woman as their lives will likely become hell. If these allegations are true, I hope they nail them to the wall. Be nice if one of these atty generals looks into political contributions from ins companies as well
There are grossly inept people in every profession. That includes engineers. I have reviewed many engineers’ reports and in some it is clear the engineer does not have a clue. Some engineers purposefully slant the facts due to biases. In a catastrophe, a company is sometimes forced to hire “professionals” with an unknown expertise. If common engineering practice supports a particular conclusion those nonconcurring may be flawed. I do not know what the facts are. I just know there should be no rush to judge.
Something that always exasperates me is consumers\’ desire to get something for which they did not pay. If you buy a Volkswagen, that is what should be delivered, not a Mercedes. Yet, people don\’t buy the proper coverage and then expect to get it anyway. Insurance companies are like any other businesses. They have to deliver the product you bought or they go out of business.
I have worked for State Farm. I can tell you only my experience with them. It has always been one of the highest professionalism, a bent towards paying claims if anything could be found in the contract to enable payment and to skewer any gray area to the insured\’s advantage. I have never been told not to pay something that is covered. On the contrary, I have been told to pay claims I thought to be very questionable as far as coverage. I think most people believe an insurance company can just pay anything regardless of the contract. That is not the case, and, no one would expect any other business to do that. That is how businesses fail. If uninformed readers take nothing else away from this, please realize insurance is not a social program. It is a business that MUST make a profit. If it did not, you would have no insurance to purchase. Its products are priced (rated) for what they are and that is what you should expect on delivery.
Those who make blanket statements about an insurance company need to realize that it is the people who work for them who determine whether they pay or not. Some managers are concerned about their performance ratings and are tempted to stretch credibility to make a good impression on management. After all, they want to stay employed too.
Congratluations to these women who did the right thing. State Farm lies and cheats and will even commit perjury to get what it wants. I have the documentation to prove my perjury charge.
It will be interesting to see what happens to these two sisters. They first off will never hold an insurance job again. Second, they signed a confidentiality agreement, and the violated it by providing the attorney the documents.
If SFarm gets their top notch lawyers on this, they might get it thrown out on that basis. It\’s all about who has the deepest pockets…
About the confidentiality agreement broken and records being shared – I think a lot of it will have to do with exactly what was shared. What did they turn over to the attorney\’s. Did they turn over the orginal estimates and then a copy of what State Farm gave the insureds? Did they turn over a copy of the altered documents? Confidentiality may have been broken – but when one party is committing fraud – then that is a good reason to break that confidentiality.
Granted they may never be hired by an insurance company again. But chances are they will be hired by plenty of attorneys looking for \”expert\” witnesses.
It might be interesting to see what the financial reward was for these \”whistleblowers\”. Were the engineering reports altered or were they second opinions ? Were the engineering reports made by local engineers that have to live with their neighbors fearing the consequences of a report unfavorable to the insureds ? Me thinks there could be more to this than the eye can see, and then again, maybe not.
I\’m not sure I would rush to applaud these two. First, as pointed out, they violated a confidentiality agreement. Second, they turned over personal nonpublic financial information, a potential violation of state and federal privacy laws. Third, none of these allegations have withstood the rigor of cross-examination or courtroom challenge, nor has the other side been presented. Did anyone else note that their mother is a friend of Scruggs? In view of the fact that most claims have been settled and billions of dollars paid, and that the Scruggs lawsuits have failed on their most salient aspect (e.g., trying to invalidate the flood exclusion), I\’m not sure this is an obvious case of insurer wrongdoing.sejuzz
Isabel, you state that you have not received what you paid for. If you purchased a Flood Policy and paid for it & the damage was caused by flood waters then by all means your flood claim should be paid! However, if you just purchased a home owners policy then of course flood is excluded. In that case wind damage should be paid. If you neglected to purchase a flood policy then you are most likely out of luck. Hope things work out for you. That is an awful experience to go through.
They will never be prosecuted.. especially if their allegations of fraud are upheld. Confidentiality agreements dont cover hiding violations of the law.
Thanks, Jay for your comments.
Here\’s what I have learned. Flood insurance is a myth and if you don\’t believe me, then ask the 90 families in Maryland who had it 3 long years ago who did not receive what they PAID for.
No one has rock concerts or benefits for us, no one is helping us build, and our insurance, the great Mutual of Omaha told us to sue. The shocking part is that no one really cared. Our house was torn down and they originaaly offered us $36,000. Yes, 36k. For a house.
Ok, so we sued. Let\’s see if there\’s any justice at all or if the big insurance companies will win again. This is not how things are supposed to work.
Keep in mind that we all purchased flood insurance. We did not ask for any charity or freebies.
We did what we were supposed to do.
In light of all the previous conversations posted here, it is abundantly clear that the industry needs and benefits from a system of checks and balances since the insurance companies appear to wield all of the power. Consequently, I remain remissed at all the venom spewed at us Public Adjusters on this website. For the most part, we strive to keep the insurance company adjusters honest.
No one,, least of all me believe that the insurance companies shouldnt make a profit…
Funny though how only the conclusions in these cases in particular always skewed towards the insurance company.
I can tell you in my personal case ( not with state farm ) I was initially paid 5500 on a total claim of 335,000. After spending nearly 5,000 of my own money to refute the insurance company\’s claims ….they agreed that there was substantial wind damage prior to water entering my home. We settled for just under half of the total policy value. In the end it was a fair payout… but the 5 grand of my money to prove them wrong is gone.
It\’s good to see your still around… dropping little tid bits to skew opinions.
Yes, State Farm IS named in this suit, along with 16 other insurers operating in Maryland. Let\’s not forget the nine independent adjusting firms, Computer Sciences Corporation, FEMA, the US Attorney General, and Maryland Insurance Commisioner, amoung others!
This is basically a shotgun blast by the trial lawyers to see what they can hit. \”Somebody\’s got to have done something wrong, and I bet we can get some money out of them!\”
Correct me if I\’m wrong, but if the problem is with the NFIP, shouldn\’t you be mad at the Feds? I know the \”big insurance companies\” sell and service the policy, but they didn\’t design it, FEMA did.
The insurance companies are paid 3% of the estimate total for handling the claim, so wouldn\’t it be smarter to over pay? If the insurance companies are only in this for the money, it would only make sense, wouldn\’t it?
But then the Feds would be suing the insurance industry for overcharging FEMA, and I don\’t see that happening. FEMA is getting sued along with the insurance companies because the trial lawyers want you to think there is this cozy relationship between the Feds and insurance.
My boss taught me some thing some years ago:
To maintain power in a struggle, whether it\’s segregation, politics, or lawsuits, you have to divide and conquer. Keep those you have power over focused on the other side and you can get away with almost anything.
Some insurance companies actually tried to help but not Omaha.
The sadist that handled most of the Maryland claims, went out of his way, and beyond his authority, to make all of our lives a living hell. He threatened to not pay a penny, require multiple estimates, demand letters from engineers, and county officials etc. He rejected every estimate we sent.It was a full time job to deal with the endless requests. No one at Omaha was interested in looking at the way this person was handling anything. He had free rein to badger all of us. The stress was unbearable and we will never be the same.
The flood was the least horrible part. Dealing with Mutual of Omaha was a nightmare. I don\’t know how that guy can live with himself. A lot of unnecessary human tragedy by one sick individual.
Please don\’t tell any of us that he was just doing his job. That\’s nonsense.
You have no idea.
Actually, don\’t the Carriers/Insurers (WYO\’S) that participate FEMA\’s National Flood Insurance Program take 30% of all NFIP premium dollars, and then receive an additional 3% for loss claim adjustments?
This is a classic example of why we need Public Adjusters…To help put individuals like these in their place, and assist insureds get paid fairly and quickly!
Thx for your thoughts on the issue at hand. It is nice to see some \”Level Headed\” balanced comments. There are just too many cry babies with an axe to grind commenting to these posts. State Farm is following the rules here, plain and simple. If 2% of their claims ends up questionable, thats better than the industry brings to the table. They are still the benchmark for overall operational quality in this industry.
Although there was no storm damage
to my home in North Georgia, I did
have a pipe burst. It took two months
to get an adjuster out. When the
adjuster came there was a Restoration
company with her. I had no choice
about who repaired my home and the
restoration company came in with a
sledge hammer and knocked out my
kitchen cmpletely. They replaced my
hardwood flooring with low grade
materials) They cut my new cabinets
too short and they are awful. Now
they want me to go to Home Depot
with $13000 and purchase. replacement
cabinets. (Ha! Ha!) They gave me
$1500, to repair the new flooring.
I have complained to the presidents
office six times to no avail, the
state insurance commissioner says
they can\’t do anything. The governor
give won\”t reply. DOES ANYONE HAVE ANY
SUGGESTIONS on what to in Georgia?
I\’m don\’t know the exact percentages, but I think you are close with 30%. The agent\’s commission comes out of that, which is around 15%, and is in line with most homeowner\’s policy commissions.
So the carrier gets about 15% for servicing the policy, and then 3% or so of the loss total for claim handling.
From comments you have made in the past that 20% general contractor\’s Overhead & Profit is not enough to survive on, would you agree that 15% is not exactly \”lucrative\”?
Hello Joe,
We have several cases we are consulting on involving many adjusters using preferred remediation companies that ARE NOT experienced in this type of work. We have two cases in Ga. were these so called carpet cleaning companies come in and do contractors work and have no certification or permit to do so, leaving the home owner to clean the mess up. We are finding this more and more hiring of substandard contractors and using carpet cleaning companies to do specialized mold, water damaged remediation projects. All in the name of saving the insurance company money. This could not be saving the insurance company money because they are now being sued for bad faith. I think the insurance industry needs to verify there preferred vendors credentials and make sure their certified in the appropriate industry work they are undertaking. You may e-mail us at rhollister@environmentaladminastrators.com and we will try to get you pointed in the right direction
295000 claims settled, 1100 of which required engineering reports, and 500 of those still open. What a heck of an accomplishment by the largest property and casualty insurer in America. Wonder
when those two birds went on the attorneys payroll, and what the punishment
will be for handing over confidential policyholder documents that may include private data.
\”So the carrier gets about 15% for servicing the policy, and then 3% or so of the loss total for claim handling.\”
I believe that receiving 33% of billions and billions of other peoples dollars, and having ZERO dollar risk for \”servicing\” NFIP claims, is a much, much sweeter deal for insurers verses their typical book of business business.
Also it seems some need to try to mimic their catastrophe loss claim [denial, footdragging, lowballing] \”adjusting\” strategies with their daily loss claim settlement strategies.
Too many hands in the accounting cookie jar/profit pot are gonna\’ get stuck…
I wish I could say I am shocked by the insurance company\’s actions, but sadly, we went through the same thing with \”Mutual of O…\” flood insurance after Hurricane Isabel in Maryland 3 years ago.
We still have not received what we paid for and are still struggling with the financial and emotional effects.
You depend on the insurance companies to help you in this time of desperation, and all they do is fight you and do everything they can to avoid paying on policies that you purchase for disasters like floods.
Insurance companies can easily rebound after this, since it\’s only money.
Mutual of O… insurance has ruined our lives.
You keep hoping someone will do the right thing. These women deserve a medal for having a conscience. Do you insurance companies remember what that is?
Depends on the company – State Farm & Allstate are some of the worst. I applaud these 2 woman as their lives will likely become hell. If these allegations are true, I hope they nail them to the wall. Be nice if one of these atty generals looks into political contributions from ins companies as well
There are grossly inept people in every profession. That includes engineers. I have reviewed many engineers’ reports and in some it is clear the engineer does not have a clue. Some engineers purposefully slant the facts due to biases. In a catastrophe, a company is sometimes forced to hire “professionals” with an unknown expertise. If common engineering practice supports a particular conclusion those nonconcurring may be flawed. I do not know what the facts are. I just know there should be no rush to judge.
Something that always exasperates me is consumers\’ desire to get something for which they did not pay. If you buy a Volkswagen, that is what should be delivered, not a Mercedes. Yet, people don\’t buy the proper coverage and then expect to get it anyway. Insurance companies are like any other businesses. They have to deliver the product you bought or they go out of business.
I have worked for State Farm. I can tell you only my experience with them. It has always been one of the highest professionalism, a bent towards paying claims if anything could be found in the contract to enable payment and to skewer any gray area to the insured\’s advantage. I have never been told not to pay something that is covered. On the contrary, I have been told to pay claims I thought to be very questionable as far as coverage. I think most people believe an insurance company can just pay anything regardless of the contract. That is not the case, and, no one would expect any other business to do that. That is how businesses fail. If uninformed readers take nothing else away from this, please realize insurance is not a social program. It is a business that MUST make a profit. If it did not, you would have no insurance to purchase. Its products are priced (rated) for what they are and that is what you should expect on delivery.
Those who make blanket statements about an insurance company need to realize that it is the people who work for them who determine whether they pay or not. Some managers are concerned about their performance ratings and are tempted to stretch credibility to make a good impression on management. After all, they want to stay employed too.
Congratluations to these women who did the right thing. State Farm lies and cheats and will even commit perjury to get what it wants. I have the documentation to prove my perjury charge.
It will be interesting to see what happens to these two sisters. They first off will never hold an insurance job again. Second, they signed a confidentiality agreement, and the violated it by providing the attorney the documents.
If SFarm gets their top notch lawyers on this, they might get it thrown out on that basis. It\’s all about who has the deepest pockets…
About the confidentiality agreement broken and records being shared – I think a lot of it will have to do with exactly what was shared. What did they turn over to the attorney\’s. Did they turn over the orginal estimates and then a copy of what State Farm gave the insureds? Did they turn over a copy of the altered documents? Confidentiality may have been broken – but when one party is committing fraud – then that is a good reason to break that confidentiality.
Granted they may never be hired by an insurance company again. But chances are they will be hired by plenty of attorneys looking for \”expert\” witnesses.
It might be interesting to see what the financial reward was for these \”whistleblowers\”. Were the engineering reports altered or were they second opinions ? Were the engineering reports made by local engineers that have to live with their neighbors fearing the consequences of a report unfavorable to the insureds ? Me thinks there could be more to this than the eye can see, and then again, maybe not.
I\’m not sure I would rush to applaud these two. First, as pointed out, they violated a confidentiality agreement. Second, they turned over personal nonpublic financial information, a potential violation of state and federal privacy laws. Third, none of these allegations have withstood the rigor of cross-examination or courtroom challenge, nor has the other side been presented. Did anyone else note that their mother is a friend of Scruggs? In view of the fact that most claims have been settled and billions of dollars paid, and that the Scruggs lawsuits have failed on their most salient aspect (e.g., trying to invalidate the flood exclusion), I\’m not sure this is an obvious case of insurer wrongdoing.sejuzz
These sisters should be prosecuted. I hope \”the book\” is thrown at these two women.
Isabel, you state that you have not received what you paid for. If you purchased a Flood Policy and paid for it & the damage was caused by flood waters then by all means your flood claim should be paid! However, if you just purchased a home owners policy then of course flood is excluded. In that case wind damage should be paid. If you neglected to purchase a flood policy then you are most likely out of luck. Hope things work out for you. That is an awful experience to go through.
They will never be prosecuted.. especially if their allegations of fraud are upheld. Confidentiality agreements dont cover hiding violations of the law.
Thanks, Jay for your comments.
Here\’s what I have learned. Flood insurance is a myth and if you don\’t believe me, then ask the 90 families in Maryland who had it 3 long years ago who did not receive what they PAID for.
No one has rock concerts or benefits for us, no one is helping us build, and our insurance, the great Mutual of Omaha told us to sue. The shocking part is that no one really cared. Our house was torn down and they originaaly offered us $36,000. Yes, 36k. For a house.
Ok, so we sued. Let\’s see if there\’s any justice at all or if the big insurance companies will win again. This is not how things are supposed to work.
Keep in mind that we all purchased flood insurance. We did not ask for any charity or freebies.
We did what we were supposed to do.
In light of all the previous conversations posted here, it is abundantly clear that the industry needs and benefits from a system of checks and balances since the insurance companies appear to wield all of the power. Consequently, I remain remissed at all the venom spewed at us Public Adjusters on this website. For the most part, we strive to keep the insurance company adjusters honest.
.
.
http://www.femainfo.us
http://www.femainfo.us/Links/Complaint.final.htm
No one,, least of all me believe that the insurance companies shouldnt make a profit…
Funny though how only the conclusions in these cases in particular always skewed towards the insurance company.
I can tell you in my personal case ( not with state farm ) I was initially paid 5500 on a total claim of 335,000. After spending nearly 5,000 of my own money to refute the insurance company\’s claims ….they agreed that there was substantial wind damage prior to water entering my home. We settled for just under half of the total policy value. In the end it was a fair payout… but the 5 grand of my money to prove them wrong is gone.
Roger P.,
It\’s good to see your still around… dropping little tid bits to skew opinions.
Yes, State Farm IS named in this suit, along with 16 other insurers operating in Maryland. Let\’s not forget the nine independent adjusting firms, Computer Sciences Corporation, FEMA, the US Attorney General, and Maryland Insurance Commisioner, amoung others!
This is basically a shotgun blast by the trial lawyers to see what they can hit. \”Somebody\’s got to have done something wrong, and I bet we can get some money out of them!\”
Isabel,
Correct me if I\’m wrong, but if the problem is with the NFIP, shouldn\’t you be mad at the Feds? I know the \”big insurance companies\” sell and service the policy, but they didn\’t design it, FEMA did.
The insurance companies are paid 3% of the estimate total for handling the claim, so wouldn\’t it be smarter to over pay? If the insurance companies are only in this for the money, it would only make sense, wouldn\’t it?
But then the Feds would be suing the insurance industry for overcharging FEMA, and I don\’t see that happening. FEMA is getting sued along with the insurance companies because the trial lawyers want you to think there is this cozy relationship between the Feds and insurance.
My boss taught me some thing some years ago:
To maintain power in a struggle, whether it\’s segregation, politics, or lawsuits, you have to divide and conquer. Keep those you have power over focused on the other side and you can get away with almost anything.
Some insurance companies actually tried to help but not Omaha.
The sadist that handled most of the Maryland claims, went out of his way, and beyond his authority, to make all of our lives a living hell. He threatened to not pay a penny, require multiple estimates, demand letters from engineers, and county officials etc. He rejected every estimate we sent.It was a full time job to deal with the endless requests. No one at Omaha was interested in looking at the way this person was handling anything. He had free rein to badger all of us. The stress was unbearable and we will never be the same.
The flood was the least horrible part. Dealing with Mutual of Omaha was a nightmare. I don\’t know how that guy can live with himself. A lot of unnecessary human tragedy by one sick individual.
Please don\’t tell any of us that he was just doing his job. That\’s nonsense.
You have no idea.
Mark,
Actually, don\’t the Carriers/Insurers (WYO\’S) that participate FEMA\’s National Flood Insurance Program take 30% of all NFIP premium dollars, and then receive an additional 3% for loss claim adjustments?
Sounds like a pretty lucrative deal…
rogerpoegc@yahoo.com
This is a classic example of why we need Public Adjusters…To help put individuals like these in their place, and assist insureds get paid fairly and quickly!
gk,
Thx for your thoughts on the issue at hand. It is nice to see some \”Level Headed\” balanced comments. There are just too many cry babies with an axe to grind commenting to these posts. State Farm is following the rules here, plain and simple. If 2% of their claims ends up questionable, thats better than the industry brings to the table. They are still the benchmark for overall operational quality in this industry.
Although there was no storm damage
to my home in North Georgia, I did
have a pipe burst. It took two months
to get an adjuster out. When the
adjuster came there was a Restoration
company with her. I had no choice
about who repaired my home and the
restoration company came in with a
sledge hammer and knocked out my
kitchen cmpletely. They replaced my
hardwood flooring with low grade
materials) They cut my new cabinets
too short and they are awful. Now
they want me to go to Home Depot
with $13000 and purchase. replacement
cabinets. (Ha! Ha!) They gave me
$1500, to repair the new flooring.
I have complained to the presidents
office six times to no avail, the
state insurance commissioner says
they can\’t do anything. The governor
give won\”t reply. DOES ANYONE HAVE ANY
SUGGESTIONS on what to in Georgia?
dude…but they are the \”good neighbor\”….LOL
Roger,
I\’m don\’t know the exact percentages, but I think you are close with 30%. The agent\’s commission comes out of that, which is around 15%, and is in line with most homeowner\’s policy commissions.
So the carrier gets about 15% for servicing the policy, and then 3% or so of the loss total for claim handling.
From comments you have made in the past that 20% general contractor\’s Overhead & Profit is not enough to survive on, would you agree that 15% is not exactly \”lucrative\”?
Hello Joe,
We have several cases we are consulting on involving many adjusters using preferred remediation companies that ARE NOT experienced in this type of work. We have two cases in Ga. were these so called carpet cleaning companies come in and do contractors work and have no certification or permit to do so, leaving the home owner to clean the mess up. We are finding this more and more hiring of substandard contractors and using carpet cleaning companies to do specialized mold, water damaged remediation projects. All in the name of saving the insurance company money. This could not be saving the insurance company money because they are now being sued for bad faith. I think the insurance industry needs to verify there preferred vendors credentials and make sure their certified in the appropriate industry work they are undertaking. You may e-mail us at rhollister@environmentaladminastrators.com and we will try to get you pointed in the right direction
295000 claims settled, 1100 of which required engineering reports, and 500 of those still open. What a heck of an accomplishment by the largest property and casualty insurer in America. Wonder
when those two birds went on the attorneys payroll, and what the punishment
will be for handing over confidential policyholder documents that may include private data.
One may wonder who all is going to be found guilty of intentionally defrauding the general public.
Mark, you said;
\”So the carrier gets about 15% for servicing the policy, and then 3% or so of the loss total for claim handling.\”
I believe that receiving 33% of billions and billions of other peoples dollars, and having ZERO dollar risk for \”servicing\” NFIP claims, is a much, much sweeter deal for insurers verses their typical book of business business.
Also it seems some need to try to mimic their catastrophe loss claim [denial, footdragging, lowballing] \”adjusting\” strategies with their daily loss claim settlement strategies.
Too many hands in the accounting cookie jar/profit pot are gonna\’ get stuck…
-rogerpoegc@yahoo.com
Stay tuned for an unethical claim handling fiasco involving an auto accident.
Nearly 5 years in the making and no end in sight.
“Deny, Delay and Don’t Pay, Like a Good Neighbor”
Webcast coming soon.