Adjuster Sues Sisters for Releasing State Farm Files

By | September 27, 2006

  • September 28, 2006 at 7:20 am
    Mike says:
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    When all is said and done, I\’ll be interested to see if the sisters were doing
    what was ethical or criminal.
    To me, this depends on if what they say State Farm was doing was actually what occurred…So, we shall see….

  • September 28, 2006 at 8:08 am
    Ed says:
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    People who report wrongdoing by their employers to the proper authorities (insurance commissioner, attorney general, the SEC) are whistleblowers and entitled to certain legal protections. People who steal documents from their employers and give them to a party that is suing their employer or their employers client are guilty of theft. Lawyers that accept such documents are guilty of receiving stolen property and risk having evidence, that could have been obtained properly by subpoena, excluded from evidence.

  • September 28, 2006 at 3:51 am
    bob laublaw says:
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    I hope these sisters are fined and imprisoned. No one is above the law.

  • September 28, 2006 at 5:45 am
    Mark says:
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    No one is above the law, including giant State Farm.

  • September 29, 2006 at 12:38 pm
    Plot thickens says:
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    Sounds like Dickie might be helping a well known North Mississippi author with his next best seller, thinly disguised as fiction. Would it be the first time?

  • September 29, 2006 at 12:45 pm
    Plot thickens says:
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    Sounds like a plot for a new book for a North Mississippi well known best selling author. Don\’t think it would be the first time. Always wondered if attorneys
    got royalties on those thinly disguised plot lines.

  • September 30, 2006 at 7:55 am
    RJ says:
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    My take on this is that IF there is indeed fraud, the Sisters should prevail.

    I do not think any \”secrecy agreement\” is legally binding in the cases of any illegal activity. It would be \”collusion\” to do so.

  • October 2, 2006 at 4:34 am
    Anonymous says:
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    IF there was fraud on State Farms part, the sisters will certainly be protected by federal whistleblower laws as all of the information was also handed over to both the Attorney General for the state AND the US Attorney for Mississippi.

    Also, I doubt most of that information could have been gotten through the courts as it has been well documented in the press that State Farm has shredded tens of thousands of work papers since the storm.

    Now the federal grand jury in Jackson is looking into state Farms past for a pattern of fraud…. Hell and State Farm has even taken the unprecedented action of NOT using Haag as of late…..LOL… im sure in the end they will lay it off on the Engineering Firm.

  • October 2, 2006 at 11:05 am
    State Farms a Comin, I\'m Run\ says:
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    State Farm has forgotten what insurance is all about. Banding risk for mutual protection. Profit is the byproduct of corporations taking on this protection for groups. State Farm has forgotten its about the people first and foremost.

    Second, the sisters may have illegally stolen the papers. If so, the state AGs have every right to subpoena them as evidence, and thereby enter them in the legal record. Once there, ANYONE may use and sue.

    One group of companies in the United States has not forgotten what insurance is about and that is your local mutual company. In recent storms here, most mutuals had claims paid off under two weeks. People are STILL waiting on State Farm.

    I see jail time and $$$ billions in fines. The thing I am wondering is why this is not in the press. This affects soooo many people right in the pocket book.

  • October 2, 2006 at 1:03 am
    Mary Maberry says:
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    You mentioned that well known Mississippi author capitalizing on insurance reality; my favorite line of his is, \”You are stupid, Stupid, STUPID!\”.

    Well I guess we can use that line for State Farm. Having seen their internal processes at work, I have little doubt about the validity of the claim.

  • October 2, 2006 at 5:54 am
    carlfarm says:
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    My dad always said no good deed goes unpunished…or something like that

  • October 3, 2006 at 1:55 am
    Lori says:
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    State Farm IS a mutual company! My feeling is that a few squeaky wheels are getting the grease. The majority of SF claims have been paid and you know, it just isn\’t possible to please 100% of the people….

  • October 4, 2006 at 11:06 am
    Anonymous says:
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    Actually,
    State Farm is a super-carrier insurance company that owns and operates mutuals. This is NOT the same thing. In Texas and other states, the operation of a farm mutual was done to skirt state carrier insurance laws. SF is not alone in this type of shenanigans.

    State Farm IS taking longer to pay claims out than mutual companies. Some folks in my area are actually cancelling SF and switching because of friends who are having problems getting claims paid with SF. Just go to Louisiana and see if you can find anyone who is unhappy with SF over how claims were paid.

  • October 4, 2006 at 3:52 am
    Finance Mike says:
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    Interestingly, the evidence the sisters provided most likely will be admissable under both criminal and civil cases. The prohibition against evidence obtained without the use of a warrant (or stolen, or what have you), only applies when a governmental law enforcement member (police, FBI, DEA, etc.) procures or causes to procure the evidence. It doesn\’t apply when private citizens act – there are many situations where such evidence remains fully admissible.

    Regarding the sisters and our boy Dickie – he\’s a scumbag and they\’re dupes. Just because they disagree with SF\’s process doesn\’t give them the right to be judge, jury and executioner. Dickie\’s just out to suck more money out of the economy and into his own pocket. Based on how things are going down there so far, even with the evidence they provided, Dickie\’s gonna lose. If not, that huge sucking sound you hear will be every insurer pulling out of Louisiana, all lines of business.

  • October 4, 2006 at 4:43 am
    Lori says:
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    You are misinformed. State Farm has no shareholders other than policyholders which makes it a Mutual company. State Farm owns no other companies other State Farm subsidiaries (for lack of a better term). As far as taking more time to pay out claims than other mutual companies, I don\’t see how that has any relevance. Most mutual companies are much smaller than State Farm and probably had 2-3% of the claims that SF did.

    I\’m sure I could find people in LA that are unhappy about how their claims are being handled. I\’m also sure that there are many times more people who are satified with their results.

    When you have as many claims happening at one time it is very difficult to get them all taken care of in a month or two or six! There are other variables that come into play than just writing a check.

  • October 8, 2006 at 5:55 am
    Kerwin Tschetter says:
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    Who in government is responsible for investigating fraud committed by the Insurer?

    What would you do if you have reported information that a financially troubled insurance company had systematically and \”as a general practice of business\” sought to defraud claimants to an FBI field office, where you reported that contrary to laws of your own state\’s Insurance Division, they would not even meet with you to look at your evidence.

    This evidence implicated not only this company, but other companies using this same practice.

    This same FBI agent who interviewed you, later tells you that he has confirmed your information, but he has personally been threatened by senior executive officials within the FBI in Washington DC with the \”loss of his pension\” if he continued to pursued this case any farther?

    This FBI field agent said he had been instructed by management to focus his investigations on bank robberies if he wanted to remain in the FBI.

    Later you learn that the Deputy Director of the FBI at that time has since accepted a position as CEO of the Insurance industries\’ funded \”National Insurance Crime Bureau\” and that the former Insurance Commissioner during that period now sits on the Board of Directors your states largest Insurance Company.

    The Insurance commissioner of this insurance companies state of domicile had allowed the company to transfer $200 million from the holding company to it\’s thrift division, get $900 million in tax deferments not pay over $1 Billion in accepted claims. It was later revealed this Insurance Commissioner had former been on the Board of Director of a Bank the held 100 of thousands of shares in this holding company and held a $25 Million dollar loan made buy this company when the commissioner was on the Banks credit review committee.

    The statutes of the state have since been amended in 2005 by the state legislature so that these practices are no longer illegal, but this revision to the statutes now appear to be in violation of equal protection clauses of both the state\’s and the Federal government\’s Constitutions.

    Forty-one insurance companies in this field, including mine, were later were place in liquidation with the loss to the states\’ insurance guaranty funds of 10\’s of Billions of dollars in losses that were later tacked on the premiums of future policy holders.

    Where should one then turn, when the cops are bad?

    When three consecutive LA Insurance Commissioners are accused of fraud maybe we need to look at how the Insurance Industry is Regulated in this country.

    What has happened to this once great country?

  • October 8, 2006 at 7:42 am
    Kerwin Tschetter says:
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    Is State Farm still using it\’s:

    \”Performance, Planning and Review\” (PP&R) program

    Note: Justice Ginsburg, dissenting opinion in the U.S. Supreme Courts decision State Farm vs. Campbell April 2003

    http://caselaw.lp.findlaw.com/scripts/getcase.pl?court=US&vol=000&invol=01-1289#dissent3

    also
    http://laws.findlaw.com/us/000/01-1289.html

    The Campbells sued State Farm for bad faith, fraud, and intentional infliction of emotional distress.

    State Farm amplified the harm by at first assuring the Campbells their assets would be safe from any verdict and by later telling them, postjudgment, to put a for-sale sign on their house.

    To justify punishment based upon recidivism, courts must ensure the conduct in question replicates the prior transgressions.

    (\”[T]he Campbells demonstrated, through the testimony of State Farm employees who had worked outside of Utah, and through expert testimony, that this pattern of claims adjustment under the PP&R program was not a local anomaly, but was a consistent, nationwide feature of State Farm\’s business operations, orchestrated from the highest levels of corporate management\”).

    …the Campbells framed this case as a chance to rebuke State Farm for its nationwide activities. App. 208

    (\”You\’re going to hear evidence that even the insurance commission in Utah and around the country are unwilling or inept at protecting people against abuses\”); id., at 242

    =================

    The large size [$145 Million] of the award upheld by the Utah Supreme Court in this case indicates why damage-capping legislation may be altogether fitting and proper. Neither the amount of the award nor the trial record, however, justifies this Court\’s substitution of its judgment for that of Utah\’s competent decisionmakers. In this regard, I count it significant that, on the key criterion \”reprehensibility,\” there is a good deal more to the story than the Court\’s abbreviated account tells.

    Ample evidence allowed the jury to find that State Farm\’s treatment of the Campbells typified its \”Performance, Planning and Review\” (PP&R) program; implemented by top management in 1979, the program had \”the explicit objective of using the claims-adjustment process as a profit center.\” App. to Pet. for Cert. 116a.\”

    [T]he Campbells presented considerable evidence,\” the trial court noted, documenting \”that the PP&R program … has functioned, and continues to function, as an unlawful scheme … to deny benefits owed consumers by paying out less than fair value in order to meet preset, arbitrary payout targets designed to enhance corporate profits.\” Id., at 118a-119a.

    That policy, the trial court observed, was encompassing in scope; it \”applied equally to the handling of both third-party and first-party claims.\” Id., at 119a. But cf. ante, at 13, 17 (suggesting that State Farm\’s handling of first-party claims has \”nothing to do with a third-party lawsuit\”).

    Evidence the jury could credit demonstrated that the PP&R program regularly and adversely affected Utah residents.

    Ray Summers, \”the adjuster who handled the Campbell case and who was a State Farm employee in Utah for almost twenty years,\” described several methods used by State Farm to deny claimants fair benefits, for example, \”falsifying or withholding of evidence in claim files.\” Id., at 121a.

    A common tactic, Summers recounted, was to \”unjustly attac[k] the character, reputation and credibility of a claimant and mak[e] notations to that effect in the claim file to create prejudice in the event the claim ever came before a jury.\” Id., at 130a (internal quotation marks omitted).

    State Farm manager Bob Noxon, Summers testified, resorted to a tactic of this order in the Campbell case when he \”instruct[ed] Summers to write in the file that Todd Ospital (who was killed in the accident) was speeding because he was on his way to see a pregnant girlfriend.\”
    Ibid.

    In truth, \”[t]here was no pregnant girlfriend.\” Ibid.

    Expert testimony noted by the trial court described these tactics as \”completely improper.\” Ibid.

    The trial court also noted the testimony of two Utah State Farm employees, Felix Jensen and Samantha Bird, both of whom recalled \”intolerable\” and \”recurrent\” pressure to reduce payouts below fair value. Id., at 119a (internal quotation marks omitted).

    When Jensen complained to top managers, he was told to \”get out of the kitchen\” if he could not take the heat; Bird was told she should be \”more of a team player.\” Ibid.

    (internal quotation marks omitted). At times, Bird said, she \”was forced to commit dishonest acts and to knowingly underpay claims.\” Id., at 120a. Eventually, Bird quit. Ibid.

    Utah managers superior to Bird, the evidence indicated, were improperly influenced by the PP&R program to encourage insurance underpayments.

    For example, several documents evaluating the performance of managers Noxon and Brown \”contained explicit preset average payout goals.\” Ibid.

    (\”[T]he Campbells demonstrated, through the testimony of State Farm employees who had worked outside of Utah, and through expert testimony, that this pattern of claims adjustment under the PP&R program was not a local anomaly, but was a consistent, nationwide feature of State Farm\’s business operations, orchestrated from the highest levels of corporate management\”).

    and

    The Utah Supreme Court sought to apply the three guideposts we identified in Gore, supra, at 574-575, and it reinstated the $145 million punitive damages award. Relying in large part on the extensive evidence concerning the PP&R policy, the court concluded State Farm\’s conduct was reprehensible. The court also relied upon State Farm\’s \”massive wealth\” and on testimony indicating that \”State Farm\’s actions, because of their clandestine nature, will be punished at most in one out of every 50,000 cases as a matter of statistical probability,\” ___ P. 3d, at ___, 2001 WL 1246676, at *15, and concluded that the ratio between punitive and compensatory damages was not unwarranted.

    and

    The most relevant civil sanction under Utah state law for the wrong done to the Campbells appears to be a $10,000 fine for an act of grand fraud, which is dwarfed by the $145 million punitive damages award.

    The Utah Supreme Court\’s references to a broad fraudulent scheme drawn from out-of-state and dissimilar conduct evidence were insufficient to justify this amount. P. 18.

    and more at

    http://laws.findlaw.com/us/000/01-1289.html

  • October 8, 2006 at 8:23 am
    Kerwin Tschetter says:
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    \”The insurance industry needs to take a long, hard look…at itself,\” New York Attorney General Spitzer said.

    \”If the practices identified in our suit are as widespread as they appear to be, then the industry\’s fundamental business model needs major corrective action and reform.

    There is simply no responsible argument for a system that rigs bids, stifles competition and cheats customers,\” he added.

    Referance

    N.Y. Attorney General Spitzer Sues Marsh Over Contingent Commissions
    By Andrew G. Simpson, Jr.
    October 25, 2004

    New York Attorney General Eliot Spitzer on Oct. 14 sued Marsh & McLennan Companies, the nation\’s biggest insurance brokerage firm, alleging that it steered clients to insurers with whom it had lucrative contingency agreements, and solicited rigged bids from major insurers for insurance contracts. Spitzer also announced that two insurance company executives have pleaded guilty to criminal charges in connection with the scheme.

    http://www.insurancejournal.com/magazines/west/2004/10/25/features/48447.htm

  • October 9, 2006 at 10:12 am
    Kerwin Tschetter says:
  • October 22, 2006 at 9:57 am
    Kerwin Tschetter says:
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    http://members.fortunecity.com/awoll1/MyFiles/Paper%20chase.htm

    Paper Chase
    by NBC\’s John Larson
    June 23, 2000

    Dateline investigates State Farm Insurance Company and its little-known practice of \”paper review.\” In a paper review, State Farm employees review a patient\’s medical records rather than actually examining the patient. The Dateline crew discovered that some State Farm employees use this practice to manipulate the system. For example, the crew found that some employees \”secretly orchestrated the supposedly independent medical results, helping author reports and dictating changes to medical opinions that led to lower recommended payments for medical claims.\”

  • June 19, 2009 at 1:57 am
    StopUSAGiveaway says:
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    EWveryone who has a State Farm Policy as a consumer: I am seeking to file.
    How dare State Farm raise the rates so they can steal from us to give to
    THE RACE=LA RAZA=666=EVIL
    THE RACE is here due to former illegals being donated citizenship now having THE RACE non profit, TV, programs, scholarship et all.
    This is the USA and THE RACE calls us, we the people who uphold our laws: as One Nation Under GOD
    the race calls us Racist”
    Time to remove their extortion funds and from FORD FOUNDATION too.
    Outrageous.
    BETRAYAL to US TROOPS:our sons, daughters, fathers, mothers, grandfathers, and brandfathers ages l8-62 each generation being systemtically sacrificed on foreign soil for Open Borders Criminal Illegal Alien Heathen Breeders via sperm donor exponentials from womb to tomb for 8 (EIGHT) generations as parasites on our soil
    StopUSAGiveaway@live.com
    Do Unto Others As You Would Have Them Do Unto Y O U



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