The Scheme – fingerlickin chickinpickin meat city Mind Games (Chapter 3 Qui Tam)

Mind gamesI’ve been to meat city to see for myself…mind games fuck a pig mind games…fingerlickin chickinpickin meat city shookdown u.s.a…mind games

Anything can become a weapon. In mind games, words become missiles – hope killing daggers to the heart of an issue hidden among other words and as difficult to detect as a needle hidden in a haystack of needles.

Lennon wrote Mind Games during a period of separation from Ono that led to his involvement in a triangle with Ono and another woman. Sped up and backward tracked, his favorite expression fuck a pig is hidden in the song Meat City.

In the mind games insurers have played since Hurricane Katrina, fuck a pig translates to anti-concurrent causation played at any speed, tracked forward or backward, during the period of separation of damage from coverage – a period when words are mind games played with hope killing daggers to the already broken hearts of policyholders.
In his report on The Legal Storm in Katrina’s Wake, Dean Starkman described the mind game State Farm was playing with Charles and Linda Spears who lost their home on on the northern edge of Lake Pontchartrain.

A spokesman for State Farm, based in Bloomington, Ill., says its investigators found that water caused most of the damage to the Spears’s house and that engineering reports support the company’s assertion.

But Gerald Ciacca disagrees. Ciacca, who lives 80 yards inland from the Spearses, stayed through the hurricane because he got a late start and feared being trapped on the clogged roads. In an interview, he said he watched from a garage as the winds abruptly shifted from the north to the southwest as the hurricane passed.

“That’s when all hell broke loose,” he says. “It was just unbelievable. It was like nothing I’ve ever seen. That’s when everything come apart.”

He said he saw a whole row of houses on the Spears’s block literally torn apart by wind, one next to the Spears’s collapsing like a “deck of cards,” leaving little for the storm surge to damage.

Ciacca, who says his insurer, a unit of Liberty Mutual, paid his claim nearly in full, said the damage to his home was largely done by the time he retreated to an attic as waters rose and flooded about a foot of his first floor.

The Spears’s next-door neighbor, Leon Dupreire received $75,000 for wind damage from Allstate, but only after the company initially denied the claim altogether.

“The first thing they wanted to tell me was that it was all flood, but I wasn’t going to fall for that,” he said. He said he told Allstate representatives: “I’m an old Marine. I’m going to follow the chain of command. I can go until we hit God.”

Starkman’s story reveals that State Farm was not the only insurer playing mind games when he quotes the Spear’s neighbor in a similar battle with Allstate.

A more recent report,  Tricks of the Trade: How Insurance Companies Deny, Delate, Confuse and Refuse, suggests insurers play mind games hopeful that some policyholders will “hit God” before the claims settle.

Claims supervisors at AIG have reported locking checks in safes until claimants complained, delaying payments until they were a year old, and disposing of important correspondence during routine “pizza parties.”  [The insurance company] made it so hard to make a claim that people either died or gave up.”

Following Hurricane Katrina, few were in a position for mind games delaying payment.  Instead the mind game most prevalent was about if  – if there would even be a payment that could be subject to delay.  In Tricks of the Trade this mind game is described as the trick of Confusing Consumers.

Insurance contracts are some of the most dense and incomprehensible contracts a consumer is ever likely to see. More than half of all states have enacted “plain English” laws for consumer contracts, yet many Americans still do not fully understand the risks they are subject to. After Hurricane Katrina, insurance companies used obscure “anti-concurrent” clauses to get out of paying claims. Consumers who purchased hurricane insurance and thought they were covered suddenly found the coverage eliminated by an obscure clause they could not hope to understand.

Until the MID report of the State Farm Market Conduct Exam, I had begun to think I might “hit God” myself before the ambiguity of the “anticoncurrent causation” clause was established and the Fifth Circuit’s decision in Tupeker was overturned.

Although the Fifth Circuit Court of Appeals…has ruled State Farm’s Anti-Concurrent Causation (ACC) is not ambiguous, its application in Katrina claims appeared confusing even to its own employees and claims managers.

One State Farm manager who was designated as an expert witness in one case interpreted the clause to say that if water would have taken the whole property that nothing was covered even if wind got there first and caused damage first. (This appears to corroborate testimony from some claims representatives that if water touched it, wind was not covered)

However, by the time I finished reviewing the report in preparation for this series of posts, I was more worried that I would “hit God” in my excitement over hitting “pay dirt”– the biggest fuck a pig mind game of all.

  • Two reports, one from OIG and the other from MID, using distinctly different methodology, not only reached similar conclusions but had similar omissions in what the investigators and examiners reviewed.
  • It seems contrary to research science for this to happen. OIG selected a method that does not produce predictable results. In other words, the findings of that report applied only to the claims investigated.
  • MID, on the other hand, used methodology that was designed to examine a sample of claims in a way that predicted the extent of similar findings in the total body of claims.

Sop and I both have posts relating to the OIG report – mine defining the methodology is here and Sop’s with insight from his CPA perspective here.

Instead of repeating the information in those posts, let’s take a look at what was not the subject of either the investigation or the examination

Mind gamesI’ve been to meat city to see for myself

First, read the section of text in the MID report where I found clues calling attention to one of the omitted aspects of the inquiries about claims handling following Katrina – one inquiry without regard to carrier and the other specific to State Farm’s claims handling practices and the source document for these quotes:

Based on the media attention surrounding the documents purloined [sic] by the Rigsby sisters, the examination team felt compelled to personally review the documents.  It was important, at least initially, for the examiners to see the documents in the context in which they were produced.  The MID filed a formal motion in the United States District Court in Alabama seeing permission to review the documents that had been turned over to to the Court per the December 8, 2006 injunction entered by Judge William M. Acker, Jr…Following a detailed review of the purloined [sic] documents, it was decided that MID either already had access to certain documents or the remaining documents were not significant to how claims were handled by the Company. There was no “smoking gun” as previously alleged by the Rigsbys.

The examination team requested that State Farm provide the documents purloined [sic] by the Rigsby sisters.  State Farm responded by advising the examiners they had no way of determining what documents were copied.  In the later part of 2007 examiners discovered, indirectly, that State Farm had indeed performed an analysis of the claims the Rigsbys had accessed and had knowledge of exactly which claims and the specific times they had accessed them…(pages 38-39, emphasis added)

What, then, am I suggesting the examiners failed to investigate?  I found no indication there was an  evaluation of the technology that made it possible for State Farm to know what documents the sisters copied, when the copies were made, or if there was any correlation between those copied and the significant number of incomplete claims or those completed when additional information was added  during mediation.  Did I miss the results or those from an outside evaluation of State Farm’s technology and/or a section on the outcome of any investigation into the company’s internal capacity to produce reports tracking use of the system with the level of detail the Rigsby sisters were tracked? I think not.

The report of the OIG only referenced the data base of NFIP claims when citing it as source of claims pulled for review.

I have no way of knowing what would “smoke” in the gun of either agency but the capacity of both systems “smokes” in mine and the failure to investigate this aspect of the claims handling process could very well be connected to MID’s failure to find the “smoking gun” claimed by the Rigsby sisters.

A side observation is State Farm made the same misrepresentation of their ability to identify the documents copied by the Rigsby sisters that the Company made to MID to others.  Most recently, I believe, the misrepresentation was made in documents filed with Judge Senter’s Court following the Rigsby’s request for discovery of same for the purpose of responding to dispositive motions filed by State Farm and E.A. Renfroe in the Rigsby qui tam case.

Mind gamesI’ve been to meat city to see for myself

The second omission attracting my attention was the failure of both the investigators and examiners to establish the relationship between the Expedited Claim Handling Process and other events and/or outcomes noted in the reports.

I recall no assessment of the impact the Expedited Process at all in the MID reported findings.  However, a close look at some of the findings of the examination suggest the Expedited Process was more valuable as a back-up for decisions that might not otherwise have needed justification than it actual use.  There were reference in the report that begged an inquiry from the examiners, including these examples.

Based on sworn testimony from Company officials, Company management on or about September 13, 2005, finalized the development of a Wind/Water Protocol. The Protocol was developed as “a guide for handling various wind and/or water claims in Louisiana, Missisippi and Alabama.  The Protocol outlined the procedures that were to be used for determining coverage where wind and water may have been involved in the loss.  This process was developed after certain State Farm management surveyd the damaged area on the Mississippi Gulf Coast where they made note of all the “total loss denials”.

The Company acknowledged it had never used a wind/water protocol in previous catastrophes and it was never fully explained why such a protocol was integral to the handling of claims on the Gulf Coast. (pages 27-28, emphasis added)

The OIG report contained on possible explanation-such a Protocol would facilitate participation in the Expedited Claim Handling Process announced in a memorandum from David Maustad dated the 21st of September – a process advised by unidentified representatives of the industry that could not have taken place any earlier than the storm itself – if it was developed for Katrina during the three-week period since the storm.

With only the data available having no details about the development, the process could have be ready and waiting for first hurricane causing the extensive damage needed to test the process.  In that context, certain State Farm decisions make more sense – the Haag report, the first ever decision to obtain engineering reports slabs, and the also first time use of the wind/water protocol.

September 13, 2005 was also on or around the date the Haag engineering provided the report that was the basis of the Protocol – and likewise of benefit in the Expedited Process.  Interestingly, according to the statement from the Rigsby sisters qui tam claim quoted below, the use of the Protocol would also be evident in the electronic system that wasn’t examined or investigated by either agency

instructing adjusters to overstate the amount of damage when using the XACT Total program in order to “hit the limits” of the flood policies;

Mind gamesfingerlickin chickinpickin meat city shookdown u.s.a…mind games

Mind games played with OIG investigators and MID examiners – and, even officers of the Court.  The name of this game is the drama triangle.

…a psychological and social model of human interaction The model posits three habitual psychological roles or roleplays which people often take in a situation:

  • The person who is treated as, or accepts the role of, a victim,
  • The person who pressures, coerces or persecutes the victim, and
  • The rescuer, who intervenes out of an ostensible wish to help the situation or the underdog.

As the drama plays out, people may suddenly switch roles, or change tactics, and others will often switch unconsciously to match this. For example, the victim turns on the rescuer, or the rescuer switches to persecuting.

The covert purpose for each ‘player’ is to get their unspoken psychological wishes met in a manner they feel justified, without having to acknowledge the broader dysfunction or harm done in the situation as a whole.

Games in this sense, are devices used (often unconsciously) by a person to create a circumstance where they can justifiably feel certain resulting feelings (such as anger or superiority) or justifiably take or avoid taking certain actions where their own inner wishes differ from societal expectation.

mind games fuck a pig mind games…Played with too much risk to last as a risk management strategy, the next move can only be the blame game.

The Scheme: The best place to hide a needle is in a haystack of needles.
Introduction:The Scheme: you lived the movie

The Scheme: the best place to hide a needle

The Scheme: first there were just word games

8 thoughts on “The Scheme – fingerlickin chickinpickin meat city Mind Games (Chapter 3 Qui Tam)”

  1. The examination team requested that State Farm provide the documents purloined [sic] by the Rigsby sisters. State Farm responded by advising the examiners they had no way of determining what documents were copied. In the later part of 2007 examiners discovered, indirectly, that State Farm had indeed performed an analysis of the claims the Rigsbys had accessed and had knowledge of exactly which claims and the specific times they had accessed them

    State Farm lied to Judge Senter and the MID. Of course they ignored direct orders from MID so I understand why they lack respect there but a federal judge?

    Now we are beginning to find out exactly what type of people do lawyering for the Farm. I’m getting the feeling they are no better than the unethical trial lawyers they claim to dislike.


  2. The quoted text is back in the comments but it’s there in the report…if you read further, you’ll see that MID lost time and money – everyone did but insurers and they made money on every delay

  3. Sop:

    You forgot to use the word “greedy” before “trial lawyers.” Because of course, as everybody knows, there are NO greedy insurance lawyers. The word “greedy” (used to describe “trial lawyers” and “personal injury lawyers”) played a pivotal role in the election of the newest Louisiana Supreme Court justice. Nice to know that when you represent plaintiffs before the La. Sup. Ct., at least one of the judges already thinks you’re greedy.

  4. “greedy trial lawyers” make an appearance in Chapter 4 – but no one in their right mind would consider them “greedy” after the financial crisis has redefined the word.

  5. The “gag” may still be working but the “joke” is on those who promote that line of thinking – in their twisted logic path, the only thing worse than a “greedy trial lawyer” is a “public interest lawyer” and we have just elected one President.

    You can always drown the “gag” with a country tune if there’s enough beer for a sing-along – the beer will have to be BYOB but I’ve got just the tune for you and you could make it the ringtone on your phone.

    We all face the final judgment and it’s very strict they say.
    When your time comes, I wonder what you’ll do.
    Will you bow your head in shame or turn your head the other way?
    Will your lawyer talk to God for you?

    Go down to
    Emergency Louisiana Hurricane Katrina Summit – Atlanta, GA

    Atlanta Meeting Tape One

    Atlanta Meeting Tape Two

    This is the Sept. 7, 2005 meeting for adjusters and company representatives arranged by LA Commissioner Wooley.
    NFIP Administrator David Maurstad is up in Tape Two. He says he has already had meetings and conference calls with insurers about waiving the detailed claims procedure. He also supports the industry’s claim that if wind and water both caused the loss, the homeowners policy excludes coverage but NFIP pays.
    Taxpayers were not represented.

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