Did Chip Merlin discover the slabberator mentioned in the scheme? That I don’t know; but, he definitely happened upon some interesting information — cross posted below — and the title of his related postposes a very interesting question: Are Computerized Estimates by Pilot Catastrophe Adjusters Low Because of a Special Database?. SLABBED tags on to the end of Merlin’s post with comments linking the Rigsby qui tam.
Some Mondays are more interesting than others. When I go to conferences with adjusters, I make a point to ask about “in the street” information on insurers I am litigating against. The information and leads to witnesses or evidence are often extremely valuable to my clients. Adjusters know when the orders from claims management are wrong and aimed at paying less than what is fairly owed. Most want to disclose facts about insurers that wrongly demand underpayment.
A current problem regarding the disclosure of such activities is that catastrophe firms and insurers usually make the individual catastrophe adjusters sign confidentiality and non-disclosure agreements preventing whistle blowing from ever taking place. These agreements should be illegal. Can you imagine any reason society should tolerate contracts that prevent employees from disclosing improper claims conduct? What if the mafia could enforce such agreements? Yet, that is largely why Renfroe sued the Rigsby sisters–to shut them up about State Farm’s multiple engineering reports indicating excluded flood rather than covered wind caused damage to State Farm’s customers. (emphasis added @ SLABBED) Continue reading “Did Chip Merlin find a slabberator? Are Computerized Estimates by Pilot Catastrophe Adjusters Low Because of a Special Database? (with a Rigsby qui tam tag on from SLABBED)”
“Sugarcoated” the news was not; so, I’m guessing the “right people” took note of Sam Friedman’s View from the Pressbox:
There is a phrase in journalism called “burying the lead,” meaning you fail to put the most important part of the news story right up in the first paragraph. When reporters do this, it’s just poor or lazy writing. But when sources are guilty of this sin in their press releases, it’s called “spin”–putting the best face on bad news. That’s the case with the latest industry-wide financial results reported by ISO and PCI.
Indeed, the two groups chose to “lead” with reassurances that the industry remains in good financial shape, boasting that insurers have $437.1 billion in policyholder surplus, $554.4 billion in loss and loss adjustment expense reserves to cover claims that already were filed, and another $201.5 billion in unearned premium reserves to cover losses arising during policies in effect on March 31.
It’s hard to spin a $1.3 billion first-quarter loss—the worst results it has recorded in more than 20 years, the Insurance Services Office said. The numbers are not hard to believe; but, whether they tell the whole story is an entirely different matter. Continue reading “…and did the chickens come home to roost or is the rooster crowing off shore? P&C reports 1.3 billion 1Q loss”
Chalk it up to the visit of one of my “grand dogs” but cats of no kind were on my mind as I was reading the comment SLABBED reader CLS posted on the Allstate Finance Board:
One could say I was barking up the wrong tree with the few words I changed:
Dell State Farm, Nationwide, Allstate, USAA, and employees KNEW that they were NOT ALLOWED to sell cameras bill wind damge to the National Flood Insurance Program UNDER the [WYO] CONTRACT that COVERED Dell’s the Company’s sales and claims handling of the GOVERNMENT SALES Flood Insurance Program…
Simply stated, there’s more than one way to skin a cat. For example, you can cat a hedge or hedge a cat.
There is also more than one way an insurer can commit fraud:
Justice Pierce: I’m giving you – the example is 95 percent of the home is destroyed, the flood comes in and gets the other five percent and you know that. Does your interpretation of the word “sequence” mean you pay zero?
Mr. Landau: YES, your Honor.
Just change a few words and the story is the same.
When your interpretation of the word “sequence” means you pay zero on claims of wind damage and your policy excludes flood, then the hurricane reinsurance you purchase doesn’t transfer any risk – and that is NOT ALLOWED. Not in any “sequence”.
Having discovered the detour attempted by the insurer defendants of Louisiana’s Road Home litigation – a petition to the Fifth Circuit with leave to file an Interlocutory Appeal granted the 19th of this month – SLABBED turns to the orders of Judge Duval for background on the issues under Appeal.
The Louisiana Road Home program is a grant program funded by the United States Department of Housing and Urban Development (“HUD”) and operated by the Louisiana Recovery Authority. In the wake of Hurricanes Katrina and Rita, Congress appropriated funds for disaster relief to be administered through HUD’s Community Development Block Grant Program. HUD distributed some of these funds to Louisiana, which in turn created the Road Home program to distribute these funds as grants to homeowners. Road Home grants are designed to compensate homeowners up to $150,000.00 for structural damage, exclusive of contents damages, caused by Hurricanes Katrina or Rita.
Katrina litigation in Louisiana has suffered from the Fifth Circuit’s overly broad definition of “flood” and off-the-wall ruling on anti-concurrent causation, as well as the heavily promoted image of “Katrina the flood”. However, Sop will likely be as surprised as I to learn, Despite the request of this Court, the State could not point to any federal statute or regulation governing the Road Home program that could create a legal subrogation.
Congress appropriated disaster assistance funds to existing federal programs, including HUD’s CDBG program, subject to rules governing the allowable use of program funds. The CDBG rules required each recipient state to develop and submit a plan for approval and the federal approval process includes a review to ensure a plan is consistent with related federal law.
Consistent with federal law, the Road Home program prohibits providing any relief Continue reading “Insurer defendants attempt detour of Road Home”
Now the improvisers: Continue reading “Monday Music: Unlikely Combinations”
So much happened while I was out last week that the Dan Rather quote makes a good introduction to this update on Katrina litigation reporting the sequence of [selected] events [from last week] in no particular order:
Watson v Nationwide:
Nationwide may not be able to determine the sequencing of the loss until the event is over; but, Judge Senter had no problem determining the sequence, deciding the event was over, and issuing an Order on Nationwide’s Motion for an Extension of Time…to Take Remand-Related Discovery-
Nationwide has asserted that the non-diverse defendants in this action were fraudulently joined to defeat this Court’s diversity jurisdiction. This is an issue upon which Nationwide, as the removing party, has the burden of proof, and an issue on which Nationwide expected to prevail at the time this case was removed. Yet in the ten months that have elapsed since removal, Continue reading “And now the sequence of events in no particular order – a Katrina litigation update”
We have our file copy here, but I also like the visual embedding enabled by Scribd. Both USAA and Natiowide counsel’s arguments look even sillier in print IMHO.
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Mr Weiser is retired after thirty nine years with US Army Corp of Engineers in the New Orleans district. He has compiled a boatload of research and given his experience with USACE his perspective is interesting in light of the ongoing NOLA area flood control rebuilding and MRGO litigation.
I’ll also add that while we have been highly critical of FEMA at times we also greatly valued the input we received from rank and file FEMA employees as we welcome all viewpoints here at Slabbed. While we are primarily insurance and legally oriented we have a big enough tent to include NOLA flood control as a topic. If you are with the USACE and are moved to comment we’d love to hear from you. – sop
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I was not surprised to see a WaPo story about health insurance under the lede Senate Report Finds Insurers Wrongfully Charged Consumers Billions.
Meantime President Obama and his seeing eye dog have been MIA on the P&C end while they busily concoct plans to socialize medicine here in the US.