Aiken v USAA: Rimkus Gets a Free Pass

Rimkus skates because they were not hired by the Aiken’s according to a ruling yesterday in Aiken v USAA. I will certainly remember Judge Senter’s ruling letting Rimkus off the hook next time one of my colleagues is hit with a malpractice suit by a third party over an audit report. On it’s face this decision means its open season on us consumers by the hired guns of big insurance since they appear “not accountable” for their work product to third parties.

Rimkus and James W. Jordan had a contract with USAA to adjust the claim, notwith the Aikens. As a result, Rimkus did not have a duty under Mississippi law to deal fairly and in good faith with the Aikens, as does USAA. The insurance policy USAA provided the Aikens is considered a contract.

Even if the Aiken’s prevail in their suit monetarily this will be a loss for the greater cause of fairness in claims adjusting so long dominated by claimant abuse since the McKinsey recommendations were adopted as the new gold standard by the insurance industry.

In any event today’s Sun Herald story.

Judge dismisses Rimkus from USAA suit

Senter said there was no proof of gross negligence
By ANITA LEE

GULFPORT –Insufficient evidence of gross negligence and fraud led a judge to dismiss Rimkus Consulting Group Inc. and a company engineer from an insurance lawsuit after the policyholders’ case was presented to a jury in U.S. District Court.

USAA Casualty Insurance Co. hired Rimkus to inspect the Pass Christian vacation home of David W. and Marilyn M. Aiken, which was destroyed by Hurricane Katrina. USAA is still presenting its arguments, and the case could go to the jury as early as today.

Rimkus and James W. Jordan had a contract with USAA to adjust the claim, not with the Aikens. As a result, Rimkus did not have a duty under Mississippi law to deal fairly and in good faith with the Aikens, as does USAA. The insurance policy USAA provided the Aikens is considered a contract.

The Aikens maintain USAA ordered an engineering report that would minimize wind damage to their property, insured for more than $680,000. USAA paid them $178,205 for wind damage. They received maximum benefits of $278,000 for damage from tidal surge under a federal flood insurance policy. USAA also adjusted the flood claim.

U.S. District Judge L.T. Senter Jr. noted the Aikens accepted the flood insurance money even though they contend a tornado destroyed their vacation home and boat house before Katrina moved ashore.

“At most, the evidence against Rimkus and Jordan would support no more than a finding of simple negligence in the investigation of the claim,” Senter said in dismissing them from the case. “The testimony and evidence are not sufficient to support a finding that these defendants handled this matter in a grossly negligent or wanton matter with malice or with reckless disregard for the rights of the insureds.”

A report Rimkus sent USAA in December 2005 concluded Katrina’s wind or water was sufficient to destroy the house and boat house, saying the percentage of damage wind caused before the storm surge arrived could not be determined.

At USAA’s request, Rimkus issued a supplemental report in March 2006 that detailed construction components wind could have destroyed before tidal surge destroyed the building superstructures. USAA based its payment to the Aikens on the March report. Rimkus and USAA witnesses said the supplemental report was meant to clarify how much the Aikens were owed, not to deny coverage.

Pink Pig: How Insurance Crooks View You the Customer/Claimant

Folks this Cowboy has been educatin’ the public for almost a year now on how these fancy insurance crooks masqueradin’ as honest businessmen screw the public. Welp folks, nothing says how these miscreants view their own customers better than their own words. In today’s installment of “As the Pink Pig Turns” we hear how a insurance company was actually proud of screwin’ their customers, including a man so badly injured in a car accident he couldn’t work for a year yet these crooks wouldn’t give him anything. He had to sue and the rest is history. For Nick Peressini Pink Pigs do fly. But what about the countless untold others – the 80-90% that just take their screwin’ from Big Insurance unable to fight back?

Here is some deposition quotes from one of them crooks. Though he admits he done wrong he is still ain’t sorry for what he done.

In the deposition video, it is clear that Scott is not sorry for how Peressini’s claim was handled.

Livingston: “For each one of those months, April through October, you violated the regulation, correct?”
Scott: “Yes.”
Livingston: “And that wasn’t fair to Mr. Peressini, was it?”
Scott: “No.”
Livingston: “So you think she’s lying under oath about what she did, or do you think maybe you ought to accept what she said under oath and apologize to this guy?”
Scott: “I’m not going to apologize.”
Livingston: “Why not?”
Scott: “‘Cause I’m not going to.”
Livingston: “Why not?”
Scott: “‘Cause I’m not going to.

So there you have it folks, these insurance claims adjustin’ crooks think you are a rube, a conquest, another notch on their belt buckle on their way to collectin’ their big fat Christmas bonus and they don’t care if they cheat you. It makes this Cowboy sick to his stomach! Pull up a chair and watch the news story embedded on the web page courtesy of 7news Denver.

We’re all supposed to have insurance and at one time we will all likely need to file a claim. Ever wonder how the companies decide what to pay and when to pay?

7NEWS looked into a company’s practice that the state’s insurance commissioner calls “inappropriate and unprofessional conduct.”

The company, American Family Insurance, said it’s done nothing wrong

But a Boulder jury said there was something wrong and handed down a $3 million verdict against American Family Insurance.

Breaking News: Hood Opens New Criminal Investigation of State Farm

Well wouldn’t you know it if good ole Jim Hood ain’t steppin’ in to do Dunn Lampton’s job and bring them crooks at State Farm to justice for dumpin’ their wind obligations on the us taxpayers via the flood program. This Cowboy did a post on the topic and Sop did one with pictures to show how them crooks did it and stole from Uncle Sam hisself.

Jim Hood has been listenin’ folks and has heard our cries for justice. If George Bush and his political band of big business boot lickers at the US Justice Department in DC won’t brings these crooks to justice thank God we got Jim Hood!

Hood, Moore moving into action against State Farm

By ANITA LEE[email protected]

Mississippi’s current and former attorneys general are back on the offensive against State Farm insurance companies.

Attorney General Jim Hood is asking a federal judge to dissolve a court order that prevents him from continuing a criminal investigation involving State Farm. Hood says the investigation is not related to a 2006 criminal probe by his office into State Farm’s handling of policyholders’ Hurricane Katrina claims.

The suspended investigation is secret, but court records indicate State Farm sued to stop it after Hood tried to subpoena company records.

Meanwhile, former Attorney General Mike Moore said in a sworn statement that he and Hood did not use the threat of criminal prosecution in late 2006 to coerce State Farm into settlement of policyholders’ Hurricane Katrina claims, as State Farm alleges.

Instead, Moore’s statement said, State Farm insisted Hood agree to drop his prosecution of the company before it would sign on to a proposed global settlement of policyholders’ claims reached in early January 2007.

Hood did agree to end his 2006 investigation of State Farm, but he says that promise hinged federal court approval for a global settlement of policyholder claims.

The proposed settlement failed to win court approval. State Farm contends it has honored its agreement by re-evaluating claims through the Mississippi Department of Insurance. However, Hood says the company failed to live up to standards set out in the original settlement proposal.

The legal dispute has been clouded by the indictment of policyholders’ attorneys from the Scruggs Law Firm, which withdrew from the legal partnership then renamed the Katrina Litigation Group. While the indictment was not directly related to policyholders’ lawsuits against State Farm, the company has accused Scruggs of ethical and legal violations in the lawsuits and questioned his relationship to Hood and his criminal proceedings.

Scruggs reached a settlement of 640 policyholder claims with State Farm in November 2006, according to a State Farm letter. The global settlement of other Coast claims, reached in January 2007, was rejected by U.S. District Court Judge L.T. Senter Jr.

From Insurance Regulator to Insurance Lobbyist: Incest in the System

It turns out George Dale is not the only local insurance commissioner going straight from his elected office to work in the Insurance Industrial Complex. Strangely Adams and Reese was silent on their hiring of Robert Wooley, the first insurance commissioner in Louisiana in several years not in jail because of corruption. This quote from the story sums up why none of the authors of this blog trust our insurance regulators and is the basis for our opinion that federal oversight of this industry is well past due:

“Bob Hunter, a former Texas insurance commissioner who is director of insurance at the Consumer Federation of America, said that Dale’s new job at a law firm that represents so many insurance interests is another unfortunate tale of regulators caring more about the industry than the people who elected them.

“Nothing surprises me any more. The insurance industry and the regulators are so intertwined. We’ve had now two presidents of the NAIC (National Association of Insurance Commissioners) go directly to lobbying jobs with the insurance industry, and we’ve had so many former insurance commissioners head off in that direction, it’s disgusting. How can the public trust state regulation with all this going on?” Hunter asked.”

sop

AIken v USAA Continues: More Employees Take the Stand

Yesterday the trial resumed after the holiday break with Rimkus and USAA employees taking the witness stand. From the looks of the Sun Herald story, yesterday was not very eventful as employees from Rimkus and USAA took the stand to deny the engineering reports were changed simply to save USAA money. Given what we have found regarding the McKinsey consulting recommendations regarding claims handling and its apparent widespread use across the insurance industry as the new claims adjusting bible I have a hard time believing those statements. This would never come out in Court but I’d love to see if just one of these altered engineering reports resulted in a favorable change for the claimant/insured. Forgive the sarcasm but I suspect if such were the case pink pigs really do fly…..

sop

USAA employees testify in case
By ANITA LEE [email protected]

GULFPORT –Employees testified that USAA Casualty Insurance Co. did not conspire with engineering firm Rimkus Consulting Group Inc. to deny coverage to a couple after Hurricane Katrina.

“Absolutely not,” said Rimkus manager Paul Colman, whose denial was echoed by two USAA claims managers testifying in the second week of the U.S. District Court trial.

The three were called to the stand Tuesday by the plaintiffs’ attorneys, who are trying to prove USAA pressured Rimkus to change reports that would minimize what the company owed for wind damage.

USAA paid David W. and Marilyn M. Aiken $178,205 for wind damage on a policy that exceeded $680,000 in coverage for their Pass Christian vacation home. The Metairie couple is seeking full coverage, plus punitive damages based on the allegation their claim was denied in bad faith.

USAA employee William McNamara, who supervises adjusters and coordinated work by engineering firms after Katrina, testified Tuesday afternoon. He said Rimkus provided reports for USAA on 200 properties. McNamara also verified he called Rimkus to request its engineering report on the damage be corrected and include more detail.

McNamara said he was not attempting to change the engineering company’s opinion about the cause of damage. Instead, he said, USAA needed the wind damage detailed in order to estimate what the Aikens were owed.

Rimkus had closed the file in December, after sending USAA a report that said, in part: “It cannot be visually determined from the remaining physical evidence the percentage of damage resulting from surge forces and the percentage of damage resulting from wind forces.” Federal flood insurance covered the Aiken’s damage from storm surge, paying them policy limits of $250,000 – less than half the home’s value.

A day after McNamara contacted Rimkus in March 2006, the engineering firm sent USAA a “supplemental report” that listed construction components most likely damaged by wind, including gutters, the roof, siding and trim. The supplemental findings also said a storm surge of 20 feet above ground, excluding waves, destroyed building super- structures.

Bad Faith Claims Handling: The New Norm for Big Insurance

Folks we got sold a pig in the poke with tort reform as our legislators just give them crooks in Gucci suits a bigger club to hit the common man right in the head. That’s right boys and girls, insurance companies will deny legitimate claims knowing most folks won’t fight ’em but occasionally people do like this Tow Truck outfit. So pop some pop corn, pull up a chair and see if Pink Pigs Fly. This video is dedicated to this Cowboy’s favorite corporate insurance lawyer in Portland Oregon, Mr. David Rossmiller.

Like this story says and Sop can personally vouch, there is no dollar amount too low for these crooks to try and screw you. And don’t you know that corporate insurance lawyers love making big fat fees fightin‘ for a year over $3000. If you want to be paid fair like, be prepared to sue!

Crooks in Gucci Suits? You Betcha. Put the Screws to the Customer

Insurance companies and their scallywag lawyer enablers like Ronnie Musgrove and Greg Copeland have no problem screwin’ the common man for a fee. Folks, this Cowboy won’t sell you a Pig in the Poke and neither will Anderson Cooper with CNN. Ole Anderson details first hand the underhanded tactics these crooks in fancy Gucci suits use to take advantage of old folks and the general public. Pull up a chair and take a look how the bad hands people treat accident victims.

Let the Lawsuits Fly: Good Hands in Boxing Gloves

We are diligently working rumors of a shareholder suit being filed against Allstate over the ramifications of their claims practices for investors. If the rumors hold another significant legal front has opened against this embattled insurance giant.

Allstate is not sitting still though obtaining a stay against the Florida Department of Insurance Regulation’s ban of the company announced last week:

Appeals Court Blocks Allstate Order

Friday January 18, 5:18 pm ET
By Brent Kallestad, Associated Press Writer

Court: Allstate Can Keep Selling Insurance Pending Appeal

TALLAHASSEE, Fla. (AP) — A court Friday allowed Allstate Corp. to keep selling insurance in Florida while the company appeals an order barring it from writing new policies.

State regulators told Allstate on Thursday to stop writing policies for what officials said was a failure to comply with a state subpoena in a dispute over the premiums the company charges for homeowners insurance in Florida.

The 1st District Court of Appeal stayed the order from the Office of Insurance Regulation pending the appeal, although it gave the office 10 days to show why the company shouldn’t be allowed to sell insurance in the meantime.

“This allows our more than 1,100 agents and their employees across the state to continue to do business in Florida, to create jobs and to serve their communities,” said Allstate spokesman Adam Shores. “We’re going to continue to work with OIR to provide the information they’ve requested in their subpoena.”

Ed Domansky, a spokesman for the Office of Insurance Regulation, said the state has 10 days to file its response but would probably file sooner.

“This is just another step in the process that enables Allstate to further delay production of the documents we requested,” Insurance Commissioner Kevin McCarty said Friday. “I will do everything within my authority as Florida’s insurance commissioner to ensure that the suspension remains in effect.”

McCarty has demanded information about why the company hasn’t dropped rates to the satisfaction of insurance regulators following last year’s passing of a bill meant to lower premiums. As part of that investigation, McCarty subpoenaed the company and officials at OIR said this week that the company appeared to be stalling and not giving up documents state investigators wanted.

The suspension had applied to all types of insurance sold by Allstate’s 10 insurance companies doing business in the state, but does not affect existing policy owners.

Benefits of Doubt

Until this week, I thought Ground Zero was as low as you could go; but, I underestimated the power of Hurricane Katrina.

Sop’s “Sunday Bonus” was intended as our collective “pass” on extending the scope of this blog to include the legal storm that hit the Scruggs Katrina Group. In fact, by the time we were up and running, the wind of that storm had broken the group apart and the Scruggs firm was “roof surfing” in the surge of an indictment.

The great lesson of Katrina, however, has been the benefits of doubt – so much so that the only certainty at times has been the storm. If it weren’t for doubt about claims handling, there would have been no justice for all who lost their homes to Hurricane Katrina.

The benefits of doubt balance the scales of justice. Too many are weighing the claims related to the indictment of Scruggs without benefit of doubt – and, guilt or innocence aside, injustice is the result.

Thus, I open the scales of justice here for discussion and welcome all who want to weigh in and provide the benefit of doubt.