I reckon the folks at McKinsey and Company didn’t check with a lawyer before designing that new fangled way of adjusting insurance claims…

[youtube=http://www.youtube.com/watch?v=_WGg1PQPhns]

Sometimes a quick video clip says it all. Texas law requires insurance adjusters to be “open and honest” with homeowners and deal with them in a way that is “fair and reasonable.” But insurance companies regularly fail to abide by their legal duties to homeowners. And in this deposition footage, a home insurance adjuster just can’t explain why he has so much difficulty understanding the law.

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Bloomberg Article The Insurance Hoax Finalist for Prestigious Journalism Award

Lord knows I don’t have time to write this post but I made the “mistake” of checking in on Sam Friedman’s blog at the National Underwriter and saw two pieces well worth noting. I’m going to concentrate on the Bloomberg story The Insurance Hoax that is a finalist for the Daniel Pearl Award for Investigative Reporting from the Deadline club in New York.

Mr Friedman’s opinion that the story is a hatchet job on the insurance industry has some validity in my opinion, from a straight industry point of view. He is very fair in his reporting on insurance issues and I respect his take. However, under the talking points do lie some very real problems with how insurers adjust their claims. As industry blogger David Rossmiller pointed out himself in a particularly insightful post on the legalities behind a “first party claim”:

An adversary relationship is assumed to exist between the insurer and insured from the time the claim is filed, and generally speaking, no fiduciary duty arises on the part of the insurer.  This doesn’t mean it’s OK for insurers to cheat you, merely that it is understood that an inherent conflict exists to an even greater degree than in third-party claims, where it could also be said that a conflict exists, because paying for the legal defense of an insured is expensive.  All this is inherent in the nature of insurance, and is why we have various rules ranging from bad faith laws to  interpreting ambiguities against the insurer in insurance law. Continue reading “Bloomberg Article The Insurance Hoax Finalist for Prestigious Journalism Award”