Do insurers routinely cheat policyholders in lowballing homeowner claims? They do if you believe the story out this morning by Bloomberg News.
The 6,000-word piece is filled with horror stories by unhappy claimants, quotes by industry critics and allegations by former insurance company adjusters. It covers everything from software systems to record industry profits to successful lawsuits against insurers.
The piece starts with the story of Julie Tunnell of San Diego, whose home was lost to wildfire in 2003, and her insurer offered $220,000 of the estimated $306,000 to rebuild. No word from the authors on what the limits of her policy were or whether the estimate might be inflated. But nonetheless, they write this blanket condemnation:
Tunnell joined thousands of people in the U.S. who already knew a secret about the insurance industry: When there’s a disaster, the companies homeowners count on to protect them from financial ruin routinely pay less than what policies promise.
And then the article goes downhill from there.
No new ground is covered by the authors. It’s a greatest hits collection of all the negative stories going back many years.
There’s a lot of circumstantial evidence to indict insurers here, but this story lacks balance and context. “Routinely” is such a subjective word. Nowhere is there statistical evidence to back it up. Convince me my providing trending data from insurance department complaint files. How about a statistical sampling of satisfaction rates among claimants — along with an accurate count of claims that are deemed by regulators and the courts to be wrongly denied or lowballed.
The story also fails to cite the pressure on insurers — and their legal duty — to resist inflated and fraudulent claims. The authors seem to suggest that insurers should not investigate claims but just hand over whatever amount is demanded by claimants.
That’s not to say that unsavory claims practices don’t exist. Insurers should get whacked hard when they screw up. But let’s keep the misdeeds in perspective. If insurer surveys are still showing 90-plus percent of claimants are satisfied with the claims-handling process, then the problems likely are isolated.
But still, insurers need to get ahead of this issue. The statements in defense put forth have been weak.
The growing perception that insurers are cheating hurts the efforts by the anti-fraud community to reduce public tolerance of fraud. Legislators also tend to be much less sympathetic when they think there constituents are not being treated fairly.
Insurers have a fine line to tread: They should pay legitimate claims fully and quickly, aggressively detect and resist bad claims — and have the wisdom to carefully distinguish between the two.