Saturday, August 29, 2009

State Farm, Allstate and the McKinsey Report

CNN anchor Anderson Cooper recently did a two-part series on the business practices of State Farm Mutual Insurance and Allstate Insurance. It was the culmination of an 18-month CNN investigation of low-impact, soft-tissue injury accidents around the country. The series was then broadcast on CNN. The links to the two segments are listed below.

Three major insurance companies joined together and hired the legendary business consulting firm McKinsey and Company. McKinsey, in their customary fashion, looked at the insurance companies’ business practices and made recommendations on how to increase profits in a report entitled “The Three Ds: Delay, Deny and Defend.”

In delaying a claim, insurance companies place significant financial pressure on a policyholder or claimant. That pressure can force a policyholder or claimant to accept a much smaller claim settlement amount.

By denying a claim, insurance companies force policyholders and claimants to seek legal representation. Many personal injury attorneys are reluctant to take on a client for a small loss, since attorneys often work on contingency fee schedules. So, in the absence of good legal representation, policyholders and claimants are once again forced to accept “lowball” settlement amounts from insurers.

In defending a claim, the insurance companies take the position of forcing the policyholder first into the Appraisal process found in most policies. This requires that each party choose a representative, and then the representatives choose and umpire. The agreement of any two of the three chosen constitutes the claim amount. But this will add months to any claim process. The next step for the policyholder or claimant is to file a lawsuit. This will add years to the eventual settlement...if they can find legal representation and pay for it.

Insurance companies have taken this position with the intent of making the legal process so costly for personal injury attorneys that they become even more reluctant to accept new clients for small cases.

So far, the “Delay, Deny and Defend” tactics have been wildly successful for any insurance company that has adopted the tactics. Industry profits have risen considerably over the past few years, despite significant catastrophic events such as Hurricane Katrina.

Here are the links to the CNN reports.

Part One

Part Two

There is also a tremendous book available about this topic, entitled “From Good Hands To Boxing Gloves: The Dark Side of Insurance,” by David Bernardinelli. Here is a link:

From Good Hands to Boxing Gloves: The Dark Side of Insurance

There are some things you can do as a policyholder or claimant to prove your claims. Visit the website at: for more information.

Verdict on Aftermarket Parts Costs Insurance Company $17 Million

American Family Mutual Insurance Company was ordered to pay $17 million to settle part of a class action lawsuit over aftermarket parts in Missouri.

A jury in Jackson County, Missouri returned a decision that American Family had wrongly paid automobile damage claims based upon the use of aftermarket replacement parts.

Aftermarket auto parts are not held to the same testing and safety requirements as Original Equipment Manufacturer (OEM) parts. Consequently, they may fit on a car as a replacement part, but the use of an aftermarket part does not constitute repairing the car to the pre-loss condition. Insurers love aftermarket parts because they are considerably cheaper than OEM parts.

The jury verdict affects 315,000 Missouri policyholders who filed claims between May 1990 and December 2004.

Ted Pintar is one of the Plaintiff attorneys. “It (the verdict) sends a clear statement to insurance companies who continue to force inferior aftermarket parts on insureds as part of their claims practices.”

A spokesman for American Family Mutual Insurance Company said that the company would appeal the verdict.

Friends, don’t think for a minute that the insurance companies will just roll over and accept this verdict as a standard for the nation. Every state has its own Department of Insurance, and they will continue to conduct business as usual on a daily basis. So, if you have a car wreck, you must still insist IN WRITING that your vehicle be repaired with OEM parts.

First and foremost, your car will not be as safe as it was before the accident if aftermarket parts are used.

Second, there is the matter of Diminished Value. Every car loses value once it has been in a collision and has to be repaired. A vehicle repaired with OEM parts will lose less value than one repaired with aftermarket parts.

You must fight for your own safety and the value of your car. The insurance company does not care about either.

Fight and WIN!

Saturday, August 8, 2009

Event Cancellation Insurance: Protecting Your Big Event

The event was the COMDEX convention held at the Georgia World Congress Center in Atlanta. COMDEX was the annual global IT convention, featuring the newest computers, electronics and gadgets. This was the biggest convention held in Atlanta each year. 200,000 people would attend the convention over four days.

Two days before the convention opened, a category 3 tornado struck downtown Atlanta. The twister tore off 100,000 square feet of roof from the Convention Center and dumped hundreds of thousands of gallons of rainwater inside. Local news footage showed water cascading down a big stairway like a waterfall.

COMDEX was cancelled. The financial losses for the event planners fairly boggle the mind.*

What if the show can't go on? The consequences — particularly for a corporation staking big bucks on a marketing event or for an association that gains most of its revenue from an annual conference — can be dire. One safety net is event cancellation insurance, which can protect your event investment against catastrophes, strikes, earthquakes and snowstorms.

Event Cancellation Insurance has been around for decades, and has a long history of protecting special events from conventions, to trade shows, to exhibitions, entertainment or sporting events.

An insured may have incurred expenses all year long preparing for an event but can't afford for an unpredictable event to cause its cancellation. Think of the costs for travel, venue deposits, rescheduling costs, as well as other costs including planning.

Often the kinds of problems that can lead to postponement, cancellation or relocation of an event are out of the planner's control. Look to Event Cancellation Insurance for the kind of coverage needed to protect that financial exposure.

Whether planners should invest in cancellation insurance depends upon how important an event is to an association or corporation financially and what kind of risk it is assuming. If your group event is planned for 50 people, you’d probably not buy this policy. But if 500 or 5,000 people were expected to attend, event cancellation insurance could be crucial to your bottom line.

Sometimes, event planners don’t think about event cancellation insurance. They either are unaware that such coverage exists, or mistakenly rely on the insurance of the event a convention hall. The venue’s insurance will help them rebuild or repair. But it won’t help the event planners find another venue, or compensate them for the costs they incur or income they lose from cancellation.

Coverage and Cost

The rule of thumb is that cancellation insurance covers perils that are beyond the control of a planner, such as inclement weather, strikes, outbreaks of disease and so on. You can also purchase coverage for “Non-Appearance,” in case your event relies on the appearance of a person or group (speaker, performers, player, invited guest). The policy also covers things such as extra expenses for trucks and workers in case an exhibitor doesn’t break down his exhibits. What is not covered are lack of planning, low attendance from a lack of interest or poor marketing, or bankruptcy of the planner.

Coverage begins as soon as the premium is paid and usually extends for five days after the event. Coverage purchased well before an event can be a godsend if something happens to the facility where you’re booked, as the coverage would cover costs of relocation and notifying attendees.

The cost of this coverage is calculated on a policy-by-policy basis. Every event is different and each has unique risk exposures. The standard costs of this coverage run about fifty cents per $100 of coverage. However, variables like location (areas susceptible to hurricane or earthquake) or season (winter is higher than spring, summer or fall) can push the price up towards $1 per $100 of coverage. So, a $1 million policy might cost up to $10,000 or more.

When To Buy

Event cancellation insurance is usually less expensive if purchased far in advance. Insurers increase the premium rate, theorizing that the closer the event is, the more desperate the planner must be for coverage.

We recommend that you get at least two price quotes before making a buying decision. We also recommend that you review a sample copy of any policy before purchase to determine what is covered and what is excluded.

Then, have a super successful event!

*This catastrophe was entirely fictitious.

Thursday, August 6, 2009

Contractors Alert: Your Liability Carrier May Start Playing Rough

If you are a General Contractor (GC), you most assuredly carry Comprehensive General Liability insurance for your business. If you’ve spent any time reading your policy (fat chance), you may remember that the terms and conditions of the policy require you to protect yourself and your insurer.

Specifically, when you hire sub-contractors, you are supposed to require that the “sub” execute a Hold Harmless agreement as part of the contract, in which the sub agrees to protect the general contractor from liability for acts of which the sub is found legally liable. Further, the sub is supposed to name the general contactor as an Additional Named Insured, which provides a legal defense to the GC. At that point, the GC’s policy becomes excess over the sub’s coverage.

I used to be a General Contractor, and I know GCs pretty well. They, being a somewhat independent bunch, frequently do business with subs on little more than a handshake or a phone call. These subs are people they’ve used repeatedly, and a high level of trust is in place. The idea of getting all that contract paperwork executed before the first hammer is lifted or spade turned is just a pain in the backside. So, it regularly gets ignored.

Unfortunately for GCs, the insurance companies have been taking it in the wallet as they have absorbed liability for the GCs when they fail to get that Hold Harmless in place. So, the risk management efforts that the GCs are supposed to do aren’t getting done. And that has the affect of transferring the risk to the insurance companies.

They get to pay when the GC’s contract fails to contain a Hold Harmless Clause.

They get to pay when the GC doesn’t require his subs to maintain their own insurance.

They get to pay when the GC doesn’t get himself listed as an Additional Named Insured on the sub’s policy.

So, the insurance companies have begun to issue policy endorsements that deny coverage when there is a loss due to the sub’s operations and the GC did not get the Hold Harmless Clause into his contract and proof that the sub named the GC as an Additional Insured. The insurers are figuring that the only way to get the attention of the General Contractors is to put some of the GCs’ assets on the table.

On August 4, 2009, the California Court of Appeals issued the ruling in North American Capacity Ins. Co. v. Claremont Liability Insurance Company. The ruling upheld this Contractors Warranty Endorsement, and stated that the insurance company could take an excess position even if the subcontractor had no insurance, simply because it was their duty to have insurance. Therefore, the endorsement and coverage could proceed AS THOUGH the subcontractor had the coverage in place.

To quote the ruling:

“We find the “clear and explicit” meaning of the contractors warranty endorsements, as used in their “ordinary and popular sense” by a layperson establishes a precondition of coverage as to work done by subcontractors for whom (the GC) failed to secure both a written hold harmless agreement and a certificate of insurance. The trial court therefore did not err in finding the contractors warranty endorsement enforceable under the facts of this case.”

Now that the insurance companies have a favorable court decision in their back pockets, you should expect your insurance carrier to play for keeps. A potential liability claim denial will bring a new discipline to the business life of the General Contractor.