This week’s Senate listening to on the insurance coverage business’s claims practices following pure disasters wasn’t only a made-for-TV second. It was a five-alarm warning siren for policyholders and insurers throughout the nation. With pictures of collapsed breezeways, tales of kids sleeping on flooring after insurers not paying, and property insurance coverage adjusters primarily confessing to being neutered into glorified picture-takers whose estimates are going to be modified by others not onsite, one may ask whether or not it’s time to begin treating insurance coverage declare abuse because the nationwide downside it’s.
Senator Josh Hawley despatched a letter on January 24, 2025, calling for a Senate listening to to research insurance coverage firms’ claims dealing with following Hurricanes Helene and Milton. In his letter, he described studies of widespread declare denials as “morally obscene.” He invited insurance coverage executives to testify earlier than the Senate Homeland Safety and Governmental Affairs Subcommittee on Catastrophe Administration, which he chairs. He additionally requested detailed data on the variety of denied claims, the explanations for these denials, and the common response occasions for disaster-related claims. This letter set the stage for the Could 13, 2025, listening to, the place policyholders, adjusters, and insurance coverage executives offered testimony on the business’s response to pure disasters.
The listening to was a no-holds-barred spectacle. 1 Policyholders like Natalia Miguel and Jacob Vertel laid naked what it’s like when your own home is diminished to splinters, however your insurance coverage firm affords you pocket change for claims cost. Miguel’s Georgia house was crushed by a 70-foot tree after Hurricane Helene. Allstate’s preliminary provide? $46,000. Her contractor’s estimate? North of $497,000. It took months, a number of adjusters, and the intervention of a public adjuster and an engineer simply to get Allstate to grudgingly up their provide to underneath $100,000. In the meantime, the roof nonetheless leaks, the wires nonetheless spark, and Allstate nonetheless insists all the pieces’s working as meant. 2
Vertel’s story was simply as stomach-churning. 3 His North Carolina house was rendered uninhabitable by a twister whereas his spouse was pregnant with their second youngster. State Farm informed them the home was livable, even after the county slapped a “don’t enter” discover on the entrance door. After 228 days, they nonetheless haven’t made repairs. At this level, the one factor much less responsive than the State Farm claims division is a taxidermied cat. No less than the State Farm claims govt apologized for the claims dealing with.
However probably the most explosive testimony didn’t come from policyholders. That testimony got here from the individuals who have been despatched to assist them. Two impartial adjusters, Nick Schroeder and Cliff Milliken, testified underneath oath that Allstate reviewers usually instructed them to change or delete estimates to reduce payouts. 4 They described a system the place estimates have been scrubbed of inconvenient details by reviewers who had by no means set foot on the property, and if an adjuster pushed again? They have been yanked off the file or blacklisted totally. Milliken even said that after agreeing to testify earlier than the Senate, he received the dreaded name that he was being “lower off.” A lot for the business’s infinite blather about integrity.
Senator Hawley laid into the Allstate govt whom I wrote about in Understanding Management from Contained in the Insurance coverage Claims Machine: Reflections on Mike Fiato’s Imaginative and prescient. My wager is he loved studying about his management in my weblog greater than his day within the chair responding to Allstate’s dealing with of claims.
Doug Quinn, director of the American Policyholder Affiliation, added a pointed reminder that this isn’t new. He cited systemic fraud going again to Superstorm Sandy, Katrina, and past. He urged the committee to think about what many people within the trenches have lengthy been saying: State regulators are asleep on the wheel, and state regulation is just not sufficient. His view is that we want federal enforcement, not simply to punish fraud, however to stop it. He made the purpose that the {dollars} insurers withhold unfairly from a disaster-struck house owner usually trigger the American taxpayer to cough up federal support by FEMA. 5
Now, right here’s the place issues actually received fascinating. Throughout a podcast dialog I had with insurance coverage protection lawyer Steve Badger simply final evening, he made an offhand statement that deserves extra airtime. He said that apart from the Large 4—State Farm, Allstate, Progressive, and Farmers—and the distinctive breed of Florida insurers, he not often hears of systemic insurance coverage claims abuse. That’s proper. In accordance with Steve, the unhealthy habits appears concentrated in a particular herd.
Shouldn’t the subsequent Senate listening to function the opposite two claims executives from the Fab 4? How concerning the Florida-based carriers and their govt management? What concerning the Florida Insurance coverage Commissioner? It’s no secret that Florida is a petri dish of high-risk property insurance coverage and political theater. It’s time to place the highlight the place the policyholder ache is most acute.
There’s one other piece lacking from this dialog. The courageous souls who testify towards their employers are normally the sector adjusters despatched to assist the policyholders. They deserve greater than applause. They deserve safety and perhaps even slightly gratitude. Congress ought to contemplate an Insurance coverage Whistleblower Safety Act that not solely shields truth-tellers from retaliation however requires firms to self-report violations and show that inner whistleblowers are promoted, not punished. The adjusters on the listening to shouldn’t have to decide on between their careers and their conscience. It ought to be prolonged to engineers and employees who find out about altered engineering or outcome-based studies.
Shouldn’t there be a federal unfair claims apply legislation that offers catastrophe survivors the suitable to sue when insurance coverage firms stall, lowball, and outright sabotage legitimate claims? The present patchwork of state-level treatments leaves too many with out recourse. If a tree falls on your own home and your insurer sends you a verify for lunch cash, there ought to be a transparent, federal treatment. If Congress is critical about defending Individuals from catastrophe, it’s time to begin holding insurers accountable underneath federal legislation. And perhaps, simply perhaps, we will get again to the concept that insurance coverage is a security internet, not a entice door.
The photograph above reveals Merlin Regulation Group lawyer Steven Bush within the background on the Senate listening to. In case you have any inside details about insurance coverage firm fraud, please contact Steven Bush. We’re combating for these whistleblower safety legal guidelines, that are desperately wanted to assist preserve the insurance coverage claims business in verify and trustworthy.
Thought For The Day
“It’s by doubting that we come to research, and by investigating that we acknowledge the reality.”
—Peter Abelard
1 Transcript of listening to earlier than the Senate Homeland Safety and Governmental Affairs Subcommittee on Catastrophe Administration, Could 13, 2025.
2 Written testimony of Natalia Miguel submitted to the Senate Homeland Safety and Governmental Affairs Subcommittee on Catastrophe Administration, Could 13, 2025.
3 Written testimony of Jacob Vertel submitted to the Senate Homeland Safety and Governmental Affairs Subcommittee on Catastrophe Administration, Could 13, 2025.
4 Written testimony of Nick Schroeder and Cliff Millikan submitted to the Senate Homeland Safety and Governmental Affairs Subcommittee on Catastrophe Administration, Could 13, 2025.
5 Written testimony of Doug Quinn submitted to the Senate Homeland Safety and Governmental Affairs Subcommittee on Catastrophe Administration, Could 13, 2025.
