{"id":895351,"date":"2019-01-02T17:03:03","date_gmt":"2019-01-03T00:03:03","guid":{"rendered":"https:\/\/www.myconstructionexpert.com\/blog\/?p=895351"},"modified":"2019-01-02T17:03:11","modified_gmt":"2019-01-03T00:03:11","slug":"property-insurance-claims-procedures-should-be-transparent-and-uncovered-in-market-conduct-studies","status":"publish","type":"post","link":"https:\/\/www.myconstructionexpert.com\/blog\/property-insurance-claims-procedures-should-be-transparent-and-uncovered-in-market-conduct-studies\/","title":{"rendered":"Property Insurance Claims Procedures Should Be Transparent and Uncovered in Market Conduct Studies"},"content":{"rendered":"\n

Chip Merlin | Property Insurance Coverage Law Blog<\/a> | December 30, 2018<\/p>\n\n\n\n

\"\"<\/figure><\/div>\n\n\n\n

Merlin The Moose<\/strong><\/em> is a client favorite at the Chicago Merlin Law Group office. We won him at a charity auction last year. He also led me to some creative research uncovering a problem with market conduct studies and the transparency of property insurance claims procedures many insurers keep hidden from their customers and insurance regulators.<\/p>\n\n\n\n

Moose v. Nationwide Mutual Insurance Company<\/em>1<\/sup> involved a relatively common action which many long-time insurance agents bring against their captive insurers after the management of the captive insurers change the rules of their relationship. Nationwide Mutual argued the following in the case:<\/p>\n\n\n\n

The interest of the policyholders, agents, employees, and the public are best served through policyholder ownership and control of the business. Such control helps to develop and maintain financial soundness of the Companies and provide high quality insurance service at the lowest possible cost. It is, therefore, a policy that the policyholders, through the Companies, shall maintain ownership and control of the business and all policyholder information and such ownership rights shall not be vested with either agents or employees.2<\/sup><\/p><\/blockquote>\n\n\n\n

if this is so, why shouldn\u2019t the policyholders be provided all the written claims guidelines which the insurance company is instructing its adjusters to use while adjusting their own property insurance claims? Nationwide and many other insurance companies argue these are \u201ctop secret\u201d and never provide them. Yet, the National Flood Insurance Program actually publishes the guidelines for their customers and others to analyze. Citizens Property Insurance Corporation used to publish theirs as well.<\/p>\n\n\n\n

Insurance companies are subject to market conduct studies by insurance regulators. Most would think these regulators would not only want to review closed claim files but ask for any documents showing an emphasis, changes to and the actual written claims procedures and directives which insurance company adjusters are being required to follow.<\/p>\n\n\n\n

If we had this transparency, wrongful claims practices, like the Farmers \u201cBring Back a Billion\u201d claims initiatives in the late 1990s may never have come into being for fear of regulatory fine and public embarrassment.<\/p>\n\n\n\n

Could you imagine a manufacturer of a product not providing the service and product manual to its customers? No way. Yet, this is exactly what is happening when we allow a property insurance company and claims management to initiate claims procedures which are not in good faith but in only the insurance company\u2019s financial interest.<\/p>\n\n\n\n

Quote of The Day<\/strong><\/p>\n\n\n\n

\u201cIf you want to go foraging into the wilds of Canada without proper gear, you deserve what you get, even if that happens to include being attacked by an undead moose.\u201d<\/strong><\/em>
\u2014Mira Grant<\/em>
__________________________________
1<\/sup> Moose v. Nationwide Mut. Ins. Co.<\/em>, No. 5:08CV77, 2011 WL 4368351 (W.D.N.C. Sept. 19, 2011).
2<\/sup> Id.<\/em> at *9.<\/p>\n","protected":false},"excerpt":{"rendered":"

Chip Merlin | Property Insurance Coverage Law Blog | December 30, 2018 Merlin The Moose is a client favorite at the Chicago Merlin Law Group office. We won him at a charity auction last year. He also led me to some creative research uncovering a problem with market conduct studies and the transparency of property insurance… Continue reading Property Insurance Claims Procedures Should Be Transparent and Uncovered in Market Conduct Studies<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-895351","post","type-post","status-publish","format-standard","hentry","category-insurance-estimates","entry"],"jetpack_publicize_connections":[],"yoast_head":"\nProperty Insurance Claims Procedures Should Be Transparent and Uncovered in Market Conduct Studies - 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