CLAIM-HANDLING GUIDELINES
CLAIMS magazine is providing the following free regional guidelines to help adjusting professionals stay abreast of each state’s property and casualty claim-handling requirements. Each guideline features 10 states, grouped by region and can be easily downloaded and printed for desktop reference.
The guidelines are in chart form by state.
Special thanks to Timothy Lynch and Anne Bandle from the law firm of Lynch & Associates in Anchorage, Alaska (www.northlaw.com), who compiled this essential information.
Northeast Guidelines
Gulf/Atlantic Coast Guidelines
Midwest Guidelines
Rocky Mountain Guidelines
Pacific Coast Guidelines
http://claimsmag.com/Pages/Claims-Magazine-Claim-Handling-Regulations.aspx
Claims Handling - Time Limits - State by State Guides
Lynch & Associates of Anchorage, Alaska has also prepared and posted on their web site a summary, by state, of some acts required of insurance companies in claims handling, and the time limits applicable, along with cites to the relevant statutes.
http://www.northlaw.com/Claims-Handling-State-Guides/
The National Association of Insurance Commissioners (NAIC) issued some Model Laws which have been adopted in whole or in part by many states in the form of Unfair Claims Handling Acts or Guidelines or Regulations.
Model # 900 - Unfair Claims Settlement Practices Act
Model # 902 - Unfair Property/Casualty Claims Settlement Practices Model Regulation
They can normally be purchased individually.
More information or copies of the Model Laws can be ordered from:
http://www.naic.org/store_pub_legal.htm
United Policyholders, a consumer advocate organization, has prepared and posted Guidelines for Reviewing Adjusters’ and Contractors’ Estimates to Repair/Rebuild Your Home as well as providing many other useful tips for dealing with insurance claims.
http://www.unitedpolicyholders.org/pdfs/Guidelines_Estimates.pdf
Mike Johnston, a trial lawyer from Oklahoma who practices in the area of insurer's bad faith, has prepared a list of what he considers the "Top 40" types of acts of bad faith by insurance companies: The Bad Faith Top 40
http://www.quatloos.com/traps/badfaith.htm
Thomas F. Segalla published a quite lengthy and well researched article entitled Bad Faith as a Continuum: From Claim to Trial, available on The Federation of Defense and Corporate Counsel website. The article appeared in the FICC QUARTERLY, Vol. 52, No. 1, Fall, 2001
http://www.thefederation.org/documents/segalla.htm
For a quick summary of where your state may stand on Bad Faith as a cause of action, either tort or contract, check out the Policyholders of America web-site at http://www.policyholdersofamerica.org/does_your_state_punish_bad_faith.pdf for a chart covering the 50 states. For definite information on your state, consult a local attorney as laws change frequently.
ADJUSTER PROFESSIONAL CODE OF ETHICS
The Canons and Rules of the Code of Professional Ethics
By: Chartered Property Casualty Underwriters Society
http://www.aicpcu.org/doc/canons.pdf
Ethics Guidelines
By: Society of Registered Professional Adjusters
http://www.rpa-adjuster.com/ethics.html
Code of Conduct: Rules of Professional Conduct and Ethics
By: National Association of Public Insurance Adjusters
http://www.napia.com/learn/code-conduct.asp
IASIU Code of Ethics
By: International Association of Special Investigation Units (IASIU)
https://www.iasiu.org/about_us/code_of_ethics
THE FUTURE
Factory and Firm: The Future of Claims Handling by McKinsey & Company
The evolving of claims handling - good or bad?
https://www.mitchell.com/mcms/content/pub/White_Papers/McKinsey_Factory-Firm_whtp-1962.pdf
PROBLEM AREAS TO BE AWARE OF
The Ten Worst Insurance Companies in America: How They Raise Premiums, Deny Claims, and Refuse Insurance to Those Who Need it Most
By: American Association for Justice [Formerly the Association of Trial Lawyers of America (ATLA)]
The Ten Worst Insurance Companies
1. Allstate
2. Unum
3. AIG
4. State Farm
5. Conseco
6. WellPoint
7. Farmers
8. UnitedHealth
9. Torchmark
10. Liberty Mutual
http://www.justice.org/resources/AAJ_Report_TenWorstInsuranceCompanies_FINAL.pdf
The “Good Hands” Company or a Leader in Anti-consumer Practices? Excessive Prices and Poor Claims Practices at the Allstate Corporation July 18, 2007
By: J. Robert Hunter, Director of Insurance, Consumer Federation of America (CFA)
A report by the CFA on their findings following their investigation of Allstate’s business practices
http://www.consumerfed.org/elements/www.consumerfed.org/file/finance/Allstate_Report_07_18_07.pdf
Property/Casualty Insurance in 2007: Overpriced Insurance, Underpaid Claims, Declining Losses and Unjustified Profits January 8, 2007
By: J. Robert Hunter, Director of Insurance, Consumer Federation of America
This report concludes that: “The property/casualty industry has been remarkably successful in recent years in maximizing profit through rate increases, coverage reductions, inappropriate claims practices and the shifting of high risks onto taxpayers.”
http://www.consumerfed.org/pdfs/2007Insurance_White_Paper.pdf
Patterns of Greed 2007: How Insurance Companies Put Profits over Policyholders
By: American Association for Justice [Formerly the Association of Trial Lawyers of America (ATLA)]
According to this report, “the insurance industry has made a practice of collecting billions of dollars from policyholders over the years and then stiffing them in their time of greatest need.”
http://www.justice.org/resources/POG2007.pdf
An Insurer in the Grip of Greed
By: David J. Bernardinelli. Published in TRIAL, July 2007
A discussion of Allstate Corp and McKinsey & Co. And a re-design of Allstate’s claims handling
http://www.kanoski.com/CM/Custom/Insurance%20Industry%20Exposed.pdf
CNN 360 Anderson Cooper - Auto Insurance
Video - Part 1 - http://www.youtube.com/watch?v=pSj3FLO3IXA&feature=player_embedded
Video - Part 2 - http://www.youtube.com/watch?v=pkq-CX17aO8&feature=related