How They Raise Premiums, Deny Claims, and Refuse Insurance to Those Who Need it Most
4. State Farm
10. Liberty Mutual
The U.S. insurance industry takes in over $1 trillion in premiums annually.3 It has $3.8 trillion in assets, more than the GDPs of all but two countries in the world (United States and Japan).
Over the last 10 years, the property/casualty insurance industry has enjoyed average profits of over $30 billion a year. The life and health side of the insurance industry has averaged another $30 billion.
The CEOs of the top 10 property/casualty firms earned an average $8.9 million in 2007. The CEOs of the top 10 life and health insurance companies earned even more—an average $9.1 million. And for the entire industry, the median insurance CEO’s cash compensation still leads all industries at $1.6 million per year.6
Profits Over Policyholders
But some companies have discovered that they can make more money by simply paying out less. As a senior executive at the National Association of Insurance Commissioners (NAIC), the group representing those who are supposed to oversee the industry, said, “The bottom line is that insurance companies make money when they don’t pay claims.”7 One example is Ethel Adams, a 60-year-old woman left in a coma and seriously injured after a multi-vehicle crash in Washington State. Her insurance company, Farmers, decided the other driver had acted intentionally and denied her claim, contending that an intentional act is not an accident. Another example is Debra Potter, who for years sold Unum’s disability policies until she herself became disabled and had to stop working. All along, Potter thought she was helping people protect their future, but when her own time of need came, she was told her multiple sclerosis was “self reported” and her claim denied—by Unum, the very company whose policies she had sold. In cases like these, and countless others, the name of the game is deny, delay, defend—do anything, in fact, to avoid paying claims. For companies like Allstate, there are corporate training manuals explaining how to avoid payments, portable fridges awarded to adjusters who deny the most claims, and pizza for parties to shred documents.
The insurance industry is in dire need of reform. For too many insurance companies, profits have clearly trumped fair dealing with policyholders. The industry has done all it can to maximize its profits and rid itself of claims. Allstate CEO Thomas Wilson outlined the strategy when he said the company had “begun to think and act more like a consumer products company.”176 Allstate has enjoyed a return double that of the S&P 500, but its policyholders have suffered cancellations, nonrenewals, and punishing loss-prevention techniques.177 Wilson has been unrepentant: “Our obligation is to earn a return for our shareholders.”178 Wilson is one of many insurance leaders who have lost sight of their legal and ethical responsibility to policyholders. Now they answer only to Wall Street. The time is due for insurance reform that will level the playing field for consumers.
Allstate—The Worst Insurance Company in America
CEO: Thomas Wilson 2007 compensation $10.7 million (predecessor Edward Liddy made $18.8 million in compensation and an additional $25.4 million in retirement benefits)
One company stood out above all others. Allstate’s concerted efforts to put profits over policyholders has earned its place as the worst insurance company in America. According to CEO Thomas Wilson, Allstate’s mission is clear: “our obligation is to earn a return for our shareholders.” Unfortunately, that dedication to shareholders has come at the expense of policyholders. The company that publicly touts its “good hands” approach privately instructs agents to employ a “boxing gloves” strategy against its own policyholders.1 In the words of former Allstate adjuster Jo Ann Katzman, “We were told to lie by our supervisors—it’s tough to look at people and know you’re lying.
There is no greater poster child for insurance industry greed than Allstate. According to CEO Thomas Wilson, Allstate’s mission is clear: “our obligation is to earn a return for our shareholders.”9 Unfortunately, that dedication to shareholders has come at a price. According to investigations and documents Allstate was forced to make public, the company systematically placed profits over its own policyholders. The company that publicly touts its “good hands” approach privately instructs agents to employ a hardball “boxing gloves” strategy against its own policyholders.10 Allstate’s confrontational attitude towards its own policyholders was the brain child of consulting giant McKinsey & Co. in the mid-1990s. McKinsey was tasked with developing a way to boost Allstate’s bottom line.11 McKinsey recommended Allstate focus on reducing the amount of money it paid in claims, whether or not they were valid. When it adopted these recommendations, Allstate made a deliberate decision to start putting profits over policyholders. The company essentially uses a combination of lowball offers and hardball litigation. When policyholders file a claim, they are often offered an unjustifiably low payment for their injuries, generated by Allstate using secretive claim-evaluation software called Colossus. Those that accept the lowballed settlements are treated with “good hands” but may be left with less money than they need to cover medical bills and lost wages. Those that do not settle frequently get the “boxing gloves”: an aggressive litigation strategy that aims to deny the claim at any cost. Former Allstate employees call it the “three Ds”: deny, delay, and defend. One particular powerpoint slide McKinsey prepared for Allstate featured an alligator and the caption “sit and wait”—emphasizing that delaying claims will increase the likelihood that the claimant gives up.12 According to former Allstate agent Shannon Kmatz, this would make claims “so expensive and so timeconsuming that lawyers would start refusing to help clients.”13 Former Allstate adjusters say they were rewarded for keeping claims payments low, even if they had to deceive their customers. Adjusters who tried to deny fire claims by blaming arson were rewarded with portable fridges, according to former Allstate adjuster Jo Ann Katzman. “We were told to lie by our supervisors. It’s tough to look at people and know you’re lying.”14 Complaints filed against Allstate are greater than almost all of its major competitors, according to data collected by the NAIC.15 In Maryland, regulators imposed the largest fine in state history on Allstate for raising premiums and changing policies without notifying policyholders. Allstate ultimately paid $18.6 million to Maryland consumers for the violations.16 In Texas earlier this year, Allstate agreed to pay more than $70 million after insurance regulators found the company had been overcharging homeowners throughout the state.17 After Hurricane Katrina, the Louisiana Department of Insurance received more complaints against Allstate— 1,200—than any other insurance company, and nearly twice as many as the approximately 700 it received about State Farm—despite the fact that its rival had a bigger share of the homeowners market.18 Similarly, in 2003, a series of wildfires devastated Southern California, destroying over 2,000 homes near San Diego alone and killing 15 people. State insurance regulators received over 600 complaints about Allstate and other companies’ handling of claims.19 Allstate says the changes in claims resolution tactics were only about efficiency.20 However, the company’s former CEO, Jerry Choate, admitted in 1997 that the company had reduced payments and increased profit, and said, “the leverage is really on the claims side. If you don’t win there, I don’t care what you do on the front end. You’re not going to win.”21 For four years, Allstate refused to give up copies of the McKinsey documents, even when ordered to do so repeatedly by courts and state regulators. In court filings, the company described its refusal as “respectful civil disobedience.”22 In Florida, regulators finally lost their patience after Allstate executives arrived at a hearing without documents they had been subpoenaed to bring. Only after Allstate was suspended from writing new business did the company, in April 2008, finally agree to produce some 150,000 documents relating to its claim review practices.23 Still, some commentators believe many critical document were missing.
Allstate’s “boxing gloves” strategy boosted its bottom line. The amount Allstate paid out in claims dropped from 79 percent of its premium income in 1996 to just 58 percent ten years later.25 In auto claims, the payouts dropped from 63 percent to just 47 percent.26 Allstate saw $4.6 billion in profits in 2007, more than double the level of profits it experienced in the 1990s. In fact, the company is so awash in cash that it began buying back $15 billion worth of its own stock, despite the fact that the company was simultaneously threatening to reduce coverage of homeowners because of risk of weather-related losses.27 Despite its treatment of policyholders, Allstate’s recent corporate strategy has focused on identifying and retaining loyal customers, those who are more likely to stay with the company and not shop around. The target demographic, as former Allstate CEO Edward Liddy said, is “lifetime value customers who buy more products and stay with us for a longer period of time. That’s Nirvana for an insurance company.”28
Loyalty only runs one way, however. While Allstate focuses on customers who will stick with it for the long haul, the company is systematically withdrawing from entire markets. Allstate or its affiliates have stopped writing home insurance in Delaware, Connecticut, and California, as well as along the coasts of many states, including Maryland and Virginia.29 In Louisiana, Allstate has repeatedly tried to dump its policyholders. In 2007, the company tried to drop 5,000 customers just days after the expiration of an emergency rule preventing insurance companies from canceling customers hit by Katrina. Allstate dropped them for allegedly not showing intent to repair their properties. After an investigation by the Louisiana Insurance Department, Insurance Commissioner Jim Donelon said, “[A]t best, it was a very ill-conceived and sloppy inspection program. At worst, they wanted off of those properties.”30 Allstate also used an apparent loophole in the law by offering its policyholders a “coverage enhancement” which the company would later argue was a new policy, and thus exempt from non-renewal protection.31 In Florida, Allstate has dropped over 400,000 homeowners since 2004.32 The move has landed Allstate in trouble with regulators because the company appears to be keeping customers if they also have an auto insurance policy with Allstate. Florida law prohibits the sale of one type of insurance to a customer based on their purchase of another line of coverage.33 Allstate officials have acknowledged that most of the 95,000 customers nonrenewed in 2005 and 2006 were homeowners-only customers. The company ran afoul of regulators in New York for the same reason, and was forced to discontinue the practice.34 In California, while other major homeowner insurers, including State Farm and Farmers, agreed to cut rates, Allstate demanded double-digit rate increases in what the former insurance commissioner described as an “exit strategy.” John Garamendi, now the Lieutenant Governor, said, “[T]hey’ve said they want to get out of the homeowners business in a market that is competitive, healthy and profitable.”35 Consumer advocates have also complained that Allstate put an ambiguous provision in homeowners’ policies that may have deceived some policyholders into thinking they had coverage for wind damage when they did not. Socalled “anti-concurrent-causation” clauses state that wind
and rain damage—damage covered under the policy— is excluded if significant flood damage occurs as well. Therefore, those with policies covering wind and rain damage and “hurricane deductibles” still faced the prospect of learning, only after a catastrophic loss, that they had no coverage.36 In 2007, then U.S. Senator Trent Lott sponsored legislation requiring insurers provide “plain English” summaries of what was and what was not covered in order to stop this kind of abuse. “They don’t want you to know what you really have covered,” said Lott.37
10. Liberty Mutual
CEO: Edmund F. (Ted) Kelly 2005 compensation $27 million
Like Allstate and State Farm before it, Liberty Mutual hired consulting giant McKinsey & Co. to boost its bottom line. The McKinsey strategy relies on lowering the amounts paid in claims, no matter whether the claims were valid or not. By all accounts, Liberty Mutual has not become as notorious as its rivals for the deny, delay, and defend tactics that McKinsey encouraged. However, that has not stopped the company from leading the way in complaint rankings and stories of short-changed victims.171 In fact, Liberty Mutual is facing a glut of litigation from its own vendors who say the company’s cost-cutting has resulted in poor claims processing and a spike in lawsuits.172 Like several other big property casualty insurers, Liberty Mutual has also begun abandoning policyholders across the country. The company has pulled out of many states—not only hurricane susceptible states such as Florida and Louisiana, but also northern states such as Connecticut, Rhode Island, Maryland, Massachusetts, and much of New York. A 2007 New York Times article highlighted Liberty Mutual policyholders James and Ann Gray of Long Island. The Grays were “nonrenewed” by Liberty Mutual despite the fact that they lived 12 miles from the coast and had “been touched by rampaging waters only once, when the upstairs bathroom overflowed.” In fact, Liberty Mutual and its big name competitors have left more than 3 million homeowners stranded over the last few years.173 New York regulators chastised Liberty Mutual for tying nonrenewals to whether a policyholder had an auto policy or other coverage, against state law.174 Liberty Mutual has also gone where even its big property casualty rivals Allstate and State Farm have feared to tread by trying its hand at massive corporate fraud. While the likes of AIG, Zurich, and ACE settled charges that they colluded with broker Marsh & McLennan in a huge bidrigging fraud, Liberty Mutual remains the only insurance company that refuses to concede guilt. The fraud centered around fake bids that companies submitted to Marsh in order to garner artificially inflated rates. Liberty Mutual claims its business practices were lawful and that regulators’ settlement demands are “excessive.”175
Colleges Challenge a Common Protection in Sexual Assault Lawsuits: Anonymity
The former college student said she had been raped three times as an undergraduate at Florida A&M University, twice by students and once by an acquaintance who was on campus regularly.
She withdrew from the university and filed suit, saying that campus officials did not do enough to investigate the claims and protect her from being attacked again and again. As a precaution, she identified herself in public court papers only as S.B.
Her school fired back three times with a demand for the court: Reveal her full name or toss out the case.
For years, students have filed sexual assault complaints under pseudonyms, which allow them to seek justice without shame or fear of being targeted. Universities have generally accepted the practice.
But in two recent lawsuits — S.B.’s case against Florida A&M University and a suit by nine women against Dartmouth College — the schools have demanded that students publicly reveal their identities, going against longstanding legal practice intended to protect plaintiffs in sensitive disputes.
Experts on sexual assault cases say that these demands amount to a newly aggressive stance by universities that face potentially damaging lawsuits, and that they run counter to the spirit of federal civil rights policies. The identities of the women in both cases are known to the university lawyers, but not to the public.
“What you’re seeing in this particular case is real hardball,” said Andrew Miltenberg, a lawyer who typically represents men accused of sexual assault. “And it’s still not the way most lawyers or schools handle it. They’re a little bit more gracious about protecting someone who was their student.”
On Wednesday, S.B.’s lawyer sent a letter to more than 40 state legislators objecting to the university’s tactics and asking them to investigate the matter.