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Accidents Happen But Insurance Companies are Created

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I have always enjoyed reading, watching, and listening to various recounts of historical information on a wide range of topics. Wikipedia is a scary resource given the ease of access and also in creating of the history online. However, for broad strokes and a general overview it has proven quite resourceful.

  • Did you know that insurance has been around in some form since humans have gathered together in communities, or societies?
  • The form of insurance as we know it culminated as a result of the mercantile trade along treacherous rivers and oceans where the chance of loss was great, thus if a merchant received a loan on the shipment they would pay the lender additional monies to cancel the loan if the shipment was lost or stolen.
  • Did you know the first insurance company in America was created here in Charleston, South Carolina?

I won’t bore you anymore with history but just as we have advanced as humans, so to have our societies (at least in most parts of the world), and thus our businesses, or economies.

As stated in one of many lessons learned in Sun Tzu’s, Art of War:

It is said that if you know your enemies and know yourself, you will not be imperilled in a hundred battles; if you do not know your enemies but do know yourself, you will win one and lose one; if you do not know your enemies nor yourself, you will be imperilled in every single battle.

Therefore, I try to learn as much as I can about insurance companies and convey that knowledge the best I can to clients that come in with questions.  Those questions mainly consist of:

  • trying to understand how their insurance company can treat them so poorly after they have religiously paid their premiums without ever having an insurance claim;
  • trying to understand how the insurance company of the negligent, ignorant, or omitting party, will not provide them a fair amount for the injuries, troubles, and ordeals they have experienced through no fault of their own; and/or
  • why the insurance company will not call them back or appreciate what they have had to experience and instead treats them disrespectfully or with disdain.

Well, it is very simple. It’s about money. The money insurance companies want to save by minimizing the payout on your injury, property, and/or life insurance claim. Simply stated insurance companies make money two ways:

  1. Through underwriting, the process by which insurers select the risks to insure and decide how much in premiums to charge for accepting those risks;
  2. By investingthe premiums they collect from insured parties.

The whole insurance business model is summed up succinctly as such:

 to collect more in premium and investment income than is paid out in losses

Your injury, or insurance, claim is the loss being referred to above. What the at fault party’s insurance company pays you cuts directly into their bottom line and therefore the less they can get out of paying your claim, the more they can invest in those really complicated structured asset backed securities, or CDO’s. You remember the recession was caused by ____? Greed.

And that greed can work both ways, on your extreme valuation or consideration of the fair amount to be paid and the insurance company’s extremely low valuation of your claim-regardless of facts.  Thankfully, advocates and plaintiffs’ attorneys exist to assist you in this eternal struggle of good vs evil. If you had to pay a plaintiff’s attorney the hourly wage the insurance company pays the defense attorneys, or advocates, I doubt you would ever be able to fight a fair battle.

Again we learn from Sun Tzu’s, Art of War:

Thus, what is of supreme importance in war is to attack the enemy’s strategy.

Please consider disrupting the strategy of insurance companies to make profit off of your injuries by low balling, denying, delaying, and defending against what you know is wrong. Just because insurance coverage has almost been made mandatory doesnt mean those same insurance companies have to make millions in profits off of your backs. Rise up and fight, now is your time!

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Insurance Companies Don’t Care About You: They Care About Your Premiums

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In my article, “How Do Insurance Companies Make Money?“, I go over Profit = earned premium + investment income – incurred loss – underwriting expenses.  However, it is not my intention to be that technical this time around.

Insurance companies have many different layers, or divisions, but you as the client, or insured, interact with insurance companies on only 1-2 levels:

  1. Insurance Agent-sells varying forms of the insurance, or service.
  2. Insurance Adjuster– protects the insurance company from losing money on the service for which you paid for the insurance company to provide to you by way of a premium and insurance contract (policy). Adjusters minimize the “incurred loss” in the above equation.

As to the Insurance Agent:

It has been my experience that these professionals provide you with information on the varying types of insurance– property, casualty, life, health, and disability. They should review the different policies they have available and the coverages which those policies provide, along with the price.  However, they are not usually legally oriented or familiar with the “back door” aspect of what they are selling.  Meaning, they are doing exactly what they are suppose to be doing, “selling insurance”.  Your insurance agent will most likely refer you to the nearest consolidated insurance claims center if you were to need the service you paid for by way of an insurance claim.

For example: if you were injured in an automobile wreck, lost your shingles when a storm came through, and/or the property or person you bought insurance on was damaged/injured in anyway.  Your insurance agent does not usually handle that, they refer you to a claim center with insurance adjusters. If your insurance agent is kind enough to assist you with the insurance claim procedure they still have no authority, or impact, in how the claim is resolved.

As to the Insurance Adjuster:

They are usually not in the same state as you.  If they provide you any information about your legal rights please ask them if you can record the conversation or get everything they just “counseled” you on in writing.  Insurance adjusters have not passed any state Bar requirements to be lawyers and/or offer legal advice. They work for the insurance company that makes money when it brings in more premiums that are paid by their clients than it pays out in insurance claims.  Their interest are not aligned with your interest as they are evaluated on ensuring that insurance claim payouts are minimized.

Read-One of the factors that an insurance adjuster is evaluated on for their job and them keeping it is to offer you the least amount of money possible for your injuries and/or property so that their employer, the insurance company, maximizes its profit.

Common Misconceptions I hear all the time in my office:

  • I thought they would do the right thing;(Why would you think that? Again, your insurance agent may be the kindest person in the world but that is not who you are dealing with.)
  • I have never had a problem with my insurance company the 20 years that I have had them; (How many times have you had to file an insurance claim? Oh, now the light bulb goes off.)
  • The insurance adjuster told me I didn’t need to get an attorney or another appraiser;(Now why would they not want you to get an opinion other than theirs? *hear Jeopardy music*)
  • The insurance adjuster said I couldn’t go see the doctor;(Why are you listening to anyone other than a doctor in regards to medical advice?)
  • I don’t want to sue anybody;(80-90% of the time no law suit is filed. If one is filed it may list the negligent party but that is because insurance can’t be mentioned in a trial. The insurance company is the one that actually defends any law suits you bring and pays money up to their coverage amount if a verdict is rendered.)

All I ask is that you be informed and educated on the interest of all the parties involved and not just assume anything.

“Knowledge is of no value unless you put it into practice.” — Anton Chekhov