Insurance Company Executive Comes Clean with Insurance Claims Tactics that Shortchange Consumers as Stated in Consumer Federation of America Study
As experienced Pennsylvania personal injury attorneys who also handle product liability cases, we have known that many insurance companies utilize computerized claim systems which are easily adjusted to make broad scale “lowball offers and claims payments” to injured consumers. It is unconscionable and widespread.
Insurance carriers have known for a long time that they can add to their bottom line if they continue to undervalue, delay, deny, and defend claims. The Consumer Federation of America (CFA) issued a report on June 4, 2012 entitled, “Lowball; An Insider’s Look At How Insurers Can Manipulate Computerized Systems to Broadly Underpay Injury Claims.” Mark Romano, CFA’s Claims Project Director, is a “subject matter expert” on Colossus injury claims evaluation at Allstate and Encompass Insurance Company’s for almost ten years. Colossus is the dominant claims system in the marketplace and is sold by Computer Sciences Corporation to insurance companies. The report identifies specific deceptive insurance company techniques that are used to directly and indirectly produce lowball claims. These include, but not limited to, the following:
- Directly reduced payments by a pre-determined amount across the board.
- Selectively remove entire cost claims from data used to determine the acceptable range of payments for particular injuries. This has the effect of lowering payments for all claims of this type.
- Require insurance companies without medical training or credentials to second guess medical professionals by altering injury determinations, thus dictating lower payments for certain injuries.
- Encourage adjusters to downplay or even ignore the likelihood that injured consumers will need future medical treatment or will be permanently impaired disallowing payments.
- Encourage adjusters to determine that drivers are partly at fault for the auto accident that injured them even when they may not be.
Many of America’s premier insurance companies have been systematically ripping off consumers by manipulating the system’s input directly in order to reduce claim payouts.
A major class action lawsuit, Hensley v. Computer Sciences Corporation, revealed disturbing information about how Colossus and other similar products are marketed to and used by insurance companies.
The experienced Pennsylvania catastrophic injury and wrongful death lawyers of Reiff & Bily have known for a long time that the proper response to the delay, deny, defend strategy utilized by insurance companies is to aggressively prosecute your claim always understanding that the insurance company is not your friend. In another recent case, to add insult to injury, a defense lawyer was found guilty in a fake evidence scheme.
When it comes time to paying claims, insurance companies and their attorneys employ hardball tactics many times selfishly putting their own interests before that of the insured or claimant. Many times the consumer is not even aware that a computerized claims assessment was used to process their claim even though the program and input may be incomplete and flawed. Claimants are well served to seek aggressive and experienced counsel to represent their legal interests rather than settle for what insurance companies routinely offer. Most attorneys will offer to represent your interests on a contingent fee which means that if there is no recovery, there is no fee owed. Additionally, experienced counsel should be willing to advance all costs and expenses necessary to prosecute your claim to the maximum of their abilities.
At Reiff & Bily, we salute the Consumer Federation of America report and will continue to strongly advocate for consumers’ rights and on behalf of consumers injured in accidents.