Former Claims Adjusters Recount Fraudulent Claims Handling Practices

Former Insurance adjusters testified, February 2021 to Washington state lawmakers, in support of House Bill 1428, giving first hand accounts of the corruption and fraud in the claims handling world. Both claims professionals gave testimony that was contrary to the Insurance Industry’s reports regarding the “adequate protection,” and “the desire among insurers to provide quality service at a reasonable price to our insureds.”

The Claims professionals emphasized the insurance companies lack of safety concerns so as to always keep repair costs down. 

Insurance companies have a duty to handle claims with good faith. An insurance adjuster could be liable for breaching the duty of good faith among other applicable state statutes.

  • Unreasonable delays in processing claims
  • Underpayment of claims
  • Failure to thoroughly investigate a claim
  • Misrepresenting the nature and damage of the claim

Former American Family senior auto damage adjuster Jackson Clemmons reported not feeling comfortable with many of the company’s claims handling practices. He said “Instead, we were mainly trained on how to negotiate down claim settlements as low as possible, ” and his daily mandate was to “never match a body shop’s estimate.” Clemmons last straw was when he realized he wasn’t working for the vehicle owner with respect to repair best practices and safety, but only working to lower American Family’s cost “by any means.”

 Former GEICO adjuster Josh Green stated “My advancement opportunities within GEICO relied on writing the lowest possible repair, controlling rental costs, and CSI.”

“We were not rated on safety of repairs,” he said. He also claimed he could control those GEICO KPIs, describing the ability to manipulate who received CSI surveys.

For more detail read the article here.

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