Tag Archives: Maine Bureau of Insurance

Investigating Insurance Company Profits

Maine insurance adjusters, are generally honest and credible. NPR is broadcasting a shocking and informative investigation of gross malfeasance under the flood insurance program, which the U.S. taxpayer subsidizes if there are not enough funds to cover large scale catastrophic losses.

Sept. 20: Business of Disaster

Who profits when disaster strikes? FRONTLINE and NPR investigated the aftermath of Superstorm Sandy — revealing that private insurance companies working for the government have made hundreds of millions of dollars at the same time that thousands of homeowners are claiming they have been underpaid. “We found that disasters like Superstorm Sandy aren’t a disaster for everyone,” says NPR reporter Laura Sullivan, who along with FRONTLINE producer Rick Young and his investigative team spent a year digging into how Sandy recovery dollars were spent.

From NPR News Investigations

“In 2009, a Government Accountability Office audit told FEMA to figure out how much profit the flood insurance companies are making off the flood program and take that into account when it paid them.

But Wright, who took over the flood program for FEMA last year, says he doesn’t know how much money the insurance companies make from the program.

“I’ve never looked at the book of business to understand their profits,” he says. “So you’d need to go specifically to the companies to understand those numbers.”

The nation’s largest insurance firms declined to disclose their profit margins on the flood program.

However, every year the insurance companies report what it actually costs them to do their flood work to the National Association of Insurance Commissioners, an industry association of government regulators. And every year, FEMA reports what it pays insurers who participate in the flood program. With both numbers, you can do some math. Government auditors used a similar method in 2009.

Based on the latest figures, that analysis shows the insurance companies together made anywhere from $240 million to $406 million a year just on their flood work since 2011 — without having to pay any claims.”

Insurance Statistics

The Maine Bureau of Insurance publishes a lot of information. Homeowner Insurance Complaint Comparisons will be helpful when property insurance is due to renew. United Policyholders offers good advice on purchasing insurance and making the most of potential discounts as well as information specific to each state.

Maine Bureau of Insurance

Winter brings pipe breaks and water damage, the Maine Bureau of Insurance offers this advice to homeowners in the claim resolution process-

“If you and the insurer still disagree about the value of the claim, review the appraisal provision in your policy. It is a simplified procedure to resolve disagreements about the value of a property damage claim.

If you have trouble with or questions about your claim, you also may contact the Bureau of Insurance for help. The Bureau of Insurance has consumer services personnel who can help you work with your insurer to resolve disagreements.”

Water Damage & Mold Insurance Information

The Maine Bureau of Insurance publishes A Consumer’s Guide to Homeowners Insurance that will be helpful in determining variations in coverage options. Not all policies offer the same coverage. Usually water damage is covered but it depends on the cause of the damage. Mold contamination may not be covered depending upon the policy.

Property Insurance Claims

Not all insurance companies respond immediately to property damage claims by sending an adjuster to review property loss and damages. The appearance of an adjuster on site can take several days or weeks. There are instances where property loss is desk adjusted by insurance company personnel who have not been on site at all.

We have worked with skilled, experienced adjusters who are always prepared for on site assessments. They ask questions and review damaged areas, taking comprehensive measurements and collecting data from specialized meters. Competent adjusters are objective and professional in assessing property damage.

We have also seen independent adjusters who are unprepared and reluctant to investigate property damage thoroughly. Only rudimentary measurements are collected and no supporting data is recorded to substantiate property damage. In those instances, the insured are often left with unpaid balances for abatement and restoration work on claims that have not been assessed properly.

Consumers have resources available to them. The Maine Bureau of Insurance offers electronic complaint forms
http://www.maine.gov/pfr/insurance/eform_pc.htm
as well as a printable paper version http://www.maine.gov/pfr/insurance/documents/pdf/ComplaintForm_PC.pdf .

Insured consumers are also offered recourse via litigation, demanding payment for losses incurred as the result of property damage. The State of Maine is diligent in its efforts to afford protections to insured consumers as illustrated by Court decisions.

Ultimately, it is the insured’s responsibility to record a complete history, including all conversations with the insurer and independent adjusters, from the time damage is discovered/reported until claims have been paid. Ethical adjusters and insurers will provide correspondence documenting authorized coverages and repairs. Inclusive recordkeeping during an insurance claim will help to protect the interests of all parties.