Mar 162015
 

InsuranceBusters.net What the Hail is Really Going on in Texas

What the Hail is Really Going on in Texas?….Accountability! An In Depth Look at Proposed Legislation

 

“The Insurance Company Protection Act of 2015”

Amendments to Sections 541 & 542 of the Texas Insurance Code

 

Clarification and full disclosure: My name is Cal Spoon. I am a licensed Public Adjuster # 1594236 and I ownInsuranceBusters.net, License #1603054 in the Great state of Texas along with a slew of others. Texas is my birthplace, and my home. It is where my family resides and two of our offices are located. You could say I have a vested interest. I am a consumer as well as an insured. I have family who are also affected by every bad decision in here.

Things I am not. Politically involved or motivated, an attorney….well that about sums it up  as far as insurance goes, and that is what this is about.

A “Consumer Protection” change to the existing “Consumer Protection” act already in place. Unfortunately, when something works as it is supposed to, and protects the actual consumer, someone comes along with changes such as these that actually GUT ANY protections the insured had before. This is a travesty, and could not be construed as anything else from anyone who was properly informed on ANY of the issues they are attempting to change. Prepare to be informed.

 

To: Texas Legislature

Senators and Representatives of the State of Texas

Insureds….. Everywhere.

 

Please find enclosed a full and detailed description of the travesty that these proposed changes would have on the current landscape of insured home and business owners. Please realize, this is the only publication that I am aware of that is NOT provided by the very people who stand to profit from these very revisions.

Without haste, let’s look at who is actually introducing these heinous revisions.

Senator Larry Taylor – This will not be the first time Mr. Taylor has put his foot in his mouth, and as is true with every politician, in order to benefit himself.

  1. Taylor owns the Taylor Insurance Agency. When he sells insurance, and his sales lead to claims filed, his commission, bonuses and general income takes a hit. No lawsuits means he will reap the benefit of those non-suit losses. How? Because covered claims do not get paid with the current legislation, and penalties in place. See his page here: http://www.trumantaylorinsurance.com/
  2. Lobbyist, who spend hundreds of millions of dollars a year for what…to buy votes and steer legislature to their benefit. This is wrong on so many levels, however it is the norm, and usually results in the everyday citizen losing the voice they voted into office to swift city slicker who talks fast. Mr. Taylor receives campaign donations and no telling what else we are unaware of. Regardless of how he is compensated, his vote is being bought. The cost? Protections for insureds throughout Texas, and eventually, like any evil that prevails in one place, it will rear its ugly head in another.
  3. Taylor had this to say in a recent article. “They’re incentivized to drag these claims out,” said Taylor, who owns the Truman Taylor Insurance Agency in Friendswood, a Houston suburb. “I don’t know of any savings account that offers eighteen percent. There’s too much of an incentive for abuse.” Taylor said he plans to frame the legislation as a “consumer-bill-of-rights type bill” because the costs of litigation could cause insurers to increase their premiums. Texas homeowners already pay an average of $1,661 per year for insurance, 60 percent more than the national average, according to the National Association of Insurance Commissioners.
  4. Taylor, the 18% fee is not one anyone with any common sense would categorize as a savings account. It is a penalty to an insurer when they shirk the duty your constituents and their insured. It is a PENALTY, NOT A SAVINGS ACCOUNT!
  5. TWIA – While Mr. Taylor boasts his wins against TWIA, let’s take a closer look at what his junk changes actually did for constituents…you know…insureds. Here is what attorney Eric Dick had to say. “In 2013 the Texas legislature changed the law for Texas Windstorm Insurance Association (TWIA). Specifically, it removed the liability for TWIA from Texas Insurance Code, Chapter 541 and 542, and Texas Business and Commerce Code, Chapter 17.  It’s important to note that Texas Insurance Code 541 (and Texas Business and Commerce Code, Chapter 17) provide a safeguard for unfair or deceptive insurance practices.  Texas Insurance Code 542 provides a strict liability penalty when an insurance company doesn’t promptly pay a claim. The legislature then added Texas Insurance Code 2210.574 and 2210.575 which reduces penalties for insurance companies and requires appraisal in the event TWIA underpaid the claim.  If appraisal isn’t promptly requested then the insurer has no remedy.”

 

House Insurance Committee: The following members of this committee should resign, and their replacements be well versed in insurance, without being able to actually profit, directly or indirectly from any legislation they have passed. (This should be a no brainer, but read on.)

 

Rep. Guerra, Bobby District 41 – whose clients list as attorney can be found here. As you can see, they represent some of the largest insurers in the Nation. There is no way this bill will not directly benefit every one of his clients, because he represents the insurer…NOT THE INSURED! http://www.guerraleeds.com/clients/

 

Rep. Meyer, Morgan District 108 – whose clients also include some of the largest insurers in the world. Again, and without question as to where their true loyalties lie.  http://www.bracewellgiuliani.com/practice-detail/insurance-litigation

 

Rep. Vo, Hubert District 149 – I am not certain where Mr. Vo fits in, but here is what Wikipedia has to say about him. “The Houston Chronicle has reported numerous stories about apartment complexes owned by Vo. The complexes have been cited by the City of Houston for various building code violations. [1] “His rival, Greg Meyers, made this comment, which just literally cuts this whole scenario to the bone. “”Hubert Vo is obviously abusing his public office to benefit his personal business,” he said. “This is a serious breach of leadership, ethics and integrity, and it needs to be fully investigated by outside parties to determine if any undue influence was sought by Representative Vo.” Found here: http://www.chron.com/news/houston-texas/article/Lawmaker-Vo-used-state-letterhead-in-complaint-to-1534846.php

My question for Mr. Vo, very simple: If you cannot fix the apartments you own, and the city has to cite you, to which you retaliate with an official letter of Official Letterhead, claiming you were being picked on, when in actuality, you were taking money from YOUR OWN TENANTS, which resulted in profits for you. What is the difference between your situation, and that of the insured citizens of Texas? None. You will take as much as you can, only acting on the horrible conditions when there was absolutely no other choice. Article here:http://www.chron.com/news/houston-texas/article/Lawmaker-Vo-takes-blame-for-substandard-apartments-1769007.php  Just out of curiosity, did Mr. Vo file insurance claims on any of those properties?

 

Rep. Sheets, Kenneth District 107 – If you remember House Bill 930, and the travesty that was meat of that bill, which was designed to deter insureds from filing ANY claims at all. They “shelved” this bill until a later time. I wrote a small article on the effects of this bill, found here: http://insurancebusters.net/2013/03/22/hb-930-big-insurance-in-texas-bought-state-representatives-in-texas-short-and-longterm-fall-out-for-insureds/  This would have been another attack on insureds that is not only unjustified, but would penalize ANYONE who filed a claim. Why in the world did you buy insurance in the first place?

 

There is so much more to these folks and their ties to insurance than this, however, I have to find stopping points, and attempt to condense as much information as I can into something our fellow voters can and will read. I am going to attach a link to the actual draft can be found, and then I will move onto the merit of the actual proposed changes and their fallout for insureds.

InsuranceBusters.net Change the World

 

Draft Copy of Proposed Changes to Texas Insurance Code: http://insurancebusters.net/wp-content/uploads/2015/02/Draft-Texas-Insurance-Legislation.pdf

The Existing Texas Insurance Code Can be Found Here: http://www.statutes.legis.state.tx.us/Docs/IN/htm/IN.542.htm

 

I am only a lowly Public Adjuster. Definitely not an esteemed Senator, nor State Representative. Not even an attorney. In fact, I am just a guy, like you, the insured. I got into trouble when I was 17 years old. This single thing has haunted me since then…. 25 years. Until I became involved heavily into the insurance side of this industry, I truly believed the entire population was better than me, and that held especially true of the police force, judges, attorneys and pretty much any government office. What I have actually found out, is that when I was got into trouble, I always raised my hand and took my consequences. As it turns out, I am in a select category of people who actually believe that is the only way. The ultimate realization that all of these people who looked down upon me, were committing atrocities daily. Elected officials caught in schemes from one end of the world to the other. Every time, breaking laws, both moral and legal, that cannot even begin to be comprehended. Our elected officials have been bought out. Almost every single one of them. What other purpose do lobbyist have? In saying that, one must realize proof is needed. I have posted a copy of the draft revisions and will now address each point in turn. Yes, some of these are painful for my profession as well, and the truth is quite simple, there are rotten apples everywhere. In every profession, in every city, in every state. That is no different from Columbine or any other horrific event where an INDIVIDUAL or SMALL GROUP OF INDIVIDUALS acted independently, yet their actions have been combined and turned into a call for strict gun control. This type of legislation, in any form, only serves to punish the responsible law-abiding citizens while allowing the criminals to run free. Stricter laws are needed for Public Adjusters, I agree. However, one cannot, in one fell swoop lump them together in a thinly veiled attempt at reducing costs to insurers who would not have had the opportunity to be PENALIZED, had they not broken the rules in the first place. The original authors of this legislation where not slaves to lobbyist, and profiting from their own companies who were directly affected by the very legislation being presented. There should be an inherent law that restricts anyone who can introduce and change legislation to be in that same field, ever. This is common sense and one of the largest example of a conflict of interest that can be used.

The opening statement of the draft, attempting to change the current legislation with their big claim to fame being the ludicrous claim that by relieving the current standards in place, which insurers cannot comply with now, that we, the CONSUMERS, will be protected. I am not sure if anyone actually reads this, or maybe it is treated as the affordable care act, and we must first “pass” it to see what is actually in it…

There are a few statistics thrown in for good measure. Where are the numbers substantiating these claims, and who performed these studies? We have studies of our own, that we have conducted over the last five years. We will get into that later, with specifics, however, my point here is that numbers are being quoted that are “approximate” at best, and there is no validation, nor correlating evidence that would OR could state otherwise. Evidence that social media outlets such as Facebook, Twitter, and YOUTUBE have also contributed to the rise of claims, along with massive TV, radio, internet and sports presence insurers have. These issues have not even been addressed as contributing factors, when in fact, they are probably more responsible than all the other elements combined, yet insurers chose to actively attack the only protections insureds had.

One must also realize at this point, many people who have damaged property are afraid to file claims. They are afraid of rate hikes, denials, and negative claims history…… Again, I will ask the redundant question. Why do we purchase insurance? The notion that more insureds are filing claims, and this upsets the insurers who accepted their overly priced premiums, yet are mad that some of them actually had the audacity to file a claim, and expect that insurer to act on the contractual promise they made. Shame on them.

 

Before you read this, you must first remember that you purchased insurance for one reason, to file a legitimate claim if you had one. You expect the insurance company to come to where the loss occurred, valuate your loss, and pay you everything your policy promised it would….. Somehow, we lose all sense of reason in this respect. The simple idea that we expect the entity who owes to come out and voluntarily pay their profits, when there are absolutely no safeguards in place, is, well….ridiculous. Any money an insurance company owes you, and does not pay, turns into immediate profit. If owed you $10,000.00, yet looked you dead in the face and said I only owe you $2500.00, I would receive the benefit of $7,500.00.

This is from the following article, and explains from Allstate’s own CEO: http://www.bloomberg.com/apps/news?pid=nw&pname=mm_0907_story1.html

“Jerry Choate, Allstate’s chief executive officer from 1995 to ’98, said at a news conference in New York in 1997 that the company’s new claims-handling process had reduced payments and increased profit, according to a report in a March 1997 edition of National Underwriter magazine. Insurers can’t make significantly more money just from cutting sales costs, he told reporters. “The leverage is really on the claims side,” Choate said. “If you don’t win there, I don’t care what you do on the front end. You’re not going to win.”

The more cash insurers can keep from premiums, the more they can invest. This pool of assets–most of which the companies invest in government and corporate bonds–is known as float.

“Simply put, float is money we hold that is not ours but which we get to invest,” billionaire Warren Buffett, CEO of Berkshire Hathaway Inc., wrote in his annual letter to shareholders this year. “When an insurer earns an underwriting profit, float is better than free,” he wrote in 2006. Omaha, Nebraska-based Berkshire Hathaway generated 51 percent of its $11 billion profit in 2006 from insurance.” End Article Quote
So, we have a clear understanding, they are using our premiums that are owing to us and fellow insureds to buy into our government…

Actual Changes:

  1. Page 3 line 18 Strikes the word knowingly. Current licensing rules require licensee to be competent and knowledgeable. This actually allows them to “knowingly” misrepresent the facts.
  2. Page 4 lines 1 thru 5 adds an additional section that has at least one phrase that is wholly ambiguous, in favor of the insurance company. “Compromise Settlement.” In insurance, a carrier owes what the policy allows, there is not a compromise, and the insured did not pay for a compromised settlement. In my opinion, the whole section is added to install this phrase.
  3. Page 4 lines 9 & 10 adds another section, adding yet more ambiguity to the process by using the phrase “reasonable investigation” without actually defining “reasonable”. This allows a proven gray area that insurers manipulate to delay and mitigate their loss. The insured should always have a very CLEAR set of standards.
  4. Page 4 lines 16 thru 21 adds section (B) which frankly, is confusing to me, and I read these numerous times daily, it is my job. It appears to state that if an insurer would believe they are liable for one portion, yet it has a liability issue on another, that they, the insurer, could withhold payment…. Again, this one is somewhat confusing even to me. If you want anyone to follow rules, they must be clear and concise.
  5. Page 7 lines 22 thru 24 continued on Page 5 lines 1 & 2 adds a new section with a thinly veiled statement at the end, “except as may be specifically provided in the policy”. This language allows them to add language to their policy that could completely circumvent the ENTIRE STATUTE. This is just one of the many attempts throughout this proposed “Consumer Friendly” bill that would give insurers that very ability, to completely shirk their obligations whenever they choose.
  6. Page 7 lines 3 thru 6 adds the insurers ability to claim a “compromise settlement” amount on a claim that THEY determine is doubtful or disputed. Think of the hurricanes, Katrina, Ike, Rita, Sandy, Irene and give me one good reason to believe that any insurer could ever be trusted solely to pass judgment on the merit of a claim.
  7. Page 7 lines 21 thru 23 adds subsection (c) which again allows an insurer to determine a “good faith dispute” over coverage, alleviating any responsibility or penalties when an insurer chooses to conveniently decide there is a dispute.
  8. Page 6 lines 1 thru 3 adds subsection (d) where the insurer is limiting, through our own legislation, the insureds ability to seek all necessary relief when fight Goliath.
  9. Page 6 lines 19 thru 23 removes the ENTIRE PENALTY and remedy for an insurer who violates any, or as is most common, all of the governing rules against treating an insured fairly. Does the common citizen, or consumer pay penalties when they are late on credit cards, loans, bills…taxes? Every part of their life, they pay fees when they do not honor their obligations. And when they are deceitful, they are not exempt of from Deceptive Trade Practices, nor any other protections afforded to an insurance carrier. Why would we exempt them from the very rules the rest of us have to abide by….they have more control than any citizen ever dreamed coupled with the ability to approve or deny a claim based on profits and losses…and not merit.
  10. Page 7 lines 15 thru 17 adds language that requires an insured to go through even more hoops than before. First and foremost, the insured is a laymen. To require them to jump through multiple arduous tasks with multiple names, titles and certified transactions could only deter a portion of people from filing a claim at all, or, if they did file the claim, and did it to the best of their ability, yet missed a few of the crucial steps, the insurer could and absolutely would throw their claim out, whether valid or not. Again I recommend any of you revisit the flood vs wind issues with Katrina and multiple others where insurance companies were caught, and found guilty of shirking their claims responsibility and passing their costs of to the consumer, yet again, through NFIP.
  11. Page 7 lines 21 thru 23 and Page 8 lines 1 and 2 adds the additional language to support the above listed changes as well as limiting the insureds time to file a claim. Currently, they have two years, which is a good practice, and are also accommodated by the current statutes these mongrels are attempting to revise. Statute of limitations is correct at two years. It allows physical damage that may not surface immediately, to be overlooked. Especially when a claim was filed, yet the insurer unfairly denied coverage. A two year statute of limitations allows a period of time for many reasons, most of which are tied to this concept. If an insurer will not pay for “unseen damage”, the insured would obviously need time to consider exactly what those “unforeseen damages” may actually be, and claim them on their policy before it expires. The next policy will not pay for a loss that occurred during another policy period, which is correct.
  12. Page 8 lines 3 thru 14 adds the ***ADDITIONAL*** burden on the insured to follow a strict and foreign procedure, just to file the claim, while adding additional language that would exempt the insurer from ANY responsibility provided the already confused insured missed some of these “critical” steps, or risk being denied on a covered loss.
  13. Page 8 line 18 adds the word “business” days. There are already 15 consecutive days given. The previous legislators saw a need to define reasonable because insurers obviously benefit, and use that benefit, when it is not specified. I will also add, add in the changes addressed above, the insurer here, and through the remainder of this section, attempt to tell you they need more and more time, and no consequences, when they are very clearly attempting to add ***ADDITIONAL DUTIES TO THE INSURED AND REMOVING ANY AND ALL PENALTIES, WHILE REDUCING THEIR TIME AND ABILITY FOR RECOURSE ON THE VERY SAME ISSUES INSURERS ARE REQUESTING MORE TIME FOR, YET REDUCING ANY PENALTY IF THEY STILL choose NOT TO MAKE THE DEADLINE! They are penalizing you, the laymen, when insurers, the presumed professional, shirks every duty their license and current statutes require of them.
  14. Page 8 line 24­ adds the words “inspection reports” for what insurers can demand, while refusing to provide the same to an insured, even after a court has demanded them to do so. Here is just one blatant, provable example…there are so many more. http://www.nytimes.com/2015/02/17/nyregion/hurricane-sandy-victims-say-damage-reports-were-altered.html?smid=fb-share&_r=1
  15. Page 9 lines 2 thru 15 adds actual language that would first, and again, allow the insurer to define reasonable, then require a signature under oath, followed by a statement under oath, which historically scares people, and is added as a scare tactic to the actual LEGISLATION. Do you feel you should be submitted to formal proceedings just to file a claim?
  16. Page 9 lines 20 thru 24 and Page 10 lines 1 thru 7 add language that absolves all insurance carriers from following any kind of time line, such as the one currently in place. This same section also allows the Department of Insurance to make a choice, if and when an insurer is found to have violated the rules it says they are exempt from, the language used states that the Department of Insurance ***MAY*** assess interest, but this still does not constitute a violation of the Unfair Claim Settlement Practices. If you can read, this is a direct violation and the only reason the statute even exists to begin with. On that note, we have filed at least 100 separate complaints with the department of insurance. Responses varied from “we are not a Regulatory Agency”, which is exactly what they are, to the most common, which is they suggest the insured hire legal counsel. This promotes an atmosphere that there are no rules and no one to enforce if there were. The Department of Insurance is tasked with doing just that, and the commissioner has a massive amount of power, especially when they repeatedly violate the same simple rules, over and over, yet nothing changes. This very bill, in part, proposes that if you removed the EXISTING PENALTIES, the insurer would act even better….. Really. We have documented proof on any claims made personally by me. All complaints are at my office, and available. Prepare to spend days. It will take you that long to go through the info, only to find that every single insurer acts exactly the same, which is however they choose. Lately, two insurers in particular, GuideOne and Hanover have actually obtained attorneys PRIOR to even sending “undisputed amount” owed under current legislation. This is while the good laws we have in place are already there…how do you really expect them to act when the rules have been removed…?
  17. Page 10 lines 14 thru 16 adds the word reports, which we have addressed above, and strikes some irrelevant policy language due to previous changes. There is nothing wrong with the current statutes as far as consumers are concerned, however, having a few rules to follow for an insurer is frowned upon, and this does not make any sense, common or otherwise. When the other provisions fail, so to must this one.
  18. Page 10 lines 21 & 22 mirrors the changes above and are equally useless.
  19. Page 11 lines 4 & 5 removes existing good language to be replaced with their amended time frames and self-absolution from above.
  20. Page 11 lines 9 thru 20 additional time has already been given, yet insurers want an additional out they can use to delay payment by merely sending a note stating that “They NEED more TIME”. This single move allows the insurer an ADDITIONAL 45 days to hold funds owed to the insured, yet again, without penalty. Let me pose a very quick scenario here. Hurricane Ike occurred around the time the stock market fell, and oil took a nose dive. By their own admission, they use our premiums as “float” money, and claim it is “free” money. It is not, it is money owed to insureds. With methods like above, your insurer could be investing heavily because the bottom fell out. They picked up a ton of shares of crude at $37.00 a barrel. Say it comes time where they have to release a ton of money to insureds, they trigger plans already in place to extend the payouts in order to maximize the time available for the oil to return to a minimum standard of $70.00-$100.00….. You do not have to be an economist to understand that they are not profiting from the premiums, but from the leveraging of the money they owe you, the insured. They ae now asking you to let their “FREE FLOAT MONEY” become penalty free, if and when they do get caught.
  21. Page 12 lines 2 & 3 as well as line 7 add language to solidify the “compromise settlement” phrase they have introduced into this very legislation. This very phrase is ambiguous, and lets the insurer, yet again, make a definitive ruling on their profit, while making it impossible for an insured to recover when they are actually caught.
  22. Page 12 lines 16 thru 20 adds language that appears to open the door for more and multiple deductibles, while extending the time frame for an insurer to respond on all claims. What is an insurance company supposed to do? Provide and service insurance. That is it. Why in the world can your insurer not simply work and handle claims in the very lenient time frame already given, when it is the only job they have? (See my line item 20 for answer.)
  23. Page 12 lines 23 and 24 Page 13 lines 1 thru 24 and page 14 lines 1 thru 13 this single portion deals with the penalty part of violating any of the rules they stated insurers did not have to follow above. Please read that statement over and over until you understand it fully. This gives them multiple ways, just as listed above, to draw out and delay payment for as long as they can, then send to appraisal, to drag out at least another 60 days, when the appraisal is non-binding, and then allow an insurer 15 business days to pay to avoid paying ANY attorney’s fees, penalties, fines, or interest. This is 10 more business days than allowed originally, and still in this statute, coupled with ALL the facts created in that process, yes they still want to hold your money for an ADDITIONAL 15 BUSINESS DAYS!
  24. Page 15 lines 1 thru 13 add language that would reduce the penalty payment from 18%, which is the current, correct rate for failing to abide by the rules and withholding funds from your insured to a miniscule 3%. How many of you pay this type of interest on anything you own? Larry Taylor’s words ring in my ear, yet again…****”They’re incentivized to drag these claims out,” said Taylor, who owns the Truman Taylor Insurance Agency in Friendswood, a Houston suburb. “I don’t know of any savings account that offers eighteen percent. There’s too much of an incentive for abuse.”**** Mr. Taylor, this is NOT AN INTEREST ACCOUNT, IT IS A PENALTY! Pretty simple question here. If you have no penalty for holding that money, and every benefit from holding it, including the use of it, does this not create a conflict of interest in its own right?
  25. Page 15 lines 21 thru 23 adds an additional 15 days to ***EACH*** of the stated deadlines, amounting to an additional 45 days, to exceed all of the time extensions they have already attempted to extend.
  26. Page 16 lines 4 thru 24 and Page 17 lines 1 thru 24 and page 18 lines 1 thru 4 removes existing health consumer languages and add provisions that would be detrimental to every single insured. Not only Texas, but the other states in the union who will follow suit, and harm even more insureds…consumers…taxpayers… In essence they have gutted the entire reason for anyone to take an insureds case on a contingency basis. They also added language like knowingly. As time and history has told us, we cannot tell when our own government knows something, much less when an insurer knew it was breaking the law. The very statutes proposed dictate a much more sinister objective. One that after being in this industry for many years, the research needed to complete this article, and my own life experiences that paint a very vivid picture of exactly what insurers have planned and already accomplished in Texas. ************************** I know this is has been a long journey, I know of no other way to explain, in plain English, exactly what is going on. As you have seen none of this benefits you, the insured. Quite the opposite. It cripples you and any resources you might have against the largest corporations in the world. Now, let me put it all together for you, so that you may see the larger picture. In September of 2013, TAPIA and Defense attorneys won what they believed to be a huge win for insureds. The removal of contractors from the claim process. At the time, like most Trojan Horses, everything looked very positive. Fast forward to the 2015 legislation, and insurers are now attempting to remove any recourse or reason an attorney of Public Adjuster would help an insured. This effectively leaves you, the insured, standing in the middle of a crash up derby, all alone, with the drivers all wearing blindfolds. (You must realize, currently both attorneys and Public Adjusters are normally paid on contingency, if there is no recovery, there is no fee. Public adjusters are capped at a maximum of 10% of the claim, while attorneys are restricted to only “New” money, meaning anything the insured paid prior to issues arising are untouchable from the attorney. The insured is not left with a huge bill and no results. This particular method is THE ONLY WEAPON DAVID HAS AGAINST GOLIATH.) Both professions are regulated heavily. Make no mistake, if an insurer could catch any of these people doing what they claim, they would parade them in front of you like trophies…we are the biggest threat to them, and they are attempting to remove that threat, at your expense, while claiming your honor at the same time…. You cannot do both. This also limits the recovery from other remedies and makes them exclusive to this code, again giving insures an out to circumvent the new lax rules. You have to realize, again, these laws did not just appear, they were added by very smart people who had already suffered the damages of an insurance company who had no rules, and no recourse. Insurers are now trying to “Un Do” the laws already here.
  27. Page 18 lines 8 thru 23 and Page 19 lines 1 thru 13 adds additional language to solidify the additional steps an insured must take prior to attempting to sue their insurer. This also adds an additional work load on the attorney by requiring a ton of additional documentation before even taking a claim, then reducing their fees to almost nonexistence. More work for less pay….do you want some of that?
  28. Page 19 lines 14 thru 23 and Page 20 lines 1 thru 18 adds language to again strengthen the additional duties required of an insured to perform additional, confusing acts, that if not performed, according to this section, they can throw your claim right out of court, valid or not. Does this sound like a consumer friendly bill?
  29. Page 20 lines 19 thru 23 and Page 21 lines 1 thru 7 adds language that allows an insurer to absolve the actions of their agents and employees and claims adjusters as long as the insurer says it will. This takes the ability to hold adjusters and employees responsible for underpaying claims to meet quotas and gain bonuses. Their license, as issued, should control their actions, not their employers. You must have the license to have the job, therefore the license precludes the employment agreement, and you cannot have one without the other. This is not an opinion, it is a fact. Each must remain individual, because both understand the consequences, no other profession allows the employer to absolve wrongdoing of their employees. Laws and rules are for everyone.
  30. Page 21 lines 9 thru 16 solidifies an insurer’s ability to dismiss anything that does not conform the new strict filing regulations listed above. Do you see ANY of these solidifying the insureds rights? No, that’s because that is what the current legislation already does.
  31. Page 21 lines 17 thru 22 and Page 22 lines 1 thru 23 and Page 23 lines 1 thru 23 adds language that solidifies the insurance companies position on a settlements. It clearly allows an insurance carrier to force an insured to instigate suit, provided they could find an attorney to take their claim, to obtain a settlement offer the insured owed prior to attorney’s ever getting involved. It then limits any and all recovery, while stating that this practice does not constitute an act of unfair or deceptive trade practices. I can promise you one thing, if you attempted anything like this against an insurer or anyone else, they would convict you of both. And hang you like they try to do contractors. As State Farm did to Joe Radcliffe, and eventually lost a $14.5 million dollar verdict because of. http://insurancenewsnet.com/oarticle/2013/12/19/radcliff-wins-defamation-award-against-state-farm-a-439079.html#.VOZN_fnF9S0
  32. Page 24 line 1 thru 21 adds completely new section that appears to limit the existing four-year statute to two years. An attorney would definitely need to explain this to the rest of non-attorneys…. ;-)
  33. Page 24 lines 22 thru 24 and Page 25 lines 1 thru 16 this allows the commissioner to implement or use laws as they see fit. Most of the time, the insurance commissioner comes from somewhere within the insurance industry, usually with a very high-profile career, when they are elected, pay close to attentions to their donors and those that have the most to win and lose from their success…. Follow the money.
  34. Page 25 lines 20 thru 24 Limits ability to collect interest, removing yet again, any penalty for failure to perform.
  35. Page 26 lines 5 & 6 adds public adjuster to the lists of professionals who are not allowed to solicit to the penal code. I do not personally solicit. I have no issues as long as there are standards set in place as to when and where the solicitation can happen. There is room for improvement, as with any mechanism.
  36. Page 27 lines 18 thru 23 Outlines when the Public Adjuster can send any approved material. When an insured is in need, 31 days is a lifetime, and this should be shortened to a maximum of 14 days for any communication save whatever their final on solicitation would be.

You do not need all of these to prevail, or even a majority. A few, some of them even singularly, will suffice to allow insurers to circumvent the ENTIRE STATUTE, rendering the Department of Insurance useless, Contractors useless, Public Adjusters useless, and no recourse in the court system. Essentially, and with complete totality rendering the very consumer it was supposed to “protect”, absolutely, without fail, all alone against Goliath. David at least had a weapon. This….this travesty, exists only to harm the consumer. They just were not prepared for people to actually fight back that understood what the ramifications of these actions will cause.

 

After all of this information, all of the items stacked against you and I, the average insured…Does this really look like a consumer friendly bill, or does it look like what it actually is… Another attempt to protect big corporations at the expense of the little guy…you and I?

 

This is what once Texas Insurance Commissioner says… ” It’s despicable not to make good-faith offers to everybody,” says Robert Hunter, who was Texas insurance commissioner from 1993 to ’95 and is now insurance director at the Washington-based Consumer Federation of America. “Money managers have taken over this whole industry. Their eyes are not on people who are hurt but on the bottom line for the next quarter.”

 

 

Insurers always threaten to leave…..who are they leaving? Their customers…..they are always there in some form or another, under the name Lloyd’s.

Insureds often believe their insurance company is backing them with THEIR money. They are not. They are backing you with your own money. If at any time, it appears they may lose money, even your money they had intended to keep, they will simply disappear, and guess who foots the bill, again?

See: (The TPCIGA is a non-profit association created by the legislature to pay certain claims of Texas insurance consumers in the event that a property-casualty company becomes insolvent.  TPCIGA is not an insurance company; it does not issue policies, collect premiums or make a profit, or otherwise stand in the shoes of an insolvent insurance company.  We exist solely to pay claims when an insurer becomes insolvent.  All insurance companies that are licensed to sell property and casualty insurance in Texas are required to be members of the association and to contribute to our fund.  Our governing statute is found at Tex.Ins.Code chap. 462.)

 

Closing:

If you have read this, and can find anywhere that this an actual protection bill for the insured, please do not hesitate to comment below. Be careful and concise, let us know who you are, and who you represent, just as I have.

If you are going to cite statistics on anything, especially hail claims in McAllen, Texas, provide facts, all of them. Yes many lawsuits were filed, and in my opinion, not near enough. We hold an amount of data that is unprecedented. This is just our database. There are many other who will be linking and adding to this saga. Insurers, by design, have figured out how to cut costs prior to you ever filing a claim. Deciding to not pay for certain things before you even paid for the policy. Nothing that you see in insurance today came overnight. They have in arguably spent enough money to make an ENTIRE WORLD believe that letting the person who owes the debt decide how much that debt is, or if it even exists, is not only acceptable, but in your best interest……think about that one for a while.

 

Cal Spoon 02/19/15

#ProtectTheInsured

If you would like to add information to this, feel free to comment below, or contact me through the link at my name.

 

Here are some good articles and sites where information was obtained.

http://www.calactx.com/2015/02/06/attorneys-insurers-facing-off-over-hail-litigation-in-texas/

http://www.zelle.com/news-events-342.html

http://www.wardlawclaims.com/adjusters/2015-adjuster-conference/

https://insurancecouncil.org/

http://www.claimsjournal.com/news/southcentral/2014/12/01/258372.htm This article is very suspicious, simply because we have no facts, yet I believe they found and culminated a good story to appeal to Hispanic Americans and not filing ANY claims.

See some of the damage for yourself: http://www.srh.noaa.gov/bro/?n=2012event_midvalleyhailprelim

http://www.valleycentral.com/news/story.aspx?list=195030&id=878662#.VOCjwPnF-T8

https://www.nicb.org/newsroom/news-releases/hail-damage-claims-in-the-us

http://www.propertycasualty360.com/2013/04/17/top-10-states-for-wind-and-hail-losses

http://www.bizjournals.com/austin/blog/abj-at-the-capitol/2015/01/altering-insurancetexas-lawmakers-take-aim-at.html?page=all

Biased reports, only giving partial facts….. http://www.tala.com/wp-content/uploads/2014/08/HAILSTORM-REPORT.pdf

http://www.nytimes.com/2015/02/17/nyregion/hurricane-sandy-victims-say-damage-reports-were-altered.html?smid=fb-share&_r=0

http://www.propertycasualty360.com/2015/02/04/war-on-hail-declared-in-texas-as-insurers-fight-ex

http://thelawdictionary.org/article/what-percentage-of-lawsuits-settle-before-trial-what-are-some-statistics-on-personal-injury-settlements/

http://www.law360.com/articles/606208/2014-hail-related-insurance-litigation-year-in-review

http://www.bloomberg.com/apps/news?pid=nw&pname=mm_0907_story1.html

https://www.tpciga.org/faqs.html

http://www.insurancecouncil.org/docs/public/link/SettlingUpAfterIke-galveston-9-13-13.pdf

http://www.newsday.com/business/ag-raids-li-engineering-firm-in-probe-of-sandy-claims-denials-1.9950513

http://newyork.cbslocal.com/2015/02/17/superstorm-sandy-victims-insurance-companies-conspired-not-to-pay-us/

http://www.nbcnewyork.com/news/local/HiRise-Supervisors-Bogus-Home-Inspection-Reports-Sandy-Search-Warrant-292458671.html

 

Legislation in Tennessee attempting to eradicate the very laws similar to those proposed in Texas by Senator Larry Taylor and pushed by Steven J. Badger. They have had a very good taste of this Insurer Friendly type legislation and are actively, with bills on the floor, trying to REMOVE IT!

http://wapp.capitol.tn.gov/apps/BillInfo/Default.aspx?BillNumber=HB0453

 

Another Public Adjusters perspective who lives in a state where they currently have this type of proposed legislation in place. They have the bill listed above introduced and well on its way to passing, TO CHANGE THESE LAWS TO THE ONES TEXAS CURRENTLY HAS IN PLACE.

In other words, they are taking their freedoms back while Texans are being stripped of theirs……No.

http://www.cornerstonepac.net/trending-1.html

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