Dog Bite Claims on the Rise

Posted by Benji Riggins on June 1, 2012 under Claims | Be the First to Comment

Dog bite claims increased 16 percent in 2011 compared to 2010, and have grown close to 48 percent since 2003, according to figures released by the insurance industry.

On the eve of National Dog Bite Prevention Week, the Insurance Information Institute and State Farm Mutual Automobile Insurance Co. released figures indicating that dog bites are costing the insurance industry hundreds of millions of dollars each year.

I.I.I. says that, in 2011, dog bite claims amounted to close to $479 million with a total of 16,292 claims filed.

I.I.I. says the increase can be attributed to “increased medical costs as well as the size of settlements, judgments and jury awards given to plaintiffs, which have risen well above the rate of inflation in recent years.”

According to Bloomington, Ill.-based State Farm, the company paid more than $109 million in claims resulting from 3,800 dog bite claims in 2011.

California was number one on State Farm’s list for dog bite claims and money paid out, with 527 claims for an estimated $20 million. Illinois was second with 309 claims and $10 million.

In conjunction with National Dog Bite Prevention Week, which runs May 20-26, the U.S. Postal Service released its list of the top 25 dog-attack city rankings.

Los Angeles was number one with 83 attacks, followed by San Diego with 68 and Houston with 47.

The Postal Service says that, nationwide, there were more than 5,577 postal workers attacked in 1,400 cities. The attacks on workers cost the Postal Service close to $1.2 million last year.

According to the center for Disease Control and Prevention, there are more than 4.7 million people bitten by a dog each year and 800,000 seek medical attention for their bites. Of those bitten, more than half are children.

As part of a campaign, the participants in National Dog Bite Prevention Week have issued a series of tips to reduce the risk of dog bites.

Among the steps:
•Socialize your dog so it know how to act with other people and animals.
•Discouraging children from disturbing a dog that is eating or sleeping.
•Avoid exposing your dog to new situations in which you are unsure of its response.
•Never approach a strange dog and always avoid eye contact with a dog that appears threatening.

By Mark E. Ruquet, PropertyCasualty360.com

Consumer Group Publishes ‘Insiders’ Advice’ on Filing Auto Claims

Posted by Benji Riggins on March 13, 2012 under Claims | Be the First to Comment

The Consumer Federation of America, a Washington, D.C.-based group whose insurance division is directed by consumer advocate J. Robert Hunter, recently published a guide with “insiders’ advice” on filing a successful auto insurance claim, collecting a fair settlement, and dealing with adjusters.

The guide says many people are intimidated when they file an auto insurance claim, because they have never done it before or are worried about getting less than they deserve for personal injuries or damages to their car.

“You should report the loss to the insurer as soon as possible. Your insurer cannot begin the claims’ payment process until you do so,” the guide says. It adds, “It is your choice — not the insurer’s — as to where your vehicle is repaired.”

And when trying to get the insurer to address the insured’s concern, “aim higher up the company’s ‘food chain’ than the adjuster’s supervisor if you want to get your problem resolved.”

“The last thing a local or regional claims’ office wants is a call from the home office about a complaint,” the guide says. “They are evaluated based on how they resolve the complaint, which means that they’ll work hard to resolve the complaint as quickly as possible.”

It also advises the insured to “file a complaint with your state insurance department.” It says that “While the department may not help resolve your complaint, they will pass it on to the insurer. Most companies treat these complaints seriously.”

The full report, “Guide to Navigating the Auto Claims’ Maze,” can be found at Consumer Federation of America’s website.

By Young Ha |

NICB: First-Half Questionable Claims Rise 4.5%

Posted by Benji Riggins on September 29, 2011 under Claims | Be the First to Comment

Dramatic Uptick in Medical-Related and Vehicle Hail Damage Referrals

The number of questionable claims (QCs) filed during the first half of 2011 increased 4.5 percent when compared to the previous year, according to a recent analysis conducted by the National Insurance Crime Bureau (NICB).

This report takes into account a total of six referral reason categories—property, casualty, commercial, workers’ compensation, vehicle, and miscellaneous—for the first half of 2009, 2010, and 2011.

The “QC” terminology denotes claims that NICB member insurers submit to the Des Plaines, Ill.-based not-for-profit organization for closer review and investigation based on one or more indicators of possible fraud. One claim may contain as many as seven different referral reasons.

From January to June of this year, 48,887 QCs were logged, compared to 46,766 for the first half of 2010. For the same period in 2009, the number of suspicious claims requiring investigation totaled 41,309. This translates to a 4.5-percent increase between 2011 and 2010, and a two-year increase of 18.3 percent.

In regard to property-related referrals, NICB reported a surge in all categories, with the exceptions of suspicious theft/loss (non-vehicle) and fire/arson. Inflated damages topped the list of property referral reasons, with a 10-percent increase from the first half of 2010 to the same time period in 2011.

Perhaps most troubling, the number of medical-related referrals in the workers’ comp category and vehicle hail damage referrals both showed a steep upswing.

Under workers’ comp, for instance, just two referral reasons combined for a whopping 445-percent increase from the first half of 2010—inflated medical billing and duplicate billing, at 245 percent and 200 percent, respectively.

Hail damage vehicle referrals surged 109 percent, when comparing the first half of 2010 to that of 2011.

Click here for more information about commercial referrals or to view a full copy of the report.

By Christina Bramlet, PropertyCasualty360.com

Homeowners warned about ‘storm chasers’

Posted by Benji Riggins on April 26, 2011 under Claims | Read the First Comment

Complaints and inquiries to Charlotte’s Better Business Bureau more than double.

After the hailstones that clattered off shingles a few weeks ago, many area homeowners are facing a second problem: A storm of roofing contractors trolling their neighborhoods for business.

Experts stress that many are legitimate, local companies. But others are out-of-town “storm chasers,” who set up shop in the wake of severe weather.

Problems with them can range from annoying repeat visits (one homeowner says his neighborhood has been canvassed at least 10 times in the last year) to contractors who take the insurance check and leave without doing any work.

The practice of door-to-door roof selling isn’t new. But with two serious hailstorms since last spring, roofing contractors have been out in force. On April 9, hail as large as baseballs hit the region.

Complaints about roofing companies to Charlotte’s Better Business Bureau have more than doubled over the past year to 154. So far in April, more than 11,000 people have searched for roofing contractors on the site, more than double the number that did in February.

“It seems like it’s all we’re seeing,” said Tom Bartholomy, president of the Charlotte BBB. The last 15 months have brought the largest surge in roofing complaints Bartholomy said he’s seen in 28 years with the BBB.

“Their typical M.O. is there’s been hail damage in the neighborhood, they’ve been doing other work in the neighborhood and they’d be happy to go up and do a roof inspection,” Bartholomy said. If any damage is found, the contractors usually tell homeowners that their insurance will cover a new roof.

“The combination of ‘Oh, I have hail damage? And I can get a free roof?’ just lowers people’s defenses extraordinarily,” Bartholomy said. Dozens of out-of-state companies have set up shop in Charlotte over the last year, he said.

In most cases, home owner’s insurance will cover replacing all or part of a roof damaged by hail, which can leave dents or damage to shingles.

One reason for the boom – aside from the hail – could be that North Carolina only requires contractors to have a license for work over $30,000, much more than a typical $5,800 to $7,500 roof. In South Carolina, contractors need to pass an exam and get licensed for any work over $5,000. Virginia requires a license for any work over $1,000.

Some area homeowners say they’re fed up with contractors knocking on their doors.

Russell Spinney, president of the Wesley Springs neighborhood association in Wesley Chapel, said representatives from four companies have gone door-to-door there.

“The roofing companies have descended on our neighborhood,” Spinney said.

Spinney is waiting to hear from his insurance company about whether he needs a new roof because of hail. If he does, he’ll go with a contractor they recommend.

Joel Levy, who lives off Mount Holly-Huntersville Road, said at least 10 salesmen have approached his house.

“Every time there’s a storm, for the next several weeks people start knocking on our door saying, ‘Look, your roof has some age there, and we can see you’ve got some hail damage,'” he said.

“We’re literally one of the last houses (on the block) that hasn’t had our roof done.”

He recently challenged one salesman, telling him that he would research the contractor’s business history. He never heard from the contractor again.

“If Gandhi showed up wanting to show me a roof, at this point I’d say he was a crook,” Levy said.

Other homeowners told similar stories. A woman who lives off Tyvola Road said a man claimed to be licensed for repair work in both North and South Carolina. When she checked out his name online, she found he didn’t have a license from either state.

The N.C. Department of Insurance says that there’s generally nothing wrong with contractors peddling their services, but offers to negotiate with insurance companies can be illegal. You need a license to act as an adjuster, which is what such offers usually amount to.

State Farm agent Jeremy Fulkerson said he’s seen the number of hail claims rise over the last year.

Ideally, he said that an insurance adjuster will work with a roofing contractor to come up with a damage estimate. Insurance companies pay customers for their claim, and the customer pays the contractor.

In the worst-case scenario, customers can lose their insurance payment if they sign the whole check over to an unscrupulous contractor who leaves. They then typically have to replace the roof themselves.

That happened to one of Fulkerson’s clients last year after the contractor declared bankruptcy and left town. “She had no recourse,” he said.

Some 300 North Carolina customers lost about $2 million last year when roofing company American Shingle went bankrupt. They had already signed over their insurance checks. Three of the company’s executives were arrested and charged with theft in Georgia.

Some roofing companies, such as Precision Roof Contractors, say they encourage potential customers to look them up on the BBB’s website. The company has been in Charlotte since 2009 and has an A+ rating, with no complaints filed with the BBB.

“We urge our homeowners that we’re dealing with to check us out,” said sales manager Jason Lawson. He said Precision sends salesmen out in the wake of storms to areas they know from weather reports have been hit with hail.

“These other contractors that are coming in here from out of state are looking at these same reports,” Lawson said.

Bartholomy said the best tactic for homeowners is to just say no.

Said Bartholomy: “If that person shows up on your doorstep and says, ‘Hi, there’s been hail damage in your area,’ say, ‘Thank you very much, I’ll call a local roofer and have them check it out.”

By Ely Portillo
elyportillo@charlotteobserver.com
Posted: Tuesday, Apr. 26, 2011

Read more: http://www.charlotteobserver.com/2011/04/25/2249219/homeowners-warned-about-storm.html#ixzz1KdyiH5sA

North Carolina Offers Mediation for Storm Claims

Posted by Benji Riggins on April 22, 2011 under Claims | Be the First to Comment

Homeowners in North Carolina whose property suffered recent storm damage but had their claims denied by their insurance company may eligible for a mediation program.

Insurance Commissioner Wayne Goodwin announced the program in the wake of a massive storm system that swept across the Southeast last weekend leaving behind dozens of fatalities, destroyed homes and dead livestock. In North Carolina alone, some 24 people were killed.

The Disaster Mediation Program was created by lawmakers after the 2005-2006 hurricane season to help homeowners resolve disputes with insurers in designated disaster areas .

Following the recent storms, Gov. Beverly Perdue declared 18 counties disaster areas while state officials estimated that up to 440 homes were completely destroyed and 6,000 damaged.

Under the program, homeowners can request a mediation conference if their homeowners’ insurers deny or partially deny their claims. During the mediation an independent mediator with no ties to an insurance company will help discuss and negotiate a possible settlement.

“I want to make sure the insurance claims process goes as smoothly as possible for our citizens,” said Goodwin. “Mediation will help homeowners resolve disputes with their insurance companies in a fair and timely manner.”

The Disaster Mediation Program is available only to homeowners; commercial property and auto policies are not eligible. The total amount of the claim or the difference between an insurer’s coverage and the disputed portion of the claim must be at least $1,500. The disputed claims don’t include claims denied because of policy exclusions or the because policy was not in force at the time of the loss. The request for mediation must be made within 60 days from when the claim was denied.

Travelers Finds Water Damage Ten Times More Likely Than Fire

Posted by Benji Riggins on September 17, 2010 under Claims | Be the First to Comment

While fire may be a common worry among homeowners, claims data from Travelers suggests their homes could be as much as 10 times more likely to be damaged by water than by fire.

Fortunately, much of this water-related damage can be prevented, and taking a few simple home maintenance steps can help increase the chances of keeping a property safe.

Travelers recently analyzed its homeowners insurance claims in North Carolina, excluding claims related to catastrophes, and found that damage caused by water accounted for 28 percent of its property claims in the state, compared to three percent for fire. Furthermore, of those water damage claims, weather accounted for only five percent, meaning that proper maintenance within the home may help homeowners avoid some of these problems.

“When considering annual household cleaning projects, it’s a great time to inspect and perform maintenance on household systems and appliances,” said Ron Stephens, Regional Vice President for Travelers. “Checking washing machine hoses, ice maker connections and the plumbing around water heaters are a few simple actions you can take to prevent both damages and a lot of headaches.”

After examining the most common causes of water damage for Travelers customers in North Carolina, claim and risk management professionals from Travelers have developed a number of easy steps homeowners can take to help avoid many of these non-weather-related water problems. The following list provides preventive measures to help avoid the top four common causes of non-weather related water damage:

Leaks from washing machine hoses: Washing machine hoses should be inspected annually and replaced every five years – or immediately, if there are any signs of cracking or bulging.

Leaky plumbing around water heaters: Plumbing should be inspected annually and repaired if there are any signs of leaks or corrosion. When possible, water heaters should be installed in an area with floor drains to minimize damage if leaks should occur.

Leaks from refrigerator ice machines: Ice maker connections, usually located behind the refrigerator, should be inspected annually and hoses replaced if they appear cracked or corroded.

Clogged drain lines on air conditioning units: Air conditioning drain lines should be checked yearly.

Read more: http://www.insurancejournal.com/news/national/2010/09/17/113337.htm#ixzz0zohyhr6t

Insurers Report Rise in Questionable Claims Led By Hail, Auto Glass

Posted by Benji Riggins on September 3, 2010 under Claims | Be the First to Comment

Property/casualty insurance companies are reporting that the number of claims requiring more scrutiny than normal rose again in the first half of this year compared to 2009.

The National Insurance Crime Bureau’s first half 2010 questionable claims (QC) report examines six referral reason categories of claims— property, casualty, commercial, workers’ compensation, vehicle and miscellaneous.

Overall there was a 14 percent increase in QCs in four of the six categories in 2010 when compared to the first half of 2009. These are claims that NICB member insurance companies refer to NICB for closer review and investigation based on one or more indicators of possible fraud. A single claim may contain up to seven referral reasons.

Of note were the 107 percent increase in questionable hail damage claims and 527 percent increase in questionable auto glass claims so far this year when compared to the first half of 2009.

“Hail loss claims and QCs are generally concentrated in the central section of the U.S. However, seven of the top 10 states with the highest hail loss QC-to-claim ratio are not in the central section. This suggests that fraudulent hail losses can occur in any part of the country,” the report notes.

“While there have been modest declines within a few categories of referrals, the 14 percent increase in the overall number of questionable claims for 2010 raises concerns,” said Joe Wehrle, NICB’s president and chief executive officer.

Wehrle said NICB, its member insurers and law enforcement have pursued suspected unscrupulous roofing companies that take advantage of storms to fake or deliberately cause damage to roofs in an effort to get insurers to pay for a replacement roof that wasn’t damaged by a storm. They have also been putting pressure on staged accident rings in various regions including Tampa, where this has become a major problem.

“We’re seeing concern from our members about criminal rings that are deliberately damaging vehicle windshields in order to file an insurance claim, and in some cases are not doing satisfactory repairs or replacements,” Wehrle said.

NICB is supported by nearly 1,100 property and casualty insurance companies and self-insured organizations.

Source: National Insurance Crime Bureau

Read more: http://www.insurancejournal.com/news/national/2010/08/02/112084.htm#ixzz0vTYP12p7

Dog Bite Claims Top $400M in 2009; Rise 30% in Last 6 Years

Posted by Benji Riggins on August 18, 2010 under Claims | Be the First to Comment

Dog bite claims cost the insurance industry $412 million in 2009, an increase of 6.4 percent from 2008.

Dog bites account for more than one-third of all homeowners insurance liability claims paid out in 2009, says the Insurance Information Institute (I.I.I.).

An analysis of homeowners insurance data by the I.I.I. found that the average cost of dog bite claims was $24,840 in 2009, up slightly from $24,461 in 2008.

Over the six-year period since 2003, the cost of these claims has risen nearly 30 percent. Additionally, the number of claims increased by 4.8 percent to 16,586 in 2009 from 15,823 in 2008.

“The rise in dog bite claims over the last seven years (2003-2009) can be attributed to increased medical costs as well as the size of settlements, judgments and jury awards given to plaintiffs, which have risen well above the rate of inflation in recent years,” said Loretta Worters, vice president at the I.I.I.

With more than 50 percent of bites occurring on the dog owner’s property, the issue is a major source of concern for insurers.

More than 4.7 million people in the United States are bitten by dogs annually, and nearly 900,000 of those, half of them children, require medical care, according to the Centers for Disease Control and Prevention (CDC). Of those injured, 386,000 require treatment in an emergency department and about 16 die.

The rate of dog bite related injuries is highest for children aged five to nine years old; the rate decreases thereafter. Almost two-thirds of these injuries among children ages four years and younger are to the head or neck region. Injury rates in children are significantly higher for boys than for girls.

Dog Owner Liability

There are three kinds of law that impose liability on owners:

1. Dog-bite statute: The dog owner is automatically liable for any injury or property damage the dog causes, even without provocation.

2. “One-bite” rule: In some states, the owner is not held liable for the first bite the dog inflicts. Once an animal has demonstrated vicious behavior, such as biting or otherwise displaying a “vicious propensity,” the owner can be held liable. Some states have moved away from the one-bite rule and hold owners responsible for any injury, regardless of whether the animal has previously bitten someone.

3. Negligence laws: The dog owner is liable if the injury occurred because he or she was unreasonably careless (negligent) in controlling the dog.

In most states, dog owners are not liable for losses incurred by trespassers who are injured by a dog. A dog owner who is legally responsible for an injury to a person or property may be responsible for reimbursing the injured person for medical bills, lost wages, pain and suffering and property damage.

Source: I.I.I.

Read more: http://www.insurancejournal.com/news/national/2010/08/18/112569.htm#ixzz0wzM9uvSO

Claim Frequency, Severity Higher For Hybrid Vehicles

Posted by Benji Riggins on August 9, 2010 under Claims | Be the First to Comment

NU Online News Service, Aug. 2, 3:36 p.m. EDT
Hybrid vehicles overall have higher collision claim frequencies and a 6.5 percent, or $182, higher average claim severity than gas-powered vehicles, according to a Mitchell International Inc. study.

The study, featured in Mitchell’s quarterly publication Industry Trends Report (ITR), also notes that hybrid drivers are significantly more likely to receive traffic tickets than drivers of gas-powered vehicles.

Regarding claim frequency and the higher number of traffic tickets, Greg Horn, vice president of Industry Relations, Mitchell International, reported in ITR that one reason may be where hybrid drivers live. Most live in urban settings, ITR noted, where tickets and accidents are more frequent.

Additionally, he said the profile of hybrid drivers has changed in recent years. As recently as 2008, hybrid purchasers were mostly concerned with their carbon footrint and impact on the environment. “While their politics may have been liberal, their driving habits were conservative, making them a very good risk to insure,” Mr. Horn said in his story.

Since then, hybrids have caught on with drivers interested in cutting fuel expenses. “This shift changed the hybrid driver profile and brought with it a change in the risk profile,” he said.

Mr. Horn, citing rating integrity solutions provider Quality Planning, said Toyota Prius owners received .38 tickets per 100,000 miles driven compared to .23 tickets per 100,000 miles for non-hybrid drivers. He noted that is a 65 percent difference.

Regarding claim severity, Mr. Horn said the higher hybrid numbers even showed when comparing the same car models. The Honda Civic hybrid model, for example, has a 6.9 percent higher severity than the gas-powered model. The Ford Escape hybrid had a 9 percent higher severity than the non-hybrid.

Mr. Horn said the higher severity is partly because of higher mechanical labor charges for hybrids. More mechanical operations, he said, are sublet back to dealerships for completion.

Alternate parts use is also lower for hybrids, Mr. Horn said. Interestingly, he noted, this is seen even for like car models. He said loyalty accounts for this. Hybrid owners, he said, are “one of the most loyal groups” and are more inclined to bring their vehicles to the dealership for repairs.

NU Online News Service, Aug. 2, 3:36 p.m. EDT
Hybrid vehicles overall have higher collision claim frequencies and a 6.5 percent, or $182, higher average claim severity than gas-powered vehicles, according to a Mitchell International Inc. study.

The study, featured in Mitchell’s quarterly publication Industry Trends Report (ITR), also notes that hybrid drivers are significantly more likely to receive traffic tickets than drivers of gas-powered vehicles.

Regarding claim frequency and the higher number of traffic tickets, Greg Horn, vice president of Industry Relations, Mitchell International, reported in ITR that one reason may be where hybrid drivers live. Most live in urban settings, ITR noted, where tickets and accidents are more frequent.

Additionally, he said the profile of hybrid drivers has changed in recent years. As recently as 2008, hybrid purchasers were mostly concerned with their carbon footrint and impact on the environment. “While their politics may have been liberal, their driving habits were conservative, making them a very good risk to insure,” Mr. Horn said in his story.

Since then, hybrids have caught on with drivers interested in cutting fuel expenses. “This shift changed the hybrid driver profile and brought with it a change in the risk profile,” he said.

Mr. Horn, citing rating integrity solutions provider Quality Planning, said Toyota Prius owners received .38 tickets per 100,000 miles driven compared to .23 tickets per 100,000 miles for non-hybrid drivers. He noted that is a 65 percent difference.

Regarding claim severity, Mr. Horn said the higher hybrid numbers even showed when comparing the same car models. The Honda Civic hybrid model, for example, has a 6.9 percent higher severity than the gas-powered model. The Ford Escape hybrid had a 9 percent higher severity than the non-hybrid.

Mr. Horn said the higher severity is partly because of higher mechanical labor charges for hybrids. More mechanical operations, he said, are sublet back to dealerships for completion.

Alternate parts use is also lower for hybrids, Mr. Horn said. Interestingly, he noted, this is seen even for like car models. He said loyalty accounts for this. Hybrid owners, he said, are “one of the most loyal groups” and are more inclined to bring their vehicles to the dealership for repairs.

Questionable insurance claims increase

Posted by Benji Riggins on August 4, 2010 under Claims | Be the First to Comment

Questionable insurance claims increased by 14 percent during the first half of 2010, fueled by a dramatic spike in car windows that may have been intentionally smashed by owners, according to the National Insurance Crime Bureau.

Nearly half of the 7,993 cases of suspected fraud reported during the period were connected to vehicles, with cases ranging from deliberately damaged car windows to staged accidents.

According to Joe Wehrle, president of the group, the increase was less than the 20 percent rise during the same period last year, but dubious claims remain a top concern.

Criminals “try to take advantage of the insurance company’s desire to pay claims as quickly and efficiently as possible,” he said.

The increase in suspect claims coincides with a decline in U.S. payrolls, while the jobless rate sits at a 26-year high of 10.1 percent after increasing 8.6 percent during the past two years.

More than five times as many car windows appear to have been smashed on purpose in order to generate insurance payouts, rising from 239 last year to 1,498 in 2010. Meanwhile, suspected bogus vehicle accidents increased 27 percent year-over-year.