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Delay, Deny, Defend: Why Insurance Companies Don't Pay Claims and What You Can Do About It
Abstract
The essential promise of an insurance policy is that when a claim is filed, the company will pay what it owes, promptly and fairly. Increasingly that promise is being violated. Insurance companies often delay payment of valid claims, deny payment in part or altogether, and force claimants to litigation to receive the benefits to which they are entitled. This new book exposes and documents the problem and offers solutions for consumers and lawmakers.Today insurance companies often delay payment of justified claims, deny payment altogether, and force policyholders and claimants to litigation. Since the 1990s, as a result of the intense focus on price competition and maximizing shareholder value, insurance companies have transformed the claims process into a profit center, adopting elaborate systems to cut payments to policyholders and claimants. Many of these systems have been designed by McKinsey & Co. and other large consulting firms, and they involve sophisticated techniques to avoid the prompt and fair payment of claims and to reward company employees for underpaying valid claims. Delay, Deny, Defend describes the history and operation of these systems in automobile and homeowners insurance, including segmenting claims, litigation strategies, computer systems such as Colossus and Xactimate, and changes in the role of claims adjusters. It also includes chapters on insurance in natural disasters such as Hurricane Katrina and on insurance fraud. Among other sources, the book uses insurance company internal documents, statements of present and former company executives, trial testimony, and other material not widely available. The book concludes with advice for consumers and proposals for legal and regulatory reform.
... Insurance firms require information financial risks faced by a customer leasing fleets of heavily polluting diesel cars. They focus on avoiding harms caused by unethical insurance firm Behavior of delay, deny, and explain when settling claims with customers (Feinman, 2010). Fund managers require insights into CSR risks faced by investee companies when misusing social media data about their customers. ...
This paper explores issues of Corporate Social Responsibility (CSR) and Net Zero change in financial firms, with reference to top teams, employees, customers, citizens, and other stakeholders. It proposes a holistic approach to managing these problems of change, of reducing harm to people and environment, and contributing to social sustainability. Changes in financial firms and financial markets to become CSR and Net Zero oriented are being driven by major external change. There are increased demands to reduce harm to individuals, teams, and the environment, and to maintain social sustainability. The change pressures combine with problematic internal firm and external network predispositions. These exacerbate barriers to change and contribute to CSR and Net Zero problems. The paper uses a conceptual framework or “Behavioral theory of the financial firm” (BTTF) to think holistically about these problems and their impact on humans, their social systems, and physical systems. The BTFF is a basis for management and stakeholders to promote change based on credible organizational practices and prevention of exploitation of human capital and social conditions. These support social sustainability and occupational health and safety, or the ability of current and future generations to create healthy, living, and liveable communities in financial firms, and amongst external stakeholders. This holistic narrative and metaphor approach is a means for individuals and teams in the firm and externally to answer the question, “What is going on here?” when responding to uncertainty. The contribution of the paper focuses on firms, practitioners, and academics by closing knowledge and values gaps in fields of practice and academia. This has potential “to make a difference” in; researching, learning, thinking, and believing about desirable actions and responses to problems and harms, and to demands for Net Zero and CSR oriented change in financial firms and wider systems.
... Thus, they hey are unlikely to purchase any preventive techniques such as insurance, safeguard from risk, most especially high severe situation, and frequent low situation. However, constructive arguments have been raised in the past, as to those factors influencing insurance purchase to include absence of trust concerning insurance providers (Feinman, 2010); high level premiums (Kelly & Vu, 2010;Pullis, 2010); not acknowledging the exigency of insurance (Laury, Mcinnes, & Swarthout, 2009). ...
In recent times, firms or businesses in the Hotel and Tourism industry
across the globe have suffered setback financially in terms of patronage and
turnover. This is out rightly attributed to the emergence of the invincible enemy
– the COVID-19 pandemic. The upper echelon of organization, thus have a
role to play in reviving this sector. Against this backdrop, this study examined
the impact CEO gender and educational background on the financial
performance of hotels in Nigeria. This study sampled three listed hotel in the
Nigeria Stock Exchange from 2017 to 2020. Ordinary least squares regression
was employed to empirically ascertain the relationship between variables of
the study. The study found that CEO gender has no significant impact on the
financial performance of Hotels in Nigeria. Secondly, the study found that
CEO educational background has positive and significant impact on the
financial performance of Hotels in Nigeria. The study recommends that CEO
with hotel and tourism educational background should be appointed in hotels
in Nigeria to improve the financial performance.
... It has been argued that factors impacting insurance take up include the high price of premiums (Deposit Power/Real Estate Institute of Australia, 2007;IFSA, 2005;Pulis, 2010); lack of trust in the insurance sector (Feinman, 2010); not seeing the need for the insurance (IFSA, 2005;Pulis, 2010), and availability of life insurance within superannuation funds (Pulis, 2010). Factors related to literacy also appear to influence insurance take-up, including insurance policies being difficult to understand such as the difference between product types (IFSA, 2005;Pulis, 2010); and the lack of skills in evaluating risk (Capuano and Ramsay, 2011). ...
Underinsurance and low financial literacy have been shown to be key issues impacting the effectiveness of personal financial management. Both issues are made more important by the complex financial system, an ever moving array of financial products and services, and the progressive move towards self-reliance in retirement. These factors suggest a greater degree of financial independence and more effective financial decision-making is required over the long-term, both of which may be undermined by low financial literacy and underinsurance. Little is known, however, about the impact of financial illiteracy on the propensity to seek and retain insurance. Using an interview methodology, we obtained the views of informed and non-informed participants to examine insurance literacy in Australia. We find evidence that insurance literacy of consumers is generally low and exacerbated by factors such as low product knowledge, low trust of providers, low awareness of risk mitigation strategies, and behavioural decision-making biases. These factors can culminate in a perception of low value and subsequent underinsurance. Furthermore, this appears to be more acute for personal insurances as opposed to general insurances.
Markets are taken as the norm in economics and in much of political and media discourse. But if markets are superior why does the public sector remain so large? Avner Offer provides a distinctive new account of the effective temporal limits on private, public, and social activity. Understanding the Private–Public Divide accounts for the division of labour between business and the public sector, how it changes over time, where the boundaries ought to run, and the harm that follows if they are violated. He explains how finance forces markets to focus on short-term objectives and why business requires special privileges in return for long-term commitment. He shows how a private sector policy bias leads to inequality, insecurity, and corruption. Integrity used to be the norm and it can be achieved again. Only governments can manage uncertainty in the long-term interests of society, as shown by the challenge of climate change.
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