The “redesign” of insurance claim departments by State Farm, Allstate, Farmers, USAA and other insurance companies harms policyholders and consumers. The courts have held these insurance companies responsible for wrongful conduct in redesigning claims departments to stop fairly paying claims in order to maximize corporate profits. These changes in insurance industry practices have been publicized as shown by the recommended reading and viewing list in the appendix below.
State Farm led the auto insurance industry with its claim department redesign in 1979 for the purpose of increasing revenues by reducing or denying benefits. This was accomplished by abandoning insurance industry standards for good faith claim handling, and “redesigning” its claims procedures to require its adjusters to “delay, deny and defend” injury claims regardless of merit. This dishonest conduct has cheated consumers, including its own policyholders with first party underinsured motorist and uninsured motorist coverage, out of billions of dollars in policy benefits. These benefits were purchased by policyholders in good faith for protection and peace of mind should a claim arise (but unfortunately for those having a claim, their claim was predetermined to be adjusted for low value).
State Farm’s cheating created a competitive advantage over other automobile insurance companies, motivating some to follow State Farm’s lead in redesigning their own claim departments. These insurance companies spent hundreds of millions of dollars to rewrite their claims manuals to require their adjusters to disregard the industry standard good faith handling rules and to use dishonest claim handling tactics. Allstate alone spent $250 million on its claim department redesign, the results of which are discussed below. The financial bottom line was and is the generation of additional billions of dollars of annual revenue per year for these insurance corporations by not fairly paying claims. Since state insurance departments have not regulated this institutional bad faith misconduct, it is up to the cheated policyholders and their lawyers to right this wrong through the civil justice system. Solutions to this reprehensible misconduct are provided below.
State Farm’s Dishonest Misconduct
Despite attempts at secrecy and destroying incriminating evidence, State Farm’s dishonest misconduct eventually was discovered. Through litigation spanning 24 years, the details about State Farm’s wrongdoing came to light, culminating in the United States Supreme Court opinion of State Farm Mutual Automobile Insurance Company v. Campbell,[1] where the court noted that State Farm created “a national scheme to meet corporate fiscal goals by capping payouts on claims company wide,” which was referred to as “Performance, Planning and Review, or PP&R policy.”[2]
In a close 5 to 4 vote, the court reversed the Utah Supreme Court’s affirmance of a jury verdict against State Farm in the amount of $145 million in punitive damages for bad faith in handling the defense of an auto collision case, and remanded with instructions that the U.S. Supreme Court favored single digit multipliers for compensatory to punitive damages to comport with due process. Justice Ginsberg wrote in her dissent that she would have affirmed the jury verdict for $145 million in punitive damages on the key criterion that the “reprehensibility” of State Farm’s conduct was supported by ample evidence.
State Farm implemented PP&R in 1979 with “the explicit objective of using the claims-adjustment process as a profit center,” which “continues to function as an unlawful scheme to deny benefits owed to consumers by paying out less than fair value in order to meet preset, arbitrary payout targets designed to enhance corporate profits.” The scope “applied equally to the handling of both third-party and first-party claims.”[3]
Common tactics used by State Farm included “falsifying or withholding of evidence in claim files” and “to unjustly attack the character, reputation and credibility of a claimant and make notations to that effect in the claim file to create prejudice in the event the claim ever came before a jury.”[4]
Former State Farm employees testified they were subjected to “intolerable and recurrent pressure to reduce payouts below fair value” and at times “forced to commit dishonest acts and to knowingly underpay claims.”[5] Ample evidence was presented that State Farm’s policy was “deliberately crafted to prey on consumers who would be unlikely to defend themselves.” Several former employees testified “they were trained to target the ‘weakest of the herd’ -- the elderly, the poor, and other consumers who are least knowledgeable about their rights and thus most vulnerable to trickery or deceit, or who have little money and hence have no real alternative but to accept an inadequate offer to settle a claim at much less than fair value.” [6]
To insulate itself from liability, “State Farm made ‘systematic’ efforts to destroy internal company documents that might reveal its scheme,” despite having a “special historical department that contained a copy of all past manuals on claim-handling practices and the dates on which each section of each manual was changed. Yet in discovery proceedings, State Farm failed to produce any claim-handling practice manuals for the years relevant to the Campbells’ bad-faith case.” Evidence showed claims management was ordered to destroy a “wide range of material of the sort that had proved damaging in bad-faith litigation in the past.” “In recent years State Farm has gone to extraordinary lengths to stop damaging documents from being created in the first place.”[7]
“State Farm’s ‘policies and practices,’ the trial evidence thus bore out, were ‘responsible for the injuries suffered by the Campbells,’ and the means used to implement those policies could be found ‘callous, clandestine, fraudulent, and dishonest. …The Utah Supreme Court, relying on the trial court’s record-based recitations, understandably characterized State Farm’s behavior as ‘egregious and malicious.’”[8]
The underlying Supreme Court of Utah’s opinion provided more details about State Farm’s dishonest and fraudulent wrongdoing. In Campbell v. State Farm Mutual Automobile Insurance Company,[9] rical baseline from 1922 to 1977ned to recuse, and the initialnion.s s ground to es given to the same interrogatory filed in ththe court reviewed considerable evidence to support the finding that “State Farm repeatedly and deliberately deceived and cheated its customers via the PP&R scheme…State Farm’s fraudulent practices were consistently directed to persons - poor racial or ethnic minorities, women, and elderly individuals - who State Farm believed would be less likely to object or take legal action.”[10]
The court recounted evidence that showed “State Farm engaged in a widespread pattern of fraud…that demonstrates that State Farm specifically calculated and planned to avoid full payment of claims, regardless of their validity. Thus the nature of State Farm’s conduct supports the imposition of a higher than normal punitive damage award.”[11]
“A high probability of recidivism justifies a higher than normal punitive damage award…In light of State Farm’s decades-long policy of fraudulent and dishonest practices in its handling of claims, it is difficult to imagine how such ingrained policies of corporate culture can be easily or quickly changed.”[12] “The harm propagated by State Farm is extreme when compared to the statistical probability that State Farm is likely to be required to pay damages only once in 50,000 cases.”[13] Other wrongful acts of bad faith included “evidence that State Farm employed predictable experts…engaged in hardball litigation tactics, and discriminated on the basis of sex and race.”[14] The court noted the $145 million punitive damages verdict was not unreasonable, given the need to sufficiently deter and punish State Farm.
The employment of defense lawyers willing to violate the ethical rules of professional conduct was a key component in State Farm’s enforcement of its mandated hardball claims methods of “Delay – Deny – Defend.” This “fraudulent scheme” increased revenues by billions of dollars per year, so it easily justified State Farm paying millions of dollars per year to defense lawyers hired to defend insured defendants in injury lawsuits. State Farm’s instructions to defense lawyers were outrageous, and were quoted by the Supreme Court of Utah, as follows:
There was also evidence that State Farm actually instructs its attorneys and claim superintendents to employ ‘mad dog defense tactics’ — using the company’s large resources to ‘wear out’ opposing attorneys by prolonging litigation, making meritless objections, claiming false privileges, destroying
Following remand by the U.S. Supreme Court, the Utah Supreme Court reduced the punitive damages amount from $145 million to $9 million to comport with the single digit multiplier of compensatory to punitive damages, as required by the U.S. Supreme Court’s opinion. Campbell v. State Farm Mutual Automobile Insurance Company.[16]
Unfortunately, it appears the Utah Supreme Court and the dissenting justices of the United States Supreme Court were correct when they noted that future wrongdoing by giant corporations would not be deterred unless large punitive damages awards could be enforced. After the punitive damages verdict was reduced from $145 million to $9 million, State Farm’s and other insurance companies’ insurance abuse has continued to the detriment of policyholders in first party UIM and UM cases, and to injured plaintiffs and defendants in third party cases.
Policyholders and injury claimants are forced to file a lawsuit as the only option to a low valued settlement offer. A key component of the claim department “redesign” is using the civil justice system as the “Kill Box” for injury claimants unwilling to accept a low settlement offer. Sadly, the character assassination tactics and other violation of ethical rules by unscrupulous defense lawyers often defeat even the most meritorious of injury claims.
The Fruits of State Farm’s Ill-gotten Gains
The Utah Supreme Court noted State Farm’s surplus increased from $2.65 billion to $25 billion, and its assets increased from $6.3 billion to $54.75 billion, in the period from just before PP&R was implemented in 1977 to 1995. This shows the great profitability of State Farm’s fraudulent scheme.[17] State Farm’s web page has a company history stating it was founded in 1922. From inception in 1922 to 1977, in 55 years, State Farm’s assets grew to $6.3 billion per the court’s opinion, which averages $0.12 billion per year as a baseline. The court noted from 1978 to 1995, in 17 years during which PP&R was adopted, State Farm’s assets grew to $54.75 billion, an increase of $48.45 billion, which averages $2.85 billion per year over 17 years. This is an average increase of 2,400 percent per year over the baseline, once State Farm stopped following insurance industry good faith claim handling rules in 1978. From 1995 to 2013 according to State Farm’s online annual reports, State Farm’s assets increased to $129.34 billion, an increase of $74.59 billion since 1995, which averages $4.14 billion per year over 18 years. This is an average of 3,400 percent increase per year over the historical baseline, and an increase of 1,200 percent per year over the 2,400 percent per year increase for the initial PP&R period up to 1995 that was mentioned in the court opinion. Dishonesty pays and pays well!
State Farm Caught Lying About Buying a Judicial Election
State Farm made the news for getting caught buying justice in Illinois. The insurer paid millions to a judge’s campaign in order to get a billion-dollar verdict against it reversed. In 1999, State Farm lost a $1,056,180,000 verdict for repairing insured vehicles with cheaper, aftermarket parts instead of OEM parts. State Farm appealed to the Supreme Court of Illinois. While this appeal was pending, the insurer campaigned for and donated money to a candidate in a race for the Supreme Court of Illinois, the very court that would decide State Farm’s appeal. The candidate backed by State Farm ultimately won the election, which was the most expensive state supreme court race in U.S. history, with $9.3 million raised.
When the policyholders who won the verdict objected to this judge deciding the appeal, State Farm told the court it had only donated $350,000 to the judge’s campaign. The judge declined to recuse, and cast the deciding vote to overturn the verdict against State Farm, which occurred in 2005.
Years later, a former FBI agent discovered that State Farm lied when it said it only donated $350,000 to the judge’s campaign. State Farm actually donated between $2.5 and $4 million to the campaign. Based on this evidence, attorney and former Republican senator from Tennessee, Fred Thompson (among others), filed a class action lawsuit to reinstate the $1+ billion verdict against State Farm, which is pending.[18]
Allstate’s Dishonest Misconduct
In litigation spanning 15 years, the Arkansas Supreme Court found in Allstate Insurance Company v. Dodson,[19] that Allstate adopted dishonest auto claims handling practices, similar to State Farm’s practices quoted above, by adopting a “nationwide practice of deliberately low-balling small insurance claims for bodily injury and taking advantage of financially-vulnerable personal-injury victims.”[20] The court characterized this scheme as Allstate declaring “economic warfare” against injury victims, and noted as follows: