Monday, February 26, 2007
Insurance report draws big response
Our report on auto insurance claims in minor impact crashes has literally flown across the Internet since we first aired it. What has struck me is the sheer number of people who have contacted CNN regarding their experiences. (Read Drew Griffin's initial report on insurance company practices)

They are almost all identical: minor crash, a person experiences some pain or minor injury, which has led to years fighting to have their claims processed, or mostly, the injured person has just given up and gone on with their lives, deciding it is not worth the aggravation of having to hire an attorney.

We reported that some of the major auto insurers have saved billions of dollars with a policy know as "delay, deny, defend:" delay handling your claim, deny you were hurt and defend their decision in drawn-out court battles. Industry spokespeople say it's not true.

These billions of dollars used to go to pay doctor bills, therapy for injuries and lost wages from all that time off work after an accident. My goal now is to find out where that money went. The journey continues.
Posted By Drew Griffin, CNN Correspondent: 6:15 PM ET
  31 Comments
Drew, I think it's great that you're keeping up with this story. By law we are required to have auto insurance, but are there laws to protect us? I think premiums are outrageous, we should at least be able to get basic medical care and repairs done. Thanks Drew...
Posted By Anonymous Jess, Paris, KY : 7:43 PM ET
Hi Drew,
Insurance. it's one of those damned if you do and damned if you don't issues. We all pay out the wazoo to insurance companies, but when you want to collect, the adjuster acts offended. The nerve! Insurance companies really need some regulations. I appreciate 360 following up on this story. Maybe this negative publicity will get the kinks ironed out. Now, if you could do a follow up on Mr. Waller's exoneration in Texas and keep Governor Perry honest, I would be grateful. Let us know what we can do to help this innocent man. Thanks AC/360!
Posted By Anonymous Betty Ann, Nacogdoches TX : 7:47 PM ET
What about the good insurance companies? Let's see the ones that don't employ these tactics. As an attorney who defends insurance companies, I see more fraud on the other side - people who are eager to make an eager buck. If you want to be fair, you need to do a story on insurance fraud and how it costs consumers; you also need to point out the good insurance companies, like USAA for example.
Posted By Anonymous Angie, Austin, Texas : 7:48 PM ET
Hi Drew,
I read your report and I was instantly attracted to it. You see, I work for an Auto insurance company as a Bodily Injury Adjuster. I can only speak for the company I work for but we do not have "delay, deny, defend" policy when it comes to a minor crash. Since the first day of my training, I was told to be fair to all the parties involved in the accident. Before working for an insurance I was involved in a heavy car accident, so I definitely have the perpective every-time I deal with a claim.
Our view in minor crashes, or low impact accident is that if its a minor accident ($1000.00 or less, no frame damage) most people should not be hurt. There are exceptions to that rule (i.e. older people, children, pregnant women). We get this view from most accidents of this type in which no-one is hurt an from reports of accident-reconstruction experts.

I have a case in which our insured rear-ended the other party. Our vehicle had no damage, the claimant had less than $750.00 damage (no frame damage). The claimant had two children as passengers. The Claimant driver ended up having $3000.00 worth of medical bills, while the children did not visit the doctor at all. Six months passed after the accident and I attempted to settle the case by offering $3000.00 to the claimant (the amount of the bills) and $400.00 for each children. The claimant wanted $10,000 for him an $5000.00 for each of the children. The claimant accussed me of trying to robe him and his children. I asked him if he ever took his children to the doctors and he said no. But he wanted $5000.00 in case his children began to feel pain in the future.

Should I pay the claimant's demand which would affect my insured's rates?
If his children didnt feel pain 6 months after the accident and they feel pain tomorrow-- how do we know hat the pain is caused by the accident. How could I justify to my insured paying the claimant's demand when there is hardly any damage?
$3000 in medical bills with minimal damage. How do I know that his pain was caused by the accident? For all I know, he had this pain before the accident.

Delay, deny, defend. I don't know about that. All I know, is that Fairness must go both ways.
Posted By Anonymous Diego, Los Angeles, CA : 8:05 PM ET
Drew,
People! Auto insurance companies are in the business of making money not "like a good neighbor, we will be there..."

With thousands of more vehicles on the roads this century, tele-lawyer "personal injury" scams, crazy weather, cell phone-carrying lunatics, road rage, and teenage drivers, are we surprised they are losing money?

I believe for this industry to survive, they have gone to "drastic" measures beyond human understanding; gone to a world of insurance committees; gone to rent-a-doctors and nurses; and have gone by the wayside of what they first stood for...integrity as insurance companies.

Whether it is in "their hands or it is like a good neighbor," it is about capitalism pure and simple. It is not personal. It is not the little shop down the lane where you could talk to your insurance agent after a fender bender. It is about big business.

And when it is about big business, injured individuals fall through the cracks. They depend upon it.

Thanks for keeping them honest Drew.
Posted By Anonymous Liz, Milwaukee, Wisconsin : 8:09 PM ET
It is a great shame that healthcare/insurance policies are not protecting and caring for its client, and it will require all of us to continue this conversation to make sure insurance pays the Doctors for the services given to patients in need. Chiropractic has been bullied and treated unfairly by the Insurance Companies 'medical model' of healthcare.
Posted By Anonymous Jason Minogue, Waco, TX : 8:12 PM ET
Oh my goodness this exact same thing happened to me after my car crash. The company didn't give me the money I deserved and just kept ignoring me. I aruged with them to the point where I just didn't care and gave up. But hopefully when I see this report I will be inspired to fight for what is rightfully mine and hire an attorney. This is something I m not gonna miss, it's just what I need to see.
Posted By Anonymous Courtney, Austin, Texas : 8:15 PM ET
Drew,

I saw your initial report and it hit home at my house. I too was involved in an accident and settled my case in 18 months. All my lost wages were documented, all my medical bills were documented and all my car bills were documented. All my personal and business tax returns for 7 years were focused on in arbitration.

In the end I received 10% of the total in lost wages less 40% to my attorney.

See Drew, I am female and was told I made more money than the arbiration attorneys. I was told to go back to work and forget about it. I was told I was lucky because I had an education.

Not one attorney could put a total figure on my unborn child that I lost as a result of the accident. The attorneys told me to go home forget about it and have another baby. Really, how do you forget?

Meanwhile, as far as your report is concerned, keep up the fight for those of us who are honest and really just want what is due to us.

When you are done with the car insurance companies, come down to Florida and I can fill your ears with our current homeowners insurance crisis -- dropping insurance and rising rates.
Posted By Anonymous Renee Bradenton, FL : 8:48 PM ET
I used to work in a claim department for a company that had a minor impact program. The acronym for these types of claims was M.I.S.T.I for minor impact soft tissue injury claims. The common translation for MISTI used by the employees (jokingly but with some merit) was "might I suggest trial instead"
Posted By Anonymous george, Birmingham, AL : 9:04 PM ET
Hi Drew,
There really isn't any type of insurance that pays out well anymore. Auto, health, homeowners etc. We pay out a lot to get peanuts in return. Sounds like capitalism is alive and well..And they've added insult to injury by giving us policies that require a telescope to read the fine print. Somewhere in that print, it must say 99.9 percent of the money goes to them and what's left is ours. Big Wow.. Take Care
Posted By Anonymous Lorie Ann, Buellton, Calif. : 10:00 PM ET
After thirty years in the insurance industry underwriting tough casualty business, including many automobile accounts, I can tell you lots and lots of stories about people who scam the insurance companies. Motorcyclists who run into STOPPED dump trucks, injure themselves, and sue for $2,000,000. Drunk, wasted uninsured drivers who drive without lights on and turn in front of other vehicles, causing injury to their passengers, who then sue the OTHER vehicle and COLLECT $1,000,000! Mind you, the passengers were also wasted.

Why these huge awards? Because the sympathetic jurors don't realize that when they get sucked into believing the outrageous stories created by plainiff attorneys and award huge amounts to these undeserving plaintiffs it is they, the jurors, who are really paying for their generosity through increased insurance premiums. This is a society of get rich quick thinking. Most people think insurance is a lottery.

I agree with the writer who suggested a CNN do a report on fraud on insurance companies. There is another side that needs to be told.
Posted By Anonymous Evelyn, Hartford, CT : 10:45 PM ET
Regarding the Martinez case, she spent thousands of dollars getting massages, acupuncture, and other treatments and the other driver's insurance company is supposed to pay for whatever the injured party wants? Where do we draw the line? If insurance companies do not make a profit, they won't be in business -- and consumers won't be able to have a choice. If America wants to remain competitive throughout the world, we'd better have plenty of profitable businesses here at home to keep us ahead. I know so many people who view getting hit as an opportunity to make money. Insurance puts you back to where you were before the incident. They should be legitimate claims, but it's like going to the doctor to get better. If the doctor doesn't make you feel better, sue him. That'll teach him. This type of mentality is what's making insurance costs go up. It's also a gravy train for scams and unscrupulous doctors and lawyers.
Posted By Anonymous Tammy, Charlottesville, VA : 11:27 PM ET
I can feel Renee's pain. I was involved in a car crash. My car was fine, but my back was not. After x-rays and MRI's I ended up with a herniated disk and two bulged disks. My attorneys had the guts to tell me, that in order to get paid, I needed to have back surgery. Oh yeah! Let's risk being paralized my entire life woohoo!!

I pay my auto insurance every month on time. Never defaulted! Today, five years later the injury is worse and all I have to account for is a bad back, pain and $2500.00.
Is it fair to the good and honest consumers?
Posted By Anonymous CS Davie Florida : 11:32 PM ET
Thank you for your report on insurance company practices. I am a physician who has been treating auto accident patients for years. I have seen firsthand the many lives ruined in the name of insurance company greed. The industry as a whole treats auto accident victims as liars and cheats, and the doctors who try to help them like with the same lack of dignity and respect. Please continue to dig into this subject, I guarantee that the deeper you go the slimier the findings. The insurance industry is truely the "evil empire".
Posted By Anonymous Russ Parker, D.O., Colorado Springs Colorado : 11:34 PM ET
Drew,

Your show hit home, myself and my boyfriend where in a accident in may of 2005, We were on a motorcycle, on vaction with friends. A girl on her cell phone hit us, she admitted she blew the yeild sign, her insurance co., is StateFarm. We where almost killed because of her, and have gone through alot of surgerys, rehab and emotional pain. We hired a lawyer in the state it happened in. StateFram still is holding out, won't help pay our bills, and an investorgater is snooping around. We did nothing wrong and statefarm has made us feel like we are at fault. The girl who hit us had 2 prior accidents 3wks. apart. We are being hounded by hospitals, doctors, ect. We are still in litagation. Why would a ins. co. insure aperson who has had prior accidents and tickets and then uphold there conduct? Pleaase keep investagating the ins. cos. so people like us won't have to suffer the emotional pain and financial losses.
Posted By Anonymous Melodye Getz Penargyl, Pa. : 12:05 AM ET
The propaganda which the auto insurance industry has injected into society by over exaggerating the fraud involved in accidents is a farse. There may be some out there, but it is a mere fraction of all the people who are injured. The public is being duped. The real fraud involves the focused effort by insurers to consistently lowball innocent victims of accidents. One tool in the insurance company arsenal not addressed in your piece is the widespread use of professional expert medical witnesses hired expressly to debunk legitimate injury claims. Please keep shining the light on what really goes on with these insurance companies.
Posted By Anonymous Bob, Miami, Fla. : 12:15 AM ET
I had to comment after seeing the show. First, I have to say that these techniques are nothing new and have been adopted by insurance companies for some time. The reason why these techniques have been hidden for so long is because the media (in general) have focused on these "jackpot jury awards" (which are rare in the whole scheme of things) and have not focused on the poor people like the ones featured in this story.

I have seen this time and time again. See, I work for a medical provider and I strictly deal with reimbursement issues, and while the practice serves mostly people with health related issues, we do see a good amount of personal injury, workers comp and auto accidents.

While the practice of "Delay, Denied and Defend" is a good summary, it doesn't even begin to describe the complex strategy these companies implement to limit financial exposure to medical claims. These techniques are not just limited to auto insurers, but most of all health care insurance. I could go on and on, but ask you're self, what you really get for those inflated premiums.
Posted By Anonymous Scott Pfeiffer, Schaumburg, IL : 12:34 AM ET
Drew,

It all depends on the company, Insurance seems like a very competitive business. The issue at hand is for each individual person to shop around for an insurer with a good track record as well as the total costs of a premium. Now, some things are total BS like a single person paying a higher rate (or more taxes, or getting payed less money in the military service) than a married person.

I had a LARGE claim that was MY fault and I received prompt, proffessional service from my Insurer. I received all the coverage that I paid for, which had it not been mandated by state law, I would never have had it.

Later on, I was rear-ended, and elected to wait for 'the other person's' insurance company to handle it (so I could avoid paying the deductable), the damage to my car was light, but the exhuast system was effectively destoyed. The body work got 100% coverage, but the adjuster 'depreciated' the value of the exhaust because of the mileage on my odometer. The logic stunned me... an exhaust pipe doesn't wear out due to mileage, if it doesn't rust, it'll last forever. That was an insurer cutting corners.

I do not really enjoy the requirement to pay large premiums, but they are a neccesary evil if you want to own an automobile when you can't afford to buy one out of pocket. I only own (the bank really owns it) a car, because our society is developed around the automobile.
Posted By Anonymous Ian, Jacksonville FL : 2:00 AM ET
I am so disappointed on this series. I have worked in this industry for 13 years. I have taken statement from people who can't even say what their doctor looked like, what type of treatment they received, and damage to vehicles that do not match. Plain Fraud. Other times it is soft fraud- people exaggerating in hopes to get a settlement to pay some bills. Then there are the people who have serious injury from a minor impact. That is maybe 10% of the time or less. Just because a former insurance attorney is making $500 an hour testifying for plaintiffs does not make it truth. It makes him rich. You need to speak to people who have nothing to gain and have experience in the industry- middle management and claims people. I used to work for State Farm and I was never asked to do anything unethical. Find a better cause.
Posted By Anonymous Sherry, San Diego CA : 2:36 AM ET
Drew, thank you for bringing these kind of practices by insurance companies to the general public's attention. Until we had an accident in Oct 2005, we had NO idea that we were in bad hands. My husband and I are both doctors and we were denied basic medical care by a company that our insurance company employs to save them money. A doctor from their company actually denied my husband's MRI based on his symptoms and stated that "these things tend to get better with time". Ultimately, I demanded the MRI, threatening to file a claim with the New Jersey Divison of Banking and Insurance. The MRI revealed a very dangerous inward herniation in his spine that required an operation. If we practiced medicine like insurance companies do, we would be sued for malpractice. I told my agent that. He told me that he was unable to help us. He also told me that he had discussed our case specifically at a recent meeting. I believe he knew that being doctors, we could ultimately prove that they were committing what I call "insurance malpractice" by having a nurse and/or doctor that never examines you make medical decisions that can seriously affect your life. The agent also informed me that my insurance company was discussing dropping the company they employ because of their practices. They never did drop them, instead, the company changed their name and denied no wrongdoing.
You need to continue to keep this problem in the public eye so that people who have not had an auto accident know what they are in for if they ever do! I try to inform people in my state about the NJ Division of Banking and Insurance. It is the only organization that the insurance company is afraid of and the only reason for that is that they don't want to deal with the paperwork. Just using their name helped us in our daily battle against the insurance company to get the basic care that any doctor would have recommended.
Posted By Anonymous Dr. Lorraine Bopp New Jersey : 2:50 AM ET
Drew,if it wasn't for the " impact " with another automobile in which money could be collected, most people wouldn't even care. Let's be real. Some of these so called injuries that people claim when involved in a minor impact with an automobile can also be duplicated when sneezing, stepping off a curb, or picking up a baby, yet because theres no deep pockets to stick their hands into to collect from people don't bat an eye when those types of injuries occur.

Also, I know delay, deny and defend sounds cool, but doesn't a company have the right to investigate the legitimacy of the claims submitted it ? What about those people so take advantage of the opportunity to make claim for their injuries when they have no relation to the accident they were involved in ? Why should the insurance company have to pay for those ? Does it not have an obligation to it's honest policyholders to investigate those claims to the fullest extent ??

Imagine this.....an impact where the damages are barely visable. The party claming injury misses weeks from work, racks up thousands in medical bills and claims an ungodly amount of pain and suffering. Sure, sometimes their injuries are related to the impact, even very minor ones, but those situations are the exception rather than the rule and the insurance company should do all that it can to investigate those claim before opening it's checkbook and eventually asking for premium increases to help defer their cost.
Posted By Anonymous Ben Chavis, Raleigh North Carolina : 5:00 AM ET
I am a chiropractic physician trained in Auto Crash Injury Forensic Risk Assessment. The role of doctors is to report injuries that are present and to report when there are no injuries. The biggest problem is showing that it is very possible that people in low or no damage crashes do get injured. I have participated in research that shows that in crashes under 10 mph from the rear head accelerations are upwards of 10g. Jet pilots black out at 5-7g. The no crash no cash policy of some of these insurance companies is not founded in science. I would submit that it is founded in greed.
Posted By Anonymous Dennis, Tallahassee, FL : 6:52 AM ET
One tactic that warrants being looked at is the insurance company tactic of ordering an IME or "independent medical examination." When a person opens a claim for an auto injury and begins care with a physician, insurance companies typically order an IME. The result of the IME is predictable - no care needed. The reason - IMEs are very profitable for the evaluating doctor (who is usually a failure in practice). If they say care is needed they will not be asked to do any more evaluations. If they say no care is needed, they get a steady stream of evaluations and a nice cash flow. All part of the insurance companies "slow, low and no" payment program.
Posted By Anonymous Dr. Kerry Thomas, Grand Rapids Michigan : 6:58 AM ET
I think we need to take it all with a big grain of salt. While we can beat up insurance companies all we want, we do have to take in consideration all of the vultures who hover over accidents.

When you consider that after any given accident you have a host of lawyers, doctors/chiropractors, and other parties who appear to "come to the rescue", you can understand why an insurance company will want to settle the amount as quickly as possible and wash their hands of the entire affair. Litigation costs money and dragging cases through the courts is tiresome for both parties - after all, insurance companies must pay lawyers to defend them.

And in the end, who comes out the victor? Lets say your medical bills amount to $10,000 and you tack on another $5,000 in miscellaneous charges and future costs. A lawyer will cost you about 1/3 of the winnings. So you're now back down to around $10,000. If the insurance company offers you $10,000 - is it really any worse that getting a lawyer for $15,000 and spread over 3 years? No. It is actually to your advantage to settle for such an amount. Consider that if you take the $10k now and invest it in a CD or financial instrument returning a measly 5% interest rate, you end up coming out ahead by nearly $1,500 over the span of three years versus what you might have gotten by taking a lawyer and dragging it out over 3 years. The present value of hiring a lawyer is lower than what the insurance company is offering you.

Accidents suck but it still doesn't negate applying some basic logic and simple math calculations to see whether you should or should not take an offer.
Posted By Anonymous colson, Omaha, NE : 7:29 AM ET
My wife has been through two of these, and the only thing that has gotten a settlement out of the insurance company in both cases has been the threat of imminent trial. They are wrong, they know they are wrong, and yet they will spend much more fighting a legitimate claim than simply paying the claim would have cost them. Where does the money go? Company lawyers and company-friendly doctors. And when they finally DO pay, a big chunk goes to the attorneys you have to hire to get it, not to mention the cost to you in time and anxiety - every financial and medical record you have is likely to be demanded in hopes of finding something they can use against you. Yet odds are that, even if they pay, your bills will not be paid in full. Go after them, Drew. We pay them their premiums, and it's not so they can enrich lawyers and rent-a-doctors just to avoid doing the right thing.
Posted By Anonymous Michael, Tallahassee, FL : 8:04 AM ET
I don't watch CNN too much because of the political bias that is so apparent in most of the stories. When I saw the report on insurance claims I was amazed, one again, at the total onesidedness of the report.

I am no fan of insurance companies but to file a report where you try to make trial lawyers victims, I almost fell off the couch. (Claiming lawyers are tired of playing the waiting game.) How about supporting tort reform so legitimate cases can be heard and the courts aren't tied up with bogus cases filed by the ambulance chasers?

Fewer cases where someone sues McDonalds for spilling coffee in her own lap might clear the way for legitimate cases of injured drivers.
Posted By Anonymous Wynn, Dublin, OH : 8:35 AM ET
The same insurance companies you profiled are employing the same tactics on Katrina victims.
Posted By Anonymous Tina S, Pass Christian, MS : 8:59 AM ET
Even if you're not injured, the Insurance Company gets it's claim money back. I was at fault in a fender bender. It cost my insurer $1,200 to repair the other vehicle. My premium went up $600 per year for three years..total increase $1,800, so they ended up gaining everything back that they paid, plus $600 extra.
Posted By Anonymous Steve Ellis, Athens, Alabama : 9:39 AM ET
As a physician who sees these patients, the insurance defense lawyer and insurance adjustor comments are way off base. The actual number of fradulent claims stays at about 3-5%. However, since about 1/3 of all medical bills are racked up by people injured in crashes with less than $1,000 in property damage, that means the insurer can claim that the actual fraud rate is 1/3 or about 33%. While these is no medical research to support that an accident reconstruction expert can predict anything about injury potential, the insurers have educated their adjustors and attorneys about rampant fraud (which doesn't exist beyond the 3-5%). That's why you see the comments here from the insurance attorney and adjustor. They believe what they write only because they have been taught by an insurer who should know better, but is too enamored with the huge profits to care.
Posted By Anonymous John; Denver, CO : 10:18 AM ET
its great to finally see someone going after the 800 pound gorrilas!!!!!!!
Posted By Anonymous paul phily, PA : 10:47 AM ET
Many accident victims naturally seek chiropractic care for whiplash and related injuries which have severe medical effects over time. Despite having irrefutable x-ray evidence, detailed case histories and visit by visit notes of treatment, claims are often denied. This results in severely
expensive, painful intrusive surgery and drugging for years when simple spinal re-alignments by a competent Doctor of Chiropractic would have handled the problem in the beginning. Surely this is false economy not to mention stupidity when these claims are denied. The writing is on the wall. Continued abuses by the Insurance and Medical monopolies will
result in socialised medicine - and then where will we be? Higher Taxes and even worse care!
Posted By Anonymous Andrew Stevens Pittsburgh PA : 10:54 AM ET
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