Study Finds that Insurance Companies Manipulate Computer Programs to Pay Out Less to Policyholders

According to the Pittsburgh Post-Gazette, the Consumer Federation of America has found that computer systems used by many of the nation's largest insurers to evaluate auto and injury claims can manipulate the data in order to justify lowball offers to their policyholders or individuals injured by the negligent conduct of their insureds. What makes this even worse is that insurance regulators and consumers are unaware of the conduct of these insurance companies. According to Robert Hunter, the Director of Insurance for the Washington, D.C. based Association of Non-Profit Consumer Organizations, state insurance regulators are unaware of the scope and magnitude of this problem.

According to the report, there are numerous ways in which insurance companies utilize these programs to produce "lowball" payouts, including using biased or incomplete information that is programmed into the system. Additionally, insurance adjusters who have no formal medical training second guess doctors by entering injury codes that may result in lower settlements or payouts.

Many of you are probably shocked by this information and by the fact that insurance companies oftentimes put their own interests ahead of their insureds. After all, your insurance company is supposedly obligated to always treat you fairly and provide equitable compensation within the terms of the insurance policy for which you have paid valuable premium dollars. The sad reality, however, is that this conduct happens quite frequently. Over the past 30 years, the West Virginia Bad Faith Lawyers at the Fitzsimmons Law Firm PLLC have seen insurance companies act in this fashion countless times. Fortunately, the law provides a means of recourse against those insurance companies which behave in such manner. If you believe that your insurance company has not treated you fairly for a homeowner's claim or for personal injuries where you received underinsurance or uninsurance benefits, you may have a claim against your own insurance company.

Unfortunately, if you are an individual who has been injured by the negligence of another person and the other person's insurance company acts improperly or makes unreasonably low offers, you have little to no recourse against the insurance company. In 2005, the West Virginia Legislature and then Governor Manchin passed the Third-Party Bad Faith Act, W.Va. Code §33-11-4a, which stripped an injured individual of his or her right to file a lawsuit against another person's insurance company for treating them unfairly. This law eliminated the ability to effectively regulate insurance companies and provided them carte blanche authority to behave however they want in West Virginia. As a result of this law, many West Virginians have been deprived of meaningful and fair compensation to which they are entitled; others have been forced to endure a stressful and arduous trial to receive what is duly owed to them. It has been 7 years since the passage of the Third-Party Bad Faith Act and insurance premiums have not decreased like the insurance industry promised. Thus, it may be time for all West Virginians to reevaluate whether or not they want to continue to give away their rights to the insurance industry in exchange for false and misleading promises. If you are fed up with insurance companies behaving this way in West Virginia, we encourage you to contact your local state representative and urge them to give back West Virginians their right to hold insurance companies accountable through Third-Party Bad Faith claims.


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