State Farm Fined $4 Million by Montana Insurance Commissioner related to Private Passenger Auto Claims.

[failure2020]

@stryker4 Car repair is objective. You can measure the damaged part, see where the crack or misalignment is, pull up a catalog of parts and find the price of a replacement.

A human body is different. Somebody can say "my neck hurts" but there is no way for anyone outside of that person to say if there is any injury at all (outside of a broken bone or something like that drastic). We can't see if they feel pain or not, how much pain, how much that affects them personally, etc. A guy who runs marathons may not think anything of a little neck pain for a few days, but a guy who sits in a chair all day might find it to be horrible. Who is right or wrong? Neither, and both! It's subjective.

That's the trick to it. Now, I know you may find it hard to believe, but sometimes people are dishonest. I know! It's unthinkable... who would ever tell a lie ??? Awful to even think about, but it turns out that some people do. When that happens, medical treatment is incurred, bills are generated, and the liar has no intention of paying them. They are in this for - get ready for this - the money.

 

[stryker4]

@failure2020 I don’t know why every insurance adjuster acts like every car bodily injury claim is a 10 MPH rear end and complaint of unseen back and neck pains…there’s more than plenty of fatal and serious car accidents and the number keeps increasing.

There’s many injuries that are very serious and they are quite common; broken bones, bruises and cuts, scars, brain injuries/concussions are not objective.

And yes, I do want money for being permanently disfigured facially, wasting a month of my life healing, and days I would spend in the emergency room. Nothing about being struck by a car as a pedestrian at 30 MPH was minor for me. You’re absolutely right I do want supple compensation and then some.

But according to you, it’s okay to let medical bills acquire interests while adjusters twiddle their thumbs for months on end. You can debate whether or not chiropractors should be paid or not, but at minimum an emergency room visit should be paid out before settlements.

 

[failure2020]

@stryker4 I understand that this is going to be hard to hear, but there are actually people in the world who are - brace yourself - dishonest. They are not actually hurt, but they lie and incur medical bills - usually big diagnostic ones - for the express purpose of inflating and/or exaggerating the severity of their injury claim.

If would think that if you have really been through a terrible accident and the ensuing recovery period, you should be even stricter about it than someone who has not. I question your story, since you of all people should be the first to stand up for the rights of actual victims, trying to make sure that they get the treatment they need, ahead of anyone who is just faking it to get a big settlement later. Instead, you are advocating for less oversight? How very odd!

The truth is that medical providers are highly familiar with the insurance industry. Hospitals hire thousands of clerks just to sort out medical billing. They know very well that virtually nobody has the thousands of dollars lying around to pay for the bills that they will incur. So they don't withhold treatment when they know an insurance company will be footing the bill. Many providers work on a lien basis, which means they will just accept a portion of their patient's settlement, if one is ever paid. And they can all wait to get paid until after things are sorted out.

Legally speaking, nobody owes you a cent until you prevail in court. Getting an insurance settlement is the shortcut. It is being paid early. It is a big timesaver not only for the claimant, but for the insurance companies and attorneys and everyone else involved. But even though you don't have to convince a jury of your peers that you deserve $AMOUNT, you do still need to show enough evidence to support your demand.

As I like to tell people, we don't need the whole puzzle, we just need enough pieces that we can tell what the picture in the puzzle is going to look like when it's all together. This can take time to do, and that's OK! It will get sorted out. If you aren't faking it, then you have nothing to worry about - especially if you hire an attorney to help you.

 

[tiddy123]

@stryker4 So, thank you for letting us know that you don't work in the insurance industry.

 

[resjudicata]

@tiddy123 gullible plough governor normal market wakeful lock coherent air bear

This post was mass deleted and anonymized with Redact

 

[jason381]

@stryker4 Usually a person might receive an initial estimate, but a service has not been “received” at that point.

 

[juliand]

@stryker4 No. You can't look at a human body and estimate what it will be to repair it and what bills are A) due to the accident and B) reasonable for the injury until an accurate and comprehensive review of the entire claim is completed.

Also lots of fraud in injury claims and lots of treatments that are not rooted in medical science and not accepted by carriers.

 

[stryker4]

@juliand Well I agree with the state of Montana, boohoo.

 

[juliand]

@stryker4 People like you make me super happy I don't work BI anymore

 

[tiddy123]

@stryker4 Opinions do not require industry knowledge to have one.

However, an educated opinion requires an understanding of the legal system, which you clearly lack.

Your opinion here is as valid as my opinion on whether or not we should have more nuclear power plants.

 

[mrunknown]

@stryker4

I actually agree that BI bills should be paid as they’re received.

I had a coworker who apparently believed the same thing. They had one of the fastest times to close files and some of the highest metrics on our team.

Then, our manager pulled a couple of their claims and found that Coworker kept issuing payments for bills on claims that shouldn't have involved a medical bill. Several were claims involving someone's car getting hit while unoccupied and parked. Most were claims involving attempted theft or claims involving potholes.

Coworker got investigated and fired. Manager discussed it with us in a meeting.

 

[nomiplease]

@tiddy123 That makes sense.

 

[illuminaticlub]

@tiddy123 I used to run a frontline claims team that handled Montana claims. Absolutely bonkers. Super glad I’m out of that now and sorry for the poor bastard that inherited that work.

 

[mrs41intx]

@blmartinez I’ve been in claims for 20 years. State Farm absolutely has had this coming my entire career. In the adjuster world they are famous for this shit. They’ll put liability on any vehicle, occupied or not, moving or not. Stopped car sitting at red light gets hit? They try to give them 5-10%! It’s horseshit. My boss has 30 years in claims and said they’ve been at it his entire career as well.

 

[refei]

@mrs41intx Wouldn't have gotten hit if they weren't at the stop light. Who made them be there? Wasn't the guy who hit them. Duh...

 

[thebiblesays]

@refei Wouldn't have gotten in that accident if you weren't born. Your fault.

 

[refei]

@thebiblesays That's on my parents. Not me. File it on their insurance.

 

[thebiblesays]

@refei Nah you still chose to make it to birth. You also could have ended your life at any point prior to the accident.

 

[steve126]

@mrs41intx State Farm is truly vile when it comes to Liability. They refuse to accept. You have to arb them all the time. It’s insane.

They are by far my least favorite insurance company to talk too. Especially considering most of their “adjusters” have a negative IQ

 

[kaslene]

@steve126 And that’s even IF you get the chance to talk to them since their claims line never takes any calls

Or the hold time is like 20+ minutes