There are many people working as claims professionals in the insurance business who strive to do the right thing by the company’s policyholders. When I run into one of them, it is like a breath of fresh air. These folks seem to genuinely care about policyholders and work hard to try to find ways to pay claims. They do not relish denying a policyholder’s claim and do not feel as though they have “won” somehow by denying a claim.

Unfortunately, there are too many claims professionals who seem to fall in the opposite camp.  Some claim professionals appear to take some sort of perverse joy from saying “no” to their policyholders. I don’t know what motivates these folks. Perhaps they have been indoctrinated by a culture that promotes this kind of behavior in their company’s claim department. If being overly tough on claimants is rewarded with praise from supervisors, advancement in the company, or increased pay/bonuses, then a certain segment of a company’s employees will act this way. I have certainly seen this dynamic play out in my experience suing insurance companies.

Sometimes I think the insurance claim business draws people to it whose personalities are geared toward saying “no” instead of “yes.”  Too many of the adjusters, supervisors and managers in insurance company claim departments I have met in depositions and trials over the last 25 years just seem to be constitutionally incapable of open-minded, evenhanded, caring attitudes toward policyholders who make claims. Too many of these folks fall too easily into a mindset in which they assume a policyholder making a claim is being dishonest and trying to get “something for nothing” by seeking compensation for their loss.

Either way, whether by company culture, personality type or a combination of the two, when claim handlers approach claims with a “say no first, ask questions later” attitude it often leads to a policyholder who feels aggrieved and ends up seeking legal advice. When a skilled lawyer reviews a claim handled by an adjuster looking to “beat down” a policyholder (oftentimes by delay, needless obstacles placed in the way of a claim settlement or just plain indifference) the bad faith litigation that results ends up costing the company way more money than a fair settlement would have in the first place.