Book Reviews

Publications the homeowner should know about

Below is a list of reading material that may help assist you in the resolution of your own insurance
claim. If you have any other book suggestions let me know and I will add them to the list.

The Claim Game: A homeowner’s Guide to Avoiding an Insurance… by Andrew Wallingford

Published in August 2009. (286 pages). American. Of the insurance books I have read this is my pick for the most useful book for a policyholder with an unresolved claim. Though it has an American focus, much of what is described within its pages transfers to other common law jurisdictions relatively simply. The author suggests that a disgruntled policyholder should keep going up the corporate ladder until they find an ear willing to hear their concerns. He stresses that a claim is never closed until the very last repair has been made and the last dollar paid. The book details how insurance payments should calculated and made. He makes the point that in the claims adjusting world “if it isn’t documented, it never happened; if there’s no proof, it doesn’t exist”. He explains the need for full photographic evidence and the need to hang back on repairs until the insurer has inspected the damage. The book concentrates on the procedural aspects of claim management with much emphasis on detailed phone logs, activity logs etc. Specific examples are provided. Estimated cost of repairs and the actual cost of repairs are described and the author explains that the insurer is unlikely to keep you fully versed in the real costs involved. Scopes are described and how work to be done is priced. There is considerable detail of overhead and profit accounts and a clear description of how costs are calculated. These are aspects of the industry that insurers do not tell homeowners about. Depreciation is covered as well as an explanation of the relationship between the insurer and contractor, salvage rights, buy back of damaged items etc. In addition topics such as additional living expenses, mould, cracked foundations, building code upgrades are also detailed. The author recommends hiring your own experts and knowing when to sue the insurer. At the end of the book is a section on the importance of home inventories and a glossary.

How to Win the Insurance Claim Game by Ron Alford.

Published in 2012 (120 pages). American. The book begins by letting the reader know that nowhere in the insurance policy does it explain how the policyholder is to go about doing what it is YOU are responsible for. He explains the process that will take place once a claim has been lodged and that most insurers will use every tactic available to them to manage the claim to their benefit. He describes the various players within the organization and the difficulties of finding the common denominator between all parties. He emphasises the need to stay involved and on top of the situation. He makes the point ‘never kick a kangaroo’ i.e. never do battle with any of them until you understand the consequences of what their weapons are capable of but being timid will also not do. Understand the scope of the loss, the insurer’s desire to ‘cash out’ and the need to be vigilant because their pricing is ‘consistently wrong’. He reminds us that insurers pay former contractors to provide estimates and this is why you need your own independent bids from contractors who will actually carry out the work. There is discussion around public adjusters and their conflict of interest. At the end of the book is a useful section on the insurance rights of the consumer. And he reminds us that “as the policyholder, only you can demand that your insurance company live up to its obligations under the policy”. This is another good book for those trying to resolve a claim.

Delay, Deny Defend: Why Insurance Companies Don’t Pay Claims and What … by Jay M. Feinman.

Published in Jan 2010 (256 pages). American. An expose of insurance injustice and a plan for consumers and lawmakers to fight it. This is candid account of how insurers deny, delay and defend claims in order to minimize claims. This book may not assist you greatly in solving your claim but it will dispel any illusions you had about the insurance industry. The author talks about the computer software and marketing techniques used by insurers to shape public perception, explains how insurers actually make money by the pooling of premiums and investing at higher interest rates. There are a myriad of ways insurers delay and deny claims, Mr Feinman explores these thoroughly including the way the insurer forces the claimant to sue in response to their tactics. If you’re sitting in the camp of people still thinking insurers are the good guys – read this book.

Uncovered: What really happens after the storm, Flood Earthquake or… by Mark Goldwich.

Published June 2007 (128 pages). One of the first statements in the book is ‘think of the insurance company as your legal adversary’. It explains that millions of people have been victimized by their insurer after having endured the first disaster. The author describes denial of coverage and deflection of responsibility. The role of the engineer is discussed and details how the engineering firm is not driving the process and the insurer’s relationship with their preferred contractors. There is discussion about the ways in which software is used to underestimate claims. Toward the end of the book the author details a series of commandments that should help the policyholder see their way through a claim.

Insurance and Behavioural Economics by Howard C. Kunreuther, Mark V. Pauly, Stacey McMorrow.

Published in January 2013. (343 pages). American. A book for the academics amongst you. This is for those readers with a profound interest in the psychology of insurance. The book describes situations in which public policy and the insurance industry’s collective posture need to change. The writers detail the unrealistic expectation consumers have about the losses they may experience. It is a book about the classical economic theory and behavioural economics with respect to choices made by consumers and insurers. It is about the theory behind insurance and human choice. There is a discussion about information asymmetry, adverse selection and moral hazard. Not a book that would necessarily help you solve your own difficult claim.

Insurance: Concepts & Coverage: Property, Liability, Life, Health and Risk… by Marshall Wilson Reavis III.

Published in October 2012. American. The book provides an explanation of the various structures of insurance companies from mutual to public insurance companies, as well as a general explanation of the functions within an insurance company such as agents, brokers underwriters etc. It also gives brief descriptions of the parts of the insurance contract such as exclusions, declarations etc. It also looks at the various types of property e.g. owned, non-owned, and intangible property etc. It also considers risk management techniques used by the insurer. The book also concentrates on life insurance, the option and benefits to the policyholder and underwriting objectives within the insurance business. Also covered are the basic principles of health and disability Insurance.

Vulture Culture: Dirty Deals, Unpaid Claims, and the Coming Collapse of …. By Eric D. Gerst.

Published in April 2008. (256 pages). Early on in the book the author makes the statement “Consumers of insurance are losing millions of dollars in delayed and denied claim payments in a system favouring the insurer.” He describes the industry as poorly regulated, uncontrolled where the business climate of negative forces is allowed to flourish. The rest of the book to devoted to the history of the industry including the bid rigging involving AIG, ACE Ltd, Hartford Financial Services and Munich American Risk Partners.

The Shock Doctrine: the rise of disaster capitalism by Naomi Klein

Published in 2007. In this book the author explores the myth that the global free market was triumphed democratically. Exposing the thinking, the money trail and the strings behind world-changing crises and wars over the last four decades. The Shock Doctrine tells the story of how America’s “free market” policies now dominate the world– through the exploitation of disaster-shocked people and countries.

This Changes Everything: Capitalism vs the Climate by Naomi Klein. Published September 2014. (483 pages).

The author explains how the global economy is upping the ante from conventional sources of fossil fuel to even dirtier and more dangerous sources. It is the climate of corruption. She goes onto describe how over the past four decades corporate interests have systematically exploited crisis to ram through their policies and enrich a small elite few. There are signs that climate change will be no exception e.g. carbon credit scam and weather futures. Meanwhile the global reinsurance companies are making billions in profits selling new kinds of protection schemes to developing countries. Finding new ways to privatize the commons is the aim. Climate change has become “an existential crisis for the human species”. “Our economic system and our planetary system are now at war”. She describes the need for a change in world view – a basic income for all, rewriting of trade law, recognition of the rights of Indigenous people etc. Polite incremental change is not working. Our culture requires a fundamental shift in its governing values. The insurance arm has pushed policies that would allow corporations to stay profitable regardless of the real-world results of those emissions. There is a need to start localizing our economies again. She proposes a new model.

Disaster Insurance Claims by Geoffrey Norman.

Published in February 2013 (41 pages) describes how to liaise with a loss adjustor and work with restoration companies and contractors. It reminds policyholders to move heaven and earth to make sure that the contractors working on your restoration are those you are happy with.

What it takes to become a Catastrophe Claims Adjuster by Anthony Galloway.

Published July 2008 (56 pages). American. Describes the role of a catastrophe adjustor and explains the use of estimating software programs such as Xactimate. The book makes a point of declaring that property adjusting is not ‘an exact science’. The author states that “all insurance policies are similar” and “always rely on the insurance company’s interpretation. This will keep you working”. Yes that’s a direct quote. He covers depreciation and overhead and profit. The author ends by saying “I recommend writing as many estimates possible and get them turned in fast. The examiner is watching your turn in speed and quality of your estimates”. The book provides a good insight into the industry from someone on the inside.

Useful Websites:

Many countries have their own insurance watchdogs in the form of ombudsmen and regulatory authorities but all too often these are industry-funded organizations without the ‘teeth’ necessary to really assist policyholders. To those ends policyholders often have to help themselves. Here are some useful books:

If you can add to this list let Sarah know:

http://www.badfaithinsurance.org/ (America)
http://www.nolo.com/legal-encyclopedia/insurers-bad-faith-injury-cases.html (America)
http://insurancewatch.org.nz/index.htm (New Zealand)

© Copyright 2019 - Sarah-Alice Miles