In the Beginning

by Mark Goldwich

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I WON’T TELL you the name of the insurance company I used to work for – I’ll just tell you that it was a major player. Let’s call the company I used to work for BigCo. BigCo was really good at creating a sense of “welcoming culture” within the organization for its employees. When I started there in the late eighties, the company really seemed to offer a “family” atmosphere.

My landing a job at BigCo was quite a coup; BigCo was a prestigious company and competition to get in was fierce. They didn’t really have to advertise for new hires. You usually had to know someone or be related to someone who worked at BigCo to get a job offer there. It was a good company to work for. There were lots of benefits.

Getting promoted to supervisor in under five years was another big accomplishment. Generally, you had to work there at least seven years before you could expect something like that. So I was on the fast track. I felt as if I were on top of the world. I was a company guy. I was all about BigCo.

A big change happened for me in 1996, though. That was when I became part of BigCo’s newly developed national catastrophe program. I gave up my job as a local supervisor at BigCo. The new position required a lot of travel. Because I had taken the new job, I was now traveling around the country, staying at a seemingly endless series of hotels, and working very, very long hours. Twelve hour days were the minimum; six-day work weeks were the norm. I got a weekend off – as in two straight days at home – only every six weeks or so.

While working on the catastrophe team at BigCo, I began to see first-hand all the subtle ways the company manipulated the process to the disadvantage of policyholders. I began to notice how the words the company used pointed in one direction … but the actions we took tended to point in another, very different direction.

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Working at disaster sites, strolling through the ruins of people’s homes, was, for me, a sobering and humbling way to make a living. Supposedly, we were there to help. But often, I found us merely scurrying about trying to get just enough money into people’s hands to keep complaints at a minimum. I saw too many “high-fives” among BigCo team members when a policyholder’s claim was denied.

I also began to see that the “family culture” that BigCo took such pride in was more complex than I had imagined. It now had a darker side – you were part of the family as long as you did exactly what you were told, and as long as you accepted, without challenge, all the unspoken assumptions you were supposed to accept.

I now found myself face-to-face with those assumptions on a daily basis, and it was difficult for me to ignore their human costs. I realized that, to be “BigCo people,” we had to buy into those assumptions but never, ever say them out loud, either internally or externally. I could no longer escape the conclusion that these assumptions were uprooting the lives of a very large number of our policyholders.

Some of these unspoken “BigCo Family” assumptions were:

• Claims from consumers are likely to be inflated, if not fraudulent. Treat them that way.

• You can always find a reason to delay: request additional information; get better documentation; get clarification; say you have to investigate more fully; seek higher authority for whatever has to happen next.

• You can always find something to deny, reduce payment on, or limit.

• You can always find a way to deflect responsibility. Find someone or something else to blame for the situation the policyholder is facing.

• While you are doing these things, you must maintain, and endorse, the public position that BigCo is doing everything right, and is always out to give policyholders a fair shake. Regardless of how many policyholders complain to you about how they are treated, you must preserve the public image of BigCo as fair and responsible.

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These, I came to realize, were some of the dark secrets behind the “family culture” at BigCo. You were only part of the “family” if you agreed to conceal these basic working principles from the media, from the general public, and from policyholders.

It was time to get out. I began a career as a public adjuster. Shortly after leaving BigCo and starting work in my new field, I was working in the Florida Panhandle with a retired Air Force veteran whom I’ll call “Captain Charlie.” He and his wife had been hit hard by Hurricane Ivan.

Captain Charlie’s house had been devastated by Ivan’s winds, as well as by eight to ten inches of flood water. His roof had been turned into a sieve, and there was major interior and exterior damage. The contents of his home had been ruined. Captain Charlie’s insurer gave him a shockingly low building-loss offer, and denied his claim for the contents of his home entirely.

In a preview of the dodge the insurance industry was to become infamous for a few years later with Hurricane Katrina, Captain Charlie’s insurer told him that his entire claim

for the personal contents of the home had been rejected because the home wasn’t covered for flood damage. Guess what? Captain Charlie didn’t have a flood policy.  The fact was, though, that much of what they denied could not have possibly been damaged by flood, since the objects in question were ten inches or more off the ground and were directly underneath one of several gaping holes in a collapsed, storm-drenched ceiling.

It was an infuriating result -- one I knew I could improve for Captain Charlie. Knowing the internal workings of companies like his as well as I did, I took it as my personal mission to win Captain Charlie a better settlement. He paid me nothing up front. (None of my clients pay me anything up front.) He ended up getting over $39,000 that had originally been denied for contents of his home. I also secured additional payments on his home itself that totaled over $71,000; after you added everything up, it was over a hundred and ten thousand dollars.

I’ll never forget the look on Captain Charlie’s face when he got the news – over a hundred grand in additional payments from an insurer that had chosen to fight him tooth and nail, and had lost. I’ve never seen a man more grateful. That was my first major victory against one of many BigCos running roughshod over the very lives of the policyholders who kept them in business. There were lots more victories to come.

Mark Goldwich is president of Gold Star Adjusters, a group of public insurance adjusters dedicated to helping citizens get the maximum settlement for any insurance claim.