Miss. Probes Improper Claim Handling Charges

Mississippi's insurance commissioner has given State Farm until April 4 to answer charges that the company is ignoring evidence of wind damage and rejecting policyholders' claims for homes pushed off foundations by Hurricane Katrina.

Commissioner George Dale, in a letter to the company, said insureds complained that State Farm is telling them "even if a dwelling suffered wind damage prior to the arrival of storm surge, no claim payment for wind damage is due since the water would have washed the structure away anyway, notwithstanding damage caused by wind."

Mr. Dale said, "If this is State Farm's position, it is contradictory to representations made by State Farm to Department representatives."

The insurer takes the position that windstorm damage policies do not cover storm surge--water driven by hurricane gusts--which it views as flood damage that is excluded by policy language.

But, a spokesman for the company, Fraser Engerman, said the company does pay homeowner wind damage claims despite later flooding

"Obviously if we have an insured and they can provide credible proof that a covered peril like wind destroyed or damaged their home we will have that portion of the loss paid irregardless of whether flood later destroyed the home."

He said State Farm is gathering material and intends to respond fully to Mr. Dale's request and noted, "We are paying claims. It's important to note if folks have a concern were willing to listen and work with our insureds."

Asked if adjusters might have ignored or misinterpreted company policy, Mr. Engerman, said he could not engage in "pure speculation."

Mr. Dale, contrary to Mississippi Attorney General Jim Hood, has supported insurers denial of storm surge damage. Still, his letter advised State Farm that he expects loss to be apportioned and "any wind damage claim paid regardless of whether tidal surge/water subsequently washed the structure away or caused other damage."

In another case, a federal judge, on the same day that Mr. Dale sent his letter, told Allstate that it cannot reject an entire claim based on the presence of flooding.

Mr. Dale told State Farm to take note of his Sept. 7, 2005 bulletin that stated where there is little or nothing left of a home "it will be a fact issue whether the loss was caused by wind or water. In these situations the insurance company must be able to clearly demonstrate the cause of the loss.

"I expect and believe that where there is any doubt, that doubt will be resolved in favor of finding coverage on behalf of the insured," he said.

If the carrier believes the damage is water-caused they should have proof, the bulletin said.

The commissioner said he was concerned that insurers were basing claim decisions on structural engineer reports and ignoring eyewitness accounts.

His three-page letter told State Farm to advise him in writing how it is handling eyewitness accounts and other insureds' evidence in evaluating Katrina claims.