Support The UNFAIR Insurance Act - Rights for your unfair claim denial

Upholding National Fairness and Accountability in Insurance Reforms (UNFAIR) Act - 9 provisions protecting all policyholders

My name is Travis Priest, and I have the dubious honor of having lost all my belongings twice to toxic mold. With each outbreak, not only have I and my family had to fight for physical and psychological recovery, but we also faced battles of another kind - with insurance companies. Struggling to get insurance claims processed fairly and timely has been a nightmare. This petition is not only for me but for the thousands of people across our country facing the same ordeal, no matter the disaster causing their loss.

By signing this petition (and sharing your own story), you will:

• Help me get my claims processed (Thank you!)
• Help others by raising visibility of the problem
• Help yourself in the future when you are facing a denial

This petition is for you. The subject is dry, but the proposed solution is practical.

Both the State and Federal government, and many of our institutions, mandate that we purchase insurance. You must have car insurance to exercise your driving privileges, health insurance or pay extra taxes, and home insurance to obtain a Fannie Mae backed mortgage, and more.

“Insurance companies are in the driver’s seat when settling a claim. Insurance carriers have more negotiating strength and financial resources than the policyholder. Recognizing this, most courts find an obligation of good faith and fair dealing in every insurance policy.” - FindLaw

Insurance is in the only industry where the customer relationship is adversarial: customers are a clear and present danger to profits. This is much more than a mere shift in power dynamic, so the obligation of fair dealing is insufficient to protect consumers’ interests.

Every American will encounter an insurance claim denial or diminishment in their lifetime. Generally speaking, the only recourse consumers have is the court system, which can be slow and expensive. Insurance companies know this and it factors into their claims decisions.

I’m proposing The UNFAIR Insurance Act (“Upholding National Fairness and Accountability in Insurance Reforms”), a set of reforms to balance the power between policyholders and insurance companies. These reforms surface directly from my experiences with State Farm and Lemonade Insurance (Read the UNFAIR Blog to see my family’s journey to recovery and more about how I’m trying to address the industry’s injustices).

The UNFAIR Insurance Act

1. Establish a claims appeal process or arbitration system independent of the insurance company providing policyholders recourse outside the court system.

   Why: The legal process can be slow, expensive, and overly burdensome on consumers, making it difficult for policyholders to challenge unfair claim denials or diminishments.

2. Miranda Rights for Policyholders: Require disclosure of the claims process, including required documentation, evidence collected, how it is used, and what reviews and testing will be done.

   Why: Consumers need transparency to understand how their claims are evaluated and to ensure that their rights are protected during the process. Inform consumers making initial recorded disclosure statements while under stress that their statements may later factor negatively into claims approvals.

3. Create a guaranteed loan facility for claims so that insureds can borrow against their final settlement if it cannot be settled within a short period of time.

   Why: Delays in claim settlements can create financial hardship for policyholders, and access to a guaranteed loan facility would provide immediate relief while ensuring accountability.

4. Mandate insurance company claims rate reporting, including the number of claims, original dollar value, number of denials, denial reason codes, and final payout amounts.

   Why: Transparency in reporting would help identify patterns of bad faith practices and illuminate issues of consumer fraud, holding insurers and policyholders accountable.

5. Implement mandatory independent testing by third-party labs for claims involving environmental factors like mold, asbestos, lead, and other toxic materials.

   Why: Independent testing ensures transparency and reduces conflicts of interest where the insurer might otherwise control the outcome by selecting the testing company.

6. Grant policyholders the right to request a public appraiser who is not financially dependent on the insurance agency.

   Why: The current valuation process is often skewed in favor of the insurance company, creating an unfair bias against citizens.

7. Ensure policyholders have the right to review all evidence collected by the insurance company and provide additional evidence before a final decision is made.

   Why: The current system allows insurance companies to withhold test results and other evidence, creating a power imbalance that disadvantages policyholders.

8. What: Where insurance is mandated by law or alternative tax, then legal proceedings, payouts, and settlements cannot be subject to confidentiality or nondisclosure agreements.

   Why: This protects the public interest by preventing the concealment of important information that could affect policyholders, promote equitable treatment, and uphold trust in the insurance system.

9. Increase criminal penalties for insurance fraud and enhance penalties for insurers found to engage in bad faith practices, including punitive damages and regulatory actions.

   Why: Strengthening penalties for bad faith practices will deter insurers from engaging in unethical behavior and protect consumers from fraudulent claims handling.

10. Require a Plain Language Summary of Coverage and Exclusions.

    Provision: Mandate that all insurance policies include a plain language summary that clearly outlines scenarios covered versus those not covered. This summary must highlight exclusions that may reasonably surprise policyholders, including examples such as wind-blown water exclusions in flood insurance policies.

    Why: Policyholders often assume that common situations, such as storm surge flooding during a hurricane, are covered, only to discover exclusions buried in complex contract language. Providing a clear, plain language summary ensures transparency, helping consumers make informed decisions and avoid unexpected denials of coverage.

We are calling on our lawmakers to propose and enact legislation ensuring fair and prompt processing of insurance claims and to protect policyholders beyond the expectation of “fair dealing.” This measure will prevent families from struggling financially in the aftermath of such devastating events and handle the inevitable denials and diminishments handed out by our current system.

All of us have the right to fair treatment and full coverage under our insurance policies. Stand with me, and countless others who have gone through the misery of battling insurance claims. We are asking for your support to help rectify this appalling situation. Please, sign this petition.