Hurricanes Katrina and Rita: Effect on Claims Handling Procedures

Texas Bulletins

The Texas Department of Insurance issued the following bulletins to address the potential impact on claims handling processes from Hurricanes Katrina and Rita.

• Bulletin No. B-0051-05 (September 21, 2005)—Reminds insurers that the Insurance Code authorizes them to use nonresident and emergency adjusters to handle claims and provide prompt and immediate relief to hurricane victims and evacuees.
• Bulletin No. B-0059-05 (September 28, 2005)—Commissioner acknowledges that certain adjusters may be approaching people whose homes have been damaged and offering checks for living expenses in return for the homeowners signing an acknowledgment that their claim is for flood damage. Homeowners policies do not require that the policyholder acknowledge coverage under any particular policy before being eligible to receive additional living expense (ALE). Commissioner reminds insurers of the specific claims settlement practices required in the Insurance Code.
• Bulletin No. B-0063-05 (September 30, 2005)—Recognizes additional time periods for processing claims as allowed by Texas Insurance Code, Section 542.059 and 28 TAC 5.903.
• Bulletin No. B-0064-05 (October 10, 2005)—Commissioner recognizes complaints by policyholders that there may be no coverage, they must travel to various areas of the state to obtain settlement checks, that claims handling areas are closed, that property cannot be inspected when there are means of inspection available to the adjusters. TDI began conducting market examinations to ensure regulatory compliance with claims handling requirements.

TDI explains that an insurer must timely inspect the property before denying a claim in compliance with Texas Insurance Code, Chapter 542, subchapter B (formerly Article 21.55). ¹ Furthermore, the insurer may have a contractual duty to fully investigate any claim asserted by the policyholder, including the claim that damage may have been caused by another covered loss or ensuing loss allowed under the policy. ²

Louisiana Rules and Directives

The Louisiana Department of Insurance (LDOI) also issued Emergency Rules and directives to address the issues that arose in the claims handling process after Hurricanes Katrina and Rita. ³

• Rule 15 (August 26, 2005)—Suspends all statutory and regulatory provisions that impose on the insured a time limit to perform an act or transmit information or funds with respect to insurance in specifically identified and designated areas of Louisiana. This does not relieve the insured from the obligation to provide information and cooperate in the claims adjustment process.
• Rule 16 (August 26, 2005)—Requires that all public adjusters operating in Louisiana must register with the LDOI. Failure to register is a violation of the Louisiana Insurance Code.
• Rule 22 (December 22, 2005)—Implements a claims mediation program for personal lines residential claims resulting from Hurricanes Katrina and Rita. The Rule also addresses guidelines for construction pricing. The rule does not apply to commercial insurance, private passenger motor vehicle insurance, or liability coverage contained in property insurance policies.
• Directive 195 (February 27, 2006)—Prohibits insurers from imposing a 6-month time period on insured to make necessary repairs to property damaged by Hurricanes Katrina and Rita. Insureds now get an additional 6 months, total of 1 year, to recover the replacement costs for damages.

In October 2005, several class action lawsuits were filed in Louisiana against Audubon/AIG and Louisiana Citizens Property Insurance Corporation (LCPI) for failure to meet state mandated deadlines for adjusting claims. LCPI is a state-sponsored insurer designed to provide insurance to those in the coastal areas who could not otherwise get homeowners insurance from the private market. Audubon contracted to administer the LCPI policies through the hurricane claims, however, it lost its contract with LCPI shortly after Hurricane Katrina struck. LCPI Chief Executive Officer Terry Lisotta has been noted to say that the fact that Audubon challenged its loss of the administration contract caused delays in the changeover process and, ultimately, delays in the claims handling process of Hurricane Katrina. ⁴

Note that the Federal Emergency Management Agency (FEMA) may be less available to those with insurance since it will not "duplicate assistance" provided by an insurer and will only make decisions to aid policyholders after a claim has been settled. ⁵

It appears that progress in the claims handling process has been steady, but slow, since the hurricanes. According to the Insurance Information Institute, homeowners insurers have settled nearly 70 percent of claims from Hurricane Katrina in Louisiana and Mississippi, which is over 732,000 claims, totaling $11.4 billion. In addition, about 90 percent of more than 300,000 claims from damaged vehicles have been settled in both states, according to the Insurance Information Institute. Settled does not necessarily mean that the claims were paid. It means that the insured and the insurer have agreed on the extent of covered damage and the estimated repair costs.