Marc Anidjar
A personal-injury attorney is calling on Florida officials to provide more data about the number of auto insurance consumers who are denied compensation after filing injury claims and to determine whether legitimate disputes are being resolved fairly.
This call for more attention to the consumer impact of recent tort reforms in Florida comes in the wake of a Wall Street Journal story concluding that nationwide, 45% of auto liability and medical claims were closed without any payment last year, compared to a 35% figure recorded a decade earlier. Auto accident claims related to the repair or replacement of policyholders’ vehicles showed no upward trend over the same period, the Journal found.
Marc Anidjar, senior partner of Anidjar & Levine, which has offices in south and central Florida, acknowledged that in the wake of the state’s 2023 civil justice reforms, insurer loss ratios have fallen to their lowest levels in 15 years, top insurers are lowering rates for consumers, claims litigation has been reduced and more carriers are entering the Florida insurance market.
But he said the Aug. 9 Journal report raises new concerns that the auto market’s treatment of consumers may be falling short.
“Florida now has several years of post-reform data showing substantial improvement on the insurer side of the equation,” Anidjar said. “The next question is whether we have equally transparent data showing what those reforms have meant for injured drivers when they actually make a claim."
In short, he said, the success of tort reform needs to also be measured by what happens to consumers after a crash and not solely by what consumers pay for premiums and the volume of claims being filed in auto accidents.
Florida could have a higher denial rate for auto injury claims than what the Journal’s figures show, but there may be legitimate reasons for such insurer actions. Attorney advertising and third-party solicitations to accident victims have increased in many U.S. markets, according to Mark Friedlander, senior director of media relations for the Insurance Information Institute (Triple-I). And despite the passage of tort reforms, Florida has more litigated auto claims than any other state, Friedlander said
David A. Sampson, president and CEO of the American Property Casualty Insurance Association (APCIA), said legal system abuses can drive up the number of meritless claims, and, in turn, investigations uncover such abuses, resulting in no payouts.
“Auto liability and medical claims are a magnet for billboard lawyers and fraudsters seeking to profit off the system, which is why these claims are investigated thoroughly,” Sampson said in a prepared statement. “It is important that insurers do not pay meritless claims to control the cost of coverage for all drivers.”
Friedlander said Triple-I was not able to confirm the accuracy of the Journal’s data, but he added that numerous factors can explain why some auto claims are closed without payment. In recent years, technological advances may provide an explanation, he said.
For example, an increase in digital reporting tools and mobile claims apps make it easier for policyholders to file claims, some of which may be found not to require payment, according to Friedlander.
“Insurers continue investing in predictive analytics, artificial intelligence, image recognition and data-sharing tools that identify suspicious claims earlier in the claims process,” he said. “As fraud detection improves, more questionable claims may appropriately close without payment.”
In addition, newer vehicles generate a greater volume of electronic data through data recorders, onboard diagnostics, photos and repair scans, according to Friedlander, adding that such data can lead to more accurate accident investigations.
“Better evidence can both expedite payment of valid claims and identify claims that are unsupported or unrelated to the reported accident,” he said.
The Journal’s headline, “If You Get in a Car Crash, the Risk Is Growing Your Insurance Won’t Pay, “ thus may create a misleading narrative about drivers unfairly being denied compensation, according to Friedlander.
Other reasons for denied auto claims are that the damage falls below the deductible or investigations find another party was at fault – or fraud in the form of staged accidents and exaggerated injury claims, he said.
