Most problems are not the insurance company's fault. Most of them can be lumped under the category of "a general public who has no idea what insurance is or how it works". And I'm not being a smart-alec, heck I wouldn't know either except I do it for a living. I work for a smaller insurance company in the grand scheme of things, but even we have a few hundred thousand clients, millions of policies, and tens of millions of transactions. "Stuff" happens, you cannot transact that much business and be absolutely pinpoint perfect with every detail of it. And again, we're a smallish "regional" company who's employees actually work for us (many national brands hire independent inspectors and adjusters who may live hours from you and know NOTHING about your specifics), our employees live in your communities, go to church with you, know you personally, and still we screw stuff up. No excuses, just an explanation. The scope of the business is exceedingly bigger than you understand.
I meet with clients every day, many who are aged adults who've had insurance their whole lives, and very few / if any know what any of the numbers mean, what is / isn't covered, and just in general have a very skewed idea about what insurance even is. Most have this mental picture of a maintenance plan that should cover any conceivable loss, regardless of fault or logic. The majority of people don't even know what a deductible is. Seriously, I'm not joking. Insurance policies are named peril typically (meaning they literally tell you it only covers the following causes of loss), but even the most comprehensive policies only cover "sudden and accidental physical damage". 99.999% of the things you think an insurance company is screwing you about is because what REALLY caused your loss wasn't listed as a covered peril, and/or wasn't sudden and accidental. And NO, NO, NO, NO, they don't purposefully write limitations into the policy to screw you, they write them into the policy because claimants constantly, constantly, constantly, try to file claims on "ambiguous" causes of loss. Most of the policy language comes from trying to be legally precise defining the named perils. Such as "rot". Rot isn't covered, how on earth can rot be "sudden and accidental"? Well, did your plumbing leak? Yes. Okay, was it a workmanship issue? (not covered, THAT'S the contractor's responsibility) Was it just because it got old? (that's normal wear and tear, it's not a maintenance policy) Was it because it froze and busted? Okay, THAT is covered. They are just trying to determine what was the original cause of loss, not trying to find any way possible NOT to pay it. It's a proper understanding of what insurance is and how it works. Insurance should frankly be "catastrophic", but we claim every problem that occurs no matter how big or small.
You cannot find a sympathetic jury to an insurance company, so your notion that lawsuits prove they were screwing you is preposterous. I'll try to make this short... Several years back a lady caused a wreck on I-65. She had "full coverage" on her car (I put that in quotes for a reason, I'll come back to it). She had liability limits of $25,000 / $50,000 / $25,000.....this means if she was at-fault in a wreck, her policy would cover up to $25,000 per person for medical injuries / not to exceed $50,000 for medical injuries total for that wreck / and then up to $25,000 for property damage. (incidentally, this is the state minimum requirements, and probably the most common limits people carry because they "want the cheapest thing I can get", and/or because it's what freakin' Progressive and GEICO quote so they can look cheaper than who you have now) She had comprehensive and collision coverage (this is the "full coverage" part) with $1,000 deductibles. (For what it's worth, this was with State Farm) I do not remember the exact details, but as the story goes she somehow caused a car hauler to overturn, some cars got over the concrete median into oncoming traffic, and they also knocked down some type of big digital scrolling marquee across the interstate. Um, approx. $3 million total damages including fatalities. 3 MILLION!!!!!, and she had $25K/$50K/$25K
So State Farm pays out the full limits of her policy, pats her on the butt and wishes her luck. She sues State Farm because she was told by her agent that she has FULL COVERAGE, (her words) meaning any wreck she has is fully covered!!!! Daheck??? You can't find a sympathetic jury to an insurance company, remember? They sided with her, State Farm was to pay $3MIL (not sure where the story went from there). It's just like liberals who hate rich folks. State Farm has BILLIONS of dollars, they should've practiced "good customer service" and paid that claim, right? Why?...because they were contractually in the wrong, or because the public views insurance companies the same way liberals view rich folks? That story, even if in an unusually grand way, illustrates what we deal with every, freakin, day, nonstop, but we're the bad guys.
