Delay, Deny, Defend: Why Insurance Companies Don't Pay Claims and What You Can Do About It

by Jay M. Feinman

Why Insurance Companies Don't Pay Claims and What You Can Do About It. An expose of insurance injustice and a plan for consumers and lawmakers to fight back. Now a paperback version of the hard-hitting original.

The denial of valid insurance claims is not occasional or accidental or the fault of a few bad employees. It's the result of an increasing and systematic focus on maximizing profits by major companies such as Allstate and State Farm.

Citing dozens of stories of victims who were unfairly denied payment, the book explains how people can be more careful when shopping for policies and what to do when pursuing a disputed claim. It also lays out a plan for the legal reforms needed to prevent future abuses.

Genres: Nonfiction, Politics, Business, History, Audiobook, Economics, Sociology

248 pages, Paperback

First published January 1, 2010

About the author

Jay M. Feinman is an expert in insurance law, torts, and contract law. The recipient of numerous teaching awards, he’s also written seven books and more than 60 scholarly articles. He is a member of the American Law Institute and other professional organizations and is an advisor to United Policyholders.

Reviews

[Calum · Rating 5 out of 5]

i aint see shit

[AJ · Rating 5 out of 5]

Bullet-proof reasonings! An eye opening read for sure.

[Kes · Rating 5 out of 5]

Read this book because it’s mentioned all over the internet from the UnitedHealthcare CEO shooting. Wow. I’m not American but it’s a cold look at how the claims process can be extremely painful and adversely affects the consumer - one could even call it systematic violence perpetuated on the consumer. So much talk about how McKinsey helped improve company profitability by reducing claims payouts. The description of lobbying efforts is poignant:

> Massive campaign contributions by the insurance industry, the power of insurance trade groups, and the multiple opportunities presented by the odd structure of insurance regulation make improving claims practices and stopping delay, deny, defend difficult. But difficult is not impossible and as awareness of the problem builds, so too will pressure for action.

Hopefully, given outcry - there will be pressure for action.

-

One point that sticks with me is the description of “insurance fraud” - specifically, “consumers acting fraudulently against the insurer” and how this issue was created by insurer lobbying. But this “issue” masks “insurers acting in bad faith (some might say fraudulently) against the consumer” (aka insurer fraud). But when the regulatory bodies tried to investigate insurer fraud, insurance companies successfully lobbied against it. So we have concrete details of alleged consumer fraud and a refusal to provide details of potential insurer fraud.

And the book also touches on a deterrence effect when insurers get to advertise on consumer fraud - if you’re a consumer and you know you would be disproportionately investigated for a small claim, you might just pay for it yourself rather than making a claim you’re legitimately entitled too. Or you might give up if you’re forced to provide pages and pages of documents - and at that stage, giving up gets labelled as a “fraudulent claim” (even if giving up was because you’re emotionally worn down - and remember, normal people only claim from insurance when they have suffered a loss and are particularly vulnerable. So this process preys on the vulnerable). So “fraudulent claim” numbers end up looking high (because they potentially include genuine claims).

[Abdennasser Alaoui · Rating 5 out of 5]

You saw him? No, you didn't.

[Ryan · Rating 5 out of 5]

I've been an independent adjuster for years. This is very accurate. Made the jump to a public adjuster this year defending the insured instead and won't ever look back🔥⚜️

[Montana Evalyn · Rating 5 out of 5]

Deny defend depose

[Janna Baza · Rating 5 out of 5]

Do you hear the people sing? Singing the songs of angry men.

[Paul Lambe · Rating 4 out of 5]

Very helpful in understanding my own car accident case, which has now gone to over 12 years without settlement.

My case has been delayed, denied and defended against.

I have read many articles, cases over the years to understand the process and their side. This book covers so many of those issues I sought to understand.

If you have to defend yourself you should know, ' three special kinds of sources that insurance companies go to great length to keep under wraps or discredit. The first are insider accounts provided by former insurance company employees who have become whistleblowers. The second is information revealed in litigation against insurance companies. And the third is the documentary evidence of the redesign of claim practices to increase profits at the expense of policyholders and victims.'

It is a pro-consumer book that can help anyone facing a claim, know what their insurance company is up to.

[C · Rating 5 out of 5]

My friend Luigi recommended this book highly and I have to say, it was pretty good.

RIP Brian Thompson, shoutout to his family

[Rivara]

They should do a reprint of this book, I have a strong feeling it would be economically lucrative. I'm sure nobody would have any ethical qualms because if it's one thing these people care about it's profitability. Do it for him, it's what the healthcare CEOs would want!

[Coffee]

What a random time to read this random book!

[Teju A · Rating 5 out of 5]

Conclusion, insurance sucks!!!!!!!

[Wilson Tun · Rating 5 out of 5]

I started reading this book after the CEO incident (Luigi is innocent btw) that was publicized all around the world. No wonder the anger boiled out to this climax when the insurance companies, which are supposed to be guardians of the people, are working against the people solely for their own profits.

Although I naively hope for reforms in the legislatures to crack down on these monopolies inflicting cruelty upon the people, it has almost zero chance since the politicians are in the same pockets as those companies, feeding upon the blood-soaked money like parasites.

Maybe one day, there will be a chance.

[donna backshall · Rating 5 out of 5]

Simply an amazing and eye-opening exposé of the bastardization of the insurance industry. I knew this book was going to make me very angry, but I needed to know. Now I do, and yes, I'm furious. Informed, but furious. I'm so glad I got the audiobook version, because a hardcopy would have been thrown across the room multiple times.

In Delay, Deny, Defend: Why Insurance Companies Don't Pay Claims and What You Can Do About It, Feinman shows us the humble beginnings of insurance some 300 years ago in "contributorships", where a group of people would create a fund to serve the community should a catastrophe happen that affects and might overwhelm them all. He then walks us through the changes that happened over the decades and and centuries, where fatefully everyone's least favorite consulting company, The McKinsey Group, showed insurers that it shouldn't be about the insured, it should be about MAKING ALL THE MONEY. That's where it all went bad, really really bad. Some might even call it corrupt.

Now we're required to have all these policies that, by design, are never going to cover what is intended, thanks to McKinsey's manipulations. People cringe at the idea of putting in an insurance claim, because no one wants to endure the inevitable fight for what should be readily provided. Huge computer systems are created to "evaluate" claims and protect the insurance company's interests, never the insured. It's infuriating to hear how complex the system is and how impossible they've made it for the Everyman to simply survive a catastrophe by using their insurance. (Originally published in 2010, this book does not cover recent AI additions to slimy corporate tactics, but here's hoping for a 15-year update in the works to understand just how much worse things have gotten in the age of AI.)

The bottom line is that, the spirit of a contributorship has been lost to corporate greed. Despite regulations to prevent bad faith treatment of the claimants, insurance agencies have become FOR PROFIT companies whose focus has moved from ensuring protection of the insured to unadulterated greed, plain and simple. Literally anyone who's had to make an insurance claim -- medical, household, car -- knows at best they will get lowballed, and at worst has to prepare to fight in court, perhaps for years, for the coverage they have in good faith been paying for.

With all the political uproar going on in the world today, I find it oddly comforting that the tactics of Delay, Deny, Defend: Why Insurance Companies Don't Pay Claims and What You Can Do About It are one thing we all seem to agree are offensive and unethical. United in our hatred of the wrongdoings, one might say. For that reason, I do believe this is one book everyone should read, and soon.

[Erik Burke · Rating 3 out of 5]

It's no secret I decided to read this because Luigi Mangione read this and rated it two stars. After finishing it, I can see why HE of all people rated it that way, because at the end of the day Feinman advocates for keeping the private insurance system that the United States currently has despite all of the problems he resoundingly dissects for over 200 pages. Feinman, even with all of his insights, really offers no other solution than "lawyer up and force the government to regulate the insurance industry."

The problem with the insurance industry is that it's a scam. The promise of peace of mind is far outweighed by the fact that insurance companies are motivated solely by profit, with no repercussions or incentives to act in the best interest of their policy holders. Health insurance in particular suffers from inelastic demand, and the United States is worse off for not having Universal Healthcare. There are more health industry lobbyists than there are members of Congress, and almost all of our elected officials take some form of funding from these predatory agencies. If an insurance company illegally denies your claim, do you think that your elected official is going to protect you? Or are they going to protect the company that pays for their campaign bills?

Modern insurance as we know it today began in the 1600s with Contributionships, in which local governments would collect funds from neighborhoods that were then lock-boxed for that neighborhood only. Everyone paid a little, so that way, if one of their neighbors houses burned down, there would be funds for that person to use in order to rebuild their life. Contributionships slowly evolved into modern, privatized insurance because Contributionships weren't great when it came to widespread catastrophes, like earthquakes and hurricanes, but insurance companies used to have more of a level playing field with their policyholders because claims adjusters used to be privatized in and of themselves, and the government was a lot stricter when it came to fleecing policyholders. Then, the insurance companies bought up all of the adjusters and internalized them, started investing the float of pooled funds in order to turn a bigger profit, spent untold hundreds of millions buying out the government, bought out doctors in order to deny claims, and then developed this idea of "Delay, Deny, Defend."

Delay, deny, defend: Delay investigating a claim for as long as legally possible, deny the claim, and then vigorously defend that claim in court. Feinman does an excellent job at breaking down the logistics of this tactic, examining several court cases in which this tactic was the crux of the case, and then explains how the insurance companies will be forced to ante up a massive payout, and then they continue using this tactic because it works. They love stringing policy holders along as long as they can in the hopes that their financial situation will become so dire that they will accept a lowball offer.

I think I give this book three stars not because I disagree with it, but because the ending is so anticlimactic. Why did Feinman write this? To shed the spotlight on it? If so, he accomplishes that goal with flying colors, but why add the "And What You Can Do About It" subtitle?

I don't think it's a secret that Americans hate their systems of insurance. Health insurance in particular. So many people are afraid of going to the doctor, not because they are scared of needles or surgery, but because they are scared they will go into debt for the rest of their lives. Not one person I have ever met, be they rich, poor, young, old, black, white, gay, or straight LIKES their health insurance. We hate health insurance so much that our society is willing to commit murder in the open, Then, corporate controlled media and law enforcement make a spectacle out of finding the alleged assassin because they want to set an example, but then are confused as to why everyone hates insurance.

We as a culture need to remove profit motive from health insurance. It should be free. No one in America should ever have to pay a dime for it outside of their taxes. We've become so materialistic, individualistic, and obsessed with money that we value driving profits more than helping people in need. All avenues of change seem to be cut off, so it's no wonder so many Americans love Luigi. If I had a magic wand, I'd give us Universal Healthcare and watch how much better our lives get. The real kicker is, private insurance costs America MORE than Universal Healthcare would! And these insurance companies love to talk about how their profit margins are only 4% to 6%, but that percentage comes out to TENS OF BILLIONS of dollars into these companies pockets!

This is an enthralling read, but a frustrating one. It definitely opened my eyes. Free Luigi.

[Brenda Greene · Rating 3 out of 5]

Having experienced a large scale disaster and a protracted insurance settlement following the New Zealand Christchurch earthquakes (4 years to repair our home and 11 years to settle our land claim: see my book "You can't rush an earthquake: repair, rebuild, repeat", it certainly FELT, at times, that a lot of what this book says was true.
Insurance companies are not obliged to document what was damaged and the onus is on the claimant to demonstrate the value and extent of damage. When the claim is large, this takes a long time. To say that it disrupts your life is an understatement.
Following a large scale disaster, determining timeliness is and what is fair and reasonable becomes a matter of opinion and negotiation. In my experience, everything is negotiable, and dependent on case by case. This makes it very tricky to fight insurers. They employ the best lawyers and appear to take on people whom they know do not have the financial capital (or intellectual capital) to go to court.
It was absolutely true that more complex claims were left until last.
The absolute need for experienced builders and project managers and their roles and responsibilities is not really addressed in the book. Insurance companies are dependent on their expertise. Therefore where roles and responsibilities lie also becomes an issue. Insurers will deny responsibility as it is in their interests to do so and, from a legal perspective, it is again up to the claimant to prove them wrong.
Insurers know that costs escalate following disasters - by 40% or more, and cash settlements may include a nod to this (typically 20% on top of the settlement), but settlements themselves are often only 60% of what is due to claimants.
There is a reason why insurance companies gain from large scale disasters.
Good on Jay for writing this book.

[Sam Wescott · Rating 4 out of 5]

Not going to deny that I picked this book up after the UHC CEO shooting and probably wouldn't have read it otherwise. Only about 15-20% of my reading is non-fiction and I usually don't go for books that seem like they are going to tell me things I already know. Maybe it's the cynicism of a progressive leftist reading a book written about insurance 15 years ago, but I already knew that profit-motives drive companies to abuse their customers in whatever ways they can and it makes sense that insurance companies in particular would have a variety of cruel ways to do this with no repercussions.

And I was right. This book was infuriating. I gave it the four stars that I did because it nailed the "why insurance companies don't pay claims" part of the subtitle so thoroughly. It would have become repetitive if it wasn't so completely outrageous and offensive every time. The author was dogged in his layering of evidence, anecdotes, explanations, and accusations. It was quite the crusade and I do have admiration for it.

However, the "and what you can do about it" part of the subtitle is ultimately what fell short. I had my suspicions throughout the book that this author and I were going to come to different conclusions about what solutions to suggest and I was eventually proven right. While I don't think the author is necessarily wrong in suggesting that consumer protections, strict regulations, and wider awareness could have mitigating effects, I also have to note that he also mentioned that insurance is already one of the most heavily regulated industries and that is clearly not preventing the abuse. At some point I think we have to realize that you can't regulate businessmen and shareholders into having souls and some markets (going gentle here) maybe shouldn't be structured in a way to let profit motive call the shots.

To focus on the book (people smarter than me have bigger, more radical ideas here and braver people than me have had more radical actions very recently), the suggestions at the end feel like a let down after the first 90% of the book whips you up into such an indignant frenzy. You simply can't spend that much time hammering home that this abuse is intentional, systemic, and purposefully cruel and then tell me to get really good at reading insurance policies and probably be ready to hire a lawyer. That's not a satisfactory answer and that makes it a pretty lackluster conclusion to a book. I wish the author had been a little braver and little more creative in imagining a better system than this.

Anyway.

Not a great book to read when you have coverage from both Allstate and UHC.

I'm also just now realizing that this book barely even touches on health insurance. It's pretty much exclusively home and auto with a few mentions of life insurance. That feels odd, but health insurance and the US healthcare system is such a bigger festering quagmire that I can't really blame him.

Four stars. Thanks for the information and confirmation. I am, once again, furious.

[Kai · Rating 5 out of 5]

Feinman delivers a searing critique of the U.S. insurance industry, exposing how insurers often prioritize profits over policyholders. The book explores the tactics insurance companies use to avoid paying legitimate claims, from deliberately delaying payouts to outright denying coverage and aggressively defending lawsuits. Feinman highlights how these practices exploit customers, leaving many vulnerable during moments of crisis, such as after accidents, natural disasters, or medical emergencies.

One of the book's strengths is its ability to break down complex insurance policies and legal frameworks in a way that is accessible to readers. Feinman combines in-depth research with real-world examples to reveal how systemic issues in the industry harm ordinary people. Particularly compelling are his insights into how deregulation and corporate consolidation have worsened these problems over time.

Feinman also provides actionable advice for consumers, such as tips on understanding policies, navigating claims processes, and advocating for fair treatment. While the book’s tone is critical, it empowers readers to be more informed and proactive in their dealings with insurers.

Delay, Deny, Defend is a must-read for anyone seeking to understand the inner workings of the insurance industry or protect themselves from predatory practices. Feinman’s well-researched arguments and consumer-focused advice make this both an eye-opener and a practical guide.

[mahnoor]

obviously exposes horrifying realities, but there's nothing even a little radical here.

extremely detailed - almost too much at times if you're only looking for a broader overview of reasons + solutions - but it's admirable that the author cares and put in this much effort. the depth of research done is evident. it's basically a case study of the health insurance industry but interestingly, it focuses heavily on all state as kind of leading the exploitation with mentions of several others who either followed or added to the race to the bottom in other ways.

a lot of numbers and specific real life examples of people and how their cases turned out. discussion of specific policies, how exactly companies rely on technicalities in defining them to get away with not paying, poor or no documentation when it's in their favor, how companies benefit from most documents being sealed and it being difficult for those in the legal system to find anything for precedence, pressuring employees by verbally encouraging unethical ways of reducing claims paid while maintaining more fair positions on paper and key strategies in the last few decades that showed declining profits for companies that didn't adapt to these pioneering n much more greedy ways. some info on evolving finance practices was also particularly eye-opening, though a little too technical and dry (my accounting classes came thru for me but i can imagine people just kinda giving up at this part.. too many ratios and whatnot) and required multiple reads. surprisingly little mention of the company we assumed would at least be mentioned though lol

it's sad that the use of technology is so embedded in their claims processing that pretty much most, if not all, employees in this industry from top to bottom can claim a lack of enough agency when it comes to responsibility because well that's what the system said and the system has knowledge of all claims we've processed and that's the most perfect number because DATA

overall: everyone knows about how insurance companies skirt their responsibilities and some of the bigger, more obvious why's (ppl can't afford lawyers, contracts designed to be difficult to comprehend by laymen, customers not knowing their options after denial etc.) but it was interesting to read about specific policies and terms applied to how they define risk and contracts that let them get away w a lot. my understanding is that the title is a reference to an abbreviation that's already part of the jargon within these companies and is not an original title. soooo this book is not relevant to current events esp. considering no mention of the key player + it literally says it focuses on property and auto insurance. any mention of health is also within those contexts like spinal injury as a result of a car accident

[Cheryl Durham · Rating 4 out of 5]

Let me start by saying this is not a book I would normally read. I selected this book because of my desire to broaden my students horizons. I am glad that I chose this book. Feinman gives you a view into an industry that few truly know about. Nevertheless, at one time or another we will all find ourselves needing these services.

Let me say that I have never had a bad experience with the insurance industry but I have heard others speak of the challenges they've encountered. I learned a great deal from reading this book. Namely, I had no idea that when it came to paying claims there was a point system to determine how in need the clients may be for the money (maybe that helps rule out the possibility of fraud). I'd like to think that if the premiums are current the delay would be minimum. I would also like to think that during a very challenging time... a client wouldn't have to defend what's rightfully theirs or be otherwise denied. In some clear cases mentioned that was not the case.

Secondly, with as much change that occurs, this is one industry that has yet to be restructured or overhauled. Thirdly, based on reports and the limited payouts from big name companies there appears to be the need for better controls and oversight. Feinman presents a great perspective. This, too, seems like a viable field (actuaries, fraud investigation and insurance agents and regulations) for new graduates to consider. I would also encourage every policyholders to track, document and inquire at every turn(from the time they consider selecting a company and a policy to the time of their call about payouts). Also, check out a Company's history by researching and talking to others. Lastly, if you feel you are getting the runaround do not hesitate to ask to speak to the Supervisor and by all means log calls with the Better Business Bureau. Note: Keep in mind that my views are based on Feinman's content. He may have had an axe to grind. He also may be sharing a view that needed to be read.

[James Spruell · Rating 4 out of 5]

Jay Feinman's book was an interesting read and included a great many anecdotal stories to support his premise. He points out how significant shifts in the insurance industry has impacted the payment of insurance claims. In particular, the change in claim centers to profit centers and the setting of employee evaluation review criteria to company centric (vs customer centric) was discussed significantly.

His use of specific individual names whether disguised or otherwise made me wonder how many law suits he potentially opened up. That aside, the book presented an interesting perspective on this side of the industry.

[Lara Brown · Rating 4 out of 5]

[that one astronaut meme] “Wait it’s all McKinsey?” Always has been.

[Jasmine Hosein · Rating 5 out of 5]

This was a totally chill book and I feel no way about it at all.

[Sonja Warner · Rating 3 out of 5]

I read this book because I work in the auto collision repair industry and we deal with many insurance companies, but it turned out to be a lot more interesting than I expected. Informative and educational, this is helpful reading for all policy-holders.

[elum · Rating 5 out of 5]

Free my guy Luigi Mangione

[Aaron · Rating 4 out of 5]

This book isn’t quite the incendiary manifesto you probably think it is; but the systemic abuses and greed it outlines, in surprisingly restrained prose, are no less shocking for that.

Yes, like 98% of Americans I am only aware of this book for the same reason you are. The news. I wasn’t quite sure what to expect, a manifesto? Muckraking journalism? A corporate expose à la The Big Short? The answer, it turns out, is none of the above and yet somehow more than I bargained for.

The tone and style of this book is about as radical as a quarterly corporate memo, but the subject matter is the stuff of middle class America’s nightmares. The author details with excruciating precision the trends and practices that, since the 90’s, have made not paying out insurance claims a default matter of industry policy. The book makes use of specific examples like All State and Farmers, but also points out the national spread of these practices. Despite its relative brevity, this book is dense and there genuinely is too much to even summarize here. To give you an idea, here are a few topics covered in these chapters.

Insurance companies waiting out or legally harassing claimants, sometimes for years, until they settle for less than they’re owed. The industry wide practice of replacing experienced human insurance adjusters with biased computer programs primed to benefit the company over the policyholder. Denying coverage based on arcane, disingenuous or blatantly absurd interpretations of policies and the facts of the case (seriously, the chapter on hurricane Katrina will absolutely make your blood boil). These are just a few of the many ways the insurance industry as a whole has gotten harder to navigate, more predatory, and in a word, worse for the consumer.

Always informative, occasionally overwhelming, Delay, Deny, Defend describes in aggregate and in individual cases, abject human suffering with all the reserve of an office email thread. The effect is at times jarring but I can understand the reasoning behind it and it’s still an infuriating, emotional, book for all its civility. Everyone affected by insurance of some kind (and that is to say, basically everyone) owes it to themselves to read this and other books like it.

[Sparkles Fantastic · Rating 4 out of 5]

4.5--This book was very informative. I fucking hate capitalism and now I'm kind of having issues not spiraling down into "drepressy Jessy" and rotting in my bed for the rest of the weekend. Hmm. So. There's your TW if you need them.

[emily · Rating 5 out of 5]

some of my favorite quotes:

“In the defense view, whiplash was not a physical response to crashes but either a psychological response as a result of the publicity about such injuries— ‘accident victim syndrome’ was one name— or was outright fraud: ‘compensationitis,’ which, as was said, was a pain in the neck that lasted until litigation had ended.” (Feinman 95)

“In MIST cases [minor injury soft tissue injuries like whiplash] medical expenses, lost income, and noneconomic losses are, as litigated personal injury cases go, relatively modest, usually in the thousands of dollars, but not in the tens or hundreds of thousands of dollars that justify major lawsuits. And that is exactly the point. By treating a minor case as if it is a major one the company makes it difficult or impossible for the victim to find an attorney willing to take the case.” (Feinman 98)

“The physician was instructed to address whether the accident caused the injury ‘Only in the negative’ (underlined twice). that is, the insurance company was only looking for an opinion that the accident had not caused the injury; any other conclusion was not welcome.” (Feinman 112)

“David Teasdale, the Haag engineer, admitted that 80 percent to 90 percent of his work consisted of investigations for insurance companies, and that he knew the companies would have to pay for damages caused by leaking plumbing…In only two incidents had Haag found that a leak contributed to foundation movement, and the Haag engineers who worked on those cases never worked on another slab foundation case again.” (Feinman 128)

“[The CA insurance commissioner] also reviewed 79 claims that policyholders had been forced to litigate to seek payment and found 418 violations [by the insurance companies], an average of 5 per claim.” (Feinman 163)

“Suspected fraud is defined broadly to include any claim in which there is ‘reason to believe’ that a claim may be fraudulent; to make it easier for companies to report, they are given special immunity from criminal prosecution and lawsuits by policyholders who are falsely accused of fraud.” (Feinman 177)

“First, most of the adopted claims practices statutes state that a company can be punished only if it violates the rules ‘with such frequency as to indicate a general business practice.’ That is a bizarre qualification, like saying that a criminal’s first offense is free and only repeat offenders or members of the Mafia should be punished.” (Feinman 218)

a little bit of what i gleaned from this book:

mckinsey is the root of all evil. the inflection point between when insurance adjusters were incentivized to properly evaluate dollar values of claims (consumer advocate) to when they became a profit optimization center (shareholder advocate) was mckinsey’s foray into the industry. by identifying claims payouts as the insurance company’s main expense (duh) and other COGS as negligible in comparison, they implemented the computerized system Colossus among others to standardize this process and intentionally lowball customers. they do this by identifying and grouping “severity points,” or causes for compensation such as water damage, bone fractures, etc., and assigning dollar values to each of these (typically way under market value) and binding insurance adjusters to the numbers (as a ceiling, but never as a floor). adjusters are then incentivized to settle the claim with as little money as possible, most times undercutting even the egregious underestimate of these computer programs.

this is exacerbated by the fact that the “experts” insurance companies hire to settle extreme claims are often only promised repeat business if they settle to the insurance company’s satisfaction. along with collusion with government officials who were former insurance company executives now lobbying for the industry to have even less regulation and having only statutes favorable to insurers approved, the insurance industry has provided itself with airtight padding to any sorts of repercussions. the icing on the cake is the insurance company’s PR campaigns to paint those insured as the aggressors, with ads depicting parents dropping their kids off to school only for their kid to get bullied because of their parents’ fraudulent insurance claims. reminds me of noam chomsky’s assertion in fateful triangle that when all else fails, accuse your enemy of the actions you’ve undertaken.

[Eye · Rating 4 out of 5]

obviously exposes horrifying realities, but there's nothing even a little radical here.

extremely detailed - almost too much at times if you're only looking for a broader overview of reasons + solutions - but it's admirable that the author cares and put in this much effort. the depth of research done is evident. it's basically a case study of the health insurance industry but interestingly, it focuses heavily on all state as kind of leading the exploitation with mentions of several others who either followed or added to the race to the bottom in other ways.

a lot of numbers and specific real life examples of people and how their cases turned out. discussion of specific policies, how exactly companies rely on technicalities in defining them to get away with not paying, poor or no documentation when it's in their favor, how companies benefit from most documents being sealed and it being difficult for those in the legal system to find anything for precedence, pressuring employees by verbally encouraging unethical ways of reducing claims paid while maintaining more fair positions on paper and key strategies in the last few decades that showed declining profits for companies that didn't adapt to these pioneering n much more greedy ways. some info on evolving finance practices was also particularly eye-opening, though a little too technical and dry (my accounting classes came thru for me but i can imagine people just kinda giving up at this part.. too many ratios and whatnot) and required multiple reads. surprisingly little mention of the company we assumed would at least be mentioned though lol

it's sad that the use of technology is so embedded in their claims processing that pretty much most, if not all, employees in this industry from top to bottom can claim a lack of enough agency when it comes to responsibility because well that's what the system said and the system has knowledge of all claims we've processed and that's the most perfect number because DATA

overall: everyone knows about how insurance companies skirt their responsibilities and some of the bigger, more obvious why's (ppl can't afford lawyers, contracts designed to be difficult to comprehend by laymen, customers not knowing their options after denial etc.) but it was interesting to read about specific policies and terms applied to how they define risk and contracts that let them get away w a lot. my understanding is that the title is a reference to an abbreviation that's already part of the jargon within these companies and is not an original title. soooo this book is not relevant to current events esp. considering no mention of the key player + it literally says it focuses on property and auto insurance. any mention of health is also within those contexts like spinal injury as a result of a car accident

[Ben · Rating 4 out of 5]

Delay, Deny, Defend: Why Insurance Companies Don't Pay Claims and What You Can Do About It

This book is as upsetting as it is empowering.

Feinman pulls back the curtain on the shady tactics insurance companies use to avoid paying claims, revealing a system designed to protect profits over people.

Reading this in the wake of the California fires was particularly enraging, as it highlights how these companies often exploit legal loopholes to evade payouts when people need help the most.

Feinman doesn’t just expose the corruption—he arms readers with practical strategies to fight back.
From understanding your rights to knowing when to lawyer up, this book is packed with actionable advice on holding insurers accountable.

I especially appreciated the real-world case studies of major wins and devastating losses.

These stories show the background of these legal battles, showing just how high the stakes can be.

I have a soft spot for books that inspire people to stand up against injustice and greed, and this one delivered.
This book is a prime example of consumer empowerment and a powerful protest against corporate corruption.

If you want to be prepared before disaster strikes—or if you're currently fighting with an insurance company—this is essential reading.

Highly recommended.

4.7/5