Insurance Journal
Wash. Woman Files Bad Faith Lawsuit Against Farmers Ins.
May 16, 2003
A Redmond, Wash. woman filed a bad faith lawsuit against Farmers Insurance
Company of Washington (Farmers) accusing the company of systematically using
a computer program called "Colossus" to provide an inaccurately low evaluation
of her severe injuries in order to artificially reduce its
settlement offer.
According to the lawsuit, Farmers used Colossus to evaluate Barbara Martin's
insurance claims arising from a serious automobile accident. As a result, the
complaint alleges, Farmers assigned an intentionally low value to Martin's
injuries and refused to pay her claim against her underinsured motorist (UIM)
coverage. An arbitrator later determined the value of Martin and her family's
damages, which included debilitating back injuries, resulting depression,
lost wages, and a diminished ability to interact with her husband, son and baby
daughter, at $377,000.
Following the arbitration, Farmers paid the UIM policy limits. This lawsuit,
filed in King County Superior Court, seeks additional damages for breach of
contract and anti-consumer practices.
The complaint alleges that Farmers bases its settlement offers on figures
provided by Colossus, effectively eliminating the ability of a human adjuster
to evaluate a comprehensive view of an insured's case. The program works when an
insurance adjuster enters data and categorical information from medical
records. Colossus then accesses a complex set of rules to decide the value of
more than 600 trauma-induced injuries. However, the program doesn't account
for intangibles, such as the lost ability to care for a child, the suit
states.
The lawsuit states that the nature of the program's data-entry and computation
features can result in artificially low settlement figures, allowing
Farmers to effectively profit from claims rather than provide reasonable
compensation to injured claimants. In addition, Farmers exacerbates the
profiteering by creating compensation incentives for employees tied to the low
settlement figures, according to the complaint.
According to the Web site of Computer Services Corporation, the maker of
Colossus, 13 of the top 20 U.S. Property and Casualty Insurers use the software
to evaluate bodily injury claims. However, insurance companies and agents do not
disclose the existence of the program, the complaint states. This is believed to
be the first case brought in the United States
specifically based on using Colossus for claims adjustment.
In April 1999, as Martin slowed for traffic on the I-90 bridge, a large SUV
rear-ended her car, slamming the vehicle across two lanes with such force that
it ripped the driver's bucket seat from the vehicle chassis. The accident left
Martin with severe injuries to her spine and neck, which cause chronic back pain
and debilitating headaches that, according to doctors, will require a lifetime
of care.
Following the accident, the negligent driver's insurance company paid Martin
$100,000, acknowledging that her damages were actually greater than the
available coverage. Farmers saw things differently, according to the complaint.
Although Martin's UIM policy provided for $100,000 in addition to what the
negligent driver covered, Farmers refused to offer anything for damages, based
on an artificially low Colossus evaluation, the suit alleges. After nearly three
years of trying unsuccessfully to obtain a fair settlement from Farmers, Martin
went through arbitration in February 2003.
The lawsuit names defendants Farmers Insurance Company of Washington, Farmers
Group, Inc., and Farmers Insurance Exchange. Farmers has yet to be served with
the lawsuit, according to Mary Flynn, Media Relations manager, and therefore is
unable to comment.