A Deep Dive into Insurance Claims: Insights from Chip Merlin’s Interview with Steven Bush

In the latest episode of Claim Game, I sat down with Steven Bush to dissect the state of insurance claims handling, particularly following major catastrophes like hurricanes or wildfires. This conversation offers a revealing look at how the claims process is evolving and, in many cases, not for the better when it comes to policyholders’ interests. Steven Bush’s background as a restoration contractor, public adjuster, and now policyholder attorney positions him to speak both to industry trends and to the human impact of system failures.

Systemic Issues in the Insurance Claims Process

The heart of the discussion centers on how many insurance companies have increasingly found ways to minimize or deny legitimate payments to policyholders. The interview highlights tactics insurers use, such as systematically modifying or disregarding field adjuster reports to reduce settlements. Bush outlines cases where field estimates were slashed or replaced entirely by “desk adjusters,” effectively rendering the field professionals assigned to investigate and adjust facts of the claim powerless to advocate for fair compensation. This trend, he argues, transforms adjusters into mere data collectors, undermining their expertise, knowledge and accuracy of the claims process.

The Role of Whistleblowers and Media Exposure

A critical portion of the interview discusses the efforts of whistleblowers who come forward to expose questionable industry practices. Bush notes the high personal and professional risks these individuals face and the significant vetting required before the media or legislators act on their stories. Yet, such exposure, ranging from national TV segments to legislative hearings, remains a crucial check on the insurance industry’s claims handling misconduct. The conversation points out that current effective genuine reform often hinges on the willingness of insiders to break their silence.

Manipulation of Engineering Reports

Bush also draws attention to the growing problem of engineering reports being used as tools to minimize payouts. He observes that many recent policyholder complaints center around engineer documents that are misapplied, factually incorrect, or even appear to have been written about the wrong property. This misuse not only erodes trust but also directly impacts the financial recovery of families and businesses after disaster strikes.

Ethics, Advocacy, and the Need for Reform

A recurring theme in the interview is the erosion of ethical standards within claims handling. Bush, with a lot of comments from me, argued that what ought to be a fair and good faith process has grown increasingly adversarial. From our view, many insurance companies’ priorities have shifted toward limiting financial exposure at the expense of policyholders’ well-being. In this current environment, Bush advocated and emphasized the importance of policyholders asking tough questions and seeking outside help if they suspect their claim is being mishandled.

Barriers to Change in Florida and Beyond

Since the whistleblowers who have been highlighted were primarily discussing Florida claims, the interview takes a close look at the unique challenges facing policyholders in Florida. Bush is candid in his assertion that legislative and regulatory bodies have generally failed to create meaningful remedies protecting policyholders, and that recent political dynamics have further emboldened insurers while narrowing policyholders’ legal options. The lack of robust oversight, according to Bush, contributes to the normalization of questionable conduct across the industry. He frankly indicated that he did not think any meaningful policyholder protections would be passed legislatively as long as Governor DeSantis is in office.

Personal Risks for Advocates and a Call to Action

Bush shares personal anecdotes, including facing threats and targeted investigations. He emphasizes the future employment stakes for those who choose to speak out. Despite these risks, he maintains that collective action by whistleblowers, policyholders, and legal advocates remains the most effective path toward restoring integrity to insurance claims. Bush ends the discussion with an appeal for more transparency and courage from industry professionals, as well as the general public, to bring about long-overdue reforms.

My conversation with Steven Bush shines a spotlight on troubling trends in the insurance industry’s handling of claims and the impact on ordinary policyholders. It is both a warning against growing complacency and a rallying cry for increased scrutiny, media involvement, and legislative change. As the claims handling system becomes more complex and, at times, more adversarial, informed and empowered policyholders, along with steadfast advocates, will be critical to safeguarding the rights of those who need insurance protection most.

Here is a link to the discussion.

Thought For The Day  

“If you see something that is not right, not fair, not just, you have a moral obligation to do something about it.”
— John Lewis