MAY
1, 2006
LEGAL AFFAIRS
Business
Week:
In Tough Hands At Allstate
It's fighting accusations that its methods deny policyholders legitimate
benefits
David Berardinelli is something of a bon vivant. The Santa Fe (N.M.) plaintiffs'
lawyer collects fine wine, has chefs from local restaurants over to cook in his
home, and restores classic Porsches. He's also about to become a published
author.
His book, From Good Hands to Boxing Gloves,
won't burn up the best-seller lists. But it's already making waves. It tells
the story of the key role played by management consultant McKinsey & Co.
in reengineering auto insurance claims operations at Allstate Corp. (ALL
) -- and it's a story Allstate doesn't want told.
In February, a
What is it that Allstate so badly wants to keep under wraps? In a written
response to BusinessWeek, the
insurer says the McKinsey material contains proprietary business secrets. The
documents also present a clear risk to the company's reputation. The title of
Berardinelli's book is drawn from a McKinsey slide that suggests that Allstate
should treat some of its claimants with "boxing gloves," rather than
with its trademark "good hands." Collectively, the documents present
a portrait of business strategies that are at odds with the insurer's
carefully cultivated public image. Rather than simply rushing to the scene of
an accident and doling out cash, Allstate deploys a variety of systems set in
place by McKinsey to make sure it pays the minimum necessary -- and it plays
hardball with those who seek more.
Berardinelli, 57, has provided BusinessWeek
an exclusive copy of a draft of the book, as well as more than 200 typed pages
of notes he took on the McKinsey slides. His tale illuminates the largely
hidden role McKinsey has played as a key architect of claims practices in use
across the insurance industry today. In addition to advising Allstate,
McKinsey has also done work for Farmers Insurance Group, USAA, State Farm, and
Fireman's Fund (AZ
). While many of the cost-reduction strategies McKinsey recommended at
Allstate remain in place, some have been reined in following legal and
regulatory challenges in several states.
EPIC WAR
Berardinelli's book is certainly a partisan one, written to support "bad
faith" lawsuits that he and other attorneys have filed against Allstate
alleging mistreatment of policyholders. He says that the McKinsey project,
which lasted from 1992 until at least 1997, institutionalized aggressive
practices aimed at enriching investors at the expense of customers. "When
you strip away all the fancy jargon, all this is a plan for switching money
from the policyholders' pockets to the shareholders' pockets," he
maintains. In the decade after Allstate instituted the McKinsey program in
1995, the amount of money it paid out per premium dollar in car accident cases
declined from about 63 cents to 47 cents, according to A.M. Best.
Mckinsey declined to comment, citing client confidentiality. But Allstate says
Berardinelli's allegations are "unfounded and unproven." Rather than
trying to cheat customers, the company says, its claims revamp was just good
management: an effort to "become the premier claim organization in the
industry." A major goal, it says, was to benefit policyholders by
identifying "exaggerated and fraudulent claims." In its written
response, Allstate further said its "processes are absolutely sound"
and that its goal is "to investigate, evaluate, and promptly resolve each
claim fairly, based on the merits."
The battle over the McKinsey documents is just the latest round in an epic,
decades-long war between insurers and the plaintiffs' bar over access to one
of the biggest treasure troves of cash ever created: the billions of dollars
in premiums held by insurers to pay claims. For years, each side has cast the
other as evil incarnate. In the early 1990s, when Allstate retained McKinsey,
there was a widespread sense among insurers that they were paying too many
illegitimate automobile-accident claims and that an aggressive plaintiffs'
bar, fueled by a wave of newly allowed attorney advertising, bore much of the
blame. One focus of the program McKinsey introduced at Allstate, called Claim
Core Process Redesign (CCPR), was aimed at striking a blow at that trend.
But plaintiffs' attorneys around the country allege that various elements of
CCPR go beyond eliminating fraudulent claims and operate in a systematic way
to deny policyholders legitimate benefits. Copies of Allstate's massively
thick CCPR manuals have been circulating among trial lawyers for years.
Although plaintiffs have had piecemeal success in bad-faith cases against
Allstate, the insurer points to seven court rulings that have rejected attacks
on CCPR. Last December a
Berardinelli is convinced that the McKinsey material could turn the tide. The
documents "explain why McKinsey built CCPR," he says. In his book he
compares Allstate to a vendor of canned peas and argues that the documents
"show how McKinsey...deliberately designed Allstate's claim factory to
arbitrarily 'underfill' every can of Allstate insurance."
He begins his story in 1992, when, Berardinelli believes, McKinsey made its
initial presentations on the Allstate project. (Allstate confirms that it
retained McKinsey in the early 1990s.) Berardinelli's notes on the McKinsey
slides, which he has filed in court, show that the consultants' goals were
far-reaching. The objective, according to notes on one slide, was to
"radically alter our whole approach to the business of claims." The
consultants also advised the insurer on what steps were needed to achieve
those ambitious goals.
Just why Allstate brought in McKinsey at that time isn't clear. But
Berardinelli notes that in 1993, Allstate's then owner, Sears Roebuck &
Co., spun off 20% of the insurer to the public and distributed the rest of the
Allstate stock to Sears shareholders two years later. Freed of their ties to
the large and struggling retailer, Allstate executives could now connect their
personal financial fortunes directly to improvements in the insurer's bottom
line. Jerry D. Choate was president of Allstate's personal property and
casualty operations when McKinsey was retained, and the notes on several
McKinsey slides list him as a participant in the project. Choate went on to
serve as Allstate's chairman and chief executive from 1995 through 1998. By
the end of 1997 he had accumulated shares worth tens of millions. He could not
be reached for comment.
Allstate's "gross opportunity" if McKinsey's plan were fully
implemented, according to Berardinelli's notes on one slide, was $550 million
to $600 million in savings, almost all of which would come from reducing
claims payments, not from cutting expenses. The consultants then targeted
several areas as presenting the greatest opportunity for reductions. Fraud was
one, with one slide stating that "it may exist in approximately 11
percent of current claim volume," according to Berardinelli's notes.
DRY SPIGOT
Another major focus was on "subjective" injuries, meaning claims for
such things as emotional distress and pain and suffering, as opposed to
"objective" injuries, such as broken limbs. To get a handle on these
claims, the notes on the slides show, McKinsey worked with Allstate to install
Colossus, a computerized claim-evaluation system sold by Computer Sciences
Corp. (CSC
) Colossus compares a claimant's injuries with a database of similar cases and
recommends a settlement range. Plaintiffs' attorneys have alleged that
insurers can "tune" Colossus to consistently spit out lowball
offers.
Berardinelli's notes show one McKinsey slide stating that the system has been
"extremely successful in reducing severities with reductions in the range
of 20% for Colossus-evaluated claims." ("Severities" is
insurance industry jargon referring to the size of claim payments.) In its
written response to BusinessWeek,
Allstate says that "Colossus is merely a tool used to assist in the
valuation" of some bodily injury claims and that adjusters use their
expertise to come up with appropriate settlements "on each individual
claim."
One of the key elements of McKinsey's plan was reducing the number of
claimants who turn to attorneys after an accident for help in collecting on
their insurance. The consultants even forecast what the potential gains in
this area would mean for Allstate's stock. A 25% drop in attorneys appearing
in several categories of cases could add $1.60 to Allstate's share price, one
slide states, according to Berardinelli's notes.
The boxing gloves slide was displayed in open court in a case against Allstate
in
In Berardinelli's view, this slide reflects what he sees as the current
practice at Allstate. Claimants in the "good hands" category may get
swift reimbursement, but they will end up with less than they're entitled to,
he says. Those who hold out for more -- and retain a lawyer to help them get
it -- face battering in the courts and potentially years of delay. "You
can get your claims resolved promptly or fairly," he argues, "but
not both." Allstate says some people hired lawyers because they were not
familiar with the claims process.
Once the CCPR program was rolled out in 1995, the effect was quickly felt by
the trial bar. "We would ordinarily settle one or two cases a
month," recalls Whitney Buchanan, a plaintiffs' attorney in
In mounting a counterattack, plaintiffs' attorneys have had some success.
Courts and regulators in a number of states, including New York, Pennsylvania,
and Washington, have forced Allstate to halt or change its practice of handing
out a controversial "Do I Need an Attorney?" form to people involved
in accidents. And Colossus, now widely used in the insurance industry, has
come under attack on a number of fronts, with attorneys alleging it is being
used to lowball claims. Last year, Farmers Insurance Group, a unit of Zurich
Financial Services, agreed in a nationwide settlement to stop using it for
certain claims.
Loquacious and professorial-looking, Berardinelli began his quest for the
McKinsey documents in a routine bad-faith suit he filed against Allstate in
December, 2000, in
During this period, Berardinelli furiously took notes as he worked in the
office of his home, perched in the southeast hills overlooking
It took two years for an interim appellate court, and then the New Mexico
Supreme Court, to rule that Allstate's appeal failed because it had filed it
one day too late. With the Supreme Court ruling in hand in March, 2004,
Berardinelli returned the McKinsey material he had to Allstate and demanded a
clean copy, free of the restrictive printing. Allstate refused, prompting the
trial court judge to hit it with the most extreme civil sanction a court can
order, a default judgment -- finding it liable without trial in the underlying
bad-faith case.
Allstate is appealing that ruling. In a court filing, Allstate argues that
Berardinelli's aim is not to have the McKinsey documents for use in a
particular case but to be able to disseminate their contents to lawyers around
the country. As he puts the finishing touches on his book manuscript,
Berardinelli would be hard-pressed to disagree.