Insurance Departments Need to Investigate Racial Bias in Claims Handling and Antifraud Efforts After Disturbing New York Times Story

Consumer Groups Say Insurance Company Special Investigations Should Be Used to Combat Fraud, Not as Pretexts for Discrimination and Unfair Claim

Washington, DC. – The Consumer Federation of America and Center for Economic Justice urged state insurance commissioners to investigate racial bias in insurance claims handling and anti-fraud efforts, after a New York Times exposé revealed detailed allegations of discrimination against Black policyholders at State Farm, the nation’s largest insurer. In a letter to the nation’s commissioners sent today, the groups asked that each State Insurance Department respond to a short survey about current departmental efforts to identify and root out claims handling bias and racial discrimination at the companies they regulate. The letter and short survey are available here.

In their letter, the groups noted that prior research has shown that people of color often face disproportionately high insurance premiums “due in large part to structural racism and systemic biases in our society and history that often turn pricing models, algorithms, and the data that feed them, into proxies for race.”  They continued, “There is no reason to believe that those problems and their legacy somehow do not impact other aspects of the insurance system.  Indeed, they certainly persist throughout the insurance system, including…the claims and anti-fraud practices of insurers.” Both organizations have previously asked regulators to examine racial bias in insurancewarning regulators about the very problem uncovered by the investigation.

According to the New York Times report, State Farm “investigators were reminded at weekly meetings…to focus on claims from ‘inner city’ neighborhoods that were at ‘high risk for fraud,’ making them easier to deny.” The impact of this coded bias described by a former employee is made worse, the consumer groups explained, by the growing reliance on Big Data and algorithms used to flag potential fraud by consumers. As with other industries facing concerns about algorithmic bias, if the data used by insurers to create the fraud identification models and train the algorithms are biased because of internal company practices and/or external racism, then company investigations will overweigh fraud in communities of color and recursively emphasize it.

The consumer advocates wrote that “exposing and fighting insurance fraud is critical for well-functioning insurance markets and for preventing escalating rates. However, fighting fraud must never be an excuse for unfair denials of claims or discrimination. Consumers deserve to have their claims fairly evaluated and not be judged according to either stereotypes or biased algorithms.”

The groups are not aware of any Insurance Departments that have vigorously investigated the potential for racial bias in claims handling and anti-fraud procedures. Through its survey, the groups hope to learn if there are efforts underway in any state and what those Departments have found. They are also asking what level of community engagement Departments have organized to hear about discrimination experiences with insurance company claims handling and anti-fraud practices, as well as what technical expertise and additional resources Departments need in order to more effectively address the problem.

Michael DeLong, 925-708-1135
Doug Heller, 310-480-4170