Delay, Deny, Defend by Jay M. Feinman — Book Summary

Delay, Deny, Defend by Jay M. Feinman is a revealing exposé of how insurance companies often prioritize profits over promises. It dives deep into the strategies insurers use to avoid paying legitimate claims and leaves readers better prepared to deal with this hidden industry crisis. This book is essential reading for anyone who owns an insurance policy.

Who May Benefit from the Book

• Policyholders seeking to understand how insurance claims are really handled
• Lawyers and legal professionals working with insurance disputes
• Regulators and policymakers in the insurance sector
• Journalists and consumer advocates covering business ethics
• Anyone buying home, auto, or personal injury insurance

Top 3 Key Insights

• Insurance companies often use a systematic strategy—delay, deny, defend—to reduce claim payouts and maximize profits.
• Industry consultants reengineered claims handling into a profit-generating operation, replacing fairness with efficiency metrics.
• Technology, legal segmentation, and biased experts are tools insurers use to underpay or deny legitimate claims.

4 More Lessons and Takeaways

• Claims processing has become industrialized. Adjusters now follow rigid systems and metrics, reducing fairness and personalized judgment.
• Companies discourage legal representation. Unrepresented claimants often get lower settlements, so insurers try to keep lawyers out of the process.
• Experts and software are not neutral. Insurance companies use “independent” experts and programs tuned to minimize payouts.
• Homeowners policies are complex by design. Vague clauses and exclusions allow insurers to deny or limit payments after disasters.

The Book in 1 Sentence

Insurance companies use deliberate tactics to delay, deny, and defend against claims, putting profits before the promises they sell.

The Book Summary in 1 Minute

Delay, Deny, Defend explains how insurance companies systematically avoid paying legitimate claims. Rather than acting as protectors, they often act like adversaries, using delays, denials, and aggressive defense tactics. These strategies—shaped by firms like McKinsey—transform claims into profit centers. Adjusters now follow software and metrics, discouraging legal help, and using biased experts. Homeowners and auto policyholders face complex rules and obscure clauses that limit or cancel coverage. In major disasters like Katrina, systemic denial tactics come to light. Feinman urges consumers to stay informed, push back, and advocate for stronger regulation.

The Book Summary in 7 Minutes

Insurance promises peace of mind. But for many, making a claim becomes a battle. Jay M. Feinman’s Delay, Deny, Defend uncovers the hidden practices of the insurance industry, showing how profit-driven strategies have transformed the process of paying claims.

Insurance’s Broken Promise

Insurance is a unique product. People don’t just buy coverage; they buy a promise. That promise is simple: pay your premium, and when something bad happens, the company will help you recover. Yet, this trust is often broken.

Insurers aim to minimize payouts—their biggest expense—while still collecting premiums. This conflict lies at the heart of the book’s argument: insurance is designed to protect, but run as a business to profit.

The Strategy: Delay, Deny, Defend

This three-part strategy isn’t random—it’s systematic.

• Delay: Insurers stall the process. They ask for repeated documentation, lose forms, or extend investigations unnecessarily.
• Deny: Claims are partially or completely rejected. Often, the reasons are obscure, tied to confusing policy terms or minor technicalities.
• Defend: If policyholders sue, insurers fight aggressively, making litigation time-consuming and expensive.

These tactics are meant to wear down claimants, pushing them to accept less or give up entirely.

How Consultants Changed the Game

In the 1990s, major insurers hired firms like McKinsey & Company. The goal: reduce losses and increase profit. McKinsey viewed claims not as obligations, but as opportunities to save money.

They introduced the idea of “leakage”—money paid beyond what’s “necessary.” Closed File Reviews (CFRs) and process redesigns aimed to cut down leakage. The result? The entire claims department was restructured to control costs, not ensure fairness.

Programs like Allstate’s Claims Core Process Redesign (CCPR) and State Farm’s ACE followed this new model. Claim adjusters became more like factory workers—following protocols, not exercising judgment.

Metrics and Machines

The human side of claims processing has faded. Software like Colossus and Xactimate now assess damage and set claim values.

Tool	Use Case	Effect
Colossus	Personal injury claims	Limits payouts using company-set data
Xactimate	Property damage estimates	Controls home claim costs

Adjusters’ performance is often judged by:

• How many claims they settle without payment
• How well they stick to software recommendations
• Whether they reduce average payout amounts

Bonuses and promotions often depend on keeping costs low, not on fairness.

Segmenting and Suppressing Claims

Not all claims are treated equally. Insurers divide them by size, type, and—most critically—by whether the claimant has a lawyer.

Represented claimants tend to receive more money. So insurers work hard to discourage legal help:

• Quick contact to build trust
• Misleading info about attorney fees
• “Take-it-or-leave-it” offers only available before hiring a lawyer

Minor Impact Soft Tissue (MIST) claims are a common target. These involve whiplash or bruising from low-speed accidents—hard to prove, easy to dismiss. Companies often deny or lowball these claims, knowing lawyers won’t pursue them due to low returns.

Experts and Software Bias

Many tools used by insurers appear neutral—but aren’t.

Independent Medical Examinations (IMEs) and paper reviews are often done by doctors hired frequently by insurers. These experts:

• Use generic language
• Spend little time on evaluation
• Rarely support serious injuries

Software like Colossus is adjusted to exclude large jury awards, keeping average values low. Adjusters must stick to these figures, even if the real case value is higher.

Homeowners Beware

Homeowners insurance is packed with fine print. Most buyers don’t fully understand their policies until disaster strikes. Insurers exploit this gap.

Key tactics include:

• Anti-concurrent causation clauses: If a covered cause (like wind) and an uncovered cause (like flood) both play a role, the claim may be denied entirely.
• Underinsurance: Homes are often insured for less than their replacement value.
• Depreciation deductions: Payouts are lowered based on age and wear of the damaged items.

These tactics were exposed after disasters like Hurricane Katrina. Thousands of homeowners saw their claims reduced or denied outright.

The Fraud Narrative

Insurers often justify tough tactics by citing insurance fraud. While fraud does exist, it is not as widespread as advertised.

The focus on fraud serves multiple goals:

• Justifies strict claim handling
• Builds public support for denying claims
• Deflects criticism by blaming dishonest claimants

But the result is that honest policyholders suffer along with the dishonest few.

What Can Be Done?

Feinman emphasizes the need for informed policyholders and strong regulation. He encourages consumers to:

• Read and understand their policies
• Document all communications
• Seek legal advice early
• Push for state-level regulatory reform

He also calls for insurers to return to their original purpose—protecting people, not just profits.

About the Author

Jay M. Feinman is a Distinguished Professor of Law at Rutgers University. His expertise spans insurance law, contract law, and legal theory. Feinman has written extensively on consumer rights, legal education, and the U.S. legal system. His work focuses on making complex legal issues understandable and actionable for the public. In Delay, Deny, Defend, he combines rigorous research with accessible storytelling to shed light on hidden industry practices.

How to Get the Best of the Book

Read with your own insurance policy nearby. Compare Feinman’s examples with your coverage. Highlight key tactics insurers use. Revisit the book after a claim experience or before renewing a policy.

Conclusion

Delay, Deny, Defend unmasks how insurers often work against the people they promise to protect. It’s a wake-up call for policyholders to stay alert, informed, and assertive. Feinman’s book is not just an expose—it’s a practical guide to surviving the insurance system.