A San Diego businessman wants to change the law and the way insurance companies do business in the U.S.
Dan Shea is the successful co-owner of the Donovan's steakhouse chain and dozens fast food restaurants across the country.
He claims one of nation's biggest industries causes huge problems for America's injured and sick. And unlike most San Diegans, Shea has the time, and the money, to make sure that people, and more importantly, state legislators all across the country, hear his message.
When Shea's elderly aunt, Kay, was critically injured in a terrible head-on crash more than two years ago in Missouri, Shea tried to help.
"She was the healthiest 83-year-old woman any of us knew," Shea says of his proud and fiercely independent aunt.
Shea says the evidence in the case clearly showed that the other driver was 100 percent at fault and admitted liability in the case, but the insurance companies for that driver refused to pay what he says was a very reasonable settlement.
That terse denial quickly provoked Shea’s anger, because, as he says, “The insurance companies spend tens of millions of dollars telling us what great companies they are and why we should be insured by them, but this is what they do when they think no one's looking."
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Shea says he quickly learned that insurance companies care only about their financial "bottom line" and will do anything to avoid paying even the most legitimate claims.
"And it's a lot of heartache for a lot of a people," Shea says.
So he fought back.
Shea hired one of San Diego's best personal and motor vehicle injury lawyers, Craig McClellan, to help his aunt’s legal team in Missouri.
He also spent tens of thousands of dollars to produce a professional video and website that tell his aunt's story and presents his searing critique of the insurance industry.
That website, which includes information provided by the trial attorneys and personal injury attorneys association, exposes about what he claims is a routine practice of the insurance industry to deny legitimate claims and withhold payments to protect industry profits.
"Just delay, delay, delay,” Shea says of the insurance companies. “And (when the victim is) an 85-year-old woman (their strategy is) ‘Let's see if she dies before the claim actually has to be paid.’"
But critics say Shea is overstating his case and painting a very unfair picture of the insurance industry.
San Diego insurance defense attorney Daniel White says insurance companies want to settle claims as quickly as possible.
White insists that insurance adjusters and company executives do not get financial incentives or bonuses for delaying payment on legitimate claims or drawing out their investigations.
"That's not true,” White tells NBC 7. “That is just simply not true."
White says most claims and lawsuits settle relatively quickly, but some, like Kay Shea's, require lots of investigation. And those investigations can yield very different opinions about the fair value of an insurance claim and who’s responsible for paying it.
"Sometimes, there just is not an agreement about that,” White says. “And that's why we have judges, and that's why we have juries."
White says crowded court calendars and cutbacks in court funding are mainly responsible for delays in the trails that are sometimes necessary to resolve an insurance dispute.
But Dan Shea won't wait.
He wants to change the law and the way insurance companies do business in the U.S.
His reform plan would require insurance companies to work in good faith with consumers, to get approval of rate increases before implementing them and establish a consumer advocate
on the state’s Insurance Commission or within the office of the Insurance Commissioner.
"This has to change in every single state,” he says. “In California, Missouri, and the other 48 states."
