Opinion ID: 1226703
Heading Depth: 2
Heading Rank: 1

Heading: The Rigsby Complaint

Text: On April 2, 2006, prior to the filing of Branch, Cori and Kerri Rigsby, employees of a company that provides disaster claims management services for several WYO insurers, filed an FCA claim alleging that four insurance companies defrauded the federal government by mischaracterizing wind damage as flood damage in the wake of Hurricane Katrina. [3] Specifically, the Rigsbys alleged that, while adjusting claims for certain WYO insurers, they learned that the insurers made a corporate decision to misdirect and misallocate claims from those of hurricane coverage to flood claims payable by the federal government. While the Rigsbys lodged these general allegations of wind/water fraud against four WYO insurers, [4] the only specific instances of fraud alleged in their complaint concerned defendant State Farm. The Rigsbys alleged that State Farm directed its employee adjusters and independent contractor adjusters to show flood damage whenever and wherever there was any amount of water damage, and to adjust the claim as flood insurance rather than hurricane insurance even though the primary mechanism for damage was wind, not flood waters. [A]djusters were told that if they initially analyzed a claim and found that the insured had less damage under flood coverage than policy limits allowed, the adjuster was told to go back through the claim a second time to ensure that the flood claim `hit limits.' The Rigsby's complaint alleged two specific instances where State Farm put this fraudulent policy into practice, both dealing with Katrina damage to homes in Mississippi, and also alleged that they provided adjusting services for Allstate.