It is difficult to have a socially desirable insurance industry, even in a market-based economy. That is because a profit-increasing strategy is to deny claims, many of which may be legitimate. The recent failure of the American International Group to compensate victims of the US Airways Flight 1549 crash into the Hudson River on January 15, 2009 is an example of this tendency for insurance companies to resist paying claims.
According to a June 12, 2009 New York Times article by Mary Williams Walsh:
A.I.G. Balks at Claims From Jet Ditching in Hudson
For the first couple of days after his flight ditched into the Hudson River, Paul Jorgenson was just glad to be alive. But then he started to need his laptop, his wallet, his car keys -- all the essentials he had stowed under his seat and left behind in the sinking plane.
A pleasant woman at US Airways told him not to worry; he would be made whole for his losses. But then the matter shifted to US Airways' insurer, the American International Group, operating under government stewardship since its bailout last fall.
"Everything went downhill," said Mr. Jorgenson, a software executive in Charlotte, N.C., whose laptop and keys have not been recovered.
When a homeowner has a burglary or a driver has a crash, all it normally takes is a call to the insurance company and a description of the loss to activate the policy. But aviation liability insurance is different. It is activated by a finding of negligence on the part of an airline. If there is no negligence, then arguably there is no liability, and no obligation to pay claims.
That poses a problem for the passengers of US Airways Flight 1549. They suffered real losses and injuries, but they are widely perceived as having been saved from sudden, violent death by their heroic and quick-thinking flight crew, led by Capt. Chesley B. Sullenberger.
"Insurance companies try to protect their assets, obviously," said Bruce D. Chadbourne, a co-author of the book, "Introduction to Aviation Insurance and Risk Management," and a professor in the business school at Embry Riddle Aeronautical University in Daytona Beach, Fla. With the airline wearing a halo, A.I.G. "is going to play hardball."
A spokeswoman for A.I.G.'s property and casualty business declined to comment.
"I wish I had a hammer to get them to do the right thing," said Andrew J. Maloney, a partner in the New York firm of Kreindler & Kreindler, which specializes in aviation litigation. He is representing some of the US Airways passengers but has not filed any lawsuits. "They're riding a wave of feel-good opinion about how well the flight crew handled the bird strike."
A spokesman for US Airways, Morgan Durrant, said the airline issued each passenger a check for $5,000 shortly after the accident to cover their immediate needs; it had no legal obligation to do so. He declined to discuss the airline's liability insurance policy or claims processes, saying the matter was pending and he did not want to jeopardize it.
Those familiar with industry practices said it would be many months before the issue of liability was resolved.
Tess Sosa, who was aboard Flight 1549 with her husband, 4-year-old daughter and infant son, said she suffered a mild concussion during the landing, and her husband was treated for a leg injury and hypothermia. The family, from New York, continues to get hospital bills, she said. But her top priority was getting the insurer to pay for therapy to reduce the risk of post-traumatic stress disorder for her and her daughter.
Because the plane was full on the day of the accident, she and her baby were seated near the wings, while her husband and daughter were far in the rear. The plane struck the water tail-first, and water began pouring in where Mr. Sosa and daughter Sophia were sitting.
Ms. Sosa, clambering over seats toward the front of the plane with her son in her arms, looked back and caught a horrifying glimpse of her husband standing in the deepening water, trying to hold their daughter above the surface.
"I can tell you, he was looking straight at me and he didn't even see me," she said. Since then she has been haunted by the image, and the feeling that in her escape she abandoned her husband and daughter.
Ms. Sosa said Sophia "remembers everything. I just want her to walk away from this knowing that we did everything we could to make it make sense." A.I.G. agents have told her that for therapy she should use her own health insurance, but it has a $3,000 deductible for mental health care.
"Why should we be paying out of pocket?" she said. "That's why they're there. They're the insurer."
Aviation insurance specialists said that an airline's liability insurer is not normally there for medical bills after a plane crash. Passengers' health insurance may indeed pay first -- for passengers who have it -- or workers' compensation for passengers traveling on business. Later, if liability is established, those insurers circle back and try to get reimbursed from the airline's liability insurer.
But that does not help accident survivors who have expenses in the meantime.
A.I.G. has told Ms. Sosa and other passengers that it would pay for therapy, but only for three sessions.
"It's like telling me, 'We aren't responsible for this. This is your trauma. You deal with it,' " Ms. Sosa said.
In one exasperated conversation with an A.I.G. claims official, she invoked the taxpayer bailout, saying she doubted Congress and the Obama administration would approve of the stonewalling. The official "told me their division didn't get a cent from the bailout," she said.
Mr. Jorgenson, the software executive, said he did not have unpaid medical bills, but was frustrated about his claims for missing possessions. He sells specialized software to hedge funds and other investment companies, and must travel frequently to financial centers, wearing expensive suits and shoes, and carrying valuable computer equipment. He recently got some of his clothing back from the airline but the shoes were ruined, he said. One suit was missing its jacket, and his cufflinks and sunglasses are still gone. He got his wallet back but not the cash it held, he said.
Because he could document losses of more than $5,000, A.I.G. sent him a second $5,000, with a letter saying he could get an additional $10,000 if he signed a statement releasing it from any further claims. Other passengers are also being asked to sign the release in exchange for $10,000.
Mr. Jorgenson said he thought this was disingenuous, because some degree of liability might eventually be established. Then A.I.G.'s policy would be in play, but the passengers would have signed away their claims.
Mr. Chadbourne said he was not surprised to see A.I.G. holding firm.
"They really cannot row their own boat, totally, because they've got other people that they are making decisions for," he said, explaining that an aviation liability policy typically spreads the risks among 8 or 10 insurers, with one lead underwriter -- in this case A.I.G. -- handling claims on behalf of the group. (Although A.I.G. is not the lead underwriter on the missing Air France flight, it is part of an insurance pool with potential liability.)
"Even though they're giving the passengers a hard time, eventually they will be compensated to some extent," he said. "There's no big pot because there's no death. But there's still mental distress, and it is a compensatable illness which, eventually, in my opinion, they deserve. They went through hell."