06/06/2025
Letās talk about the greatest shell game in insurance.
As first-party policyholders, our clients are given the policy. Thatās the contract. The playbook. The ārules.ā
But guess what adjusters use to actually make decisions? Not the policy. Not the four corners of the document.
They use something else entirely:
-OGs (Operating Guidelines)
-Best Practices
-SOPs (Standard Operating Procedures)
These internal documents dictate how the claim is handled, what the adjuster is allowed to do, how coverage is interpreted, and often, how to minimize payout.
Want to know the wildest part? They wonāt let you see them. Not even in litigation, at least not without a subpoena, a motion to compel, and a battle to the death in chambers. And yet, youāll hear adjusters say things like:
āIām just doing what the OGs tell me to do.ā
As if those hidden documents come with a cape and a sword.
So let me get this straight:
You sell a policy to a consumer.
That consumer pays their premiums, month after month, year after year. Then when the worst happens, the adjuster gets to follow a completely different, secret set of rules theyāll never show the insured?
Thatās not just bad faith.
Thatās institutionalized opacity.
Thatās a rigged system dressed up in a logo and a customer service script.
Itās time for legislation.
If OGs, SOPs, and internal adjusting procedures are used to govern how a first-party claim is handled, then policyholders deserve access. This is not proprietary, this is accountability.
Policyholders built State Farmās high-rises.
They fund Allstateās dividends.
They deserve more than a black box behind the denial.
Letās bring transparency to the documents that actually govern claims. Letās make OG access a right, not a fight.