New York Auto Glass Shop Owner Amends Complaint in $2 Million Suit Against Insurers, TPAs; Claims Business Changed in 1999

David Harner, the owner of a Auto Glass of Westchester Windshield Doctor in Westchester, N.Y., has filed an amended complaint in the suit 

Among Harner's claims of tortious interference, he suggests that many of the issues cited in the complaint began in approximately 1999. "For a period of more than 15 years, the plaintiff enjoyed a profitable relationship with his customers including, but not limited to, insurers, where the plaintiff's customers or plaintiff's insurer customers would contact the plaintiff for services, the plaintiff would submit the bill directly to the insurer, and the insurer would fully pay the invoice directly to the plaintiff," writes Harner. " … On or about the year 1999, the defendant insurers and TPAs commenced a pattern of conduct and business wherein, the defendant insurers, acting in collusion with the TPAs, would set a specific price for the types of services performed by the plaintiff."

Harner claims that the defendants' alleged actions have "denied [him] his right to earn income, his ability to bring benefits to the free market with lower claims costs, [and] create a sound business reputation, and have denied him his right to continue to operate his business without interference in a free, unfettered and profitable manner."

One of Harner's claims involves the allegation that insurer representatives who negotiate pricing or charges with repair shops in New York are required to be licensed adjusters. He includes records from several calls he says he has made to insurers and their third-party glass claims administrators (TPAs) that he suggests demonstrate this allegation. In several cases, Harner says he was told by an insurer employee that in order to get paid for work he completed for that insurer's customers he would have to bill its TPA.

Harner also cites several alleged instances where coverage was confirmed for an insured, but he says he has not been paid for the work completed.

The glass shop owner goes on to list several scripted statements that he suggests could be construed as forms of steering, such as "[The plaintiff's repair shop is] not on our list;" "We … don't guarantee [the plaintiff's] work;" and "Your policy will be changed in some fashion if you use [the plaintiff's] repair shop to perform repairs." Harner alleges that such statements could be considered "deceptive acts or practices in the conduct of business."

Under Harner's charge of failure to pay claims, he lists more than 40 instances of work he has completed dating back to 2009 for which he alleges he has not been paid.

He further catalogs several instances in which he says he was told by insurers that coverage was available for auto glass work for specific insureds, but has not been paid for the claims, nor had the claims denied; Harner refers to this as "fraud or intentional misrepresentation."