Articles Posted in Insurers’ Bad Faith

michael-longmire-lhltMGdohc8-unsplash-300x216After a serious car accident–one that involves damage to your car and the other person’s car, not to mention physical injuries–you’re in a precarious position. Between rental cars, medical bills, and lost wages, finances can quickly become a big problem. Insurance companies understand the situation you’re in, and they generally have no hesitation in using that to their advantage. 

It’s certainly not fair, but it’s the reality for victims of car accidents who need compensation. Being prepared for various stunts occasionally attempted by auto insurance companies can help you prepare for the upcoming process and protect your claim. 

  1. Offering a lowball figure to make the claim go away. 

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Let’s say you have been injured in a car wreck, or in a fall at a store, and the insurance adjuster for the insurance company of the at-fault driver or of the store owner calls you after your injury. They often want to take a recorded statement (which you should NOT give unless you have your lawyer present) about what happened, how you were injured and what your injuries are. Then they might reassure you that they “are there for you,”  and will be looking forward to resolving your claim with you, “don’t worry, everything will be okay,”  or “we’ll take care of you, just let us know when you have finished your medical treatment.”  Makes you feel better, right? So comforting and reassuring. You might even be thinking you can settle your personal injury claim without even having to hire a trial lawyer.  After all,  a trial lawyer will have to be paid for her work and if you can just handle this on your own with this very nice, concerned insurance adjuster, that’s more money for you, right?

WRONG.

One thing that is patently clear that I have come to understand in practicing personal injury law for 30 years in Georgia:  insurance adjusters are not your friends. They are trying to prevent you from being successful on a personal injury claim. They may even resort to trickery, subterfuge, and downright lies.

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I constantly hear, even from jurors, that we are a “litigious society,”  that everyone sues over everything these days. Assuming this is true, who is to blame?  Critics immediately place the blame at the feet of the injured plaintiffs who must bring the lawsuit for compensation for the injuries they have suffered that were caused by someone’s carelessness. If those darn hurt people who can’t work any longer because of their injuries would just not file a lawsuit we wouldn’t be a litigious society!!  The nerve of these people!  Getting injured through no fault of their own and then expecting compensation for the medical bills, lost wages, pain, inconvenience, inability to work, permanent scarring, loss of their normal quality of life, etc., from the person who caused it all.  The gall! Can you believe these people?

Yes.  Yes, I can. I believe these people because these are the people I represent every single day. These are the people who began their day with their normal routine like every other person but who, unfortunately, came into the path of someone who was careless, someone who wasn’t paying attention to the road, someone who was texting while driving, someone who was reckless and causes an upheaval in the life of someone else due to their negligence and carelessness.

But don’t blame these injured folks. Blame the insurance companies of the careless individuals, because it is the car insurance companies who take the stance “so sue me” and invite litigation that easily could have been avoided had they simply been reasonable in negotiating an insurance claim for personal injury.

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Does your own insurance company owe you a duty? The simple answer is “yes, of course.”  But for any of you who read my blog, you know when dealing with an insurance company nothing is ever simple and you should never assume your own insurance carrier “is on your side.”

I just recently settled a case for my clients for the maximum insurance policy limits of the at-fault driver, even though my clients’ injuries were so severe I am confident a jury would have returned a verdict in their favor well in excess of the insurance limits.  Let me explain the situation.  This case involved a car wreck in which a young driver turned left in front of my clients at an intersection early in the morning. My clients had a green light and were going straight through the intersection. The young driver stated to the police officer he “didn’t see them” before he turned and my clients could not stop their vehicle to avoid the other car that suddenly was directly in front of them as they attempted to travel through the intersection on a green light. Both of my clients suffered severe personal injuries and were hospitalized as a result.

Now a reasonable person at this point would be thinking the driver making the left turn was at fault and his insurance company should pay my clients’ bills, right?  Well, in the words of Coach Lee Corso, “Not so fast!” The insurance carrier for the driver who turned left in front of my clients at first claimed their driver was not liable! The insurance carrier was not going to pay a dime!  That’s when I get involved. After some discussion about the fact that their insured, the young driver, had violated the Rules of the Road by failure to yield the right-of-way to my clients, the insurance company then asserted it’s second position, i.e., my client, who was driving the car, was contributorily negligent by speeding and so it would not be willing to pay anything for his claim, but since his wife, who was a front-seat passenger, cannot be legally contributorily negligent, they would be willing to pay her something for her trouble, but not the policy limits.  The absurd position of the insurance company forced me to file suit. In fact, you can say the insurance company actually invited the litigation, taking the “so sue me” attitude, and I obliged them. I am sure they didn’t consult their own insured about how he wanted the claim handled.  I had to hire an expert accident reconstruction, which is expensive. Neither car had a “black box” that would prove my client was not speeding at the time of the wreck, so my accident reconstructionist performed a signals analysis that proved the defendant could not have possibly had a green left-turn arrow and could not possibly have had the right-of-way at the time he turned left in front of my clients. Then the insurance company’s lawyer took the depositions of my clients.  Their undisputed testimony left no room for doubt that they had the right of way and the defendant was at fault. Following their depositions, I made a settlement demand on the insurance carrier for the insurance limits of their insured. I gave the insurance company 30 days to respond to the demand, and if they did not pay policy limits, the demand would be withdrawn and we would proceed to trial.

statefarm         Do you believe that “Like a good neighbor, State Farm is there?”  I have previously presented plenty of evidence that the answer to that question of whether State Farm is like a good neighbor  is  a resounding “no.”  If you recall, in my case Eells v. State Farm, State Farm did everything it could possibly do within the bounds of the law (but outside the bounds of moral and ethical decency) to prevent its own policyholder from collecting on an uninsured motorist claim after the policyholder had paid premiums to State Farm for over 40 years. I blogged about that case, which went all the way to the Georgia Court of Appeals, where we prevailed, before it was resolved.  The bottom line is that State Farm will do nearly anything to avoid paying legitimate personal injury claims, including forcing its insureds to endure a trial and potential personal exposure, rather than settle a clear liability suit prior to trial.

My son, a great lover of the sport of basketball, likes to say “The ball don’t lie.”  Well, the two cases I am going to tell you about involving State Farm clearly share the theme of “the ball don’t lie,” meaning the truth ultimately comes out. Two recent trials in Georgia have placed the litigious policies of State Farm in the spotlight.  The first trial was tried last month by James Robson and Robert Glass in Cobb County. The jury returned a verdict in favor of the plaintiff for $850,000.00 after just two and a half hours of deliberation.  The at-fault driver, insured by State Farm, had only $100,000.00 in liability coverage. The plaintiff’s attorneys demanded the $100,000.00 to settle the case prior to trial, even though the plaintiff’s medical bills from her injuries were nearly $170,000.00.  This means any verdict for the plaintiff would be very likely to be in excess of $170,000.00.  State Farm had the opportunity (and the contractual duty) to resolve the case prior to trial for the demanded policy limits of $100,000.00.  The plaintiff’s attorneys gave State Farm and extension of time to decide to pay the policy limits and even had the plaintiff’s treating physician speak by telephone to the State Farm adjuster confirming for her the plaintiff required neck surgery from the car wreck.  But did State Farm do the right thing?  No. State offered only $22,500.00 to settle the case, even after admitting their insured was at fault in causing the wreck.  The jury returned what is known as an “excess verdict,”  i.e., over the policy limits, and because State Farm had the clear chance to resolve the case for policy limits, will be on the hook to pay the entire verdict.   You have often heard of “frivolous lawsuits” in the media but you seldom hear of “frivolous defenses.” This case was certainly one of them.

Another was in a case tried last week in Bartow County by my good friends and fellow trial lawyers Morgan Akin and Lester Tate of Akin & Tate in Cartersville.  In that case, the plaintiff  pulled into a roadway after stopping at a stop sign and was struck directly in the rear by a teenage driver. The investigating Georgia State Trooper measured 229 feet of skid marks left by the teenage driver as he tried to stop before rear-ending the plaintiff’s vehicle.  The State Trooper found teen driver at fault. Mom of teen driver then went to State Trooper’s supervisor with photos maintaining the plaintiff just pulled out in front of him. Ultimately, the State Trooper relented and amended the accident report changing fault to that of the Plaintiff. The Plaintiff had shoulder surgery and $90,000.00 in medical bills.  State Farm took up the mom’s torch, denied all liability and hired an expert who simply ignored the skid marks.  The plaintiff’s expert accident reconstructionist, Herman Hill, testified that not only did the teenage driver hit the plaintiff in the rear but was going 75 MPH+ at the time of the collision based on the amount of skid marks left by her car’s tires during braking. State Farm doubled down by asserting a counter claim. The Plaintiff made a settlement demand of  100K policy limits initially and then after extensive litigation made a settlement demand of $275,000.00 prior to trial. State Farm never made an offer.  The jury returned a verdict of $300,000.00.  And because State Farm had the opportunity to resolve this case within the policy limits of $100,000.00 but declined to do so, State Farm will be on the hook for the entire verdict.  Can you imagine being rear-ended by a teenage driver going 75 m.p.h. and then the teenage driver tries to blame you for it?

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Do I have a case against my insurance agent?  I feel like my insurance adjuster cared more for the insurance company than for me, her client.  Who does my insurance agent really work for?  Me or the insurance Company?

Good question! No doubt many of us think our insurance agent, with whom we have worked with, confided in and trusted, is our friend and our agent, not the insurance company. But as I often say in these blogs:  Not so fast!  Although the term “agent” is loosely thrown around in all sorts of scenarios, the actual word “agent” is loaded with ambiguity. Natch, if I have purchased my car and homeowners insurance through my “agent” I would assume that person works for me and would always have my best interests in mind. But, unfortunately, especially under Georgia Law, it doesn’t always operate so smoothly.

For example, if an insurance “agent” is independent and sells policies for multiple insurance companies, chances are he or she would be considered an “agent” of the insured who must favor the insured’s interests over the company’s. If, however, the insurance “agent” is an employee of the insurance company and not independent, then chances are this type of insurance “agent” is actually an agent of the company, not of you, and that type of “agent”/employee would put the interests of the insurance carrier over your own.

That headline should come as no surprise to my readers here in Atlanta, Georgia. Georgians have a unique ability to know when they are getting ripped off, and it appears United Healthcare has been doing that to Georgians and Americans everywhere in the form of insurance fraud. The United States Senate is holding hearings now on the issue.

Witnesses tell Senate UnitedHealth may have defrauded one in three insured Americans.

CQ Healthbeat (3/27) reports, “UnitedHealth Group officials are in for an unpleasant experience at a Senate hearing next week – if a set-up session on Thursday was any indication.” At a Senate Commerce, Science and Transportation Committee hearing today, witnesses “described how health insurers routinely defrauded millions of patients who sought out-of-network care by paying less than the insurers owed for medical bills.” A witness told the panel, which will hear from United representatives next Tuesday, that “the practice could have potentially affected as many as one in three insured Americans and lasted for at least a decade.” Committee Chairman John D. Rockefeller, IV (D-WV), “declined to say what types of changes should be included in health overhaul legislation,” saying, “I want to make sure exactly what it is we need to do…just in the saying of it, I could do damage to health reform.”

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Below is a news article from the Associated Press that details Allstate Insurance Company’s finally agreeing to pay a $7 Milliion fine for failing to disclose key documents regarding the manner in which it pays (or really, doesn’t pay) claims. The Missouri Supreme Court has held Allstate’s feet to the fire and made it clear those “good hands” are less than clean. Georgia Allstate insureds should take note and understand even on a first person claim, where you may be making your own claim against your own insurance you have paid for, your insurance company will act as your adversary. They are not “like a good neighbor” and you are not “in good hands”…they will put on their boxing gloves and will do everything humanly possible to avoid paying your claim.

AP

Allstate settles in disputed records case

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