Like a bad neighbor, insurance companies are scary.
As a personal injury attorney, I deal with insurance companies all day long, every weekday. Their job is to pay the victims of their insureds’ negligence as little as possible for the harm done to them. Fine, fine, I get it. They have a job to do, as do I. They will make some pretty horrible arguments in their efforts to rob my innocent victim clients. They will twist words and bend rules and sometimes just plain make stuff up to avoid doing the right thing.
More often than not, however, I can get insurance companies to exhibit some small measure of rational behavior and pay my clients a fair amount for their damages. Mind you, “fair” is a subjective sort of word and it will have different meanings to different people, particularly the two sides in these sorts of things; regardless, most of the time I get them to see reason with or without some great deal of effort. Granted, they almost always drive me batty with their standard party-line reasons for not wanting to pay on claims, but we can get at least close to seeing eye to eye most of the time.
Recently I was confronted with something that astounded even jaded old me. I have a client who was a strapping young man with horses and kids and four-wheelers and the active lifestyle all of that would entail. Then he was rear-ended while working and that all came crashing down around him. After triple-level spinal fusion surgery he is permanently and totally disabled. He can walk and get about, but he will never work again, and sure as heck won’t be on those horses or four-wheelers again. He’s wrecked.
Thankfully, there was a viable worker’s comp claim in the mix and we’ve been able to get his treatment taken care of and some modest income to see to his needs. In these sorts of situations, there is what is called a “third party claim” against the person who caused the accident and damages. Of course, whatever we get from that third party will have to go back to pay what worker’s comp has paid for him (that’s the law here in our fine state) so it’s a little “robbing Peter to pay Paul” but one can often get a little left over, perhaps with negotiation, to give to the injured party. In a situation like this guy has, he deserves every penny. His life is ruined as a result of this wreck and he will need every red cent he can get to keep things going around his house and help cushion the financial, physical, and psychological blows he has received.
In this instance, the person who caused this accident was insured by one of these companies you see advertising on TV. They tell you how they take care of you in an accident and make sure your life is all hunky dory when things go awry. What they don’t tell you is how they treat the other side.
I submitted a stack of medical records and bills to this company. The bills were in excess of $350,000. There is no question as to the causation of the injury or the necessity of treatment. There is no question as to the liability of the person who caused the accident. I even went so far as to provide five years of medical notes for my client preceding this accident showing a complete absence of any back issues.
That, my friends, is solid evidence of what we call a “limits” claim. The insurance company should write my guy a check for their limits and pray their insured isn’t sued. The reason they do that is because the value of our case is so high that it will likely exceed any policy they have. Let’s say the insured, the woman who caused this accident, has a policy of $30,000. That means they pay us $30,000. That’s all we get, and that’s that. Technically, we could sue her and take more from her personally, but it wouldn’t get us much more and wouldn’t be very nice, either, right? The alternative is that we HAVE to sue the lady and go through time-consuming and money-consuming litigation in order to get a court to order her to pay us a gazillion dollars, at which point the carrier will have to pay at least the policy limits (which they could have done in the first place), and maybe more if they put their insured in a position where she would face a judgment in excess of the policy limits.
I bet you can smell what’s coming. The adjuster supposedly reviewed our materials and then left me a message that went very much like this, “I see he had spinal surgery and is disabled now, and there’s no evidence that his injury wasn’t caused by this accident. But I just don’t believe you.”
What?
Let me sum it up for you:
We have a case that is clearly worth at least $1 million.
The person who caused the accident has an insurance policy.
The insurance company is refusing to pay even a reasonable amount in settlement of the claim, choosing instead to put their insured in the firing line, get her sued, and potentially have her put into bankruptcy, when all they had to do was write a check for the policy limits THAT THEY PROMISED HER THEY WOULD PAY WHEN NECESSARY UNDER HER INSURANCE CONTRACT!!
Now, my client is going to have to shell out thousands of dollars in deposition costs, mediator fees, discovery costs, and hours and hours of his own time to pursue this claim which the company could just as easily have already settled. People talk about “tort reform” and the need to rein in “trial lawyers.” But let me tell you something, kiddies: Insurance companies are what need reining in. They are one of the wealthiest sectors of business in the world and they’ve mastered the art of nickel and dime-ing the little guy into submission while they make more and more money off of the money they should be paying him.
The moral of the story is you cannot trust an insurance company any further than you can throw them. Watch ‘em, boys and girls. And if you’re hurt in an accident, seek counsel immediately; don’t let these companies get away with this. We have to fight back. And that’s what I’m here to help you do.
