Archive for the ‘Insurance Practices’ Category

Surveillance Not Uncommon in Workers’ Compensation Cases

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Private investigators and hidden camera surveillance might seem like the stuff of suspenseful TV shows.

But getting “caught” on camera can be a concern in a workers’ compensation case.

In fact, it’s much more common than you might think. A worker gets hurt at work and sees a doctor. The doctor gives the worker restrictions and says, “These are the things you are not supposed to do or else you could hurt yourself. Don’t do these things and you will get better.”

The worker goes about their life, and their case progresses towards a mediation.

Then the worker and their attorney get to mediation and the attorney for the employer and insurance company pulls up a video that the insurance company claims to show the employee doing things that they were not supposed to do. The case is now in trouble.

In workers’ compensation, we call this surveillance.

Insurance companies routinely hire private investigators to video a hurt worker in the hopes that they will “catch” them doing something that is inconsistent with the restrictions the doctors set.

Even if you think you’re aware of your surroundings and that you would know if you were being watched, that’s often not the case.

A good private investigator is invisible and if they do their job well they stay that way.

I’ve seen video taken from a private investigator in a car, in a van, and even posing as a customer in a restaurant. And in this day in age where everyone has a mobile phone with a built-in video camera, you’re probably not even aware of how often in a day you could potentially be on camera. (You should also be careful about what you share on social media because those posts could be used against you, as well.)

Clients have asked me, “Is this legal? He filmed me at MY house and when I was in my yard!”

The answer is yes, it is legal.

It’s legal for anyone to videotape you in your yard, or anywhere else in public view. There is no expectation of privacy when you are in view of the public.
Clients have also said to me, “But I wasn’t doing anything outside my restrictions and the investigator’s report says that I was lifting or carrying more than my restrictions without any apparent difficulty. How would they know that?”

It is very easy for an investigator who was hired by an insurance company to say that you “appear” to be doing something outside your restrictions, or that you were lifting, carrying or walking without any apparent difficulty. We see those types of phrases in investigators’ reports all the time.

While we can always argue that the investigator is biased or just plain wrong, it’s much easier if we simply don’t have to make these arguments.

So, what does this mean to your case as an injured worker?

Does it mean you can’t live your life or that you should be paranoid about everyone around you? Draw the curtains at home and never go out? No.

It means you should be mindful of your surroundings and made sure you are following your doctor’s restrictions all the time regardless of where you are.

That means that if you have a lifting restriction of 20 pounds that you should not be trying to carry in that 40-pound bag of dog food from the store.

If you aren’t supposed to be standing more than 15 minutes at a time then at 16 minutes you should be finding a chair at the church luncheon.

Following your doctor’s restrictions all the time — both inside and outside of work — will not only help keep your worker’s compensation case on track, it will also help you heal and get better faster.

If you think you might be under surveillance on your workers’ compensation claim and you would like help, please contact us as soon as possible.

Employers’ cost for workers’ comp insurance decreases in NC

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The N.C. Insurance Commissioner approved a 3.4 percent rate decrease for workers’ compensation insurance premiums for 2015.

The rate decrease was requested by the N.C. Rate Bureau, a group representing insurance companies, the News & Observer reported. This is further proof that North Carolina’s worker’s compensation system is working as it should and is not “broken,” as big businesses and insurance companies insist when they push for changes to state laws.

Rest assured, if insurance companies were seeing an uptick in workers’ comp claims or fraudulent cases, as they so often claim in their pleas to lawmakers, they would not have requested the rate decrease.

By the insurers own actions, it is clear further workers’ compensation “reform” is not needed in North Carolina.

The workers’ comp insurance rate decrease will take effect in April, and it’s estimated that 95 percent of businesses in the state will pay less for the coverage that protects their workers in case of an injury.

In 2014, workers’ comp insurance rates rose an average of 4.2 percent.

The actual rates paid vary based on the type of business and the number of past workers’ comp claims. 

Progressive’s underhanded treatment of accident victim’s family goes viral

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A blogger named Matt Fisher recently posted about his family’s treatment at the hands of Progressive Insurance: “My Sister Paid Progressive Insurance to Defend Her Killer In Court.”

Fisher’s sister, Katie, was killed in 2010 in an auto accident when another driver ran a red light. The other driver was underinsured, but Katie carried Progressive insurance underinsured motorist coverage that should have kicked in and paid benefits to her family.

Katie Fisher and Matt Fisher and Progressive InsuranceSource

Only it didn’t because Progressive refused to accept that the other driver was at fault for the accident (even though his insurance company quickly accepted fault and settled with the dead woman’s family). Instead, Progressive refused to pay on the claim, forcing the family to take the other driver to court to prove his fault in the accident and force Progressive to do the right thing.

If that wasn’t bad enough, Progressive actively participated in the other drivers’ defense to avoid paying on the family’s claim. (Remember, Progressive was Katie’s insurance company; the other driver had insurance with another company.

According to a story by CNNMoney:

What really irked Fisher was that Progressive actively participated in the other driver’s legal defense. His scathing post about the debacle quickly went viral and turned into a social media nightmare for Progressive.

The company has spent several days trying to explain its actions. In its latest blog post, in which it announced the settlement, Progressive wrote that it “participated in the trial procedures on our own behalf while Nationwide represented the other driver.”

On Aug. 9, a jury found the other driver at fault.

After Fisher’s blog post when viral, resulting in a backlash agains the insurer,  Progressive settled with Katie’s family. We expect that is little solace after the hell the insurance company put them through.

Unfortunately what Fisher and his family went through are pretty typical insurance company tactics to avoid paying on legitimate claims. What a horrible injustice this family suffered at the hands of Progressive Insurance in their time of grief.

To read more about what the Fisher family endured at the hands of Progressive, start with Matt Fisher’s original blog post here, Progressive’s statement in response, Fisher’s response to that, the CNN story about the case and finally Matt Fisher’s post after the long-overdue settlement was announced.

If you find yourself in an auto accident, we hope some free resources available on our website that will help you when dealing with your auto insurance company:

Check out our Auto Accident Basics newsletter. And I also recommend that you check out our guide to the different types of automobile insurance available. Now is the time that ask the important question, “Do I have the right auto insurance?” not after an accident. 

“Rich” hospitals help drive up cost of health care

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Interesting reading this week in the Raleigh News & Observer. The newspaper is running a five-part series, “Prognosis: Profits” which reveals how nonprofit hospitals are making big money, paying big salaries and saddling some of their most vulnerable patients with big bills. This is driving up health care costs and putting the burden of the sick and injured who cannot afford to pay their bills.

Here’s just a preview of the findings of the series:

Most of them are nonprofits. But many of them, especially the big ones, are making a fortune.

During the Great Recession, their profits have stayed strong, and they’ve raised their prices. Top executives enjoy million-dollar compensation packages as they expand, buy expensive technology and build lavish facilities. Their customers buy the services before they know the cost, and they often don’t understand the bills.

And the hospitals enjoy a perk worth millions each year: They pay no income, property or sales taxes.

These institutions were created with charitable missions. But many don’t look or act like nonprofits anymore. In their quest for growth and financial strength, they have driven up the cost of health care and saddled thousands of patients with bills they can’t pay.

 

DLG withdraws support for HB 813; compromises could be harmful to injured people

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We recently asked you to write to your state senators in support of legislation that would change how automobile accident claims and other personal injury cases are handled in court.

While we still believe that North Carolina’s use of contributory negligence in personal injury cases is antiquated, harsh and punishes injured people, we can no longer support the version of HB 813 now being debated by state lawmakers. Quite simply, some the the provisions that have been added to the bill as it has made its way through the N.C. General Assembly do not protect the interests of injured people.

So, we must join the N.C. Advocates for Justice in withdrawing our support for HB 813.

As a law firm that advocates for injured people, we still believe that North Carolina must move away from contributory negligence and toward comparative fault in these cases, the compromise bill currently proposed sacrifices too much

North Carolina is one of only four states that allow the doctrine of contributory negligence as a defense in auto accident and other personal injury cases. Contributory negligence is a harsh and outdated way of denying help to people hurt in accidents. Under current law, if you’re even 1 percent responsible for an accident, you CANNOT recover damages from the person who injured you, even if that person is 99 percent at fault.

The original HB 813, which we supported, sought to correct that injustice by switching from contributory negligence to comparative fault. Under the comparative fault doctrine, juries determine how much fault lies with each party in the accident and then award damages based on those percentages. The injured party is allowed to recover only that percentage of damage caused by the other person. Under the much fairer comparative fault standard, an injured person would still be able to collect a percentage of an insurance settlement to cover medical bills and compensate for injuries. Now, these victims get nothing.

 

 

SUPPORT BILL HB 813 – for injured people

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State lawmakers are preparing to vote on legislation that will impact anyone who is hurt in a car accident or suffers a personal injury that is someone else’s fault.

North Carolina is one of only four states that allow the doctrine of contributory negligence as a defense in auto accident and other personal injury cases. Contributory negligence is a harsh and outdated way of denying help to people hurt in accidents. Under current law, if you’re even 1 percent responsible for an accident, you CANNOT recover damages from the person who injured you, even if that person is 99 percent at fault.

HB 813 seeks to correct that injustice by switching from contributory negligence to comparative fault. Under the comparative fault doctrine, juries determine how much fault lies with each party in the accident and then award damages based on those percentages. The injured party is allowed to recover only that percentage of damage caused by the other person. Under the much fairer comparative fault standard, an injured person would still be able to collect a percentage of an insurance settlement to cover medical bills and compensate for injuries. Now, these victims get nothing.

It could happen to you or someone you love.

Imagine that you’re driving home after picking up your child from school or coming home from a dinner date with your spouse. You have the green light, but just as you’re crossing through the intersection, another car runs the red light. You see their headlights and you know the other driver isn’t going to stop. But in the nanoseconds leading up to the crash, you don’t swerve and you don’t blow your horn. Because all you can think about is your loved one.

The other driver’s insurance company will argue that because you saw the car coming, and didn’t do anything to prevent the collision, you were partially at fault for the accident. Because of contributory negligence, that’s enough to kill your claim and leave you saddled with medical bills resulting from the crash. All while the other driver’s insurance company gets off scot-free.

How little can 1 percent be? In North Carolina, insurance companies have used contributory negligence to deny auto accident claims because the injured person:

  • Failed to honk when passing another vehicle that sideswiped them
  • Failed to look both ways when passing through an intersection with a green light and then was T-boned by another car whose driver ran a red light
  • Failed to slam on the brakes in the seconds before another car slammed into theirs

 

Though someone else was clearly at fault in each of these examples, the victims weren’t able to collect insurance payments for their injuries because they were slightly responsible for these accidents. Does that seem fair?

We don’t think so either. That’s why we’re asking you to call, email or write your elected officials in the N.C. Senate and tell them to SUPPORT HB 813! The bill has already been approved by the state House, and the state Senate is expected to vote on the measure during the current session of the North Carolina General Assembly.

It’s very important that you let your state senators know how you feel and how you want them to vote on this bill. The insurance industry is lobbying them aggressively to keep the current doctrine of contributory negligence. They’re twisting the facts, spreading misinformation and spending thousands every week on an advertising campaign aimed at killing HB 813.

You may have heard their radio commercials claiming that automobile insurance rates will go up if the proposed legislation becomes law. That’s simply not true. Insurance lobbyists are distorting the truth to protect their industry’s profits at the expense of what’s fair for everyone.

FACT:
Before neighboring states South Carolina and Tennessee switched from contributory negligence to comparative fault, auto insurance premiums were much higher there than in North Carolina. Since the change, premiums in those states have increased at a much slower rate than premiums in North Carolina.

The insurance companies also assert that more accident claims will be paid if this new law passes. We certainly hope that’s the case because accident victims in North Carolina have too long been denied fair compensation for their injuries. It’s important to remember that with comparative fault, victims won’t be getting money they don’t deserve. Insurance settlements will be determined by each person’s level of fault.

Victims finally will be getting the justice they deserve after more than a century of unfairness under contributory negligence, a standard designed to protect insurers at the expense of suffering people.

Finally, we have a chance to protect the victims of personal injuries.

Please, contact your elected officials today and ask them to support HB 813. Tell them that current law is too harsh and needs to be reformed. You’ll find contact information for North Carolina’s state senators at the end of this letter. You can learn more about the fight for fair justice in North Carolina by visiting www.fairjusticenc.com.

Thanks for your help in passing this much-needed reform that protects injured people. This is a law that could impact all of us

Tell Your State Senators to Vote for HB 813

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The N.C. General Assembly is considering important legislation that will impact anyone who is hurt in  in an automobile accident or suffers from a personal injury.

We need you to call, write or email your state senators as soon as possible and tell them to support HB 813, which would change the standard in personal injury cases from contributory negligence to comparative fault.

We’ll be writing more about this issue in the coming days, but here’s a quick primer on what’s at stake, courtesy of  North Carolina Advocates for Justice.

All of us expect our civil justice system to be fair, but in North Carolina it’s not. Unfortunately, insurance lobbyists want to keep it that way with empty scare tactics.

Our state is one of only four that clings to contributory negligence, a harsh and outdated way of denying help to people hurt in accidents. Under "contrib," even if you are only 1% percent responsible for an accident, you cannot recover damages from someone 99% responsible.

Comparative fault, used in 46 states, allows people to recover damages from those most responsible for causing an accident. It’s a fair system that does not mean a rise in premiums.

The bipartisan House Bill 813 aims to introduce comparative fault as the new and improved law of the land. But insurance lobbyists are trying to stop this change by distorting the facts. Unlike what insurance lobbyists say, neighboring states with comparative fault have seen premium rates slow down.

Follow this link to find out who represents who in the state senate and how to get in touch with them.

Insurance Companies Practice Deny & Delay Tactics

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Good Morning America has a story that illustrates how insurance companies use deny and delay tactics to avoid paying legitimate insurance claims.

In this case, a woman with Stage 4 breast cancer tried to collect disability insurance. But Cigna repeatedly denied Susan Kristoff’s claim for short-term disability.

Cigna said she had not proven a disability. Sick and with bills piled up, Kristoff says she considered something drastic.

"If I wasn’t going to be getting better, I didn’t want to sink the rest of my family, so I spent two days in bed crying and thinking about suicide," she said.

Instead Kristoff hired an attorney. In short order, Cigna reversed course and paid her short-term benefits. Then with her lawyer’s help, she applied for the much more important long-term help.

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