Archive for the ‘Insurance Practices’ Category

Take it Or Leave It: Insurance Companies To Auto Accident Victims

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Insurance companies have a huge incentive — profits — to hardball auto accident victims.

Their television commercials are designed to make you believe the auto insurance companies are on your side. You’ve seen their slick and entertaining ads, often featuring A-list entertainers, sports stars or talking reptiles. The premise is to make you laugh and leave you with the impression that if you’re involved in a car wreck, the insurance company’s main goal is to get your claim handled quickly and get a check in your hand so you can be back on the road and back to your life without any hassle.

The reality is very different, as many of our clients who have been injured in car wrecks can attest.

Despite ads that cast them in the role of helpers and heroes, auto insurance carriers are paying less and less on legitimate injury claims while continuing to raise premiums for the sake of their profits. Rather than offering accident victims fair settlements for their injuries, medical expenses and property damage, the insurance companies have a decades-long pattern of lowballing people.

The insurance company’s message is clear: “This is our offer. Take it or leave it.”

This is especially true in low-impact accidents – so-called fender benders – which can cause serious and painful soft-tissue injuries that can be debilitating and require substantial treatment.

Accident victims who don’t take the insurance company’s low-ball offer to settle their cases are forced into litigation, which can be expensive and is very risky. The carriers are banking that most people will take the low offer rather than go to trial. That’s because the insurance companies know they can more easily afford to go to trial than you can.

These insurance carriers continue to make huge profits by denying claims and low-balling offers, but do those profits result in lower premiums to you?

Hardly. Allstate has done just the opposite by raising rates.

Do those soaring profits keep Allstate and others from continuing to stereotype accident victims who assert their rights in the courtroom as greedy or looking for a lottery-sized payout?

No. The insurance industry, as a whole, tries to portray you, the person who wasn’t at fault, as the bad guy.

The insurance companies continue to inundate the media with advertising designed to make you think they’re on your side and acting in your best interest. The result is this: more and more jurors are coming to jury duty with the preconceived notion that auto accident plaintiffs must be greedy, committing fraud, or looking for a big payday.

Not one of our clients has ever said they were happy the wreck happened because they were going to receive a settlement. In fact all of our clients wished the wreck never happened at all.

But the insurance industry perpetuates the myth that people who aren’t hurt are getting massive payouts in so-called “frivolous” lawsuits. That’s just not true, but it makes for great headlines that get the public outraged.

Always remember that the insurance carriers are working in their own best interests, not yours.

That’s why you need an experienced attorney on your side.

A CNN investigation, which remains just as relevant and accurate today as when it was first reported, came to the conclusion that “if you challenge the offer by some insurance companies you will be left with no option but to go to court, where you will be dragged through the wringer.” Their strategy is to make it look like victims are trying to defraud the insurers.

The CNN article even quotes a former juror who said she assumed that the plaintiff had already received payment for injuries and other damages from the insurance company and that she brought the lawsuit out of greed. In reality, the accident victim’s insurance claim was never paid, and she lost in court.

The revelations in this article won’t surprise attorneys who represent injured people. Large auto insurance carriers have been using these hardball tactics for decades when addressing claims. And the practice has gotten worse and more brazen in the last decade.

When an auto accident case goes to trial, the other driver is listed as the defendant, but the lawsuit is really against their insurance company. The defendant is represented by an insurance company attorney. If the plaintiff wins, the insurance company will pay any damages, not the other driver.

But jurors don’t know that because the law does not allow your attorney to mention the insurance company during court. We can’t present evidence that your claim hasn’t yet been paid by insurance. The law also does not allow your attorney to mention that the insurer’s settlement offer wasn’t sufficient to cover your medical bills.

Because of these rules of evidence, jurors often draw the wrong conclusion that the plaintiff must have already been paid by the driver’s auto insurance carrier and is just seeking more money by suing the driver personally. This is not true.

In court, the insurance company’s attorneys also will try to discredit plaintiffs by questioning the nature and severity of their injuries. The most common injuries in minor impact cases are soft tissue, muscular type injuries – things you can’t see. But that doesn’t mean you’re not hurt or that you don’t need medical treatment for those injuries, just as you would if you suffered a broken bone or head trauma.

If you’ve been involved in an auto accident, consult our helpful guide outlining what you should and shouldn’t do when dealing with the insurance company. Before talking with an adjuster or signing anything, it may be helpful to consult an experienced personal injury attorney. An attorney can help ensure that your rights are protected.

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.

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.