Personal Injury 101 For Clients – Part III

1. What will the insurance company for the person, persons or company who caused my injury do about my claim?

After the insurance company has been notified about the claim, a file is established on you and your case. An insurance clams adjuster is assigned to your file by a claims manager or claims supervisor. The supervisor may assign different adjusters to your case as it progresses.

The insurance claims adjuster responsible for your file will maintain contact with your lawyer. The adjuster will also perform an independent investigation of your claim to ascertain the following:

a. Who is at fault in your case.

b. Whether or not you bear any fault for your own injuries. This is also referred to as comparative negligence or contributory negligence.

c. Potential witnesses in the case.

d. The location of the scene of the accident.

e. The contents of police reports, Department of Motor Vehicle reports, and any other investigative reports that have been filed in the case.

After the initial investigation, the claims adjuster will request medical reports and any other reports dealing with your injuries. The adjuster will also review documents about your time lost from work. Most importantly, the insurance claims adjuster will want to receive accurate records of your medical bills, prescription bills, hospital bills, therapy bills, and any other actual expenses incurred as a result of your injury. That is why it is very important for you to maintain an accurate account of your medical bills, lost wages, and other expenses which result from your injury.

2. How does the insurance company put a value on my case?

This question is quite complicated. First, the claims supervisor or claims manager will provide that a certain amount be “set aside” as a potential value of your case. This figure is usually called “reserves.” Such reserves are the outside value that the company has established on your claim. The reserves may change as the case progresses. In serious cases, such reserves may equal what are called policy limits. Policy limits are the outside limit amounts of liability established in the insurance policy of the person or persons who caused your injury.

During the preparation stages of your case, the insurance company will keep track of your medical bills, lost wages, any permanency regarding your injury, and other factors. The company will also take into consideration the quality of evidence against their insured, the quality of your witnesses and their witnesses, extent of liability on your part, and other important considerations such as previous injuries.

If you had a previous injury in the same area of your body, the insurance carrier will want to see medical records pertaining to that injury. During the course of your claim, your attorney will be notified by the insurance company about the important factors that are being considered in your particular case.

3. Should I communicate with or contact the insurance company for the person who caused my injuries?

Absolutely not! Under no circumstances should you contact the insurance company once you have retained an attorney. If you contact the other person’s insurance company, for any reason, you could ruin your entire case with one question or one statement.

Secondly, because you are now represented by a lawyer, the insurance company, in most states, is absolutely prohibited from having any personal contact with you for any reason.

4. Can I contact my own insurance company?

If you have health insurance, medical payments insurance, automobile uninsurance or underinsurance coverage, there may be occasions when it is appropriate for you to contact your own company. However, you should always ask your lawyer whether or not such contact is appropriate. Never contact an insurance company without first obtaining approval from your attorney.

5. Will the insurance company for the person who caused my injuries dispute my claim?

If liability and responsibility are well-established in your case — that is, if fault clearly rests with the insurance company’s insured (the person or persons who caused your injury), they will try very hard to settle your claim. Insurance companies usually dispute the following types of claims:

a. Claim in which the fault rests with someone other than their insured. This could mean you or someone else involved in the incident who may have caused your injuries rather than the person who is insured by the insurance company.

b. Claims in which the insurance company and its representatives do not believe that you are injured, or that you were injured as badly as you claim. For this reason, documentation of medical bills, lost wages, and other expenses are extremely important to establish credibility and the existence of your injury.

c. Cases in which you or your witnesses have lied, exaggerated, or fabricated the nature and extent of your injury or how the incident occurred.

6. What can I do to convince the insurance company that my claim is valid?

As stated above, the most important thing you can do is to recover as quickly as possible from your injury. Insurance company personnel tend to believe those people who actively try to recover from their injuries. That is why you must cooperate with your doctor, physical therapist and other personnel who are trying to help you improve from your injury.

Secondly, insurance companies believe those people who can document their injuries through medical bills, credible medical reports and accurate lost wage information that is neither exaggerated nor subject to dispute and interpretation.

Thirdly, insurance companies usually settle cases easier with those clients who have been in active contact and cooperation with their attorney.

In summary, it is important for you to try to get better, keep an accurate record of your expenses, and cooperate with your lawyer and his or her staff.

Ten Worst Insurance Companies in West Virginia

Today, the American Association for Justice (Association of Trial Lawyers of America), of which I am a member, just issued a press release regarding the ten worst insurers in the United States. As far as I know, most of the insurers also do business in the state of West Virginia. Here is the press release:

ALLSTATE RANKS AS WORST INSURER FOR CONSUMERS

Insurance Industry Employs “Deny, Delay, Defend” Strategy, Puts Profits Over Policyholders

WASHINGTON, DC – Allstate ranks as the worst insurer for consumers, according to a comprehensive investigation of thousands of legal documents and financial filings.

The rankings show a distinct pattern of insurance industry greed amongst 10 companies that refuse to pay just claims, employ hardball tactics against policyholders, reward executives with extravagant salaries, and raise premiums while hoarding excessive profits.

“While Allstate publicly touts its ‘good hands’ approach, it has instead privately instructed its agents to employ a ‘boxing gloves’ strategy against its policyholders,” said American Association for Justice CEO Jon Haber. “Allstate ducks, bobs and weaves to avoid paying claims to increase its profits.”

Allstate (NYSE: ALL) set the standard for insurance company greed and placing profits over policyholders. Allstate contracted with consulting giant McKinsey & Co. in the mid-1990s to systematically force consumers to accept lowball claims or face its “boxing gloves,” an aggressive strategy designed to deny claims at any cost. One Allstate employee reported that supervisors told agents to lie and blame fires on arson, and in turn, were rewarded with portable fridges.

Thousands of court documents, materials uncovered from litigation and discovery, testimony, complaints filed with state insurance departments, SEC and FBI records, and news accounts were reviewed to compile the rankings and statistics.

The rest of the rankings are as follows:

2. Unum (NYSE: UNM) – Unum’s actions are even more shameful considering the type of insurance it sells: disability. Unum’s behavior was epitomized when it denied the claim of a woman with multiple sclerosis for three years, stating her conditions were “self-reported,” contrary to doctors’ evaluations. In 2005, Unum agreed to a settlement with insurance commissioners from 48 states over their practices.

3. AIG (NYSE: AIG) – The world’s biggest insurer, AIG’s slogan was “we know money.” AIG, described by commentators as “the new Enron,” has engaged in massive corporate fraud and claims abuses. In 2006, the company paid $1.6 billion to settle a host of charges.

4. State Farm – State Farm is notorious for its deny and delay tactics, and like Allstate, hired McKinsey consultants. State Farm’s true motives became apparent during Hurricane Katrina; for example, it employed multiple engineering firms until they could deny the claims of the Nguyen family of Mississippi. In April 2007, State Farm agreed to re-evaluate more than 3,000 Hurricane Katrina claims.

5. Conseco (NYSE: CNO) – Conseco sells long-term care policies, typically to the elderly. Amongst its egregious behavior, the insurer “made it so hard to make a claim that people either died or gave up,” said a former Conseco-subsidiary agent. Former Conseco executives were fined when they admitted to filing misleading financial statements with regulators.

6. WellPoint (NYSE: WLP) – Health insurer WellPoint has a long history of putting profits ahead of policyholders. For instance, California fined a WellPoint subsidiary in March 2007 after an investigation revealed that the insurer routinely canceled policies of pregnant women and chronically ill patients.

7. Farmers – Swiss-owned Farmers Insurance Group consistently ranks at or near the bottom of homeowner satisfaction surveys, and for good reason. For example, Farmers had an incentive program called “Quest for Gold” that offered pizza parties to its adjusters that met low claims payments goals. Like Allstate, it also hired the McKinsey consultants.

8. UnitedHealth (NYSE: UNH) – The SEC opened an investigation into former UnitedHealth CEO William McGuire for stock backdating, which ultimately led to his ouster in 2006 and returning $620 million in stock gains and retirement compensation. Physicians have also reported that their reimbursements are so low and delayed by the company that patient health is being compromised.

9. Torchmark (NYSE: TMK) – According to Hoover’s In-Depth Company Records, Torchmark’s very origins were little more than a scam devised to enrich its founder, Frank Samford. Torchmark has preyed on low-income Southern residents and charged minority policyholders more than whites on burial policies.

10. Liberty Mutual – Like Allstate and State Farm, Liberty Mutual hired consulting giant McKinsey to adopt aggressive tactics. Liberty’s tactics were highlighted when a New York couple’s insurance was “nonrenewed” by Liberty, even though they lived 12 miles from the coast and never experienced weather-related flooding.

Financial documents also revealed extravagant profits and executive compensation while policyholders’ claims were routinely delayed and denied:
· Over the last 10 years, the property / casualty and life / health insurance industries have each enjoyed annual profits exceeding $30 billion.
· The insurance industry takes in over $1 trillion in premiums every year. It has $3.8 trillion in assets, more than the GDPs of all but two countries.
· The CEOs of the top 10 property / casualty firms earned an average of $8.9 million in 2007. The CEOs of the top 10 life / health insurance earned an average of $9.1 million.
· The median insurance CEO’s cash compensation is $1.6 million per year, leading all industries.

To see how consumers can hold the insurance industry accountable and view a full copy of the study, visit http://www.justice.org/docs/TenWorstInsuranceCompanies.pdf.

Thanks, AAJ.

– John H. Bryan, West Virginia Attorney.

I was involved in a car accident in West Virginia – The other driver’s insurance said I don’t need a lawyer – Is this true?

Some insurance companies will send letters to people involved in car or truck accidents telling the injured person that they do not need an attorney.

Since 1995, for example, Allstate has been sending a letter entitled “Do I need an Attorney?” which makes the following claims, among others:

1. Claims are settled faster when a lawyer is not involved;
2. Lawyers charge a percentage of recovery and if you settle directly with Allstate you get to keep the entire amount;
3. Injury victims can hire a lawyer later if they don’t like the settlement offer;
The letter includes many other statements that are misleading, half-true, or not true at all.

Other insurance companies also try to convince injured people not to hire their own lawyer.
Here is the plain truth–Allstate, and the other insurance companies who send these types of letters, do not care anything at all about you or whether you receive a fair settlement.

In fact, the insurance company’s own statistics prove that its costs the insurance industry an average of $9000 more per claim when the injured person has a lawyer.

The reason the insurance companies try to convince people not to hire an experienced lawyer is because they know they can settle the case more cheaply if the injured person doesn’t have a lawyer.

The truth is that you should always at least consult with an attorney before settling a personal injury or wrongful death claim. Personally, I never charge anything for meeting with a client and answering any questions they may have about their case. Other good personal injury lawyers in West Virginia offer the same benefit.

For example, a West Virginia car accident lawyer can help you figure out:

1. The reasonable value of your case;
2. Why delay may be a good thing (or a bad thing);
3. How to get your medical bills and treatment taken care of;
4. How to recoup any lost wages;
5. How long the case will take.

And many other topics. Or any other questions you may have about your case.

The insurance companies won’t answer these questions. Or at least they won’t give you straight and truthful answers.

If you have been involved in a serious car or truck accident in West Virginiia, and the insurance company is trying to convince you not to hire a lawyer, you should know right away that they are trying to trick you into settling your case for pennies on the dollar.
And once you know the insurance company is trying to do this, you know you can’t trust a thing they tell you after that.

Interesting Look At Car Accident Insurance Claim File

There was an interesting post on the Maryland Injury Lawyer Blog today, where Ronald Miller, Jr., posted a redacted insurance claim file regarding a car accident/personal injury case. It serves as a great reminder of why car accident victims, in West Virginia and elsewhere, should contact a car accident attorney BEFORE they give that recorded statement to the insurance company, or BEFORE they accept a tiny settlement from the insurance company.

In case you didn’t know, by the time you start to recover from your injuries, the insurance company already has a ten page file filled with strategy and information designed to deny you the compensation that you rightly deserve. They probably already have recorded statements, from yourself and/or witnesses, and are handing them over to their attorneys to determine the best way to deny or lowball coverage for your injuries.

You can find the car accident insurance claim file here.

– John H. Bryan, West Virginia Car Accident Attorney.

Hearse Leading Funeral Procession Involved in Head-on Collision in Beckley – Creates Unique Car Accident Law Issues

From the Register-Herald today:

A hearse from Ritchie & Johnson Funeral Parlor leading a funeral cortege was involved in a head-on collision Monday shortly after noon.
Rick Barbero / Register-Herald Photographer

A hearse leading a funeral cortege was involved in a head-on collision Monday shortly after noon, according to the Beckley Police Department.

Police said the Ritchie & Johnson Funeral Parlor hearse was traveling northbound around the 900 block of South Kana-wha Street when it was hit by a 1993 Chevrolet Cavalier driven by Amanda Bonds. Police did not release her age and hometown.

Police said Bonds was traveling south when her vehicle struck a 2007 Chevrolet Avalanche on its driver’s side. Bonds’ vehicle continued south before crossing the center line and hitting the hearse head-on.

The funeral procession was held up for about 30 minutes while the casket carrying the deceased was transferred to another hearse. All of the funeral procession vehicles were using headlights and emergency flashers en route to the cemetery, funeral home officials said.

Police said the accident investigation is ongoing, but citations were pending.

This is an awful situation to have a hearse involved in a head-on collision while actually leading a funeral procession. To those of us who are West Virginia car accident lawyers, this situation creates some extremely unique car accident law issues. For instance, citations are “pending,” but who is going to get cited? There will be several different insurance companies involved, as well as workers compensation. Liability will have to be determined between the three drivers involved. Lastly, given that the hearse was itself struck, there could potentially be some damages claimed by the family of the deceased occupant of the hearse, depending on the circumstances.

Read the full article here.

– John H. Bryan, West Virginia Car Accident Attorney.

Should You Contact an Attorney After a Car Accident in WV?

Should you contact an attorney after a car accident in West Virginia?

The short answer is, that it depends. If the car wreck was minor and there obviously have not been any injuries, then it may not be necessary to contact a car accident lawyer in West Virginia. However, if you or anyone you care about has been injured in the car accident, especially if there is any permanent injury, or significant time is lost from work or school or household duties, then you’ll want to see a lawyer about possibly representing you in a claim against anyone else who may be responsible for your injuries. However, even if you’re not injured, don’t entirely rule it out as the facts and circumstances surrounding car accidents are always different.

Contacting an attorney who deals with personal injury (especially relating to auto accidents) can provide you with the peace of mind that no stone gets left unturned. It is especially important to contact an car accident lawyer immediately if any of the following events have occurred:

– An injury has occurred where there has been serious injury (broken bones / hospitalization) or where injuries are likely to be permanent (paralysis);
– A death has resulted from the accident;
– Fault is clearly an issue;
– Other parties were involved such as pedestrians or other autos;
– The accident occurred in a construction area;
– A police report does not accurately describe the accident and puts you at fault;
– Important technical, legal or medical issues are involved;
– The limits of your liability insurance are low,
– You have no insurance, or your insurance company suggests that you did not pay your premium.
– Your insurer starts “acting funny.”
– Your insurer involves its own attorney

Other reasons to speak with a West Virginia car accident lawyer include:

– Seeking advice on the settlement value of a claim (while not an exact science, attorneys may be able to provide best and worse case scenarios);
– Unsure if other insurance (homeowners, travel, etc.) may be available;
– Fault may be an issue;
– Determining whether your insurer may be acting in bad faith (not looking out for your best interests);
– Seeking information on how to handle negotiations with an insurer;
– You don’t know your rights;
– Confused over the terms of your policy;
– Needing an expert to review confusing paperwork or forms.

– John H. Bryan, West Virginia Car Accident Attorney.

Who Pays for Property Damage and Medical Bills after a Car Accident in WV?

Who pays for property damage and medical bills after a car accident in WV?

The answer to this question depends on your own financial resources and the circumstances of the accident.

Typical sources of compensation for damages sustained in a car
accident include:

(1) Your Car Insurance Company – Whether your insurance will compensate you for your loss depends on your insurance contract. In many contracts, there are considerations for both the first party (you and your vehicle) and any third parties (passengers, other drivers; and their property). Some contracts provide medical coverage for personal injuryof the insured and your passengers. In West Virginia, this is called “med pay,” and usually ranges from about $5,000 to $10,000. It is also important to note that any medical payments made by “med pay” will have to be paid back if you end up receiving a settlement or judgment. The policy may pay for collision repairs and possibly for a car rental while your damaged car is being fixed.

(2) Your Health Insurance Provider – You may have private health insurance or belong to an HMO. In the event of a personal injury from a car accident, you can ask your health insurer to pay for medical treatment. Sometimes, private health insurance plans or HMOs require you to seek recovery from your auto insurance company before the health organization will pay or provide medical treatment. Like “med pay,” in West Virginia, your health insurance will have a lien on any future settlement or judgment that you obtain. So it is important to realize that any future recovery that you receive will automatically subtract these subrogate amounts before you receive a dime of the recovery.

(3) Other People Involved In the Accident – In addition to the three sources above, you may be able to seek recovery from other people who were involved in the accident. West Virginia is an “at fault” states, so this option depends on how fault is apportioned among the other driver(s). This is also subject to the comparative negligence analysis (see my prior posts regarding “fault”). If you are “at-fault” for an accident that occurred in a “fault” state, contact your insurance company. It is the company’s job to defend you in court or to negotiate a settlement.

– John H. Bryan, West Virginia Car Accident Attorney.

Who Do I Contact After a Car Accident in West Virginia?

Whom do I contact after an auto accident?

(1) Police or other law enforcement – If the accident causes a personal injury or when property damage exceeds a certain dollar amount, such as $500, you are required to report the accident to police. Officers may take reports over the phone, but sometimes you have to make reports in person at the police station. Ideally, every car accident should be reported to the police at the scene of the accident. This will enable the officers to investigate the scene of the accident and take statements.

(2) Insurance company – Most auto insurance companies require their policyholders to promptly report a car accident. The time frame can be VERY short. Failure to report in time may mean the company denies you coverage.

The insurance company will want all of the basic information to help its investigation.

NOTE: Sometimes the insurance company will want you to record a statement. For example, you may be on the phone with your insurance company when a representative will ask permission to tape the conversation. If you or your passengers were injured, if you think the insurance company may claim you’re not covered, or you have any concerns about the amount of your coverage, you may want to contact a West Virginia car accident attorney before you give the insurance company permission to record. See my prior posts on how insurance adjustors work to deny your claim before it even is made.

– John H. Bryan, West Virginia Car Accident Attorney.

Determining Fault in West Virginia Car Accidents

Fault is one of the biggest, if not THE most critical element, in any car accident claim. The person at fault is the person whose negligence caused the accident, and that is the person who typically must pay for the damage caused by his or her negligence. If the circumstances surrounding your accident make it clear that one person was clearly at fault, then read no further! One of the related posts listed below should be your next stop. If, however, liability is not entirely clear or if there is shared fault, then fault is apportioned between the persons determined by the specifics of the law in your state (see below) on comparative or contributory negligence. When liability is shared in an auto accident, it is the insurer’s turn to determine the relative percentages of fault of the parties involved.

Historically, if two people were involved in an accident and the injured party was even the slightest bit at fault, he or she would not be entitled to recover anything for his/her injuries or losses. This way of determining damages is known in legal circles as pure contributory negligence. Some states, such as Virginia, still follow this harsh rule.

Other states, such as Florida, have adopted a rule known as pure comparative fault, where if an injured person is partially at fault for causing his own injuries, his damages are reduced by his percentage of fault.

West Virginia has proportional comparative fault, which is somewhat of a mix between contributory negligence and pure comparative fault. In West Virginia, even if you are partially at fault for the accident, you can still recover damages as long as you are not more than 50% at fault for the damages (some states use 51%). If the person is under 50% at fault, then his recovery will be reduced by whatever percentage he contributed to the injuries (i.e., the accident).

Fault can be determined in several different ways. Initially, it will be up to the insurance adjustor to determine the proportion of fault. Obviously, a car accident victim should be very leery of accepting this determination. An experienced car accident attorney will have the knowledge, expertise and skill to negotiate with insurance adjustors at this stage for the best possible apportionment of fault, and hence the best possible settlement. Beyond this point, it will be up to a jury to determine fault, at which point there obviously must be a car accident attorney involved, preferably one who is experienced and skilled at convincing the jury that fault properly lies with the other party.

– John H. Bryan, West Virginia Car Accident Attorney.

The “Do’s and Don’ts” Following Car Accidents

Do

Call the Authorities:

The police will help memorialize the situation, and they will create a police report about the car accident, sometime identifying who they believe is to be at fault.

Get Medical Treatment:

If you believe that you are injured or are unsure, you should go immediately to the hospital, either with a family member or friend driving you, or in an ambulance. However, injuries often arise months after car accidents occur, so it nevertheless is important to see a doctor to make sure there are no injuries that you are unaware of.

Obtain Information:

Get the contact information for all drivers, passengers, and witnesses of the car accident. Other important information to collect includes insurance information, VIN numbers, and license plate numbers of all vehicles involved.

Take Pictures:

It is a good idea to always keep a camera in your car, whether disposable or digital. Take pictures of the vehicles involved in the accident, as well as the surroundings and any skid marks on the road. Also, take pictures of any visible injuries on your body.

Call a Car Accident Attorney:

An experienced car accident attorney will know how to build your case, preserve your rights, and then deal with the insurance companies and their adjustors. An experienced car accident attorney will also be able to take the insurance company to task if they will not give you the compensation you deserve, by filing a lawsuit and proceeding towards trial.

Don’t:

Admit Fault:

Car accident law is confusing and complex, and you should never admit fault because you may not actually know who was legally at fault. Your car accident attorney will investigate the situation for you, and will be able to better determine where fault lies. If you do admit fault, then you may be denied compensation that you deserve.

Leave the Scene:

Never leave the scene of an accident. This is not only illegal, but it will surely diminish your chances for getting fair compensation for the injuries that you suffered – regardless of who was at fault.

Wait:

Do not wait for the insurance company to contact you. Do not wait to contact a car accident attorney. Doing so can severely limit the outcome of your car accident claim. The insurance companies will not wait to work against your case with their army of attorneys and adjustors – all trained to limit the compensation that you deserve.

Sign Anything:

Do not sign any papers presented to you by any insurance company without first consulting an experienced car accident attorney. Doing so may prevent you from recovering compensation for your claim.

If you have been involved in a car accident, the most important thing that you can do is to contact an experienced car accident attorney. If you were involved in a car accident in West Virginia, please feel free to contact me for a free consultation regarding your case.

– John H. Bryan, West Virginia Car Accident Attorney.