By Dale Gribow
I focus a large amount of my practice on collecting compensation for accident victims. However, it is currently more difficult to address the problems of claims strategies used by insurance companies than ever before. For this reason and those expressed herein, many desert lawyers, who do not focus on accident cases, are reluctant to accept them unless they are large.
When I first started practicing, I would send in the medical bills and the insurance company would offer 3-4 times the medicals as a settlement. Those days are gone.
Now we see $9000 in medicals and the insurance company will offer $5000. That is not enough to pay the doctors and legal fees, and clearly there would be no money for the client.
The attorney is thus left to try to find a way to generate “some money” for the client and it often involves asking the doctors to cut their bills.
Most lawyers feel it just is not worth it to have to argue with doctors to cut bills, or argue with insurance companies or defense lawyers to put money on the case. All the while, the client is unable to understand why their case is not worth more money etc. This unfortunately happens too often with low value cases.
People have read about a spilled cup of coffee generating millions of dollars in a jury verdict. The average person does not know, however, that the judge ultimately cut down the verdict to a few hundred thousand dollars. The reason for the excessive verdict was that McDonalds had had thousands of complaints that their coffee was too hot—McDonalds had made a business decision that they can get more cups of coffee from a bag of coffee at high temperatures than lower temperatures.
We work with a former adjuster who we pay to assist with the correct “buzz words” for our settlement demand letter. We want the insurance company to settle our cases and low ball our CV brethren.[GG1]
Today, insurance companies use a computer program called Colossus. The adjuster plugs in the medical bills, the injuries, amount of damage to the car, and who the doctor is and how well he/she writes a report. The computer then spits out a dollar settlement amount they can offer, a ridiculous amount, and the adjuster has very little authority to go higher.
Insurance companies tend to look at whether one went to the hospital by ambulance or by car THAT DAY. They also look at the amount of property damage. In most instances, we will not accept an accident case where the damage to the car is less than $5,000. This occurs because California juries have been finding for the insurance company and against the driver on rear end accidents……..so why should they offer money?
In a trial the attorney for the injured party cannot mention insurance, and the jury is under the impression the plaintiff is suing the individual who caused the accident.
Insurance companies know that accident cases are expensive to get to trial and that most lawyers will fold their cards when they get a low ball offer.
In addition to what has been mentioned already, insurance companies low ball based on how much of the medical bills are for diagnosis versus physical therapy. Obviously, a patient that sees a physical therapist and has a bill for $5,000 is more injured than the party that gets an MRI etc. and receives a bill for $5,000 for only the 45 minutes test. A medical bill from an orthopedist or internist is worth more than a chiropractic bill.
Insurance companies also look at the type of injury and the age of the claimant. Soft tissue/whiplash injures are not worth as much as broken bones. If a victim is 80 years old, many companies will not offer any money. They gamble that the claimant will not live to get to trial, or by the time the case comes to trial the victim will not remember anything.
We had a case a few years ago where our client developed Alzheimer’s/Dementia two years after the injury and did not remember anything. The children did not want to put their parent through a trial. I had invested about $10,000 of my money in costs up to that point when they said let’s drop the case.
A lawyer has to weigh the cost of bringing a case to court versus the potential settlement/jury verdict. With recent case law, the attorney for the victim can only submit to the jury the medical bills that have not been paid by insurance. Thus, if you have $20,000 in medicals and Medicare paid all but $1,000, then the jury will get the $1,000 bill. However, the lawyer now has to deal with Medicare, which can easily take many calls over a 6 month period to Medicare to determine the lien that has to be paid back to them.
The insurance companies over the years have placed numerous initiatives on the ballot and spent many millions of dollars on them. The average person thinks that whatever insurance companies propose is fair… UNTIL they or their loved ones are in an accident. Then they cannot understand why there is no offer or a low offer.
California needs a new initiative to bring back “BAD FAITH” which forced an insurance company to fairly handle claims. An initiative also took that away from us a few years ago.
Remember, when you drink don’t “pull a Bieber” and get behind the wheel and have an accident or get arrested for a DUI:
DON’T DRINK AND DRIVE, CALL A TAXI………IT IS A LOT CHEAPER THAN HIRING ME!
If you have any questions regarding this column or ideas for future columns, please contact Dale Gribow Attorney at Law at his NEW number 760 837 7500 and or his new email: dale@dalegribowlaw.com
