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DO I HAVE A CASE?

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Love in the Case Value

A few years ago, I had just finished settling a case. The defense attorney pulled me aside to talk about the settlement after the mediation . She told me that the insurance company had paid more on the case than they had initially set aside in reserves.

Then, she went on to explain why. She said that in the beginning, they were not that impressed with my client and thought that the jury might not be sympathetic toward him. Then, they took the deposition of my client’s wife. The insurance adjuster had also been in attendance during that deposition.

When the insurance adjuster filled out her report and then “round-tabled” the case with her superiors and the defense attorney, she kept coming back to her reaction to that deposition. The insurance company came to the conclusion that the jury might see my client differently.

They believed that they needed to settle the case because they were concerned that the jury might see my client through the eyes of his wife. It was obvious how much his wife loved and cared for him and had been there for him, throughout the entire difficult time.

Remembering that story brings me to a 2004 study that was done by the Institute of Human Thermodynamics. They asked a group of kids between the ages of 4-8, “What does love mean” , and the following are some of those responses:

“when my grandmother got arthritis, she couldn’t bend over and paint her toenails anymore.  So my grandfather does it for her all the time, even when his hands got arthritis too.  That’s love.” Rebecca – age 8

“Love is when a girl puts on perfume and a boy puts on shaving cologne and they go out and smell each other.” Karl – age 5

“Love is when you go out to eat and give somebody most of your French fries without making them give you any of theirs.” Chrissy – age 6

“Love is what makes you smile when you’re tired.” Terri – age 4

‘”Love is when my mommy makes coffee for my daddy and she takes a sip before giving it to him, to make sure the taste is OK.” Danny – age 7

“Love is when you kiss all the time.  Then when you get tired of kissing, you still want to be together and you talk more.  My Mommy and Daddy are like that. They look gross when they kiss” Emily – age 8

“Love is what’s in the room with you at Christmas if you stop opening presents and listen,” Bobby – age 7 (Wow!)

“If you want to learn to love better, you should start with a friend who you hate,” Nikka – age 6

“There are two kinds of love.  Our love.  God’s love. But God makes both kinds of them.” Jenny – age 8

“Love is when you tell a guy you like his shirt, then he wears it everyday.” Noelle – age 7

“Love is like a little old woman and a little old man who are still friends even after they know each other so well.” Tommy – age 6

“During my piano recital, I was on a stage and I was scared.  I looked at all the people watching me and saw my daddy waving and smiling.  He was the only one doing that.  I wasn’t scared anymore,” Cindy – age 8

“My mommy loves me more than anybody.  You don’t see anyone else kissing me to sleep at night.” Clare – age 6

“Love is when Mommy gives Daddy the best piece of chicken.” Elaine -age 5

“Love is when Mommy sees Daddy smelly and sweaty and still says he is handsomer than Robert Redford.” Chris – age 7

“When you love somebody, your eyelashes go up and down and little stars come out of you.” Karen – age 7

The Dinosaur Insurance Thinking

     The tour guide was taking the group to the next exhibit. He had been providing such great information that everyone in the group was staying close. Apparently, his knees weren’t hurting him like that tour guide in the Advil commercials. The group kept moving to the Dinosaurs.

     “We now come to Tyrannosauras Rex“, he said. ” This Dinosaur has been on the earth for 2 million and 6 years”. One young man with a question mark on his face and his hand in the air, leaned forward and asked, “How do you know that T-Rex has been here for that long?”

     The guide peered back at him and answered with certain tone, “Well, when I first started working here, they told me that this Dinosaur had been on the earth for 2 million years. I have been working at the museum for 6 years. That’s how I know 2 million and 6 years”.

     I just got a voice mail message from an adjuster in the medical payment division of an insurance company. They had originally denied paying my client’s medicals through her medical payment coverage. 

     When you purchase insurance; Usually, for a minimal yearly amount, you can purchase medical payment coverage that is supposed to pay your medical bills upon submission. In fact, the Virginia State Bar recommends that an attorney fee not be charged for helping clients with their medical payment coverage;  It should only be a matter of sending the bills in and receiving payment.

     It is now my experience that several insurance companies have chosen to  make it difficult in getting payment for clients. Instead they do things like send back forms, and ask that I get my client’s doctors to fill out paperwork to justify their treatment. Yea,  you can see how crazy that is. Plus, most doctors would rightfully charge just to meet about such a thing.

     Now, after that brief explanation, here’s the short “tour guide” version  of what was done. It involved military care. In a personal injury case, the government maintains a lien that should also be paid by the medical payment coverage. Early on, I usually receive notification that I agree to help  the government get paid back.

     Instead, this adjuster had orignially written that I needed to get the military doctor to fill out forms for their consideration. Othewise, “their nurse” had determined that the care was not reasonable.

     I wish I could share the joys of what I did to get some attention. Needless to say, the voice mail advised that “there had been an oversight on the submitted medical payment.  A check is on the way.”

     Unfortunately, I now am wrestling on many of these claims that should just be paid. Instead, new adjusters are told to send out form letters; Not a lot of thinking going on. I guess they would just add 6 years and say 2 milion and 6 and accept it as fact.

The Travelers Insurance Bully

     “You have to give a recorded statement”, the adjuster demanded, “It’s the law”. In this instance, the adjuster was speaking to a lady who had been rear-ended by a Travelers’ insured.

     She replied, “I have to give a recorded statement? I’ve never heard of that.”  She then went on, “What law is that?”. Something about that question must have gotten the adjuster’s attention because he went on to ask her where she worked.

     “I work at the Joel Bieber Firm as a paralegal, and I’ve never heard that the law requires a recorded statement”. The adjuster began backpedaling as he added, “Well, maybe it’s not the law but if you want me to get your car appraised, you’re going to have to give me a recorded statement”.

     If you call your own insurance, they may ask you to give a recorded statement, because the terms of your insurance contract might require it, as part of “cooperation” under the policy. In this fact pattern that happened last week, this was the insurance company for the other side. I’m guessing that this adjuster had said this same statement “that it’s the law”, many times.

     A few years ago, the legislature even added a provision that specifically deals with the recorded statements of opposing parties. Even if they are taken and transcribed, they are not later admissible in any court proceeding, if the person was unrepresented at the time.

     The quiet implication behind this law is that adjusters have been pulling tricks for a while. They say all kinds of things like “You don’t need a lawyer” or “Don’t worry, this is pretty straightforward and I’ll be fair with you”. I’ve just gotten too cynical when it comes to this kind of conduct.

     I have met some adjusters that want to do the right thing in handling claims. It’s my opinion that they are getting a lot of pressure to do it the company way. Last week, this Travelers adjuster ran into someone who had knowledge. Hopefully, the Internet serves as a way to let people know that,  just because an adjuster says it, doesn’t necessarily make it so.

     I’m blogging on that first adjuster meeting. Next up is usually when they start saying that your car can be replaced for some amount that is not possible, except by 19th century pricing. Then, they tell you that your medical bills are not reasonable and that they aren’t going to pay them, unless you get your doctor to write them a letter.  But I digress! For now, this blog is just about the insurance bully.

“Uzzy” and the Negotiation Dance

     My family tells me that I write too many blogs about the ills of the Chamber of Commerce. Lately, I’ve probably been writing too many blogs about negotiating with insurance adjusters. It’s my way to vent.

     Somehow, the video below got sent to me as a crazy sport’s video. When I saw it, it reminded me of my negotiations with adjusters. I know, when you watch the video, you will just shake your head.

     It reminded me of adjusters when they act like their offer of $500 above medical bills is a good offer, and that I should feel some relief, when they say they have a “little room to move”. Then, they never show up at the trial and never call me back after the verdict.  I just don’t think that their dance lives up to their defense.

     Let me set up the video. We have “Uzzy” performing a crazy dance as he comes into the ring. (adjuster performing the negotiation dance). I say “Uzzy” because he has his amazing gold chain around his neck. After about 2 minutes of dancing, he gets in the ring and acts tough with the other fighter. Then, it doesn’t end so good for “Uzzy”. No more dancing out of the ring.

     If the video bores you, just stop it. Maybe turn the music off! I think the ending might be a grabber. I promise, I’ll work on a better blog for tomorrow. It won’t have dancing “Uzzy” in it.

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