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Read it again, Grammy!

One of my favorite childhood memories takes me back to my love of a great story. My grandmother used to get her morning coffee and butter raisin toast. Then, she would sit down in her big red chair and I would sit on the right arm of the chair.

She would reach to her left and pick up a story book from the stack of books that were collected next to the chair. Then, she would open the book and begin to read as I would peer over her arm and look at the pictures and words that I could not yet comprehend.

She had read these same books to me over and over so many times, that I could repeat the words verbatim. Still, with exciting voice inflexion and change of voices to match each character in the books; she read them as though it was the first time, and I listened so attentively as though I had never heard this story.

The stories all had some lesson that included some hero. And, of course, there was always a good ending to the story. Then, I would say, “Read it again Grammy, read it again”. She would commence at the beginning again until we would move on to the next book. The only break usually included her getting a refill on her coffee.

Many times before bed, we would be right back to those same stories. Even if we had to take a break for real life things. As I type this blog, it takes me back to such a good feeling of just sitting there, never wanting the Grammy to stop reading.

In Saturday’s HamptonRoads.com, there was a story titled “Job seeker tries to plant seeds at Va. Beach expo”. The story included a picture of a young man standing in front of the display. He is bit out of place at the Virginia Beach Convention Center, where the Virginia Flower & Garden Show is set up.

The many displays on the floor include potted greenery and garden tools. At this one display, a 27-year-old man stands with a table behind him, and a large white sign that says “John Wike/Bachelor Degree-Business Management”. Instead of selling rakes, he is pitching himself for employment; hoping that during the three days of this convention that someone will have a job opportunity for him.

In real life, the end of the story is not always perfectly scripted. Many clients that call me also weave a story of lost wages and lost opportunity. Sometimes on their path of life, they are unable to pursue a career or take a desired job that has been offered. Other times, they miss so much work that their employer either terminates them or they lose some career advancement opportunity.

Part of the damages of an injury claim can include making a claim for lost wages. That claim exists even if a person did have sick time that they could take as a benefit of their employment. The person that hit them does not benefit from the collateral benefit of a sick leave payment.

Virginia also recognizes a claim for loss of earning capacity. Following an accident, a client may be earning more than they were earning before the car crash. However, they may have lost a job or career opportunity that could have provided a better income for their future. For that, the person that caused the crash should also be responsible.

Every day, I hear “stories” about difficulty. Fortunately, I have also seen many good endings, despite the road of difficulty in getting there.

After I read the “Wike story” about how he was seeking a job; I also continued to read the comments that followed. One person commented that they really enjoyed reading the story. Then, they wrote, “please do a followup story on him…. I bet he gets a job soon”. Just like me, they like a happy ending.

In my head, I can still hear my high voice saying to my Grandmother, “Grammy, read it again” and my grandmother turning the book to the beginning and off we go again to a happy ending.

Just for conversation, I still have people ask me about “my holidays”. So, I am posting this pic o’ day that makes me laugh:

 

 

 

Convicted Union Clerk

When I first opened our South Carolina office, I quickly learned about South Carolina’s court appointments. At the time, lawyers were court appointed to cases in every county where they practiced.

Soon, I started getting court appointments in a multitude of courthouses. Fortunately, the Chief Justice ultimately changed the rule on court appointments there. Now, as a South Carolina lawyer, you only have to have your name placed in two counties. Then, you cannot be appointed to more than 20 cases per year, and I don’t receive that many in any calendar year.

I could spend many words on stories about being appointed to matters of unusual events. For the purposes of this blog, I will discuss Union County, because of a story that I just saw in the Spartanburg online newspaper.

First, my Union court appointments. At the time, Union was about two hours from my South Carolina office. All of a sudden, it seemed that I was constantly getting several court appointments from Union County. I called and spoke to the Court clerk, who advised that there were only 23 lawyers in Union County. Since I had chosen to place advertising in their local phone book, I was added to their roster of lawyers.

The rotation of 24 lawyers meant that I kept coming back up on the master list,  for court appointment and the clerk told me that there was nothing I could do about it. Next time I received a call to renew my yellow page advertisement… I did not renew. I called the clerk and advised that I no longer was advertising there and I had no phone in that county. I was taken off the list!

The story I have attached is about the Union court clerk. This clerk was sworn in around 2004; so it was after my slew of appointments. It’s a story about the clerk being convicted of embezzling county money and being sentenced to jail time, and ordered to pay restitution of $239,982 to the county’s child support fund.

I feel bad that this happened and I am only blogging on this because my of my past experiences there. Now, when a Union story comes across my “in box”, it reminds me of my “practice” there.  Coincidentally, several of my appointments related to juvenile and domestic matters that also sometimes included child support issues. I still don’t feel comfortable handling those matters. Let me stay right in the practice of injury law where I am comfortable!

For pic o’ day, here’s a golf game spoiled:

Baseball Cards in the Attic

     It’s a story about finding the unexpected. It’s better than reaching into the winter coat pocket and feeling a $5 dollar bill. Although, that’s pretty good too.

     Karl Kissner saw a soot-covered cardboard box that had been under a wooden dollhouse, in his grandfather’s attic.  When he looked inside the box, he saw baseball cards with names that were familiar: Hall of Famers Ty Cobb, Cy Young and Honus Wagner. The cards were smaller than the cards he was used to seeing.

     After seeing the box and its contents, he put them down and began going through other boxes in the attic. Later, he took the box to a card authenticator. He was soon thankful that his grandfather, who had died in the 1940’s, had not thrown them away.

     It turns out that these cards are some of the finest examples  from a set known as the E98 series. Based on the initial evaluation, the cards should bring somewhere between $2 and $3 million at auction.  You can click for the full story of the cards above.  A treasure in the attic!     

     When I saw this story, it reminded me of a call that I received a few years back. A collector told me that it had rained through the roof and destroyed all his cards. The cards were insured, but the insurance company was only offering him $18,000 and he thought they were worth a whole lot more.

     Normally, I would not take a case that did not involve an injury. But, I sometimes do take insurance claims and I was also interested in this subject matter. I have a small collection of cards too.

     I traveled down to look at the cards that were now wrinkled and wet from the rain leak. There were several boxes of cards stacked all over a room. Some had dried but they were clearly damaged.

     Initially, I had to file suit. Then, the insurance company agreed to arbitrate the loss. Strategically, I decided to hire an expert and present a case to an arbitrator instead of a jury.

     The defense lawyer and the insurance adjuster put little value or defense, in the client’s cardboard collection. They never did offer more than $18,000. They did base that on some thought process but I can’t remember why.

     My expert put the value of the cards at around $120,000. He also was someone known in the sports collecting field because he regularly wrote a column for a Sports Card Company publication.

     I suspect that you have already guessed that I was pleased with the outcome. Yes… I was! The arbitrator came back with a verdict of $98,000 for the cards.

     My client was disappointed in his card loss but pleased in the result. The insurance company said that they would agree to make payment on the verdict. Then, they wanted the cards as well. Finally, they agreed that they really didn’t want “all those moldy cards”. 

     I found a few that still could be recognized. My client threw almost all of them out but he gave me a couple as a souvenir of our case. It wasn’t a treasure from the attic, but I guess it was “”pennies from heaven” in the form of rain. 

     Pic o’ day is one of those that keeps making me smile. Imagine if you saw this on the neighbor’s porch:

 

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.

How Bout A Little Help

 

     This video from YouTube reminded me of insurance adjusters. Recently, I have been told by some new clients, that they received a phone call from adjusters, the day of the accident, or the day after; to let my clients know that they wanted to resolve their case. The adjuster said that they would be willing to come right out and pay them $500, if they would just sign a release.

     Many times, I will hear that adjusters say that they will pay their medical bills and that there is no need for that person to call a lawyer. To date, I have never heard of an adjuster who was willing to put in writing that “You’re not at fault and we will pay all your medical bills that are related to this crash.

     It reminds me of the claim I handled, a few years ago. The adjuster said that they were at fault and were willing to settle the case. As soon as I sent the settlement package with medical bills that exceeded 20K, the adjuster advised that they were no longer accepting liability.

      Like this “help” on the soccer field, sometimes it’s just better to not receive the help.  A good Friday reminder!

Cutting the Pounds

     If you came to the blog today for the secret to weight loss, you are going to be disappointed. Although, I hear that grapefruits are still a winner and, how can you eat a shake for breakfast, for lunch and a sensible dinner? Or, someone said that they like to eat dried apples for breakfast, drink water for lunch and let them swell for supper. 

      Instead, it’s a look at the Queen making cuts at Buckingham Palace and the quotes that come from the Keeper of the Privy Purse. (gotta love those job titles) I guess I could have titled this “Queen Sheds Pounds” or “Cutting the Pennies not the Krumpets”.  Ok, no more silliness.

     Amid a tight budget, the Queen of England is making some tough choices. She has frozen the salaries of all those earning more than $73,500; She is looking to reduce her staff of 1400 employees and there is even talk that these cuts could include letting the royal piper go; who plays under her window in the mornings and is also tasked with the job as official counter of the swans.

     It’s not surprising that when times are tough, companies start looking for ways to reduce and make cut backs. However, insurance companies are held to a different standard than just  deciding to cut back. Failure to make payments on claims is called bad faith. Companies such as United Healthcare have been fined for such conduct and the American Association for Justice says the following as to how they are handling their business:                                                     

 Misrepresenting products. In 2007, the federal government suspended UnitedHealth from marketing its Medicare Advantage program, after it found that the insurer was misrepresenting its products. If you google United Healthcare and “bad faith”, you will find people from many states who have posted blogs and comments about such representation. 

 Denying and delaying claim payments. Several state insurance departments have fined UnitedHealth for wrongfully denying and delaying claim payments to policyholders and to the doctors that treat them. In fact, the American Medical Association (AMA) filed a lawsuit against the insurer for its reimbursement rates. I have attached a “complaint board” with several examples.

 Putting profits over policyholders. United Health has continually been accused of putting profits above the needs of its policyholders. The American Association of Retired Persons (AARP) licensed its name to three prescription drug plans under the United Health name. Unfortunately, costs under the plans tend to be more expensive than many other plans, and seniors who rely on the AARP name may be paying too much for prescriptions.

     Despite United Health’s decision to make cut backs on coverage, it has not made executive compensation cut backs. In 2009, CEO Stephen Hemsley received compensation of $102 million. It’s first quarter profit for 2010 has risen 21% to a profit of 1.2 Billion. Based on the comments I am pasting below, you can see that policy holders don’t feel this same generosity. Here are their comments from the United Health website:

“United Healthcare is the worst insurance company ever. Their goal is try to put every road block possible in your way, to make reimbursement for claims impossible. They are rude to deal with and lie. They are in the market to make money by denying you and your family the care you need. I give this company an F-.”

“United Healthcare indiscriminately raised our daughter’s monthly meds co-pay from $1,100 to $1,834. Their explanation? We can do whatever we want. File an appeal if you don’t like it.

Have a 35% increase in monthly premium this year with an additional $1,000 co-pay on top of first $4,000 claims are my responsibility. What insurance?”

“Impossible to speak with a supervisor, phone clerks are rude and each one gives a different answer to the same question. Repeated, systematic denial of mental health claims that are clearly covered by my policy with no real explanation of why, assured each time it is going to be taken care of just to find out a month later it is denied again for some reason that makes no sense. Never actually notified it is denied, I have to call and ask.”

     The word counter on my blog already tells me that this is too long. In conclusion, I just wanted to bring this to your attention. Sometimes I am told that I seem to really come down hard on insurance companies. In my world, this is what I see. Hopefully, more State’s Attorney Generals and legislators will say that enough is enough and it’s time to treat people fairly  instead of collecting premiums and not making payments. The next thing you know, the CEO will hire his own swan counter.

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