Archives For Insurance

No.02.imagesThe 3 easiest and cheapest ways for the insurance adjuster to shoot down the value of your claim is DELAY, DENY, and DON’T PAY.

These are effective because all they have to do is go passive and do nothing, nada, zilch.

The Three “D”s of Delay, Deny and Don’t Pay. Learn why it pays to hire an injury lawyer to help you when you are up against the insurance adjuster.When you are hurt in a car wreck, you will be facing an experienced and well-armed adversary in  the form of an adjuster who is backed by a large company.

An insurance adjuster whose sole goal is to find ways to deny your claim, delay your claim, and don’t pay your claim.

How does an insurance adjuster  make the most of the Three “D”s of  DENY, DELAY AND DON’T PAY?

Well, the easiest way is for an insurance adjuster to attack you under the guise of wanting to help you and be reasonable.

It may sound good, but beware.  It’s not true.   Do you really think the adjuster paid by the insurance company of the driver who just hit you, hurt you, and wreaked havoc on you, now wants to help you?

First, the adjuster owes a duty to help their insured, not to help  you.

Second, the adjuster wants to keep his job and paying too much to  you would  hurt him or her and worse yet for you,  paying too little scores points for him with his boss and saves money for the company and its shareholders.

Third, open claim files cost the insurance money so they want to settle it fast.  They know with time, things can change and they can lose control.  Heck, you might even gain a better understanding of your injury as time passes and you receive the medical treatment you need.

Fourth, the “mushroom” method works just fine for the insurance industy.  The longer you are kept in the dark and fed manure, then the less likely you will seek the help of a lawyer to represent you, know your legal rights, and get your medical bills paid.

The insurance company knows from their own studies over the years that knowledge is power, and their employees are well-trained in insurance law, medical issues, and the not so fine art of negotiation.  You are one person against a large company; a very, very, very large company with resources that you cannot even imagine at their disposal.

Did you know that the insurance companies share claims and medical information regarding those claims with each other through a commercially available service.   The fact that you were hurt before, may or may not be a factor in the value of your claim.  But if you are alone when you learn this, it can be quite a shock, and is intended to scare you.

You can balance the scales in YOUR FAVOR.

How?  By simply hiring an experienced personal injury attorney.  An attorney who knows the law, the courts, the medicine, and you.   A good injury lawyer can be  your “slingshot” against Goliath insurance company.

Now, for a tidbit of information that is crucial in deciding to hire a lawyer or try and save some money by going it alone.

Insurance companies do not want you to hire a lawyer.  Some adjusters even tell  you that you do not need a lawyer, telling you that paying a lawyer costs  you money so  you get less.

This is simply not true.

Worse yet, the insurance company knows it is not true.  Their own studies tell them it is not true.  Their own manuals years ago were written to keep you away from a lawyer.

There have been several studies as far back as 1999 which document the fact that insurance companies pay higher settlements to injured people who use an attorney than those who do not use  an attorney.

The insurance industry performed this study to find out if people who had accident claims received more money in settlement by using an attorney than those people who settled on their own.  According to this study conducted by the Insurance Research Council, a non-profit organization that is supported by leading property and casualty insurance companies across the United States, it was found that people who used an attorney received on average 3.5 times more money in settlement than those individuals who settled on their own.

If an insurance adjuster tells n accident victim they don’t need to hire a lawyer because they will receive less money in settlement, that would not be correct.  That would be a lie.  That would be a warning sign that the person on the other side is trying to take advantage of you and is not to be trusted

So.  Remember this truth.  Kentucky injury lawyers…… When you hurt.  We help!

The mission of the IRC is to advance the insurance industry’s view on matters crucial to insurance companies. The IRC found that people who used an attorney received on average 3.5 times more money in settlement than those individuals who settled on their own. Often times accident victims are told by the insurance adjustor that they shouldn’t hire a lawyer because they will received less money in settlement. This study shows that this simply is not true.

Truck Safety Violations Report AAJThe recent truck fatality on Interstate 65 near Elizabethtown, Kentucky highlights the dangers and concerns over the serious, and often fatal consequences, with tractor-trailer and automobile collisions.

Driver distraction is being investigated as one of the causes of this collision when the truck driver plowed into an SUV from Wisconsin killing six people.  It is sad to note distracted truck driver collisions have occurred in this stretch of road before.  Although the term is “distracted driving”, it is still negligence and failure to exercise ordinary care.  More importantly, there are many causes of distracted driving by truckers.  In addition, the truck driver stated that he hit the brakes but didn’t hit them in time.

A recent report by the American Justice Association which reviewed extensive data from federal and state authorities and the causes of truck collisions noting the large number of truck safety violations being involved:

Truck accidents occur for a variety of reasons, but many are preventable, and often are a direct result of trucking companies violating safety standards to cut corners and maximize profits. The average profit margin for trucking companies is very low, and nine out of ten start-up companies go out of business in a little over one year. These violations include such practices as overload ing trucks, allowing unqualified or untrained drivers on the road, failing to maintain tires and brakes, and compensations systems that encourage truck drivers to exceed speed limits and maximum driving hours.

Click here for the AJA report entitled, “Warning Safety Violations Ahead: Motor Carrier Companies Keep Unsafe Trucks on U.S. Roads“.

For more details on this collision plus the one that may have been triggered by it minutes later, see story from WKU “Six Wisconsin Family Members Die in I-65 Wreck in Hardin County“.

Kentucky State Police were investigating whether distracted driving caused a tractor-trailer to plow into an SUV carrying eight people on Saturday, killing six and possibly triggering a serious crash on the opposite side of the highway.

The truck driver is “telling us that he saw the vehicle that was in front of him and he hit the brakes and he didn’t hit them in time,” Master Trooper Norman Chaffins said. ” … There was a reason for that and we’re trying to figure out what the reason was.”

The late-morning crash was followed 15 minutes later by a multi-vehicle crash on the opposite side of Interstate 65 that injured three people. The site was just 15 miles from where 11 people died in 2010 when a tractor-trailer crossed the median and hit a van carrying a Mennonite family. Ten people in the van were killed along with the truck driver and the National Transportation Safety Board determined the truck driver was distracted by his cell phone.

lies-and-truth-imagesWhen you are hurt in a car wreck, you will be facing an experienced and well-armed adversary in  the form of an adjuster who is backed by a large company.

An insurance adjuster whose sole goal is to find ways to deny your claim, delay your claim, and don’t pay your claim.

How does an insurance adjuster  make the most of the Three “D”s of  DENY, DELAY AND DON’T PAY?

Well, the easiest way is for an insurance adjuster to attack you under the guise of wanting to help you and be reasonable.

It may sound good, but beware.  It’s not true.   Do you really think the adjuster paid by the insurance company of the driver who just hit you, hurt you, and wreaked havoc on you, now wants to help you?

First, the adjuster owes a duty to help their insured, not to help  you.

Second, the adjuster wants to keep his job and paying too much to  you would  hurt him or her and worse yet for you,  paying too little scores points for him with his boss and saves money for the company and its shareholders.

Third, open claim files cost the insurance money so they want to settle it fast.  They know with time, things can change and they can lose control.  Heck, you might even gain a better understanding of your injury as time passes and you receive the medical treatment you need.

Fourth, the “mushroom” method works just fine for the insurance industy.  The longer you are kept in the dark and fed manure, then the less likely you will seek the help of a lawyer to represent you, know your legal rights, and get your medical bills paid.

The insurance company knows from their own studies over the years that knowledge is power, and their employees are well-trained in insurance law, medical issues, and the not so fine art of negotiation.  You are one person against a large company; a very, very, very large company with resources that you cannot even imagine at their disposal.

Did you know that the insurance companies share claims and medical information regarding those claims with each other through a commercially available service.   The fact that you were hurt before, may or may not be a factor in the value of your claim.  But if you are alone when you learn this, it can be quite a shock, and is intended to scare you.

You can balance the scales in YOUR FAVOR.

How?  By simply hiring an experienced personal injury attorney.  An attorney who knows the law, the courts, the medicine, and you.   A good injury lawyer can be  your “slingshot” against Goliath insurance company.

Now, for a tidbit of information that is crucial in deciding to hire a lawyer or try and save some money by going it alone.

Insurance companies do not want you to hire a lawyer.  Some adjusters even tell  you that you do not need a lawyer, telling you that paying a lawyer costs  you money so  you get less.

This is simply not true.

Worse yet, the insurance company knows it is not true.  Their own studies tell them it is not true.  Their own manuals years ago were written to keep you away from a lawyer.

There have been several studies as far back as 1999 which document the fact that insurance companies pay higher settlements to injured people who use an attorney than those who do not use  an attorney.

The insurance industry performed this study to find out if people who had accident claims received more money in settlement by using an attorney than those people who settled on their own.  According to this study conducted by the Insurance Research Council, a non-profit organization that is supported by leading property and casualty insurance companies across the United States, it was found that people who used an attorney received on average 3.5 times more money in settlement than those individuals who settled on their own.

If an insurance adjuster tells n accident victim they don’t need to hire a lawyer because they will receive less money in settlement, that would not be correct.  That would be a lie.  That would be a warning sign that the person on the other side is trying to take advantage of you and is not to be trusted

So.  Remember this truth.  Kentucky injury lawyers…… When you hurt.  We help!

auto.insurance.policy.imagesHave you been hurt in a car wreck?  Then you need to know the “rest of the story”.

We all remember the Paul Harvey line of  “Now for the rest of the story”.    It was more than just a reporter’s by-line,  it was a reminder that a half-truth is not a truth at all.   A half-truth is a total lie because it  misleads, confuses, and worse – it can hurt people.

That is why I am posting today on Personal Injury Protection benefits or PIP and the rest of the story.

I frequently see promotions and advertisements where someone somewhere tells the public that they can get you Ten Thousand Dollars from your car accident.

Well,  that is a half truth.  Let me tell you the rest of the story.

Yes, when you have been hurt in a car accident in Kentucky, you are entitled by law to up to $10,000 in personal injury protection benefits.   This is sometimes called no-fault benefits or PIP benefits.

You are entitled to your personal injury protection benefits, regardless of who caused the accident or whether you are even at fault.   It is also a fact that PIP benefits are there to pay you quickly and to cover you for any lost wages or medical bills you have because of the car accident  and that you can claim PIP benefits while you are hurt and still  treating.

However, here is where you have to be careful because the half-truth can cause harm to others if you now mistakenly believe that someone has valued your entire  your case for $10,000, and that you can expect to recover $10,000 as the  amount for  your pain and suffering.

The $10,000 available to  you for PIP benefits are not payments for your pain and suffering or any permanent injury caused by the car collision.  You can only get paid for your pain and suffering from the other insurance company whose driver was at fault for causing the collision.  If anyone tells you differently or that you can get $10,000 for your injuries to include past and future pain and suffering,  medicals, and impairment to work, then you have not been told the whole story because:

  • PIP is NOT pain and suffering.
  • PIP does not pay anything unless  you have an actual wage loss or medical claim caused by a car accident.
  • PIP does not cover you for wages or medical bills unless AND until you miss the work or have the medical treatment.

Now, what is pain and suffering and how do you get paid by the insurance company for those damages?

You can get awarded pain and suffering – If you have a permanent injury or at least $1,000 in medical bills for injuries from the car accident, then you can make a claim for pain and suffering against the at fault driver’s insurance company.

However the at-fault driver’s insurance company does not represent you and is not there to help you.

The at-fault driver’s  liability insurance company will not roll over and pay you $10,000 as some might have  you believe because that is not how an insurance company makes money for its shareholders or how they protect their own insured drivers.

Worse yet for you, the liability insurer knows the lay of the land and is not required to pay you full value for your claim.   If the other insurance company can get away with it,  then they will try and settle your claim on the cheap.  Sometimes they even pay less than their own evaluation!

So, if you have been hurt in a car collision and wish to be paid for your pain and suffering from the other insurance company, then you will want to get all the money you deserve for  your pain and suffering.

That’s where a lawyer can help you.

That’s what injury lawyers do.   When you hurt, we help!

Chambers of Kentucky Supreme Court in Frankfort, Kentucky

Chambers of Kentucky Supreme Court in Frankfort, Kentucky

Although cases are tried with one eye looking at the verdict and the other eye looking ahead past the verdict by preserving the record for a possible appeal, the order or judgment being appealed must contain the “magic language” of finality, appealability, AND “no just cause for delay” language.

With these magic words, the time to appeal begins to run.

The reason I mention this is that in the following nonpublished decision by the Court of Appeals, written by Judge Joy Moore,  she refers to my first appellate case that went all the way up to the Supreme Court of Kentucky (Preferred Risk Mut. Ins. Co. v. Kentucky Farm Bureau Mut. Ins. Co., 872 S.W.2d 469, 470 (Ky. 1994).   For more recent decisions by the Supreme Court of Kentucky and the Court of Appeals of Kentucky, click here for cases I have posted at the Kentucky Court Report.

I remember the day of oral arguments vividly.  The preparation, leaving early to make sure I was absolutely on time to avoid any travel problems, etc., nervously waiting in the court room in Frankfort in State Capitol, and the peppering of questions by Justice (now retired Chief Justice Lambert) and Justice Joseph Liebson and others.

However, I most remember while waiting and reviewing my notes, I reached into my shirt pocket for my “Flair” felt tip pen to make a note on the margins.   And the pen had leaked!  I had a large green stain on my white shirt!  Fortunately, buttoning the jacket concealed the stain.  Moral of the story is that preparation is important, practice is key, and presentation paramount, but a little luck can go a long way.  The shirt was ruined, but the large green stain was hidden by the jacket and the red face of my embarassment  went unnoticed.   I probably looked a little like Napoleon with my left arm a little crossed over in front to make sure the suit coat did not reveal the green stain.  I sometimes refer to that case as a miracle, not because I prevailed on the legal issues at trial, won the appeal, or even that I survived oral argument with my shirt intact.  No, the case was a miracle because one of the litigants in the case was named Miracle!

Ohio Cas. Ins. Co. v. City of Providence, COA, NPO 11/16/2012

As a general matter, “this court is required to raise a jurisdictional issue on its own motion if the underlying order lacks finality.” Tax Ease Lien Investments 1, LLC v. Brown, 340 S.W.3d 99, 101 (Ky. App. 2011) (citing Huff v. Wood–Mosaic Corp., 454 S.W.2d 705, 706 (Ky.1970)). With that said, the circuit court had the authority to bifurcate Providence’s action against OCC into two separate claims (i.e., one claim for the interpretation of the contract and its coverage provisions, another for an assessment of damages pursuant to the contract). The circuit court also had the authority to render its decision regarding coverage immediately appealable while reserving the separate issue of damages for a later date — provided that it did so by following the requirements of Kentucky Civil Rule (CR) 54.02. See Preferred Risk Mut. Ins. Co. v. Kentucky Farm Bureau Mut. Ins. Co., 872 S.W.2d 469, 470 (Ky. 1994).

However, CR 54.02 required the circuit court’s order to recite not only that it was final, but that there was “no just reason for delay.” Watson v. Best Financial Services, Inc., 245 S.W.3d 722 (Ky. 2008). “Absent those certifications, the rule is not invoked.” Spencer v. Estate of Spencer, 313 S.W.3d 534, 540 (Ky. 2010). Here, the circuit court’s order simply recites that it is “a final and appealable order,” but omits that there was “no just reason for delay”; its  subsequent order overruling OCC’s CR 52.02 motion for additional findings did not cure this omission; and, as a consequence, the circuit court’s order, which is the subject of this appeal, is merely interlocutory and unripe for review. Watson, 245  S.W.3d 722.

The hard fact is that it was appellant Ohio Casualty’s responsibility to ensure that the circuit court’s judgment was in the proper form to invoke CR 54.02.  Spencer, 313 S.W.3d at 540. Having failed to do so, Ohio Casualty has left this Court with no option other than to DISMISS its appeal.

Here is that decision written Justice Spain in Preferred Risk Mutual Insurance Company vs. Kentucky Farm Bureau Mutual Insurance Company.  Although the parties “named” in this appeal in the style of the case, the heart of the case was a question of the availability of liability insurance coverage when someone stole your car.

Preferred Risk Mut. Ins. Co. v. Kentucky Farm Bureau Mut. Ins. Co., 872 S.W.2d 469, 470 (Ky. 1994)

[*469] OPINION OF THE COURT BY JUSTICE SPAIN

The Hardin Circuit Court, in a Summary Declaratory Judgment entered on July 18, 1991, held that an automobile liability insurance policy issued by appellee, Kentucky Farm Bureau Mutual Insurance Company Click for Enhanced Coverage Linking Searches (Farm Bureau), to its insured, Linda Sharon, did afford minimum limits liability coverage notwithstanding the fact that the collision in question was intentionally caused by one operating the insured vehicle without permission. The Court of Appeals reversed, holding that there was no mandatory coverage under the circumstances. We granted discretionary review and affirm the Court of Appeals.

[**2]  Farm Bureau’s insured, Linda Sharon, was the registered owner of a pickup truck which she bought as a graduation gift for her daughter, Lindsey Sharon. On March 6, 1990, while Lindsey had the use of the vehicle, she and her boyfriend, John Spegal, with whom she was breaking up, had a quarrel. Bruce Miracle, another friend of Lindsey, also was driving his car on this occasion, with Michael Decker and Pat Decker as guest passengers. At one point, Spegal, in a fit of anger, grabbed the keys to the pickup from Lindsey and refused to give them back. She then got into Miracle’s car, so she could be driven to her house. Spegal proceeded to back the Sharon pickup truck into the front  [*470]  end of the Miracle vehicle, in what was described as “a vindictive outburst.”

Both Miracle and Michael Decker claimed to have been injured in the collision, and were paid basic reparation benefits (BRB) by Miracle’s insurer, Preferred Risk Mutual Insurance Company (Preferred Risk). In addition, Miracle’s mother brought a tort action as his next friend against Spegal and Linda Sharon. Preferred Risk intervened in the suit as a plaintiff and joined Farm Bureau as intervening defendant, claiming subrogation of the [**3]  BRB benefits paid and payable to Miracle and Michael Decker. Furthermore, Preferred Risk included a claim for declaratory relief, requesting the Court to declare whether Farm Bureau’s policy with Linda Sharon afforded liability coverage for the collision resulting from Spegal’s operation of the Sharon vehicle.

Following the taking of depositions, Preferred Risk moved for summary judgment as to the claim for declaratory relief. After briefing by Preferred Risk and Farm Bureau, the trial court took the matter under submission and later rendered the Summary Declaratory Judgment mentioned above, declaring Farm Bureau’s minimum liability coverage to have been in force. Farm Bureau appealed to the Court of Appeals, which reversed the trial court.

The first argument raised by Preferred Risk before the Court of Appeals, and again in this Court, is that the Summary Declaratory Judgment was merely interlocutory, rather than being final and appealable as recited by the trial court. It is contended that the judgment wasn’t final since Preferred Risk sought not only declaratory relief, but also specific monetary damages from Farm Bureau by way of reimbursement for BRB amounts paid by it to Miracle [**4]  and Michael Decker. It is true that the mere recitation of the “final and appealable” provision of CR 54.02 is not determinative of the matter. Nevertheless, HN1Go to the description of this Headnote.under KRS 418.040, if an actual controversy exists,

. . . the plaintiff may ask for a declaration of rights, either alone or with other relief; and the court may make a binding declaration of rights, whether or not consequential relief is or could be asked. (Emphasis added.)

Here, it was preferred Risk who asked for an adjudication of its rights as against Farm Bureau, in addition to a further request, should coverage exist, for specific monetary damages by way of reimbursement for BRB amounts paid. The trial court, having made the requested declaration of rights, was certainly empowered to denominate this portion of its adjudication as final and appealable, notwithstanding the possible necessity of further proceedings between these parties to assess damages, or of further proceedings between the remaining parties to the litigation. The wisdom of such action by the trial court is further vindicated by our decision on the merits. Since we have finally determined that there is no liability by Farm Bureau to preferred  [**5]  Risk on the intervening complaint, there is no need for any further time-consuming proceedings between these parties for proof of damages.

The remaining contention by Preferred Risk is that the Court of Appeals erred in reversing the trial court’s holding that Farm Bureau’s liability policy was mandated by the Motor Vehicle Reparations Act (MVRA) to provide minimum limits liability coverage, notwithstanding any exclusions for intentional wrongs or nonpermissive use. We agree with the Court of Appeals that the MVRA does not so mandate. KRS 304.39-080(5) provides:

HN2Go to the description of this Headnote.Every owner of a motor vehicle registered in this Commonwealth or operated in this Commonwealth by him or with his permission, shall continuously provide with respect to the motor vehicle while it is either present or registered in this Commonwealth, and any other person may provide with respect to any motor vehicle, by contract of insurance or by qualifying as a self-insurer, security for the payment of basic reparation benefits in accordance with this sub-title and security for payment of tort liabilities, arising from maintenance or use of a motor vehicle (emphasis added).

It appears clear from this language that [**6]  HN3Go to the description of this Headnote.there is no duty on a vehicle owner to provide minimum tort liability insurance or security  [*471]  for use by an operator who does not have the owner’s permission or who converts the vehicle to his own use. Such a policy was the law in this Commonwealth before the MVRA (effective July 1, 1975) and continues to be after its passage. See Brosh v. Grange Mutual Casualty Co., 510 F.2d 1147 (6th Cir. 1975) (applying Kentucky law); and Wolford v. Wolford, Ky., 662 S.W.2d 835 (1984).

Here, Spegal was certainly not a named insured under Farm Bureau’s policy with Linda Sharon, and the trial court found from the evidence before it that his use of the Sharon vehicle was nonpermissive. Our decision and that of the Court of Appeals declaring the rights of the insurers as to whether Farm Bureau’s policy afforded coverage for this collision, necessarily depend upon this finding of fact by the trial court. Consequently, should it appear otherwise to the trial court upon any full trial of this action between the original parties on the merits, then it should certainly reconsider the matter of liability coverage.

The decision of the Court of Appeals [**7]  is affirmed and this cause is remanded to the Hardin Circuit Court with directions to enter a judgment for Farm Bureau on the issue of coverage.

Stephens, C.J., Reynolds and Wintersheimer, JJ., concur. Lambert, J., dissents by separate opinion in which Leibson and Stumbo, JJ., join.

Post written Michael Stevens

Michael Stevens