“Like a Bad Neighbor, that You should Beware”: Despite receiving premiums, State Farm avoids covering its insured’s injury based on policy technicality.

            Never underestimate the importance of time in your personal injury claim.  We are reminded of this daily in our practice by observing the behaviors of insurance companies who never stop fighting to avoid paying legitimate claims for injured people.  In the latest instance, State Farm was able to prevent itself from being responsible to its own insured for injuries sustained in a wreck on September 15, 2006.  Throughout this article bear in mind: State Farm fought for a only nine days short of five years and spent thousands of dollars until a final decision on September 6, 2011, when it was ultimately determined that the company could avoid covering its own insured’s injury.  The clear reason is that by securing a denial of coverage in this case, the company will likely earn its executives profits for years to come.

            The recent case is Lankford v. State Farm Mut. Auto. Ins. Co.  The general facts are that Mr. Lankford was injured in a wreck while in his employer’s truck.  The other driver possessed liability insurance coverage with State Farm, the same company as Mr. Lankford’s underinsured motorist coverage.  Only three days after the wreck, Mr. Lankford received a letter from State Farm seeking information on his “recent wreck” referencing the other driver’s policy.  Third parties also contacted State Farm via letter expressing subrogation interests.  In February, State Farm issued payment for property damage to Mr. Lankford’s employer.  Meanwhile, Mr. Lankford saw doctors, treated for his injuries, and in July 2007, Mr. Langford underwent a lumbar fusion surgery.  As a result, his attorney requested the policy limits information on the defendant’s State Farm coverage.  That September, Mr. Langford discussed his injuries and claims with his own State Farm agent.  On September 5, 2008, a lawsuit was properly filed on Mr. Lankford’s behalf, of which State Farm received a copy via letter mentioning the UM policies and was timely served on September 8. 

            Just to be clear, the simple facts are that 1) a man was injured in a wreck, 2) his insurance company sent him a letter three days later, 3) others wrote his insurance company about the wreck, 4) he had back surgery, 5) he wrote his insurance company about his wreck, 6) he spoke with his own insurance agent about his wreck/injury/claim, and 7) his insurance company was served with a lawsuit arising out of that wreck and injury.  All of this occurred within the statute of limitations which Georgia law provides for filing a lawsuit.  Now wrap your head around the fact that the injured man’s insurance company asserted a defense that it “wasn’t notified of the wreck/injury” and won that argument.  Still believe that big business isn’t ruling our courts?

Ultimately, the Georgia Court of Appeals determined that an insured is required to provide its insurer with timely notice of an accident under the insured’s policy, even if the insurer receives prior notice from an unrelated third party.  In other words, YOU or YOUR ATTORNEYS must set up your uninsured or underinsured motorist claim with your insurance company personally and in writing.  Just because they have heard from someone else that you were in a wreck does not mean your claim has been properly reported.  Even worse in that ruling were statements about timely notice to your insurance company.  The Court found that an unreasonable delay could mean that you have no coverage because your insurance company will no longer have to uphold its end of the policy contract covering your injury.  The Court reasoned that your insurance policy is your contract with the company and if you don’t follow its requirements, you lose your claim.

            What does this mean for you???  TIME IS OF THE ESSENCE.  Do not wait to speak to an attorney after your injury happens.  After you are involved in a car wreck, make sure that your attorney knows about all insurance policies on both the car you were riding in and in your household.  It is critical for your attorney to have that information in order to get your claim set up properly and protect you, even from your own insurance company, by preventing them from wiggling out of the policy which you have been paying premiums on every month, sometimes for years.  By knowing your company and policy information, your attorney can make sure that technicalities and policy requirements don’t prevent you from recovering from your loss.  Also, always remember to tell your attorney about any family members, other vehicles, or households which may be connected to you, as additional coverage can often be found there under Georgia law.  Knowing about these policies can make all the difference between either you or a hospital collecting the bulk your settlement proceeds for your injury.

BEWARE THE SCORPION

Many times, just after a wreck, an insurance adjuster will call the victim of the wreck. The property damage will be their “first priority” – as it should be – and they will act as nice as they can. They will act like they care about the injuries the person suffered and share stories of their own woes. They will make every effort to connect , promising that they can help. They will then ask for a recorded statement, a release and then start talking about how to resolve the injury case – now.

Over the years I have seen this scenario played out many times here in Columbus and elsewhere. Recently, a lady came to see me after trying to work with those “nice people “ at the insurance company adjustment office. She gave statements, provided releases for medical records, provided letters from her doctors explaining the life changing situation she was faced with as a result of the wreck and – after almost 2 years ( on the eve of her statue of limitations running out) - she was told “ you were already sick – you already had problems – your case has no value”.
We will file suit immediately to preserve the case and tell the story to someone other than the adjuster.

The whole episode reminded me of a parable which goes something like this:

A turtle is swimming in a lake minding his own business.
He then heard a whistle from the beach.
A scorpion was trying to get his attention and waved to him to come closer.
The turtle swam toward the beach and looked at the scorpion knowing he was a very dangerous creature.
The scorpion yelled to him, “Hey turtle – would you mind helping me get to the other side of the lake. I just need a little help.”
The turtle replied, “And how would I do that?”
The scorpion then said, “I will jump on your back and you can swim to the other side.”
The turtle said, “Are you crazy? You will sting me and I will die!”
The scorpion says, “Why would I do that? We would both die. And if you do this favor for me – I will shout your name from the treetops of what a good person you are.”
So the turtle says to himself, “That this makes sense and I could use a little positive publicity.”
So the turtle swims towards the beach and has the scorpion jump on his back, and starts to swim across the lake.
Halfway across the lake he feels a sting in his neck.
He turns to the scorpion and says, “You stung me! We’re both going to die!! Why would you do it??”
The scorpion’s simple reply, “I’m a scorpion. I sting. Thats what I do!”


Moral – when you connect with a scorpion that says, “I will help you, I wont hurt you. As a matter of fact, I will promote you,” BEWARE!!!

ITS NO SECRET: BIG INSURANCE COMPANIES ARE OUT TO MAKE BIG PROFITS

Trial attorneys like those at the Law Offices of Gary Bruce are no stranger to the tactics and bottom lines of insurance companies.  However, most injured people have never had to deal with an insurance company for anything more than paying their monthly rate.  Fortunately, folks like Anderson Cooper of CNN are trying to educate the general population about the true motives and personalities behind the cute geckos, “good hands”, and sugary sweet sales ladies.  Insurance companies have one thing that drives all those TV ads and that’s profits. 

The way they relentlessly pursue those profits is by forcing the injured to remain suffering, denying their very purpose, and not compensating those who have suffered loss.  The engine by which they accomplish this has a name.  It is “Deny. Delay. Defend.”  This three pronged approach is geared to prevent an injured person from ever getting the help they deserve from an insurance company (while claiming they protect people).  Step one is to deny your claim in hopes that you will simply not pursue it further/not know what to do.  Step two is delay any action until you are willing to accept whatever they will offer due to your immediate need.  Step three is to defend against your claim tooth and nail to make it so burdensome and costly that you will stop pursuing it.

Those tactics are why speaking to a lawyer immediately after you have been injured is so important.  Watch the Youtube links below as Anderson Cooper pulls back the curtain and shows you how an insurance company treats your claim before you have one of the Good Guys on your side.

CNN 360 Auto Insurance Part 1
CNN 360 Auto Insurance Part 2

Do you have “Full Coverage”?

One of the strategies of car insurance companies to make money is to get a driver signed up, making payments, and out the door on the road as quickly as possible.  Unfortunately, this often means that “by saving $100 on your car insurance” you are actually getting less than what you need.  Over and over again, we hear our clients tell us in our first meeting that they were told by their company that they have “full coverage”.  In truth, they have far from it.  Often they find out that they may have more than the minimum liability coverage but far less than “full coverage” for the situation they find themselves in after a car wreck.

In reality, “full coverage” is a myth as you can always purchase a larger policy with more coverage.  Generally, people expect when they are told they’ve paid for this insurance is that if and when they are in a wreck and injured, the insurance company will take care of them.  In our experience, “full coverage” seems to mean that the client may have collision and comprehensive coverage for damage to their car, but likely only has the state required minimum liability coverage, which in Georgia is $25,000.00.  Trust us, having the additional coverage necessary to fully insure your bodily injuries is another matter.

Why do we ask about full coverage in a meeting – because many times that “extra” coverage for “underinsured” or “uninsured” motorists can mean the difference between merely getting bills paid vs. a settlement that actually compensates someone injured in a car wreck for the disruption in their life in addition to bills.  For example, that coverage often is the only coverage available to cover a drunk driver who was uninsured.  Also, that coverage sometimes means that there is coverage over and above minimum limits.  Another issue Columbus readers should remember is that with Ft. Benning’s military population and Phenix City a stone’s throw away, many driver’s don’t even have Georgia insurance policies which can add further issues to evaluate. 

There are many aspects to your car insurance coverage to consider.  Even a small amount of “medical payments” coverage can pay doctor bills while someone is treating for an injury.   That coverage is sometimes the only medical coverage available. and can pay for expensive procedures like MRI exams and emergency room visits.

Full coverage means something different to everyone, and the important of insurance coverage is a topic we are sure to revisit again.  But for now, let our advice be clear.

Make sure you check your coverage with your agent BEFORE you have a lawyer ask you what coverage you have – because by then it is too late.

-The Attorneys of Gary O. Bruce, P.C.