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Collateral Source Rule: Why Your Personal Injury Settlement is Not Valued on Co-Pays

Inevitably I will have clients that  make the poor decision to try and work things out with the at fault party’s insurance adjuster, thinking the at fault insurance company would “do the right thing.”

As I have written in the past on “How Do Insurance Companies Make Money?” & since copyrighted my favorite quote:

“Would you listen to the devil on how to get to Heaven? Then why do you listen to insurance companies on how to settle claims against them?” –Trey Mills

Having only practiced close to seven (7) years doing 100% personal injury,  it is hard not to be cynical and disbelieving of anything insurance companies do or say. As an attorney I am held to a higher standard legally and ethically but for some reason the insurance adjuster can dispense false “legal advice” with no consequences. Most times what you say, can not be proven. Always ask for what the insurance adjusters tell you in writing.

Therefore, when the insurance company offers to pay your medical bills at what you paid in co-pays or reduced costs because you are fortunate to have health or supplemental insurance THEY ARE TRYING TO TAKE ADVANTAGE OF YOU.

In South Carolina the law states: The collateral source rule provides “that compensation received by an injured party from a source wholly independent of the wrongdoer will not reduce the damages owed by the wrongdoer.” Citizens and S. Natl. Bank of South Carolina v. Gregory, 320 S.C. 90, 92, 463 S.E.2d 317, 318 (1995).  A tortfeasor (at fault party) cannot “take advantage of a contract between an injured party and a third person, no matter whether the source of the funds received is `an insurance company, an employer, a family member, or other source.’” Pustaver v. Gooden, 350 S.C. 409, 413, 566 S.E.2d 199, 201 (Ct.App.2002) (citations omitted).

Stop being scammed by the insurance companies and start seeking out legal advice from lawyers. It costs you nothing to sit down and talk with most personal injury lawyers about your issues. Yes, if they take the case it will most times be taken on a contingency fee basis whereby they receive a percentage of the settlement they achieve for you. It’s a symbiotic relationship.

Do yourself a favor and ask these two questions before you settle your insurance claim:

  1. Would you rather have someone working for you, ie attorney, or someone working against you, ie insuranceadjuster?
  2. Do you think the insurance adjuster gets paid a bonus and/or receives a raise at the end of the year for paying out more money on claims, or paying out less money in claims?

To ensure the value of your settlement is reasonable and commensurate with your losses and harms, or damages, please consult with a personal injury attorney. You can contact us or find out more about us on Facebook.

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Accidents Happen But Insurance Companies are Created

I have always enjoyed reading, watching, and listening to various recounts of historical information on a wide range of topics. Wikipedia is a scary resource given the ease of access and also in creating of the history online. However, for broad strokes and a general overview it has proven quite resourceful.

  • Did you know that insurance has been around in some form since humans have gathered together in communities, or societies?
  • The form of insurance as we know it culminated as a result of the mercantile trade along treacherous rivers and oceans where the chance of loss was great, thus if a merchant received a loan on the shipment they would pay the lender additional monies to cancel the loan if the shipment was lost or stolen.
  • Did you know the first insurance company in America was created here in CharlestonSouth Carolina?

I won’t bore you anymore with history but just as we have advanced as humans, so to have our societies (at least in most parts of the world), and thus our businesses, or economies.

As stated in one of many lessons learned in Sun Tzu’s, Art of War:

It is said that if you know your enemies and know yourself, you will not be imperilled in a hundred battles; if you do not know your enemies but do know yourself, you will win one and lose one; if you do not know your enemies nor yourself, you will be imperilled in every single battle.

Therefore, I try to learn as much as I can about insurance companies and convey that knowledge the best I can to clients that come in with questions.  Those questions mainly consist of:

  • trying to understand how their insurance company can treat them so poorly after they have religiously paid their premiums without ever having an insurance claim;
  • trying to understand how the insurance company of the negligent, ignorant, or omitting party, will not provide them a fair amount for the injuries, troubles, and ordeals they have experienced through no fault of their own; and/or
  • why the insurance company will not call them back or appreciate what they have had to experience and instead treats them disrespectfully or with disdain.

Well, it is very simple. It’s about money. The money insurance companies want to save by minimizing the payout on your injury, property, and/or life insurance claim. Simply stated insurance companies make money two ways:

  1. Through underwriting, the process by which insurers select the risks to insure and decide how much in premiums to charge for accepting those risks;
  2. By investingthe premiums they collect from insured parties.

The whole insurance business model is summed up succinctly as such:

 to collect more in premium and investment income than is paid out in losses

Your injury, or insurance, claim is the loss being referred to above. What the at fault party’s insurance company pays you cuts directly into their bottom line and therefore the less they can get out of paying your claim, the more they can invest in those really complicated structured asset backed securities, or CDO’s. You remember the recession was caused by ____? Greed.

And that greed can work both ways, on your extreme valuation or consideration of the fair amount to be paid and the insurance company’s extremely low valuation of your claim-regardless of facts.  Thankfully, advocates and plaintiffs’ attorneys exist to assist you in this eternal struggle of good vs evil. If you had to pay a plaintiff’s attorney the hourly wage the insurance company pays the defense attorneys, or advocates, I doubt you would ever be able to fight a fair battle.

Again we learn from Sun Tzu’s, Art of War:

Thus, what is of supreme importance in war is to attack the enemy’s strategy.

Please consider disrupting the strategy of insurance companies to make profit off of your injuries by low balling, denying, delaying, and defending against what you know is wrong. Just because insurance coverage has almost been made mandatory doesnt mean those same insurance companies have to make millions in profits off of your backs. Rise up and fight, now is your time!

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South Carolina’s Top Three Automobile Insurance Companies

“Trey’s Top Three” continues with this second article to determine the top three insurance companies I believe evaluate and handle their claims in a professional, ethical, and reasonable manner. This analysis is based on my observations, experiences, and interactions over five years working in the trenches against these insurance companies: Direct InsuranceState FarmAllstateTravelersNationwideDairyland AutoSelective InsuranceSpecialty Risk ServicesLiberty MutualGMACInfinityFarm BureauAuto OwnersSentryOccidentalChubbBristolSedgwickGEICOProgressiveVikingGreat CentralGatewayUSAASafecoOhio State CasualtyJames C. GreenAIGGreat FallsCrawford & CoHorace MannLancer Insurance, AffirmativeCottonstatesZurichScottsdaleCinncinatiCompanionMontgomery InsuranceFrontier AdjustersGallagher BassettFirst AcceptanceConstitutional State Services ForemostAssurancePenn National,and others I cant recall at this moment. (I have settled claims against all these companies).

And the winners of “Trey’s Top Three” evaluation are:

  1. State Farm
  2. Farm Bureau
  3. Nationwide/Travelers*  (tied)

 

If you have Allstate please switch immediately as ALLSTATE IS THE WORST insurance company you could be with. When you go in and switch or modify your coverage make sure you have:

  • PIP/Medpay
  • UIM
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Three Coverages South Carolina Insurance Policy Holders Should Add

As mentioned in my previous post, I am amazed at the insurance coverages my clients never even knew existed. This challenge goes out to all insurance salesmen to better inform your clients of  the coverages and give them examples of why they need it. I know they probably don’t want to pay the extra money and you don’t get much additional commission but it’s your job to explain why $50-$100 extra a year can save them $1,000-$25,000.  I have these three things and so should you:

  1. Personal Injury Protection(P.I.P) and/or Medical Payments (Medpay) coverage- this covers you and all the passengers in your automobile regardless of fault or liability- if you don’t have health insurance this is a must;
  2. Underinsurance(U.I.M) coverage-exactly what it sounds like, except easier to understand when I explained that it helps cover you and your passengers or family when someone injures them that does not have enough insurance or assets to go after; and
  3. GAP CoverageRenters Insurance-both of these coverages take care of your possessions when they are damaged. The first being your automobile that is over financed and not worth what you owe on it. The second for your possessions while renting someone else’s home or apartment.

I can not help you if you are not helping yourself by taking advantage of the insurance coverage that actually benefits you and not someone else. As much as I comment about how I hate insurance companies, they are a necessary evil. If you are able to play the game of insurance successfully you can and will come out on top.

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Nationwide Is Not On Your Side: Marketing Jingles are Flashy, Fictional, & Frustrating

I had a client come in today with three young kids all under the age of 10 and all boys. They were tough to contain for her much less for my soon-to-be-married and “kidless” self. As I was informing my client’s mother, who owned the car, on how she had been swindled out of depreciation from State Farm with her property settlement one of the boys yelled out in a melodic manner:

 “Nationwide is on your side…”

I quickly turned towards him with the indignation of an elementary teacher, ruler in hand and asked who taught him such lies and slander? All in the room looked perplexed but none more than him. I quickly indicated to him that he had been lied to and should never repeat such blasphemy. As if on cue, all three boys chimed in: “Nationwide is on your side…”

At that point I realized what I was up against and what all Americans must face, mind numbing advertising that showers us night and day through all mediums of media.  Since the more money one entity or individual has the more exposure they will be able to give their flashy, fictional, and frustrating jingle or flat out lies……Yet at the same time I realized how effective such a childish and simplistically thought out plan can so easily massage and manipulate mainstream society.

Try not to let those insurance company jingles persuade you too much during this massive blitz of corporate marketing and advertising to get us consumers already in the mindset of spending to sell ourselves short of the true coverage and protection we need.  Be on the lookout for “Trey’s Top Three” where I pick out:

  1. the top three insurance companies that treat injured parties fairly;
  2. the top three things you need to add or include with your insurance; and
  3. the top three insurance horror stories from this year.

 

To help get your mind off that previous jingle, think about this:

The only hands that come from Allstate are wrapped around your throat.

Or maybe since I have renamed one of our local adjusters “Low Ball”:

Nationwide will chap your hide.

Don’t worry, last one:

Like a drunk driver, State Farm doesn’t care.

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