QuestionQUESTION: This is regarding an auto insurance claim. My mother had borrowed my car and was hit while making a left hand turn. The car was a small toyota and the other was a SUV which hit the passenger side door. The damage to the door panel was est. $2000. She was found at fault. The SUV had only front bumper damage which appeared relatively minor.
There were 2 male occupants in the SUV, both unrelated. Both appeared and told the LEO they were uninjured, and made no injury claims. They were walking around post-accident talking loudly and on cell-phones.
Initally, we expected a simple claim by them for auto repair. Lo and behold, within a week we received a call from our insurance co. that both had hired separate lawyers and were claiming injuries.
This has been ongoing for about a year now. We have spoken a few times with the insurance co. and they could only say that they were claiming soft tissue injury and the case was ongoing. At one point they also claimed emotional trauma-not kidding. Mind you this is from striking the door panel of a toyota with an SUV.This was less than a fender bender.
Last week the insurance co. called and stated the attorneys had requested to be shown the auto policy limits. When asked if this was recommended she stated she couldnt answer that. And at that point they would get copies of all medical bills.
If you could please tell me is it better to simply reveal limits, or is there any benefit to holding out? What happens if coverage is exceeded? Can they sue? Does it seem possible they could actually exceed coverage, which is actually minimum. Does the fact that they held out this long point to a major claim? What can I expect at this point. Please give any input you can, as I am quite nervous about this.
ANSWER: Hi Melanie,
To the best of my knowledge, in all states when the opposing attorney makes a demand for disclosure of policy limits, your insurance company MUST comply with that request.
Yes, you can be sued.
If either attorney feels that his case is worth in excess of your policy limits, he will initiate an asset research against your and your mothers assets to determine if he takes the case to trial and wins, whether or not it's going to be collectable.
If this accident happened in Tennessee or Kentucky, the statue of limitations is only one year, therefore, the attorneys must file suit to extend time. Most other states allow 2 years and a few allow three or more.
Juries are not impressed by 'soft tissue' injuries, so these types of cases rarely go to trial.
I hope this has been of help.
Sincerely,
Bennie
---------- FOLLOW-UP ----------
QUESTION: Thank you for your response. If I could ask some followup questions.
1] How does this work. Let's say the policy is for $25k and the lawyer wants to collect $50k. Does this mean the insurance co. pays $25k and then washes their hands of it? At which point if they want to collect the balance they have to sue you? And if they want more than the limits they have to actually win a trial by jury?
2] Does the insurance co. have alot of authority/means to
contest bills and charges that seem excesive and bogus? Aren't most injuries difficult to disprove? Aren't alot of accident attorneys known for running up medical charges very quickly?
3] Assuming the case goes to trial, at that point is it all-or-nothing for them? So if they win they get their full request and if they lose they get 0?
4] As far as an asset check does the attorney need permission to do this, atleast 'officially'? Anyone with a computer and credit card can do a fairly thorough asset search nowadays. Are they known to run a prelimanary check prior any official one?
5] The insurance agent I spoke to seemed to imply she would get access to all medical records after she revealed limits. Does this mean the insurance co. has no idea what kind of charges are being run up prior to that? They could potentially run up infinate amounts of tests and treatment in that case.
6] How does 'emotional trauma' work? Would it be difficult to attach that to a relative fender bender accident or is it just a matter of Psychiatrist visits/prescriptions and running up more bills that way?
Thank you very much once again
AnswerHi Melanie,
First of all, your insurance company is not going to pay their policy limits and abandon you.
After ordering and reviewing the medical records of the 'claimants', it is normal that they would have them reviewed by an Independent Medical Examiner and have both 'claimants' examined by that same doctor. Based on his findings, your insurance company will make a settlement offer to the attorneys which they feel is fair. This will start a negotiation process in which the attorneys will attempt for a higher amount. Eventually, a point will be reached where the insurance company will state that this is their final offer, accept it or file suit.
If the case goes to trial, the offer is 'off the table' and
can never be mentioned. Your insurance company will not pay one penny unless they get a full release against all future claims against you and your mother. They will provide a full legal defense in court. It's never 'all or nothing'. A jury could even make an award that is much less than the company originally offered to the attorneys, because they have no knowledge of any offers.
The insurance company can't contest medical bills that seem excessive or bogus, but the Independent Medical Examiner can, and if the case should go to trial, he will appear as a witness for the insurance company.
The opposing attorneys do not need permission to run an asset check, it's part of their job and they would be remiss in their duties by failure to do so.
'Emotional Trauma' is just a catchall phrase tossed in by the attorneys. I would seriously doubt that there are any supporting medical bills.
The latest statistics that I have read indicate that 85% of the personal injury attorneys have never taken a case to trial.
They simply rely on writing threatening 'demand' letters, hoping to 'scare' the insurance company into a high settlement, and simply fold and accept the best offer made by the insurance company. Insurance companies don't scare very easily, especially on 'soft tissue' injuries.
It seems that you have Bodily Injury Limits of $25,000 per person, $50,000 to all people.
Since I am not aware of the 'claimants' treatments or total bills, I can't make any speculations if this is adequate, but I can assure you that your company will vigorously defend you if the case goes to court.
I hope this has been of help.
Sincerely,
Bennie
