QuestionHi There Claims Guy...
My name is Clay and I live I live in Tennessee.I was involved in a accident in Tennessee in June 2006 with another driver from OHIO and I suffered a hipp,shoulder, neck and head injury...The police report show's that the other driver was at fault....The other party's Insurance Company made me a settlement offer through my lawyer and the offer was $11,414.12 and my medical bills are $11,613.23. So as you can see that the offer fall's short of my medical bills of about $199.11 and they are not offering me any suffer and pain at all which I think is around 3 times the medical bills before the lawyers fee is cut out of it "RIGHT" so my settlement offer should be a total of $34,839.69
Now the other party's Insurance Company is telling my lawyer that they are Contemplating Denying Coverage of there client that was at fault in this accident and that I had better take what has been offered to me. They say that the reason for this is that there client failed to cooperate with the defense by not showing up for the deposition. Where does this leave me? My lawyer says if this happen's there will be no insurance coverage to pay my claim so I better take the offer. Is this true ??? I told my lawyer that it's a funny thing that I had not heard nothing about this until it was time to settle this case with the other party's Insurance, and I also told my lawyer that this case has a bad smell about it that I don't like. I also told my lawyer if that is how it works with an Insurance Company Contemplating Denying Coverage on there clients... then that mean's that Insurance Companies would take on new client's and when they get in an accident the Insurance Company would just Deny Coverage and the other party involved would not get nothing for there loses...I said that was a bunch of bull and he got mad at me and began to use curse words. My question is if the other party's Insurance Denys them Coverage after an accident... they would still have to settle my claim's wouldn't they?.What can I do next..my lawyer seems to want this over with as soon as possible. I can't seem to get my lawyer to move this case on to trial after I would not except there offer. He keep's dragging this on and on but want's to settle it quick he say's. I think my Lawyer has sold out on me and he think's I don't know it. He told me to not worry, that he has this under control because we may be able to go back on my Insurance Company if the other Insurance Company secedes in Denying Coverage of there client. He said this is just an unusual situation that he has never been in and that he will just have to work his way through it. Now my lawyer thinks we might try to get my case to trial but it could take a year to get a trial date he says. Then he tells me that this could get costly and the court cost and the cost for the Doctors deposition will come out of my settlement. I think I have a bad lawyer on my hand's and that I have been sold out by my lawyer. I think I will send him a letter next week and fire him because this crap has been going on for the past 2 years. It has got to stop. Denying Coverage can they do that? I think my lawyer has set his self up for a malpractice case later..If I fire my lawyer will I have to pay him anything because he took my case on a Contingent Fee Agreement.
Questions:
1. Denying Coverage can they do that?
2. If they could wouldn't they still have to settle my claims?
3.Can my lawyer go back on my Insurance Company as he says?
4.If I fire my lawyer will I have to pay him anything because he took my case on a Contingent Fee Agreement.
5.How long can a Insurance claims case go on in Tennessee?
AnswerHi Clay,
(1) All insurance policies require that their insureds cooperate with them in the investigation and defense of a claim. If an insured fails to show for a deposition, he is not cooperating with the defense. So they do have a coverage question. Think of it this way - they insure him. They do not insure you. They have a contract with him - not you. They owe you nothing. They owe him a defense as long as he cooperates. If he fails to do so and they deny coverage, you can still sue him, but they may not defend him.
Now with that being said, it is difficult for an insurance company to deny coverage for non-cooperation. They might not win. And if they lose, he can sue them for bad faith which could be worth a WHOLE LOT more than your case. So they do not want to go down that route if they can settle the case.
(2) If they successfully deny coverage, they do not pay you anything. You do not have a contract with them.
(3) Probably. This depends on whether or not you have Uninsured Motorist coverage. You need to look at your policy or call your insurance agent and ask if you have this coverage and if so, what is the policy limit.
(4) Possibly. You need to look at the retainer agreement you signed with the lawyer. It probably addresses this. If you fire him, he will probably file a lien against your settlement. He will calculate the amount of the lien based on his hourly rate and the time he has spent working on your case up to the point you fired him. If he files a line, any payment you receive will be payable to you, your new attorney, and your old attorney. Then each of you takes a portion of the proceeds.
(5) I do not know this - but do a google search for Statute of limitations in the state of the accident (not where you live) and this should tell you.
It sounds like you do not trust your attorney. I suggest finding a new one and explaining everything. Bring your insurance policy and attorney retainer agreement, and the new attorney can explain your options. Most lawyers do not charge for the first consultation. The best way to find a lawyer is through referrals. If you don't have a referral, check the local bar association for one. TV ads are the WORST way to find a lawyer. Most of them are hacks.
As to the settlement they offered you, I'm not sure if this is reasonable or not. The 3 times rule is VERY rough and often not applicable. If all your injuries are muscles strains and bruises, your case is worth a lot less than if you have broken bones. Was all of your medical treatment fair and reasonable? Are they disputing the need and cost of it? How severe was the impact and property damage? Any permanent injuries? All these factors and more go into evaluating an injury case.
