Woodland Hills personal injury attorney, Barry P. Goldberg, works with insurance company representatives on a daily basis and can provide a clear perspective on what insurance is and what it is not. What will an insurance company do for you? What is an insurance company’s obligation? The answer to these questions are blurred and the general consuming public assumes that their insurer will “take care of them” and will “look out for their interests.” This perception is based on really clever, memorable and persuasive advertising campaigns that ultimately leave consumers disappointed when they are involved in a casualty loss.
You know the jingles and the characters—“Like a Good Neighbor” “You are in Good Hands” “On your Side” and what’s the deal with that cute English-speaking Gecko? The reasonable perception is that your liability insurer will “represent” you; that your insurer is nice and even “fun.” The truth is that a large percentage of personal injury clients seek legal representation only after being disappointed by their own interactions with insurance adjusters. We constantly hear that clients “thought the insurance company would take care of it” “that the insurance company would recover the money for us” “that the insurance company would pay my medical bills” “that the insurance company would pay us a fair amount even if we did not have a lawyer.”
It is time to get real. The insurers are businesses. They do no more and no less than what they are obligated to do by CONTRACT. Even then, they attempt to interpret your CONTRACT in a way favorable to the insurance company. Even then, they will pay the lowest amount possible short of being forced to pay more by the legal system.
The CONTRACT we are talking about is your insurance policy. Be honest—have you ever read it? Not only is it written in a way the average person could not possibly hope to understand, but it is a combination of statutory requirements and language crafted to circumvent real life court decisions that may have been decided unfavorably to the insurance companies. If that were not enough, the coverages are a buffet of choices and amounts that most consumers cannot really make informed decisions about without the help of an experienced independent agent. Do you have “Full Coverage?” I do not even know what that means.
Under the insurance CONTRACT, your insurer will not file forms with the DMV for you; they will not obtain a bodily injury recovery for you; they will not help you prove a case against the adverse driver unless it benefits them financially. You will be lucky to get a call back a week from next Tuesday because the adjusters are so overworked. The insurers will defend you if you get sued—-if they can’t figure out a way to deny coverage. Even then, the provided lawyer will have hundreds of cases and will not be particularly concerned with the outcome of your case.
By CONTRACT, and case law, the insurers only owe a duty of care to their own policy holders. Insurers owe no real duty of care to claimants. A claimant cannot sue an adverse insurance company for “bad faith” for low balling, delay and inadequate investigation.
As a business with stockholders, the insurers are in a constant hunt for saving costs internally in order to improve the bottom line. One of the biggest areas of savings is cutting down on the amount they have to pay you! Although we all suspect claim fraud is a big problem, in truth, the number of claims and amount paid for claims is down dramatically. On the other hand, has your insurance premium been reduced “dramatically?” There is a very good reason that the office buildings have the insurance company names on them and not yours!
Recently, the insurers have “hunkered down” on standard auto claims. They will only pay unilaterally specified amounts for medical care regardless of the actual charges. Insurers are attempting to pay far less for general damages like pain and suffering. Most insurers are offering less than 1 times the adjusted medical to settle claims. The days of 3 times medical as a rule is long gone.
How do insurers get away with this kind of conduct? Easy—the juries—including you—are unwilling to award proper and sufficient damages in court. Why would you? The insurers are your “Good Neighbor” or cute and loveable Geckos. So, don’t be deceived by successful advertising campaigns and understand that the claim process is adversarial. Any significant claim should be handled by an experienced advocate with intimate knowledge of the insurance industry.