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from our blog
Seatback Failures
Front occupant seatbacks play a vital safety role in rear-end crashes, similar to the purpose of airbags and seatbelts in frontal impacts. In a rear impact, a front seat should be designed to absorb energy and contain the occupant in the front seating space. Weak, defective front seats can fail, collapse and cause front occupants […]
The Insurance Industry Quick-Hit Settlement
If you’ve been in a collision and it was someone else’s fault, odds are very good that you will hear from the at-fault driver’s insurance company as soon as possible. It’s a tactic that is happening more and more in Arizona. This is done for a variety of reasons: (1) the insurance company would like to catch you off guard and when vulnerable following the collision; (2) most people are in shock following a collision and haven’t had time to determine the full extent of their injuries; and (3) the insurance company would like to get to you before you have had a chance to speak with a lawyer.
It’s very common for the insurance company to call you the same day and in some cases shortly after the collision. The adjuster will act friendly and attempt to build trust. Most people involved in a collision are vulnerable and feeling awful, both mentally and physically. It’s comforting to have an insurance company call you so quickly. Some will even say “we are admitting fault for the collision.”
But then, inevitably, you will be asked for a “recorded statement.” The adjuster will tell you that it is standard practice for anyone making a claim even if fault is admitted. Most people involved in a collision think it is an opportunity to tell “my side of the story to help my claim.” It’s NOT. I do NOT allow my clients to give recorded statements. And, I have never seen a recorded statement “help” a claim although I have seen plenty that hurt. If you are asked to give a recorded statement, you should politely decline.
Next, the insurance adjuster is going to request that you sign a medical authorization so that the insurance company can get your doctors paid. Again, this is a tactic. It will be a blanket authorization. It will be unlimited in time and scope. Do you really want to give an authorization to an insurance company so that it can obtain your medical records from any and every medical provider that you have ever seen in your life? I do NOT allow my clients to sign authorizations for the insurance company absent a confidentiality agreement or court order limiting the authorization to those records relevant to the injuries sustained in the collision. Again, if you are asked to sign blanket authorizations, you should politely decline.
This brings up what I consider the insurance company’s most egregious tactic. The insurance company, immediately following a collision, will offer a quick, nominal settlement in return for a signed or verbal release of your claim. Think about it – the insurance company offers you a quick $1,000 to $3,000 simply to walk away before you’ve even seen a doctor or received any treatment. Tempting? It’s very tempting and the insurance company knows that it is taking advantage of someone in a vulnerable position. Someone who has just been in a traumatic event can still be in shock and shouldn’t be making legal decisions like signing away their rights. Remember that most people involved in a collision usually do not realize the full extent of their injuries for days or longer.
Several years ago, before this quick settlement tactic fully developed, State Farm Insurance Company had a document called, “The Do’s And Don’ts Of A Minor Car Accident.” This document stated: “Don’t assume there aren’t injuries . . . Even low-impact collisions can cause injuries, some not appearing until days after the accident.” Of course, this great advice from State Farm disappeared about five years ago for some reason.
I am seeing a lot of this quick-hit settlement practice from most insurance companies here in Arizona. I’ll give you two examples of cases I have dealt with recently. The first case is the typical situation. Young man involved in a rear-end collision on Friday. He clearly had no fault for being rear-ended. He had never been in a collision before and had never made an insurance claim of any kind before. Geico called him soon after the collision. According to him, it was a nice adjuster who truly seemed to be concerned about his well-being. Geico’s adjuster spoke to him in length on the phone. She persuaded him to give a recorded statement. At the time she was speaking to him, he said he was experiencing pain between 6 to 8 on a scale of 1 to 10 with 10 being the most severe pain he had ever felt. He told her that he would follow up with his doctor the following week.
Soon thereafter, Geico’s adjuster ended the recorded statement. However, she did not end the conversation. In fact, this young man did not realize that she had stopped recording the phone call. The Geico adjuster indicated that she had run his expected treatment through her computer and the treatment would cost about $750.00. According the young man, the Geico adjuster then offered the $750.00 as an advance payment towards his future medical bills. The problem is that the Geico adjuster told him that he would need to give his permission for getting paid the “advance.” So, Geico turned the recorder back on and verbally stated a full and final release of ALL claims. The young man who had just been in a collision, knew nothing about insurance claims, and had no idea what was going on, simply affirmed the verbal, recorded release for $750.00.
The next day the young man could barely move because his injuries were so severe. His medical bills were going to be several thousand dollars. When he contacted Geico to pay the additional bills, Geico basically told him “so sad, too bad” because you released everything for $750.00.
Can an oral contract to release be valid? Sure. Is this “release” an adhesion contact? Yes. Is Geico’s conduct in inducing the settlement fraudulent? Probably, but it is difficult to prove because Geico did not record the entire conversation and argues that it honestly handled the young man’s personal injury claim. And, this is now no longer just a personal injury (tort) case. It is a contract case between Geico and the young man. In contact cases, attorneys’ fees can be awarded. Geico litigated a similar case in Texas a couple years ago. Not only did the Texas court uphold the release, it awarded Geico $10,000 for attorneys’ fees. So, there is an obvious risk when contesting these despicable quick-hit settlement releases.
My second case is much more unusual and also has a much happier ending. It involved another collision. Although my client had never been in a collision before and had never made a claim before, he was older and more experienced. The at-fault carrier (Allstate) called him the day of the collision. He refused to give a recorded statement. Allstate did not give up. Allstate eventually offered $1,600 to settle the claim. There was back pain, but it didn’t seem too bad at the time. My client was tempted, but discussed it with his wife. Thankfully, they decided to wait. No settlement check cashed. No release signed.
During the next few days, the back pain grew worse. It became excruciating. His legs started to go numb. His family doctor sent him to get an MRI. The MRI showed a herniation because of the collision. It was severe and required neurosurgery. He suffered permanent disability. Allstate unsuccessfully tried to get a quick-hit settlement for $1,600 on a claim that was eventually valued at over $600,000. Can you imagine how devastating it would have been to his family had he accepted Allstate’s quick-hit settlement offer?
Insurance companies are not on your side. Insurance companies are not good neighbors. Insurance companies don’t really care about you. The opposing insurance adjusters believe it is their job to settle claims as quickly and for as little as possible. No matter how nice or kind they sound, their loyalty is to their insurance employer not the injury victim. There is nothing fair about it. Please, even if you do not hire an attorney, do not give recorded statements to the opposing insurance company and absolutely do not sign personal injury releases without at least being checked by your family doctor. Of course, the best practice is to hire an attorney to look out for your interest and with the goal of protecting your rights.
Insurance Claim Appeals See High Success Rates
For some lucky people, the insurance system is efficient, functional, and fair, but to many more, it is a complicated and frustrating quagmire. It can be all too easy to get bogged down in a system designed to refuse compensation by any means necessary, and for the many who find that they are treated guilty-until-proven-innocent, it can be hard to find a solution.
Luckily, even if your initial claim was denied, there are still options. When people find themselves in similar situations and file an appeal, they often find a surprising amount of success. In fact, numbers show that those who appeal their health care claims through a 3rd party win their appeal roughly half the time.
While it is natural for those who were initially wrongfully denied to see their denial as unfair business practices, reports on appeals also mention that clerical errors are common as well, making it sound as if simple human error is to blame for the initial hiccup. One such report by the Government Accountability Office (GOA) found that in certain situations, up to 40% of all initial claims were denied for reasons such as duplicate claims, incomplete forms/information, and billing errors.
So do not worry if you filed a claim and had it denied. There are still very successful options available to you.
Homeowner’s Insurance Appraisal Process
The term “appraisal” as defined in a homeowner’s insurance policy has an entirely different meaning than the one more commonly used in every day language. Normally when we hear the term appraisal, we think of a real estate appraisal that is used to determine the value of a home. However, in a homeowner’s insurance policy, the appraisal process is more similar to a three-member-panel arbitration proceeding which is used to determine the value of a personal property loss or home repair dispute that results from a covered homeowner’s insurance loss.
Similar to arbitration, the appraisal process is an alternative dispute resolution intended to resolve disputes without the need for litigation. It is supposed to be less expensive to the insured and less time consuming. The majority of homeowner’s insurance policies enable appraisal when the insurance company and policy holder are unable to agree concerning the value of loss to a covered property. Appraisal is not available when there is a coverage dispute. In an appraisal, each party generally names their own appraiser to value the loss and attempt to reach an agreement. If the parties’ appraisers cannot agree on an amount, then it is up to a third appraiser, usually called an umpire, to resolve the dispute. Each party is responsible for the cost of their own appraiser and equally split the cost for the umpire. Attorneys’ fees and costs usually are not recoverable through the appraisal process.
Unfortunately in recent years, insurance companies have been writing complex agreements detailing the scope and procedure for the appraisal. These complex, sophisticated appraisal agreements have led to an increase in disputes between the insurance consumer and their insurance companies. Of course, the insurance consumer has no input whatsoever into the terms contained within these appraisal agreements because the insurance company simply includes the language in the insurance policy. Because insurance contracts are generally considered contracts of adhesion, i.e., the insurer draws up the contract and the insured has little or no ability to make material changes to it, Arizona consumers best defense to unfair, unforeseen terms is Arizona’s “reasonable expectation” doctrine.
Insurance companies are also becoming more aggressive in insisting that the insurance consumer sign an appraisal agreement even though the insurance consumer may not understand that the agreement does not always cover the entire scope of the loss. The insured homeowner needs to make sure the agreement he or she signs completely encompasses the scope of the insurance loss. If it does not, the insurance company will argue that the insurance consumer should not be allowed to assert a claim for those additional damages not included in the agreement.
Scottsdale Insurance Bad Faith Attorney Exposes Insurance Company Excuses
It is time to speak with a Scottsdale insurance bad faith attorney if your insurance company is attempting to use any of the following to justify or excuse its payment of an insurance claim:
1. There was an ambiguity in the way the insurance policy was written, so the insurance company didn’t believe it was obligated to pay on the claim.
The insurance company drafts these insurance policies and any ambiguity will be construed against it as the draftsman. Claiming that its own policy was too ambiguous for it to fulfill its obligation is not a winning defense. If insurance companies were permitted to escape liability with that thinly veiled argument, then insurance companies would concentrate their efforts on writing nothing but ambiguous policy provisions to avoid paying insurance benefits on any claims.
2. The insurance company acted in accordance with what is customary in the insurance industry, so it didn’t pay on the claim.
Defending itself because that’s what everyone else does is a questionable defense at best. Although acting in accordance with what is customary in the insurance industry could be useful in determining whether this insurer intentionally acted in bad faith, it is by no means an absolute, or complete, defense to liability for the improper failure to timely pay owed insurance benefits.
3. The law as applied to these circumstances is an unsettled matter, so the insurance company could not act on the claim.
Sometimes the law as applied to the particular circumstances is still an unsettled matter and insurance companies rely on this to force the insurance consumer to take action (or back down). A lawsuit for declaratory judgment on a question of the law may not in itself be an act of insurance bad faith. However, depending upon the circumstances, e.g., the insurance company effectively left the insurance consumer with no other option but to litigate the unsettled legal question, the insurance company’s conduct may be considered to have breached the duty of good faith and fair dealing.
4. Allegation that you as the insurance consumer breached the duty of good faith and fair dealing, so the insurance company isn’t liable for its failure or refusal to properly handle the claim.
Arizona law currently does not recognize comparative breaches of the duty of good faith and fair dealing. The insurance relationship is based on a contract, the insurance policy. Both parties – insured and insurer – to the agreement have obligations to the other party. The insurance policy holder must reasonably cooperate with the insurance company’s investigation of the claim. This is known as the cooperation clause of the insurance policy. If the insurance policyholder does not reasonably cooperate, this could reduce or eliminate the insurance company’s obligation to pay the insurance benefits. However, the insurance company’s obligation to still handle the insurance claim in good faith and fairly is not excused.
If your insurer has rejected your Arizona insurance claim, has delayed or failed to investigate your claim, has offered you a small settlement that is below what you are deserving of, or has otherwise engaged in acts of that might be considered bad faith, then you need to seek experienced legal representation.
Being prepared to aggressively argue against every defense, justification, or excuse that the insurance company will offer is a vital component of the Scottsdale insurance bad faith attorney’s legal strategy. These insurance cases can be very complex and technical in nature, so having experienced counsel is important if you hope to achieve the best possible outcome with your insurance claim. If you have any suspicions that your insurance company is acting improperly, then contact the Law Offices of Shane L. Harward immediately by calling 480.874.2918 for your Free confidential telephone consultation. No one should feel like a victim of their own insurance company!
Insurance Consumer Attorney – Arizona Residents Battle Bad Faith Insurance Companies
When was the last time you purchased an insurance policy? Did you get explanations that were fully comprehensible to you and not so much “insurance legalese”? Did you take time to carefully read through the printed policy terms before you signed and paid the premium? Did you feel free to negotiate with the insurance agent on a policy that really met your needs and the needs of your family? Did you get to bargain for the insurance policy language you preferred or did the insurance company offer you an insurance policy to either take or leave without any input from you on the insurance policy language? If not, you are not alone. Most individuals rely exclusively on their insurance agent’s verbal assertions, descriptions, and promises about what the policy will cover.
Did you know enough about the policy terms to allow you to comparison shop for a better deal with a different insurer? According to our insurance bad faith attorney, Arizona consumers seldom get detailed answers to their questions about policy coverage before they enter into the insurance contract. Arizonans typically fill-out the insurance application, dutifully pay the premium, and then place the written declaration of insurance away in a file or safe box. The only time the policyholder reviews the coverage is following an accident, property loss, emergency hospitalization, or some other incident. When the insurance consumer finally sits down to read the insurance policy, they will discover that it is not easily understood.
From an Insurance Bad Faith Attorney, AZ Consumers Should Always Seek an Independent Legal Opinion
Shane L. Harward knows that, as a practicing insurance attorney, Arizonans routinely purchase insurance without thoroughly investigating the coverage details presented in the policy.
The most important aspect of any insurance policy is what it will and will not cover. Most claims denials are based upon exclusions in the insurance policy. Exclusions usually appear on the last several pages of the insurance policy and attempt to take away the coverage that appears on the first couple pages of the insurance policy. Many insurance consumers are unaware of these exclusions and frankly, the exclusions are usually difficult to understand even if the insurance consumer is aware of them.
Unfortunately, most policyholders don’t find out what is actually covered until they file a claim. After paying premiums for years, sometimes decades, when Arizona insurance consumers actually file bona fide insurance claims they may be notified by their insurers that the policies bought and paid for don’t cover their medical expenses or damages originally thought. When you don’t really understand your policy provisions, how will you know if your insurer wrongfully denies your claim? You need an independent legal opinion to determine if the claim denial was violates Arizona’s duty of good faith and fair dealing.
Compounding the problem, Arizona residents who lack a clear understanding of their insurance policy coverage are much more vulnerable to the wrongful denial of claims. Those consumers may not know how to challenge their insurance company’s bad faith refusal to pay insurance benefits. And in some cases, the insurance company will attempt to rescind, or cancel, the policyholder’s insurance altogether in a blatant refusal to cover medical expenses from illness, injury, or hospitalization. Insurance consumers often believe they have no rights to insurance proceeds when insurers, acting in bad faith, pull out all the stops to avoid paying on legitimate claims.
Although the insurance policy represents a contract between the insurer and the insured, insurance policies are what the law calls adhesion contracts because the policy language is not subject to bargaining by equally positioned parties. Insurance consumers are almost always in the weaker bargaining position and take what is offered. The insurance company is at a distinct bargaining advantage, and they know it. They are the insurance experts. They draft the insurance policies. They investigate the claims. They control the money. They decide how much to pay or not pay. If you suspect that your insurance company is acting in bad faith and breaching the terms of your insurance policy agreement, that’s when you need aggressive legal representation and advocacy.
Your Bad Faith Insurance Attorney in Arizona
Do you feel pressed or intimidated into accepting less than what you feel that your insurance company agreed to pay under the insurance policy? When your insurer has rejected your claim or minimized coverage for your losses, call Shane L. Harward – Insurance Bad Faith Attorney, Arizona – at 480.874.2918. Don’t let the insurance company double-talk you out of the full value of your legitimate claim. When you suspect bad faith on the part of your insurer, contact the Law Offices of Shane L. Harward, PLC, today and protect your rights to full recovery.
Phoenix Insurance Bad Faith Attorneys – Review of Unfair Claim Settlement Practices
Unless you’ve been treated unfairly by an insurance company and sought representation with an insurance bad faith attorney in Phoenix Arizona, cases of unfair claim settlement practices are probably a bit of a mystery to you. To clear up a few misconceptions about what an unfair insurance claim settlement practice actually is in Arizona, we start with some of those unfair practices described under A.R.S. § 20-461 and Ariz. Admin. Code R20-6-801 (Arizona’s Unfair Claims Settlement Practices Act).
Phoenix, Scottsdale, Flagstaff, Tucson, etc. residents should be aware of the following 15 insurance practices (there are others, too) – all of which can be considered unfair claim settlement practices in Arizona:
1. MISREPRESENTING your insurance policy’s provisions.
2. FAILING to acknowledge and act reasonably when notified of an insurance claim, or unreasonable delay in investigating and processing the insurance claim.
3. TAKING too much time to affirm or deny an insurance claim.
4. REFUSING to pay an insurance claim without first conducting a reasonable investigation.
5. FAILING to reasonably explain the facts or laws that support denial of the insurance claim or offer of compromise.
6. LACKING good faith in providing a fair and equitable settlement when clearly liable; or attempting to influence a settlement under “Part A” of the insurance policy, for example, by delaying payment when clearly liable under “Part B.”
7. MAKING the insured sue to recover what was due under the insurance policy.
8. FAILING to have standards in place to investigate insurance claims.
9. ATTEMPTING to settle for less than a reasonable person would believe he or she was entitled to based on the insurance company’s ads and printed material.
10. RELYING on an altered insurance application when done without the insured’s knowledge or consent, for the purpose of settling an insurance claim.
11. FAILING to include a statement with insurance claims payments explaining the coverage that triggered those payments.
12. THREATENING an insurance claimant with the insurer’s policy of appealing arbitration awards to influence an insured into low-ball compromises and settlements of an insurance claim.
13. DEMANDING duplicate information during the claim investigation by requiring a preliminary claim report followed by a formal proof of loss form with substantially the same information – a tactic meant to delay investigation and payment of an insurance claim.
14. FAILING to pay the medical provider for diagnosis and treatment when the insurer is liable under the insurance policy.
15. DENYING a driver’s claim under a motor vehicle policy solely because the insured had a medical condition that could have affected his or her driving ability.
Have you or a member of your family experienced one of the unlawful insurance practices described in this post? If you believe so, then you need to take action to protect your legal rights.
Call the Law Offices of Shane L. Harward today at 480.874.2918 for a free initial telephone consultation with an insurance bad faith attorney (Phoenix and Scottsdale locations). Peace of mind alone is well worth the call!
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9735 E. Shea Blvd.
Suite 100
Scottsdale, Arizona 85259
Telephone 480-874-2918
Facsimile 480-588-5063
The Arizona personal injury, accident, and insurance bad faith dispute lawyers at the Law Offices of Shane L. Harward PLC represent insurance, personal injury and accident victims throughout the state of Arizona (AZ) including, but not limited to, Phoenix, Scottsdale, Mesa, Tempe, Chandler, Glendale, Gilbert, Sun West, Sun City, Tucson, Flagstaff, Kingman, Bullhead City, Yuma, Lake Havasu, Fountain Hills, Anthem, Ahwatukee, Carefree, Cave Creek, Gold Canyon, Bisbee, Sierra Vista, Cochise, Paradise Valley, East Valley, Maricopa, Pima, Pinal, Gila, White Mountain, Heber, Payson, Prescott, Forest Lakes, Apache Junction, Avondale, Queen Creek, Benson, Black Canyon City, New River, Buckeye, Casa Grande, Coolidge, Cottonwood, Douglas, Florence, Gila Bend, Goodyear, Greer, Glendale, Lakeside, Guadalupe, Holbrook, Huachuca City, Oro Valley, Overgaard, Avra Valley, Parker, Peoria, Pinetop, Pine, Prescott Valley, Quartzite, Strawberry, Safford, Show Low, Sun City West, Sun Lakes, Superior, Surprise, Snowflake, Tombstone, Wickenburg, Winslow, Wilcox, Williams, Young, Youngtown, and surrounding areas.