When the other driver's insurance company makes you a settlement offer
and promises to keep the medical portion of your claim open, watch out!
I have noticed a few new trends from several of the big insurance companies
lately. Several clients have come to me to review settlement offers from
the other driver's insurance company and tell them whether it sounds
fair. In short, the insurance company offers to settle your injury claim
for a small amount (usually $500-$1,000) with the promise that they will
also pay "additional reasonable and necessary medical expenses"
related to the accident. In other words, the insurance company is willing
to pay you a small amount to get you to go away and then, IF THEY FEEL
LIKE IT, they will pay your medical bills too as long as THEY believe
those medical bills were "reasonable and ncessary." Good luck
getting those medical bills paid! The problem is, the big insurance companies
NEVER think your medical bills are "reasonable and necessary."
"Reasonable and necessary" is one of the most common lies told
by the big insurance companies. In other words, while you may have received
an ambulance/hospital/doctor bill for $1,000, the insurance company thinks
that amount is unreasonable and they will pay you what they think is a
reasonable amount. What happens to the balance due? You're stuck with
it and good luck telling the ambulance/hospital/doctor that you will pay
them a "reasonable" amount!
Likewise, the big insurance companies almost always question whether your
medical treatment was "necessary." Let's say you go to the
hospital after an accident. The ER doctor orders an MRI or other tests
to determine the extent of your injuries. If the test comes back negative,
the insurance company is likely to tell you the test was not "necessary"
and they will refuse to pay it.
Another aggressive settlement tactic I've been monitoring lately is
oral settlement agreements. Perhaps knowing that most reasonable people
will want to review the settlement agreement sent to them by the insurance
company, claim adjusters are being instructed to reach an oral agreement
with the injured person and record the oral agreement. Bottom line: if
the agreement is oral, there's no written contract to review and that
makes it less likely that you will take the agreement to a lawyer to review
your rights. Oral settlement agreements work like this: A claim adjuster
calls to talk to you about your recent accident. She may tell you she
needs to record your statement, but don't let her. The insurance company
is entitled to talk to you about the accident, your injuries, your medical
treatment -- but they have NO right to record your conversation without
your agreement. Just say no. Tell the claim adjuster you'll be happy
to talk to her, but no recording.
At the end of the conversation, while still being recorded, the claim adjuster
will make a low ball offer to settle your claim before -- sometimes even
before you've seen your doctor! The claim adjuster will read the terms
of the written agreement to you -- but not give you an opportunity to
read and reivew with an attorney -- and then ask you if you agree to the
terms of the settlement. This is a new tactic and it is unclear whether
California courts will uphold such agreements. IMHO the lack of an opportunity
to review a written agreement is grounds to set aside that settlement
later, but the better course of action is to avoid the trap by refusing
to permit the claim adjuster to record your conversation.
It is never too early to discuss your rights with an experienced attorney.
I offer a free, no pressure consultation over the phone or in person and
there's never a fee until I win your case. If you were injured in
a automobile, motorcycle or other accident,
contact me today. Protect your rights!