Posted By Eugene Bruno & Associates Posted in: Motorcycle Accident.
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 necessary.” 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 review 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 an automobile, motorcycle or other accident, contact me today. Protect your rights!