As a former claims adjuster, claims investigator in SIU and now a licensed private investigator I agree with the statements outlined below. Also relevant to workers comp injuries.
1. Claimants were much more likely than those without representation to receive treatment in a pain clinic and to undergo magnetic resonance imaging (MRI) for similar injuries
2. Were more likely to be involved in apparent claim abuse
3. Received, on average, lower net payments (total payments adjusted for claimed economic expenses and applicable legal fees) than those who did not hire attorneys
4. Waited longer for payment of claims
Absolutely correct, John. I’d venture to say that this article takes a rather naive approach to the mostly sordid referral network of PIP/WC representation.
I’d add: No. 5. Paid to be an “injured” patient by a runner (financed by PIP attorneys)
No. 6. Is likely to be a non-English speaking immigrant (Hispanic, Creole, Russian, Hmong, et al)
I was rear ended some years back and received several letters from attorneys offering their services. It felt good to contact them and let them know what I thought about their offers. There was no need for them. The insurance company took care of the claim. I think many people receive calls, letters, etc. from attorneys after an accident and they would not have thought of contacting them without that push.
Perplexed, attornies are very good at obtaining accident reports and contacting claimants in a heart beat. They also advertise their services and trot out their clients to tell the public how much the attorney got for them.
We live in an entitlement society and a lot of people want to get in on the gravy train.
Is that also the professional opinion of your company, or is it suddenly different then? You bitch constantly about insurance companies not wanting to pay, seems inconsistent to me.
Or when they do something that isn’t a giveaway to brokers like selling directly online, which is really just a disguise for complaining about commissions he won’t get.
December 8, 2016 at 4:41 pm
Agent says:
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Perplexed, Actu is throwing yet another tantrum kicking and screaming in the floor of his cubicle.
December 8, 2016 at 9:48 am
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Actu, you have a serious personality disorder. Seek help for your affliction. By the way, we have more trouble going against captives and excess/surplus lines companies paying claims they owe than standard market agency companies. Leading the captives trying to dodge paying is State Farm followed by Allstate and Farmer’s group. See the latest case of State Farm being forced to pay a legitimate claim in the Katrina case. They owed it, denied it and were eventually forced to pay it. By the way, I avoid the excess/surplus lines market like the plague unless there is no one else that will take the risk.
I’ve always wondered why so many people go to attorneys to make claims on simple Auto accidents. With the 33% or more they typically scoop up, I figured it would be much more financially satisfying to do it yourself as most insurance companies are willing to make a fair offer to make the situation go away. But then I’m an insurance professional fully confident in trying to settle a claim on my own, who would only go to an attorney if I felt I wasn’t being dealt with fairly. I guess many in the masses do not have that confidence and are willing to give up 33%+ to have somebody else help.
Bill, I am fairly confident that when a claimant retains counsel they have to sign a contract and the cost of their services (maybe excluding fees) is in that contract. Some now charge 40% if a complaint is filed, whether one needs to be filed or not.
What I meant was when they seek out an attorney. He or she tells them how “bad” the insurance company is and how “you are going to get everything you deserve”. Like the time I slipped on an icy sidewalk and broke my finger; I told an acquaintance who sent me to his attorney dad. He said “those health insurers cheat people all the time”. He never mentioned the fee, and I didn’t pursue it. There are some bad insurers, but don’t paint them all with the same brush.
Just saw a notice that a notorious ambulance chaser got what he deserved. Found him dead in his car at age 56.
December 12, 2016 at 8:08 pm
County Line says:
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Yes, the legal fee is declared in the contract. But by the time that fact comes out, the attorney has done the sales job on the claimant to “close the deal”.
So right you are, Dave. Just do the math on a simple $15,000 BI claim. On average the attorney keeps 1/3 of the claimant’s settlement. How many hours of the injured party’s own time working their own claim would that $5000 pay for? When people see it that way, they would choose to at least try the DIY route, rather than give up $5k to an attorney for a short series of letters done by the attorney’s assistant on a word processing template. There are exceptions to the rule of course, but what I’ve described represents most cases I’ve seen.
I was out at a wine tasting and dinner one night. At a table of 10, 2 were lawyers and I got into a discussion about insurance claims and how you should not get a lawyer or public adjuster at the start of the claim process; it made more sense to wait for the offer and then decide if it is fair or not. One lawyer vehemently argued that you need a lawyer right away, and they almost always get a better settlement with a lawyer. As the wine kicked in, he was getting louder and obnoxious. I then asked him what % more on average to do get a claimant and he said 20% to 30% more. We had already established his firm’s fee was 33% to 40% earlier. “Case closed” I said. He became furious, turned red and someone mentioned that we had another lawyer and 8 witnesses at our table. He left! Great night!
On the other hand, it isn’t unusual for our clients to be offered $5,000 for a $35,000 valued and settled claim. Similarly, in a third party worker comp claim, our client was offered $25,000 for a case that settled for $590,000. It is rare that we don’t at least double the gross and increase the net to the injured party by 30%. But, it may be the cases we are willing to accept or how made our clients were at the initial pre-attorney offer.
My guess is that Florida’s attorney involvement is so high because of all the fraud that goes on with staged accidents.
As a former claims adjuster, claims investigator in SIU and now a licensed private investigator I agree with the statements outlined below. Also relevant to workers comp injuries.
1. Claimants were much more likely than those without representation to receive treatment in a pain clinic and to undergo magnetic resonance imaging (MRI) for similar injuries
2. Were more likely to be involved in apparent claim abuse
3. Received, on average, lower net payments (total payments adjusted for claimed economic expenses and applicable legal fees) than those who did not hire attorneys
4. Waited longer for payment of claims
Absolutely correct, John. I’d venture to say that this article takes a rather naive approach to the mostly sordid referral network of PIP/WC representation.
I’d add: No. 5. Paid to be an “injured” patient by a runner (financed by PIP attorneys)
No. 6. Is likely to be a non-English speaking immigrant (Hispanic, Creole, Russian, Hmong, et al)
I was rear ended some years back and received several letters from attorneys offering their services. It felt good to contact them and let them know what I thought about their offers. There was no need for them. The insurance company took care of the claim. I think many people receive calls, letters, etc. from attorneys after an accident and they would not have thought of contacting them without that push.
Perplexed, attornies are very good at obtaining accident reports and contacting claimants in a heart beat. They also advertise their services and trot out their clients to tell the public how much the attorney got for them.
We live in an entitlement society and a lot of people want to get in on the gravy train.
Is that also the professional opinion of your company, or is it suddenly different then? You bitch constantly about insurance companies not wanting to pay, seems inconsistent to me.
The only time I hear Agent complaining about insurance companies not paying is in reference to COMMISSION!
Or when they do something that isn’t a giveaway to brokers like selling directly online, which is really just a disguise for complaining about commissions he won’t get.
Perplexed, Actu is throwing yet another tantrum kicking and screaming in the floor of his cubicle.
Actu, you have a serious personality disorder. Seek help for your affliction. By the way, we have more trouble going against captives and excess/surplus lines companies paying claims they owe than standard market agency companies. Leading the captives trying to dodge paying is State Farm followed by Allstate and Farmer’s group. See the latest case of State Farm being forced to pay a legitimate claim in the Katrina case. They owed it, denied it and were eventually forced to pay it. By the way, I avoid the excess/surplus lines market like the plague unless there is no one else that will take the risk.
I’ve always wondered why so many people go to attorneys to make claims on simple Auto accidents. With the 33% or more they typically scoop up, I figured it would be much more financially satisfying to do it yourself as most insurance companies are willing to make a fair offer to make the situation go away. But then I’m an insurance professional fully confident in trying to settle a claim on my own, who would only go to an attorney if I felt I wasn’t being dealt with fairly. I guess many in the masses do not have that confidence and are willing to give up 33%+ to have somebody else help.
I really don’t think the average claimant has a clue about the 33%+ they’ll have to forego.
Bill, I am fairly confident that when a claimant retains counsel they have to sign a contract and the cost of their services (maybe excluding fees) is in that contract. Some now charge 40% if a complaint is filed, whether one needs to be filed or not.
What I meant was when they seek out an attorney. He or she tells them how “bad” the insurance company is and how “you are going to get everything you deserve”. Like the time I slipped on an icy sidewalk and broke my finger; I told an acquaintance who sent me to his attorney dad. He said “those health insurers cheat people all the time”. He never mentioned the fee, and I didn’t pursue it. There are some bad insurers, but don’t paint them all with the same brush.
Just saw a notice that a notorious ambulance chaser got what he deserved. Found him dead in his car at age 56.
Yes, the legal fee is declared in the contract. But by the time that fact comes out, the attorney has done the sales job on the claimant to “close the deal”.
So right you are, Dave. Just do the math on a simple $15,000 BI claim. On average the attorney keeps 1/3 of the claimant’s settlement. How many hours of the injured party’s own time working their own claim would that $5000 pay for? When people see it that way, they would choose to at least try the DIY route, rather than give up $5k to an attorney for a short series of letters done by the attorney’s assistant on a word processing template. There are exceptions to the rule of course, but what I’ve described represents most cases I’ve seen.
I was out at a wine tasting and dinner one night. At a table of 10, 2 were lawyers and I got into a discussion about insurance claims and how you should not get a lawyer or public adjuster at the start of the claim process; it made more sense to wait for the offer and then decide if it is fair or not. One lawyer vehemently argued that you need a lawyer right away, and they almost always get a better settlement with a lawyer. As the wine kicked in, he was getting louder and obnoxious. I then asked him what % more on average to do get a claimant and he said 20% to 30% more. We had already established his firm’s fee was 33% to 40% earlier. “Case closed” I said. He became furious, turned red and someone mentioned that we had another lawyer and 8 witnesses at our table. He left! Great night!
On the other hand, it isn’t unusual for our clients to be offered $5,000 for a $35,000 valued and settled claim. Similarly, in a third party worker comp claim, our client was offered $25,000 for a case that settled for $590,000. It is rare that we don’t at least double the gross and increase the net to the injured party by 30%. But, it may be the cases we are willing to accept or how made our clients were at the initial pre-attorney offer.