Articles Posted in Insurance

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Insurance companies classify injury claims for evaluation and efficiency. One of the main categories are MIST (Minor Impact Soft Injury) or LIST (Low Impact Soft Tissue) claims. Once a claim is designated as a MIST claim, the insurance company will set a value based on other MIST claims and rarely increase the offer unless there is a significant and serious change in the facts of the claim.

M.I.S.T – MINOR INJURY SOFT TISSUE CLAIMS Jonah Wolfson Miami

One of the goals of an insurance company is efficiency. It is how they maximize their profits. Think about how insurance companies encourage or reward you for going online to self-service your policy and premiums. Every time you handle your insurance issues online, you are not costing the company any employee time – and time is money.

By classifying cases insurance companies, reduce your claim to simple numbers. There is no consideration of the shock, pain or emotional toll caused by the accident as it is irrelevant to the insurance company. They can give a young claim representative hundreds of MIST claims with talking points and marching orders to handle all of the claims the same way.

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If you settle your personal injury claim, you will need to sign a release to get the money. A release basically means that you are releasing, or letting go, your claims against the responsible party. In a car accident, that usually means the owner and operator of the other vehicle as well as their insurance company. In a slip and fall injury, it would be the property owner. In a medical malpractice case, the doctor and possibly the hospital would want a release in exchange for a settlement.

Miami Accident lawyer Jonah Wolfson

Releases are covered by basic contract law. There is an offer to settle and, if agreed, an acceptance of that offer. But there must be what is called a “meeting of the minds” which means that the terms of the offer and acceptance must be agreed to by both parties. If the acceptance does not match or “mirror” the offer, then there is no agreement.

In a recent Florida case, the importance of having a “meeting of the minds” was clearly demonstrated. After a car accident, the injured party offered to settle her claim against the other driver for his policy limits with USAA Insurance Company. In addition, she offered to release her claims against the other driver. However, her attorney specifically advised USAA that she would not sign a release containing a hold harmless agreement nor an indemnity agreement. The attorney also warned USAA that any attempt to release anyone other than the other driver would act as a rejection of her good faith offer to settle.

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A chiropractor and his wife were awarded $14.5 million in their lawsuit against GEICO in Miami-Dade County. The jury’s verdict was based on a December 2004 highway collision with an uninsured motorist. Dr. David Zucker and his wife filed their lawsuit in 2006 and finally received their verdict over 9 years later.

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The jury found in favor of Dr. Zucker and awarded him damages for:

  • $767,740.00 in Past Lost Wages: The amount of money he lost as income because of the crash
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A jury told GEICO to pay $9.6 million because it failed to help its own policyholder settle a claim following a fatal accident. When an insurance company pays its policy limits that does not settle the case. Insurance companies have to try to get a release for its policyholder whenever it can. That is the duty it owes to the people who pay for their insurance.

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James Harvey was insured with GEICO with $100,000 policy limits. He had crashed his Hummer into motorcyclist John Potts and killed him. GEICO sent a check for the $100,000 policy limits to the attorney who represented Mr. Potts’ estate. The estate’s attorney properly requested GEICO to make Mr. Harvey available to answer questions about any other assets he might have to compensate the estate. GEICO said no and advised Mr. Harvey to not give a statement.

The GEICO adjuster ignored the estate’s attorney. If GEICO had allowed and encouraged Mr. Harvey to provide asset information to the estate attorney, then the estate would have executed a release for the $100,000 policy limits. After weeks of no response from GEICO, the estate filed a wrongful death lawsuit against the GEICO insured and obtained an $8.47 million verdict against Mr. Harvey.

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Everyone who owns and operates a registered vehicle in Florida is required to have Personal Injury Protection (PIP) insurance. According to Florida Statute § 627.736, for a person to be eligible for PIP medical benefits, those injured in a motor vehicle accident must seek initial services and care from specified providers within fourteen (14) days after the motor vehicle accident. Medical benefits up to $10,000 are available for “emergency medical conditions” diagnosed by specified providers, and up to $2,500 for non-emergency medical conditions. In addition, the law specifically excludes licensed acupuncturists and massage therapists from being reimbursed for medical benefits. Chiropractors cannot make the determination that a patient has suffered an emergency medical condition but are authorized to provide treatment to PIP insureds.

a sheet metal damage after a car accident. damage for insurance

The insurance companies hate to lose. We all know that. In PIP they complain about fraud and Plaintiff attorneys all the time without ever mentioning the enormous premiums collected. But one thing is certain – insurance companies are always looking at the bottom line.

Over the years, insurance companies followed one version or another of “delay, deny, defend”especially in PIP. It is simply the same pig but with different dresses. The routine defense in PIP was to win on the pleadings not with juries. However, many insurance companies began to believe that the judges who decided the cases on the pleadings were largely selected by the Plaintiff’s Bar. This belief was supported by selective background research and typical corporate thinking. As a result, a new strategy emerged.

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Insurance companies spend incredible amounts of money to experts who regularly testify at trial. In Miami car accident cases, these experts are usually board certified orthopedic surgeons or neurologists who testify for insurance companies on a regular basis and at tremendous financial gain.   However, a skilled trial attorney can expose the bias of these well paid experts and that can make all the difference in the result obtained.

headquarter of an insurance company in Miami

The Florida Evidence Code allows any party to attack the credibility of a witness by showing the witness is biased. Florida law permits evidence of any potential bias between a party and an expert. This evidence extends to a defendant’s law firm or even the employer of that lawyer.

            In Vazquez v Martinez, the court allowed evidence that proved the defendant’s experts had been paid nearly $700,000 over a three year period by the defense or its agents. The court explained: “Whether the party has a direct relationship with any of the experts does not determine whether discovery of the doctor/law firm relationship or doctor/insurer relationship is allowed. The purpose of the rule is to expose any potential bias between a party and an expert.”

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If you’ve been in a car accident, you may find yourself facing additional new expenses and financial burdens. Accident survivors may have to shoulder new medical expenses, rehabilitation costs, and may even miss time at work. They may have to repair or replace a car that has been damaged or totaled. On top of all these new concerns, accident victims may also worry that their auto insurance rates will rise.

a sheet metal damage after a car accident. damage for insurance

Concern about auto insurance rate increases are legitimate, especially in Florida. According to the Palm Beach Post, Florida is among the top ten most expensive states for auto insurance. One of the main reasons why Florida’s auto insurance rates are so high is due to the fact that Florida requires individuals to have Personal Injury Protection insurance. This insurance pays for medical expenses for injuries sustained in an accident.

It is difficult to predict if, or by how much your auto insurance may go up after you’ve been in an accident. But, it is important to understand that a personal injury claim could protect you from having to shoulder additional expenses and it can also help establish negligence in court. If you were not negligent in an accident, not only is the other driver responsible for expenses, but the likelihood that your insurance will significantly rise following the accident decreases. Whether your insurance goes up after an accident depends largely on complex algorithms used by insurance providers, which take into account everything from driving history, your location, credit history, and who was at fault in an accident if an accident has taken place.

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EVIDENCE OF FUTURE MEDICARE BENEFITS AT IS NOT ADMISSIBLE AT TRIAL

State Farm took a father and his developmentally disabled adult son to the Florida Supreme Court and lost. The son was hit by a vehicle while riding his bicycle in 2007. Since he was disabled, his father, as his parent and natural guardian, sued State Farm for uninsured motorist benefits in the case of Joerg v. State Farm.

Miami Car Accident Lawyer

Before the accident, the son was entitled to Medicare benefits because of his disabilities. At trial, the father and son asked the trial court to prevent State Farm from telling the jury about his benefits under Medicare and Medicaid. The trial court agreed with the father and his son. After a four day trial, the jury awarded a total of $1,491,875.54 which included $469,076 for future medical expenses. State Farm appealed the case all the way to the Florida Supreme Court.

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In June alone, there have been several reports of cars crashing into homes. CBS Miami reported that a car crashed into a North Miami home. While no injuries were sustained as a result of the accident, the news reports failed to mention the extent of property damage the accident caused.

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In another accident, a driver drove into a supermarket, panicked, pushed on the accelerator, crashed into two cars on Northeast 6th avenue, then crashed the car into an apartment. CBS News reports that the driver thought she was hitting the brake when she was in fact pushing down on the accelerator. The Toyota Corolla drove through a glass window, striking a 29 year old employee who sustained injuries to her side and to her head. The woman who lived in the apartment told CBS News that she would be dead if she had been in her apartment at the time of the accident.

While car-building collisions are rare, the recent rash of these kinds of accidents is a sober reminder that when these accidents take place, innocent victims suffer injuries and property damage.

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griswoldsMIAMI BEACH – This post is about your safety around the holidays. Nobody wants there Christmas tree to burn. You don’t need insurance claims or, even worse, injuries. But it happens. And, it is an easy way to ruin Christmas. But we found some suggestions to prevent this from happening. And some statistics to motivate you to be a safe Christmas tree handler! The National Fire Protection Association reports that:

Between 2006-2010, U.S. fire departments responded to an average of 230 home fires that started because of Christmas trees each year.  The fires caused an average of 4 deaths each year and  21 injuries.  The total yearly economic loss associated with Christmas tree fires is reportedly $17.3 million in direct property damage.

While Christmas tree fires on not common, they can be very serious according to the National Fire Protection Association. In fact, one out of every 66 reported fires that began with a Christmas tree resulted in death. According to the National Fire Protection Association, one in about five or 18% of fires started due to a heat source too close to the Christmas tree. Another nineteen percent of home Christmas tree structure fires were intentionally set. And about three quarters or 75% of the intentionally set Christmas tree fires occurred in the 15 days after Christmas which makes it likely the fires were due to disposal.

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