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Fraud in real estate, are you being victimized? - Part I
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Buying Auto Insurance (part 3 of 4)
Continued from part 3
Insurance Company Advertisements Deceive (part 3 of 4)
If some of the millions of dollars spent on advertising auto insurance would be devoted to fair payment of injured insured's' own claims against their own company, we probably wouldn't even have to make mention of this. However, the advertisers' portrayal of insurance responsiveness with homey images, friendly messages, beautiful music and promise of quick claims service do not equate to quality when it comes time for payment for personal injury claims following an auto accident.
We know that getting your car fixed promptly is important. Some companies may be more responsive on property damage than others, but that should not be your first priority evaluating insurance service. A day or two wait for your car is nothing compared to being literally cheated out of your legitimate payments, as is the practice of some of the more aggressive companies. See the discussion below and the links provided. If getting your car fixed in the fastest time is the most important thing for you, you can ignore everything that is written in the following paragraphs, because they focus on the bodily injury aspects of auto insurance claims service.
So, our advice is to ignore the advertising images: the insurance industry did not become one of the wealthiest in America by being everybody's best friend. Understand that these smiling people on television ads are really your adversaries. There are many thousands of reported cases where insured have been forced to sue their own companies. None of these cases has to do with getting people's cars fixed. Prompt property damage repair is the simplest and easiest part of an accident claim. Instead, these lawsuits against insurance companies all are based on claims that an insurance company did not perform according to the law and in accord with its own contractual provisions.
Research Suggestions to Check Out Auto Insurance Companies:
Our suggestion is that you research two or three companies.A good place to start is with the Better Business Bureau, followed by a contact call to your state Insurance Commissioner. You can call the Better Business Bureau (http://www.bbb.org) in your own area and learn how to inquire if any complaints have been filed. The most effective research, however, is probably through your state Insurance Commissioner . Use this url (http://www.naic.org/state_contacts/sid_websites.htm) provided to contact your Insurance Commissioner and obtain information in five topics:
1.Ask her how you can learn about the number and types of complaints that have been filed with her against or about a company that you are considering.
2.Ask her how you can obtain a count of the number of times a company has been involved in reported litigation, whether brought by the insured against his own company, or by the third party as a bad faith claim.
3.What is the reported percentage of first and third party claims the company settles by negotiation, as opposed to arbitration or litigation? Ask her for the statistics relating to the percentage of claims settled, versus the percentage that goes to arbitration or litigation. Would it surprise you to learn that over half of the claims of one of the largest and most popular companies end up in arbitration or litigation?
4.Ask her what actions or enforcements she has had to take with respect to any company you are considering.
5.Does she know if any of the companies use credit scoring to set premiums, and are there any restrictions in your state on use of credit scoring.
You Get What You Pay For:
You have heard the advertisements that one auto insurance company is the least expensive, etc. Understand that truth of the old adage applies to insurance policy purchases: you get what you pay for . The best company is probably not the cheapest. How can company policies that save premium costs have adverse impacts upon your wallet?
First, the reason a company is cheaper is that it doesn’t pay out as much as another company, nor does it provide as much service. If your own company does not pay out in a fair manner, and if you are the defendant in the case (the tortfeasor ), expect that your chances of being involved in a lawsuit are much higher than if you were insured with another (quality) company.
Since insurance is going to foot the bill anyway, why should that impact you? Well, you’ll have to be inconvenienced at home, at work, and at trial. You’ll be sued; you will have to take time off of work to see the attorney who will be hired by your company to represent you; and you’ll have to testify at depositions and/or trial. Remember, you will not be paid lost wages to participate in your own defense. But in addition to the time involved, it can be very stressful to be in a lawsuit. You will have to answer under oath regarding a number of topics, and your spouse may also have to participate.
However, the biggest impact of adverse treatment by your own insurance company may not come when you are a defendant, but may come when you are a claimant versus your own company. This could be as a claimant under your own policy, either for payment of medical expenses or payment of wage loss under the Personal Injury Protection ( PIP/MedPay ) provisions, or for underinsured/uninsured UIM coverage.
It is in these circumstances that many first party carriers become aggressive and literally cheat their own insureds out of legitimate payments. Most consumers have little knowledge of these practices, and aggressive companies are almost always successful in cutting off PIP payments for treatment far earlier than your own doctor would recommend. That is where they make the money and that’s where you’ll find yourself in need of some help.
The company will respond that you have the right to arbitration. But no attorney is going to become involved in a Personal Injury Protection/Medical Pay (PIP/MedPay) arbitration. There is not enough at stake to merit the time and effort. You can be at the mercy of the company, so select wisely. In this respect, the least expensive coverage may be no bargain at all .
Be aware that the first party carrier that advertises the cheapest price is likely the one who
will deny payment for medical coverage sooner than the other carriers. They can be quite aggressive in this respect as described in all of the IME, Medical Care and the PIP/MedPay sections. They will use the ruse of a “records review” or an “independent” medical examiner ( IME ) to deny payments due to your own doctor/chiropractor for your continued reasonable and necessary care. The so-called “independent” doctor they select is hired by the insurance industry to (nearly always) say that you “have reached maximum medical improvement, and no further treatment is necessary.”
The same type of carrier is also the one that will likely seek to limit your recovery on UIM by requesting arbitration more frequently than other carriers. These claims involve all of the damages you would expect to recover from the tortfeasor, including general damages . Thus, there can be quite a bit of money at stake, since general damages are usually a multiple of the cost of your medical care.
In evaluating UIM coverage, see if you can find out what percentage of claims are settled, mediated, arbitrated, or tried to a jury (this jury trial clause is inserted by only a few companies).Does your Insurance Commissioner have any idea how often a carrier forces its own insureds into arbitration, rather than agree to the more desirable non-binding mediation forum? Arbitration and mediation usually involve attorneys who are knowledgeable in personal injury matters as mediators or arbitration panel members.
Or, worse, do they force their own UIM claimants to go into court and present their claim to a jury?
Do you have the right to choose arbitration in UIM? Is your company is deceiving you with a clause that removes your rights to arbitration. Here is a Specific Question for the Sales Representative Regarding Forcing You to a Jury Trial
Please check your policy and ask the sales representative to be sure that your carrier does not reserve the right to a jury trial in its UIM disputes.
The tricky little phrase used in policies issued in recent years was to the effect that “disputes hereunder will be resolved by arbitration, unless either of the parties elects to have the dispute resolved as in other civil matters” . You probably would not see anything wrong with that phrase, but it is deceptive in its apparent innocence. It is a powerful tool and will in turn, only benefit the insurer.
That little phrase was intended to give the insurance company the right to a jury trial in resolving your dispute with your own company.If you and they disagree, you will not have the right to an arbitration; they will just tell you to go file a court action. And the insurer will always ask for a jury trial.
Why don’t you want a jury trial? First, you will have to pay to use the court system. You must file the lawsuit, and you will have to serve it (although they will likely accept mail service). Second, there is likely a much longer wait (currently one and a half to two years is common) for you in obtaining a jury trial date than there would be to put together an arbitration panel of attorneys. Who wants the delay? The insurance industry makes a lot of money on investments, whereas you will always need the cash to make up for some of the problems caused by the accident.
Third, it is tremendously more expensive than any other forum for resolution in your time and your costs. In arbitration, you can submit medical records to be read by the arbitration panel, and perhaps call just one of your doctors. You will pay for any time your doctor has to spend in preparation and testimony, so you will want the less formal proceeding (such as arbitration) because her fees will be a fraction of those at trial.
At a jury trial, you must present some live testimony from your doctors. (Although some records can be admitted without the doctor present, attorneys usually want the doctor present to speak to the jury, whereas at UIM arbitration, the attorney knows that the panel of trail attorneys will have some familiarity with the medical specialty, medical terms, prognosis, etc., and she therefore can simply admit the records and argue from them.) This testimony is expensive, because you will likely pay their full time away from the office, including courtroom waiting time, regardless of the results). It is a delay of a year or two, depending upon your jurisdiction, and it takes a much greater effort to succeed with higher risks than at arbitration. Therefore, the company knows that you are more likely to compromise and accept a lower award than if you went to arbitration. So please consider this an important issue in selecting your company.
Think Preventive—Protect Yourself, Your Family, and Your Passengers
We’ve seen far too many cases where the insured, in an effort to save a dollar up front, has left him or his family exposed. Insurance is a good investment; it is necessary; and, it should be purchased in anticipation of traumatic events.How can you foresee only limited consequences of an accident? You can’t.
Here are two examples of places where we have seen insureds deprive themselves of necessary coverage. The first and most obvious is PIP/MedPay .Insured people who have a good medical plan, an HMO, or who are covered through the military, often think they will rely on their medical plan and decline to take PIP/MedPay. This is a serious mistake.
Often, medical plans (or military) do not afford anything more than the long gray line of institutionalized medicine, where treatments and referrals are very limited. By contrast, your own PIP/MED PAY allows you to select your own doctor, chiropractor and other health care professionals such as specialists, with much more freedom of choice. Moreover, PIP also pays a portion of your wage loss (MED PAY does not). It would be an error to pass by a chance to purchase PIP. Please note that your HMO or health plan or military access affords no protection whatsoever for your passengers.
What will you tell the parents of the children who were riding with your child on an outing
On to part 4
About the Author
Jeanine Steele is an editor with SettlementCentral.Com, the online resource for do-it-yourself personal injury claims.
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