Because they Can; Why Insurance Companies Deny Claims they shouldn’t


I had a call from a nice lady from Dalton the other day and the reason she called is that Allstate declared that they were assigning 30% of the blame for a crash to her. This is a crash where the Allstate driver left a stop sign and pulled in front of the lady and there was a bad crash that totaled both cars. The lady was interviewed by Allstate and she said she was going 30 in a 25 when the other driver pulled out from the stop sign without looking. Allstate took this lady’s honest statement that she was 5 mph above the speed limit and threw it in her face to refuse to pay for the car in full and to deny $6,000 in medical bills from the hospital.

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Keep in mind those 5mph of speed did not affect the crash one bit. The driver at the stop sign cannot argue that she could have squeezed by and narrowly avoided collision if our lady had been going 25. The insurance carrier takes a lousy position just because they have the power.

The result is a nice conservative southern lady chooses to call a lawyer. She just wanted her car paid for her and the medical bills covered but some snide Allstate adjuster decided to be nasty and the result is I have to get involved. Months down the road after I depose the other driver and point out the obvious that the 5mph has nothing to do with how the crash happens, the Allstate lawyer will tell the adjuster they are wrong. What a ridiculous waste of resources on all sides. And why? Because they can. They have been trained to be annoying and to deny any claim they can.

Take another case we are working on. Our client is a triathlete who was training on a ride in Blue Ridge Georgia. One sunny day, as he was riding by a home on a state road, a small dog shot out of the yard and ran smack into the side of the bicycle. It knocked him to the ground and he sustained 14 fractures in his hips. There were no other witnesses.

The client is believable and the homeowner admitted that the dog was off the leash in violation of the county leash law. The family denied that the dog did anything and claimed the dog would have been injured if the dog had collided with the bike. The insurance company sent out an investigator who met with the dog. The insurance adjuster called me back and advised that they were denying the claim outright because they did not believe my client and the believed the dog was nice. I pointed out that we did not accuse dog of attacking our client; rather the dog just ran into the bicycle because he was off leash.

Fortunately we had downloaded the defendant’s Facebook page and there was a picture of the dog with a comment posted by the aunt; “how is his nose” posted the day after.

We filed suit and set the defendant’s deposition. When confronted with the evidence, she “remembered” that she found the dog after the incident with a bloody nose and cowering behind a car. The insurance carrier is now changing their position. Why did they take an investigator’s opinion of the demeanor of a dog over our client who witnessed the act? Because they can.

I just don’t get it. Why do they continue to drive innocent, ordinary people into litigation when it is totally unnecessary? I think the answer is the abundance of long sighted leadership in American Insurance Corporations. Come to think of it, there is a dearth of long sighted vision in many parts of this country.

It is apparent in the volume personal injury firms that churn up claims, jack up bills and squeeze insurance companies when the shouldn’t. It is apparent when corporations reduce staff that results in short term gains to stock prices, but long term drops. My experience has been that the long term business strategy of honesty, generosity and patience is the one that pays of in the end. The pay off is higher profits and happier customers.

In this small instance, Allstate has created an enemy for life in a very polite nurse in Dalton, Georgia. All the cute ads with Mayhem in the world won’t turn her close circle of 30 friends around. You are the Mayhem Allstate. You will reap what you sow.

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