Several weeks ago you may recall I wrote a piece decrying the decision making on a number of cases involving Geico insurance. While I am outspoken when I see injustice, it is only fair to also recognize improvement.
In the DUI case that I described, Geico went on to reverse their liability decision and has now taken care of the property damage that the clients sustained at the hands of the drunk driver. What happens with the husbands injured shoulder remains to be seen but for now the universe is back in order and functioning as it should for that family.
On the case involving two carpal tunnel surgeries that I mentioned was getting close to trial with a totally unfair offer in light of the jury value, Geico also reassessed the situation and ended up doing the right thing and resolving the claim. Do I wish for the client’s sake that they had done this a year ago? Absolutely, but as I said earlier, in the field of injury law justice delayed is still better than no justice at all.
The motorcycle case was put into litigation two weeks ago and we are now waiting for the defense to file an answer. Whether the adjuster on that file is given the latitude to better assess the risk remains to be seen but as the old song says, “two out of three ain’t bad.”
I do not inherently believe that first tier insurance companies are evil as some of my brothers at the bar do, but they can go through periods where their decision making is profoundly obtuse.
Insurance companies exist to make money and to protect their insureds against risk. They cannot protect if they have no money so I do not advocate taking unjust judgments against them. It is bad public policy. On the other hand, as the very public debate about BP’s claims handling brings to light, there has to be a balance between the consumer’s right to compensation and the insurer’s right to only pay valid claims.
To that end, I am proposing an modification of the claims handling system.
Geico, like many other top line insurers employs very seasoned trial lawyers to litigate a majority of their files.
Personal Lines Insurer Goals in No Particular Order:
1) Preservation of capital in non- loss reserve dedicated accounts. This allows the carrier to make money on its money.
2) Streamlined and efficient claims handling process with quality controls to ensure homogenous handling practices across the board. ie, don’t have adjuster x paying more to claims made by Korean Americans just because their wife is Korean American.
3) Deterrence of claims filing ( to facilitate #1)
4) Cost Effective investigation and resolution of legitimate claims.
As with any corporation, the pursuit of these goals taken to the extreme can result in unsound policies. For illustration read the Bloomberg report on McKenzie’s claims handling suggestions to Allstate some years back or the Business Week article “In Tough Hands.”
If Geico were to adopt the old Allstate model identified in the article, it would probably profit in the short term but in doing so it would undermine the highly successful ad blitz of the last few years.
Instead I suggest a tiered approach:
1) For injury claims with property damage exceeding $1,500.00, overpay by $100.00 and call it a good faith apology bonus. Buy some goodwill. I cannot tell you the number of people over the years who have admitted to me that they would never have come to a Georgia injury lawyer if they had just been treated politely during the property damage phase. Spend $100 to save thousands in injury claims.
2) For injury cases where the medical treatment is BS, like the typical Atlanta bill runup at certain chiropractic clinics who shall go unnamed. Blacklist cases involving those providers and resolve to try them all unless 1) counsel will take a ridiculously low offer or 2) unless there are paradigm shifting facts like, hard radiographic findings, legit orthopedic care that breaks the mold, high impact cases, alcohol cases.
3) Classify your Georgia injury lawyers.
What is their record of actually trying cases?
When they litigate will they actually line up legitimate medical testimony?
Do they have a pattern of milling cases as decribed in #2?
Let it be known that you will settle cases with lawyers who only operate on legit files but that you will go to guns with lawyers that bring cheesy chiro based cases. This is not to say that all cases involving chiropractic care are not serious. There are some wonderful chiropractors in Atlanta who do great work and do heal their patients; but the overwhelming majority that are involved in the car wreck industry should operate differently. For example why, if the client has health insurance and you are an approved provider are you billing the client more than 4 times to health insurance contract rate in a car wreck? It is immoral and indefensible.
Can you imagine the deterrent effect that would have on lawyers accepting those cases?
When evaluating settlement offers on cases you do want to settle, take that into account. These days, that only happens at the mediation which does not occur until a year after the lawsuit is filed.
4) For cases involving a visible solid impact and clear liability, with legitimate medical care, put a seasoned claims ombudsman or woman on the file early on, as in immediately after suit is filed. She should contact plaintiffs counsel and lay out a list of required items prior to an early mediation.
a) Full cross section of medical priors with master printout of all health insurance claims for the previous 5 years.
b) Schedule an in person meeting with the Plaintiff and their lawyer to assess jury appeal, communication skills, lawyer preparedness. Apologize, build good faith, explain your goals. Clients will take thousands less if you treat them with respect.
c) Set a mediation with a skilled mediator within the first 60 days so your litigation expenses are minimized. Even with captive counsel, there is an opportunity cost for the lawyer being tied up taking depositions and answering discovery.
If at that mediation you are simply too far apart, then continue as per usual. My impression is that you will be amazed at how many legitimate cases you can resolve, and how much business goodwill you will engender.
d) One last important thing, treat your Georgia uninsured motorist insurance claims with more attention and respect. These are your insureds and right now, they are viewed as the enemy. These people pay you premium, in some cases they have for decades. Respectful dealings will preserve their loyalty and word of mouth buzz is the best advertising money can buy. The reverse is true as well.
State Farm seems to be adopting an interesting approach to UM claims in Georgia. In several cases now, I have filed Underinsured Motorist claims and put the cases into litigation. Once State Farm finished their internal pricing of the claim, they sent our office a check for that amount with no strings attached. The cover letter advised that we were free to continue to litigate for the balance. This is genius on many levels.
a) You are fulfilling your duty to your insured. If your internal assessment is that you owe x and there are no defenses to that amount, then you owe it under the policy and it should be paid. Sitting on that dollar amount is indefensible.
b) If the check for the settlement amount is say 70% of the full value of the case at trial, the calculus for the Plaintiff’s attorney and the plaintiff shifts very quickly. Will the client really want to take another year to get to trial for the chance to recover 60% of the remaining 30% of case value-litigation expenses. Is it worth the hassle? Although the injury lawyer is duty bound to selflessly only think of the client, do you really think they will want to spend $2,000.00 on medical expert depositions for 40% of the remaining 30% of value?
I am sure there are industry regulations involved, but there has to be a cheaper and more just way of handling these claims.