Anybody out there NEVER been jerked around by an insurance company? *crickets* Hello? This thing on?
Ok. Anybody out there ever BEEN jerked around by an insurance company?
Ah, yes. That’s what I thought. Everybody has had their bad/frustrating/time-consuming/patience-draining/insert-your-own-adjective experience(s) dealing with an insurance company.
Now, I’m not accusing everybody in the insurance industry of being a bad guy here. Most are just cogs in the wheel doing the best they can. Insurance companies are HUGE organizations, hence, there’s a lot of drip between the lip and the cup. Most of the time people and insurance companies get crosswise is because of issues that are inevitable in a huge bureaucracy. Things like, hiccups in computer programs. (Like the time our homeowner’s insurance collected our premium from us twice in one year and when we found out about it two years later it took 3 months to return our overpayment). Inefficiencies in protocols. Things falling through the cracks. Etc. Etc.
But, there are times that insurance companies abuse people by committing unethical, immoral and illegal acts.
Sit back and I will illustrate.
Years ago, we had a client who slipped and fell on the stairs at a skating rink. She reached out to catch herself on the plexi-glass guard rails, but the plexi-glass had been removed earlier that day. So, when she slipped, she fell headfirst several feet onto the concrete penalty box below. Broke a vertebrae in her neck. Client had been holding a mixed drink at the time and, guess what happened when she fell? Yes. It spilled all over her.
We contacted the appropriate insurance companies. “Client can’t work. Client has medical bills. Please pay pursuant to Ridley and Dubray.” They refused because “liability isn’t reasonably clear.”
We scratched our heads. “If the plexi-glass had been up, client wouldn’t have fallen head-first several feet onto the concrete. Building code says the plexiglass had to be there.”
“Your client smelled like alcohol. She must have been drunk. She wouldn’t have fallen if she was not drunk.”
Client says she was not drunk. So, we talk to someone who was there with our client. Witness says client was not drunk. So, we take a recorded statement of witness and send it to insurance companies. Insurance companies still refuses to pay: your client was drunk.
“How do you know?” we ask.
“Because we heard it from somewhere.”
“She smelled like alcohol.”
Really? Do you think someone who spilled a drink all over themselves might smell like alcohol? Regardless, they cling to the desperate hope that client was drunk. Even though no eye-witness has actually told them she was drunk.
So, we have to file suit. And, after we reach a significant settlement in the case about how bad our client was hurt, we file suit directly against the insurance companies. For violating Montana’s bad faith law. Which, in part says that it is illegal for them to “refuse to pay claims without conducting a reasonable investigation based upon all available information.” Which means, an insurance company can’t disregard what two witnesses say without proof of the contrary.
And the insurance companies eventually settled that case for even more than the underlying one because: it’s bad faith to rely on a rumor with no evidence.