You Should Know: Beware the Insurance Company Three D’s

When you buy insurance, you’re buying security. In exchange for your hard-earned dollars, you trust the insurance company to be there when disaster strikes, to shoulder a potentially devastating financial burden. But too many insurance companies care more about profits than policyholders. They employ shady tactics to keep from paying legitimate claims, a practice we call The Three D’s.

If you’ve ever had to file an insurance claim, you know the frustration that seems baked right into the maze of endless forms and confusing small print. Companies that once lived up to their promise to “be on your side” when disaster strikes dramatically shifted business practices in the 1990s to meet Wall Street demands for short-term profits. The result is chronicled in the book Delay, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It by distinguished Rutgers law professor Jay Feinman. Not surprisingly, insurance companies are recording astronomical profits. Here’s how it works:

Trick #1: Deny, Deny, Deny Claims

Insurance companies will outright deny that an accident occurred or that the policyholder was seriously injured. Some companies even offer gifts and bonuses to employees who deny claims and keep payments to a minimum. Arbitrary rules will crop up, often referencing provisions that do not exist or that contradict a previous statement. The hope is that denial after denial will defeat and deflate claimants, making them feel they have no choice but to throw in the towel.

Trick #2: Delay Paying as Long as Possible...
Even Until Death

Endless forms, arbitrary rules and a sea of fine print discourage claims.

You’ve jumped through all the hoops and the insurance company has agreed to pay the claim, so you can rest easy, right? Think again. Delaying payment is another common tactic to boost profits. Insurance companies have been known to send out incorrect forms and then blame claimants for the error, or set very short time limits on when a claim can be made after an accident, injury or illness. In cases involving elderly or gravely ill claimants, some insurance companies have even delayed payments in hopes that the customer dies before they have to pay.

Trick #3: Defend in Court

Following a denied claim or a delayed payment, insurance companies know they can further delay writing a check by defending their questionable tactics in court. Billions of dollars in profits and thousands of high-priced lawyers on the payroll means they are always ready for a trial. Insurance companies know that many of their customers may be afraid or unwilling to hire a lawyer, and they use that fear to convince claimants that a court battle would only end in an insurance company victory.

Getting Paid What You Deserve

Forcing a claimant to sue for benefits owed is one way insurance companies fail their customers.

What can a David do against these insurance company Goliaths? Here are some tips on what to do before, during and after making a claim to an insurance company:

• Pick a reputable company: It pays to do a little homework before you sign on the dotted line. Start with this list of best/worst insurers ranked on claim denials and bad-faith practices.
• Read your policy carefully: You should know exactly what is covered and what you need for an appeal in case your claim is denied.
• Double- and triple- check forms: An incorrectly filled-out form can be used by an insurance company to deny or delay claims. Past forms can even be used as a way to retroactively deny coverage. Be thorough and honest on every piece of paper you fill out.
• Do not cash the check right away: Insurance companies will send checks with very low offers, or pay premium refunds if they rescind your coverage. Cashing these checks can be legally interpreted as accepting their offers.
• Get everything in writing: If you need to fight your insurance company, you must be able to produce every bill, form and piece of correspondence.
• Reach out for help: An experienced plaintiff’s lawyer can guide you through your claims process and provide the firepower necessary to challenge the insurance company in court if necessary.

This article appeared in our July 2017 "You Should Know" e-newsletter.

The Dangers of Texting & Driving - Facts & Statistics

"I think we can all agree: new technology offers many benefits - computers have allowed lightning fast data processing, the internet created a global world, and mobile phones provide us with convenience and a valuable safety tool.

Unfortunately, the law of unintended consequences almost always rears its ugly head when it comes to technological advances. In terms of cell phones, one of the most dangerous consequences has proved to be a rise in distracted driving." - Misha Safranski, MoneySavingPro

Click here to learn more about the dangers of texting and driving at MoneySavingPro.

You Should Know: Motorcycle Injuries, Insurance and Prevention

Americans love motorcycles: the wide-open road, the sense of freedom, the “Born to Be Wild” spirit of rebellion. Perhaps you are thinking about a biking adventure as well this summer? You wouldn’t be alone. According to numerous government and industry sources, motorcycle ridership in the United States is at an all-time high, especially among older riders.

Fatalities Continue to Rise Among Older Riders

Common sense tells us that motorcycling is simply more dangerous than driving a car. Aside from four wheels over two, cars are equipped with numerous safety features, including seat belts, air bags and a surrounding structure that protects occupants in a crash. Motorcycles are also less visible to other drivers, and require more mental and physical skill to operate safely. Finally, motorcyclists are more vulnerable to bad weather and hazardous road conditions.

While the overall number of motorcycle injuries and deaths declined slightly in 2013 and 2014, fatal accidents among older riders continue to rise. Riders 50 and older accounted for 3 percent of motorcycle fatalities in 1982, 13 percent in 1997 and 36 percent in 2014, according to the Insurance Institute for Highway Safety. Aside from the inherent dangers of motorcycling, riding without a helmet, while intoxicated or speeding are often cited as contributing factors as well.

Insurance May Not Cover Personal Injury

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Click to expand this Fool's Gear, Cool Gear infographic.

After strapping on your helmet, the next best protection you can have in case of a motorcycle accident is insurance. While all 50 states require minimum insurance coverage to operate a motorcycle, be aware that the minimums may not adequately protect you in a serious accident. Like any type of insurance, how much you'll need will depend on many different factors, including the type of bike you own, how often you ride, your marital status, your personal assets and your budget.

Liability covers bodily injury and property damage that you may cause to others involved in an accident. Other coverages include uninsured or underinsured motorist, which covers personal injury and damages caused by the driver of another vehicle who either does not have insurance or does not have sufficient coverage; collision, which covers physical damage to the motorcycle involved in a crash with an object, tree or another vehicle; comprehensive, which covers a loss from non-collision sources, such as theft, vandalism, fire or hail; and in states where applicable, medical payments or personal injury protection (PIP), which covers physical injuries to the rider and passenger.

Beyond liability, your first priority should be the coverages that pay you – and your passenger – for medical treatment, lost wages and other damages. These include uninsured/underinsured and PIP. Note, however, that the risks associated with motorcycling often make it very expensive to increase these coverages. In some cases, for example, PIP may not even be available, or may be so expensive that it is out of reach for most individuals. As when purchasing any type of insurance, seek the advice of a qualified advisor and carefully review policies from several different insurers.

Preventing Motorcycle Accidents – Tips for Riders and Drivers

To help combat the growing safety issues with motorcycles, the Motorcycle Safety Foundation has set out to improve safety through education, training and licensing. Since 1974, over 7.5 million motorcyclists have taken MSF training courses. 

The Foundation offers the following tips for riders and drivers (download) to help prevent motorcycle accidents.

For Riders:

• Be Properly Trained and Licensed – Half of all riders have never taken a proper safety class. If you take the Motorcycle Safety Foundation’s Basic Rider Course, some states will waive the written portion of the motorcycle endorsement test.
• Wear a Helmet – The facts are irrefutable: Helmets prevent fatalities an estimated 37 percent of the time for motorcycle drivers, and 41 percent of the time for passengers in motorcycle accidents, according to the NHTSA. And aside from being smart, wearing a helmet the law in 19 states and the District of Columbia.
• Fool's Gear, Cool Gear – What you wear can make it easier for drivers to see you and better protect you in a crash. 
• Never Drink and Drive – In 2013, 28 percent of cycling fatalities involved riders who were legally intoxicated.
• Ride Within Your Skill Limits and Obey Traffic Laws – Don’t ride faster or farther than your abilities will allow.
• Be a Lifelong Learner – Take advanced courses to brush up on the basics and keep improving your skills.

For Drivers:

• Watch for Motorcyclists – Motorcycles are smaller than other vehicles and often harder to see. In 42 percent of the fatal motorcycle accidents reported in 2013, a vehicle made a left turn in front of an oncoming motorcycle.
• Focus on Driving – Motorcyclists are easy to miss even when you are paying attention. Studies show that distracted drivers simply don't see certain objects like signs, motorcyclists and pedestrians. Hang up the cell phone or mobile device.
• Give Motorcyclists Enough Room – Maintain a safe distance between your car and a motorcycle and don’t change lanes too close. What would be a minor fender bender between two cars could easily be fatal to a motorcyclist.
• Use Your Turn Signals – For everyone’s safety, use your turn signals. It is also the law.
• Keep Trash in the Car – Road debris can kill a rider. And don't throw cigarette butts out of your car, either.

 This article appeared in our July 2016 "You Should Know" e-newsletter. 

You Should Know: The Latest on Marijuana and Driving

A patchwork of state laws define marijuana intoxication.

Marijuana and Driving

Studies analyzing the effects of driving under the influence of marijuana have been marked by contradictory research and imprecise measurement. Two major studies published by the National Highway Traffic Safety Administration (NHTSA) in February 2015 shed new light on a topic of increasing concern as 24 states have legalized marijuana (four states and the District of Columbia for recreational use, the rest for medicinal use). According to a recent article in Timemagazine, another five states could follow suit this year.

NHTSA’s first report confirmed predictions that legalization might lead to more stoned drivers. In a 2013-14 roadside survey of more than 9,000 drivers, 12.6 percent tested positive for THC (the principal psychoactive ingredient in marijuana,) compared to 8.6 percent in 2007 – a 47 percent increase. The percentage of drivers at or above the legal limit for alcohol was 8.3 percent, down 80 percent since a 1973 NHTSA roadside survey.

But here’s where the story takes an unexpected turn. The second NHTSA report focused on crash risk in what the agency described as the “first large-scale study in the United States to include drugs other than alcohol.” Data was collected from more than 3,000 crash-involved drivers and compared to 6,000 drivers not involved in crashes. While drivers who tested positive for THC were 25 percent more likely to be involved in a crash, other factors like age, gender, ethnicity and blood alcohol concentration were considered more likely the culprit than the presence of drugs. NHTSA researchers didn't mince words, writing: “Caution should be exercised in assuming that drug presence implies driver impairment.”

Meanwhile, the number of traffic fatalities involving marijuana-stoned drivers has increased in Washington and Colorado since both states legalized the recreational use of the drug, according to two recent reports. The percentage of drivers who used pot within hours of a fatal crash in Washington nearly doubled from 2013 to 2014, according to a just-published AAA study. A similar increase was recorded in Colorado with 10 percent of drivers in fatal accidents testing positive for marijuana in 2011 versus 5.9 percent in 2009.

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OK, So What’s “Under the Influence”?

Findings from these studies underscore another important point in this discussion: Measuring impairment in a person using marijuana isn’t comparable to blood alcohol concentration. “Most psychoactive drugs are chemically complex molecules, whose absorption, action and elimination from the body are difficult to predict,” NHTSA writes, "and considerable differences exist between individuals with regard to the rates at which these processes occur. Alcohol, in comparison, is more predictable.” Some marijuana users can have measurable amounts of THC in their bodies days or even weeks after using the drug, long after any psychoactive effects remain.

The uncertainty surrounding the intoxicating effects of marijuana is reflected in the patchwork of state laws defining driving “under the influence” of drugs. Some states follow a zero tolerance standard, making it illegal to have any presence of THC or other illegal drugs in your body while driving. Others set a legal THC limit expressed in nanograms (one-billionth of a gram) per milliliter of blood. In others, impairment is inferred based on the circumstances rather than defined by blood THC levels.

To review the laws on marijuana and driving in your state, click here.

What’s Next?

Of course, no one is suggesting that people should “blaze one and go for a joyride whenever the whimsy strikes,” wrote a New York Times reporter after reviewing the NHTSA study. There is plenty of evidence to show that marijuana use impairs driving skills. And as all these studies make clear, we need more research on the effects of marijuana and driving, along with better equipment for detecting and measuring marijuana-related impairment. It is also clear that the science of intoxication surrounding marijuana is different than that of alcohol and may demand a more nuanced response by policymakers, law enforcement and court officers. In other words, stay tuned for more on this evolving topic.

 This article appeared in our June 2016 "You Should Know" e-newsletter. 

The Dangers Of Driving Under The Influence Of Any Drug, Including Pot

Guy W. Crabtree

In North Carolina, a person is guilty of driving while impaired if they operate a motor vehicle while under the influence of alcohol or an impairing substance. The THC in marijuana would be considered an impairing substance. One would be impaired within the meaning of the law if one had taken a sufficient amount of THC to cause him to lose the normal control of his bodily or mental faculties, or both, to such an extent that there is an appreciable impairment of either or both of these faculties.  

While we too often encounter wrecks caused by drivers impaired by alcohol, a case involving impairment solely by THC is rare. One reason, of course, is that there is no roadside or magistrate’s office testing apparatus that can easily measure the amount of THC in a driver’s blood. There is no breathalyzer test to detect THC. A blood draw and testing of that blood is necessary.  

When investigating a case where impairment is suspected and the at-fault driver was taken for medical treatment as a result of the wreck, we always attempt to get the medical records, including the lab reports, from that treatment. The blood test will usually include testing for TCH and other drugs. If drugs are present we can and will use that information in our client’s favor as we prosecute our client’s case. 

Causing injury and damage while driving while impaired will subject the impaired driver to punitive damages and we will often include such a claim in the overall damages claim.

Guy W. Crabtree is a partner with Crabtree, Carpenter & Connolly, PLLC, in Durham, NC. The firm helps injured parties from all over the nation recover from injuries caused by the negligence of others.

You Should Know: Your Responsibilities as a Party Host

Protect Yourself and Your Guests When Hosting a Holiday Party

Hosting a party this holiday season? Before stamping that last invitation, learn how you can protect yourself and your guests. The legal principles at work here are called premises and social host liability. Here are tips and suggestions for preventing injuries and protecting your interests before guests arrive:

Let’s Start with Alcohol

“Holiday cheer” is often synonymous with alcoholic beverages in many people’s minds. There is nothing wrong with that thinking, but homeowners should be aware that they may be held liable in some states if intoxicated guests leave the party and cause injury or property damage to others. So...

• Encourage guests to pick a designated driver.
• Stock plenty of non-alcoholic beverages and serve food.
• Don't pressure guests to drink too much and cut off anyone who has already had enough.
• Call a cab for intoxicated guests, give them a ride (if you are sober), or offer a place to sleep at your house.
• Never allow minors to drink.
• As the host, stay in control by not drinking too much yourself.

Click to view a Drinking & DUIs During the Holidays infographic

Now, Look Around Your House

As the property owner, you are responsible for protecting your guests from unsafe conditions on your property. So...

• Fix any tripping hazards like broken stairs or loose handrails, double-stick tape throw rugs and secure extension cords.
• Remove any dangerous items that might injure children like an old freezer, a broken swing or poison hazards.
• In colder climates, keep sidewalks and steps free of ice and snow.
• If you have a pool, keep gates locked or make sure kids are supervised by an adult if using the pool.
• Consider restraining pets as you may be liable if a guest is bitten or scratched.

Review Your Homeowner’s Insurance

The liability coverage in your homeowner’s insurance may be your final line of defense if someone is hurt during a party at your home. So...

• Make sure it is in force and that your policy limits are high enough to cover an injury. Standard minimums of $100,000 to $300,000 may not be enough to cover all the costs associated with a serious injury.
• If you have significant assets in addition to your home, consider an umbrella policy for added liability protection.
• Check for exclusions and contact your agent if you have any questions.

This article appeared in our November 2015 "You Should Know" e-newsletter.