Articles Posted in Insurance

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I hate to break it to you, but despite all the cute auto insurance ads on TV, insurance companies are not “nice guys”.  At least not if you were injured through the negligence of their insured.  You have to understand this very important fact right from the get-go:  In personal injury litigation, insurance companies are not your friend.  They are not a “good neighbor”.  They are not a cute little lizard.  They are not “by your side”.  You are not in “good hands” with them.  They are a business.  Their business is to pay you as little as possible on your claim so they can yield a bigger profit.

Case in point:  Last week I settled a case for a woman who fell off a horse at a local riding stable during a riding lesson in upstate New York (near Syracuse).  It was her first time on a horse. The saddle spun around while she tried to mount, throwing her to the ground, where she suffered a serious femur fracture.  Turns out she weighed more than the saddle setup could handle. The stable owners knew it, but failed to warn her.  Here was the original position the insurance company took (you need to click the image to read it):

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After we got that letter, we sued  the stable owners.  We then took the deposition testimony of the owners and witnesses.  The insurance company lawyers then asked the trial judge to toss out our case because our client had “assumed the risk” of horse riding lessons, and had signed the waiver.  The trial judge dismissed our case.   We then appealed to the appellate court in Rochester, New York, got the trial judge reversed, and the case reinstated.  Last week, at a mediation, we settled the case for $130,000, which by the way was the amount of money we always thought the case was worth.

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This morning I was at the radio studios of Finger Lakes Radio Group in Geneva, New York.  They wanted to interview me about my new book, “Understanding Your New York Personal Injury Claim“.  Geneva’s station – WVGA – ran the interview live.  It’s sister station in Auburn, NY  – WAUB – will run it at a later date.

It was fun to be on the radio again.  Ted Baker is an excellent interviewer.  He has interviewed me several other times about my volunteer work for the Boys & Girls Club of Geneva.  He made me feel right at ease and asked very on-point questions about my book.  For example, he asked me:

Why did you write the book?

money-doctor-300x200I just read a disturbing article in the New York Times about a large-scale personal injury insurance scam in New York City.  It works like this:  A gang of fraudsters lines up “scouts” to go into poor neighborhoods in search of people willing to “fake” accidents and injuries in exchange for money.  The “victims” are then coached on how to fake both the accidents and the injuries.  Suitably trained, they then “fall” in potholes, deliberately trip outside of restaurants or other businesses, or crash cars.  The fake accident victims then visit doctors whose pockets are also being lined with the fraud ring’s money.  The dishonest doctors then “treat” the “patients” for broken bones or internal injuries that do not exist, and of course keep copious records of all the “treatment” they provide.  The doctors even go so far as performing unnecessary medical procedures to bump up the settlement value of the injury.

The five men who orchestrated this particular scam have now been indicted.  The indictment alleges that the scam lasted for five years and cost insurance carriers about $30 million.

This is the kind of dishonesty that gives New York personal injury lawyers, and personal injury victims, a bad name.  And this is the kind of news article that jury members I empanel will have in mind when I am presenting a legitimate personal injury case to them for a seriously and legitimately injured victim.  Unfortunately, juries have to wonder whether my client, and perhaps even I, am trying to pull the wool over their eyes.  And a lot of it is the fault of scammers like these guys.

law-360-300x182I recently posted a blog about New York’s top Court’s recent ruling that New York personal injury plaintiffs can win “summary judgment” against defendants without proving that the plaintiff was blameless for his own injury.  The rule previously, in most courts, was that the plaintiff could not get summary judgment without first proving that he or she was blameless. You can read that earlier blog here.

Since the blog was posted, Law360, and online legal newspaper of national renown, interviewed me about the case.  The article’s headline is:  “NY High Court’s Injury Ruling Could Spark Fast Settlements”.  The article quotes me as follows:

Michael Bersani, a personal injury plaintiffs lawyer for Michaels & Smolak PC in Syracuse, New York, said it has been in insurance companies’ best interests to stall litigation given their considerable resources. But if liability is already established, then a 9 percent interest rate on a potential $1 million verdict would glean $90,000 annually, he said. “It makes the plaintiff comfortable and makes the insurance companies very uncomfortable,” Bersani said. “If the insurance adjuster knows I’m going to get a verdict, they have much more incentive to get it resolved early and get it settled.” Bersani said the ruling will also help injured clients obtain third-party litigation funding in order to pay for daily living expenses. “Some plaintiffs are poor, and to wait out their case they have to borrow money from third-party lenders,” said Bersani, who noted that many can’t work due to their injuries and often run out of disability insurance funds. “Once you get a finding of liability, it’s easier to get a third-party lender at a better rate,” he said. “If I have an iffy case and can’t get a lender, if I get summary judgment, then it makes it a lot easier because the lender knows there will be money coming in and will get paid.”

insurance-claim-form-300x200 New York State lawmakers and Governor Cuomo just delivered New Yorkers a Christmas present.  Today Governor Andrew Cuomo signed into law the Supplementary Uninsured/Underinsured Motorist (SUM) bill, also known as the “Driver and Family Protection Act.” This important piece of legislation will protect New Yorkers statewide who are involved in auto accidents.

I know what you are thinking (if you have even read this far).  Supplemental what?  SUM what?  What the hell are you talking about?  Click.  I’m out of here . . .

But wait.  Don’t surf past this blog post just yet. I promise I will answer these questions:  What is SUM, why was it a problem, and how did New York State just fix it?  Read on, friend.

insurance-claim-form-300x200There is likely a big problem with your auto insurance.  So big, so problematic, that our legislature is attempting to fix it.  But you can fix your insurance right now, with just a phone call.

But before you make that call, you have to understand the problem and a few things about New York auto insurance.

Here’s the problem:  The minimal auto liability insurance allowable in New York pays out a maximum of only $25,000 per injured person and $50,000 collectively for all persons injured through the negligence of the vehicle’s driver.  That’s woefully inadequate if you are struck by an at-fault driver and you or your passengers suffer long-term disabling injuries that prevent you or them from working.

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I tend to get a lot of immigrant and Spanish speaking clients.  Could be because I speak fluent Spanish and am married to a Guatemalan.  I hope it is also because word spreads in the immigrant community that I get good results.

Anyway, the guy standing with me in the photo above is from Nicaragua.  One day as he was riding his bicycle to work (on the shoulder of the road, just as he was supposed to) near Rochester, NY, a car swiped him from behind and never bothered stopping.  We call that a hit and run.  The next thing he remembers is waking up all bloodied in a ditch, with a piece of broken car mirror next to him.

My Nicaraguan friend had bad injuries but also has a tough, fighting spirit.  He got back to work only five months after his accident so he could put food on the table for his wife and two children. Hard working Nicaraguan immigrant! I admire him and all the other hard-working immigrants I have had the privilege of representing.

thCentral New York personal injury lawyers like me have a tough job.  We have to convince a skeptical jury that our client’s injuries are real and significant. Most injuries are fairly “invisible”.  It doesn’t help that most pain and limitations in movement do not appear on x-rays or other films.  Unless the injury is very visible and obvious – like an amputated arm — most jurors start out with the preconceived notion that the plaintiff is either faking or exaggerating her injury to get money in court.  (Actually, this is very rarely the case, and is never the case when we at Michaels & Smolak present a plaintiff to a jury).

To present our clients’ injuries to the jury, we of course must elicit testimony from witnesses who have seen, first hand, the real life consequences of the injuries.  Such witnesses include not only the plaintiff herself and her immediate family members, employers, and others who have witnesses how the injury has changed her life, but also medical doctors who have performed surgery or treated her.  All these witnesses bolster the veracity of the injury.

The insurance companies we are up against, on the other hand, hire their own doctors to examine the plaintiff and to testify regarding the injuries.  Naturally, since these hired-gun doctors are not in the business of treating the injured plaintiff, but in supplying testimony paid for by the insurance company, their testimony tends to be biased against the plaintiff.  Their “job” is to try to minimize the injury. The examinations they perform on plaintiffs are misnamed an “Independent Medical Examinations” (“IMEs”) and the doctors who performs them are sometimes called “IME” doctors.  On the plaintiffs’ side, we prefer to call these examinations “Defense Medical Examinations”, or “DME’S”, since there is really nothing “independent” about them. (Read my prior post about IME’s).

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I have been blogging recently about how auto insurance protects bicyclists who are injured by automobiles.  For my previous blogs on this subject, click here and here.  In my last blog post, I discussed what remedies a bicyclist hit by a car has when the car either leaves the scene and cannot be identified (hit-and-run vehicle) or is uninsured.  I said that the injured cyclist can claim both no-fault  (basic medical expenses and lost wages up to $50,000 limit) and “uninsured motorist” benefits (pain and suffering compensation and any medical expenses and lost wages no-fault that go beyond the no-fault limit up to $25,000) from his or her own auto insurer or, if he does not own a vehicle, from the auto insurer for any relative who lives with him or her.  And as I discussed in the previous blogs, if the injured cyclist has Supplemental Underinsured Motorist coverage in his auto policy, he will have even higher levels of compensation available.

Today I am going to discuss what happens in the same scenario, but where neither the cyclist nor  anyone who resides with him owns a vehicle, and thus there is absolutely no auto insurance available.  Is the injured cyclist completely without a remedy?

No!  At least not in New York State.  And here’s why:

Bicycle accident, wheel in front of car low angle shot, focus on car Lenklypse 2012
I blogged just the other day about four ways auto insurance can protect you if you are hit by a car while on your bicycle.  Actually, there is a fifth way I did not tell you about.  Here it is:   Hit-and-run insurance, a/k/a “uninsured motorist” coverage.

It’s pretty unusual for one motor vehicle to strike another one and take off from the scene of the accident.  Even if that happens, the hit-and-run driver is likely to get caught if he takes his car in for repairs.  The police will be canvassing local body shops and repair shops for cars that match the description of the hit-and-run vehicle.

But things are different when a car strikes a bicycle.  There is usually little or no damage at all to the car (although the bike and cyclist are crushed!).  The driver can easily just drive away.  For example, a terrible car-on-bike hit-and-run happened a few years ago right near my hometown in Geneva, NY. The hit-and-run driver was eventually caught and prosecuted, but the bicyclist ended up losing his leg.

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