July 8

How Do Insurance Companies Calculate a Personal Injury Claim?

How Do Insurance Companies Calculate a Personal Injury Claim?

By: Heath C. Murphy + Car Accidents

Property damage claims are fairly straightforward to determine. The value of property is can be determined by the marketplace. Personal injury claims, on the other hand, are more complex. One reason is because it is very hard to calculate pain and suffering. Another reason is because of the unpredictable nature of jury awards. Two different juries hearing the same case with the same facts and the same lawyers presenting evidence in the exact same way are likely to arrive at two differing damage calculations. Insurance companies do not like uncertainty and have sought to remove it from negotiations with people injured in accidents.

History of Personal Injury Claims

Until the 1990s, insurance adjusters had broad authority to evaluate and pay personal injury claims. Adjusters actually met the injured people and evaluated their credibility and strengths and weaknesses as a potential witness. They heard the story the jury would hear and would make offers based upon actual quantifiable losses and their evaluation of the injured person. In the 1990s that all began to change with the creation of Colossus.

What is Colossus?

Colossus is a computer program originally created for Allstate that assigns values to personal injury claims. Colossus is believed to be used by Aetna, Allstate, CNA, Erie, Farmers, Metropolitan, Ohio Casualty, The Hartford, MetLife, Travelers, USAA and Zurich to estimate personal injury claims from auto accidents and motorcycle accidents. Every insurance company that uses Colossus will state that it is merely a tool to uniformly evaluate all insurance claims, but according to former employees, it has been used to systematically generate low offers at the expense of injured people in order to generate record profits for insurance companies.

Colossus’s estimation is based on numerous factors that negatively affect a claim and lower the value of the case. Employees of the companies utilizing Colossus will enter in information from the medical records of the injured party. Colossus will then simply assign a value to an auto accident victim’s bodily injury. It awards higher values for injuries like broken bones and gives greater value to victims who went to the hospital immediately after the accident. As such, Colossus allows any auto insurance company that uses it, to artificially drive down injury values. The insurance companies also control the information fed into the Colossus program and in turn, they can reduce the benchmark or baseline values by only inputting the lowest settlement amounts.

Colossus Investigation

The National Association of Insurance Commissioners, along with the Florida, New York, Iowa and Illinois insurance departments conducted an 18 month investigation in Allstate’s use of Colossus. The investigation found “inconsistencies in Allstate’s management and oversight” of Colossus. Essentially, the investigation concluded that there were no internal procedures in place that would ensure that Colossus was properly given the information necessary to properly evaluate the claims. Jury verdicts that were deemed unusually high could be excluded and information necessary to fine tune the program could be omitted. Allstate paid $10,000,000 to settle the claims against it, but did very little to change the process and oversight of the program.

More Evidence Against Colossus

In 2012, Mark Romano, a former employee of Allstate, co-authored a paper entitled “Low Ball: An Insider’s Look at How Some Insurers Can Manipulate Computerized Systems to Broadly Underpay Injury Claims.”[1] Mark Romano is a Tampa native and the former Allstate employee who was paid to implement the Allstate version of Colossus.

Mr. Romano learned that if he made minor tweaks or “turned a few knobs,” he could generate millions in savings for the company. Mr. Romano’s knob turning generated savings of $33,000,000 in his first 3 years on the job. Exploiting inconsistencies in the computer program is merely one method insurance companies have used to save money at the expense of their insureds. Mr. Romano has alleged that Colossus can be manipulated to produce “low ball claim’s offers” by:

1. “Tuning the program” by predetermined percentages. This will reduce the top end claim amount and therefore decrease the maximum amount the adjuster may offer to resolve the case.

2. Selectively excluding high end claims from the calculations.

3. Manipulating certain “user friendly” features of the program to create arbitrarily low settlement offers.

4. Having adjusters who enter in the medical information routinely second guess medical professionals regarding the severity of injuries.

5. Having adjusters arbitrarily enter a final prognosis that is favorable to a lower payment amount.

6. Having adjusters arbitrarily enter permanent impairment ratings into the program.

In conjunction with Colossus, Allstate, at one point in time implanted a policy which has become known as the “Good Hands, Boxing Gloves” policy. Essentially, it has been alleged that Allstate trained its employee to build a rapport with customers and discourage them from hiring lawyers to handle their car accident claims. They would pay these claims to these unrepresented persons in within 180 days, but for their insured clients that hired an attorney would get the boxing glove treatment. The goal was to delay payment for 3-5 years. According to David Berardinelli, an attorney that sued Allstate for these practices, the “good hands” approach actually consisted of stringing along the insureds for several months and then as the financial pressures on the injured person mounted, a low ball offer would be made and often accepted.[2]

Though several states are attempting to place more regulations on the use of Colossus, it is unlikely to be banned in the near future. For those injured in a car accident, it is important to hire an attorney that is familiar with injury calculations used by the big insurance companies, but who is also able to evaluate claims on a case by case basis and be willing call the insurance companies on low ball offers and proceed to trial.

Contact an Experienced Car Accident Lawyer at The Law Offices of Bobby Jones

Have you or a loved one been injured in a car accident? Contact an experienced St. Petersburg car accident attorney at The Law Offices of Bobby Jones today. When you contact our office we will immediately set an appointment where you will meet your attorney and be provided with his/her personal contact information. If you do not have transportation or you cannot drive, your attorney will travel to meet you and discuss your case with you.

If you or a loved one has been injured in a car accident caused by the negligence of another, you should immediately call an experienced personal injury attorney in St. Petersburg at The Law Offices of Bobby Jones at (727) 571-1333 during regular business hours or (727) 753-8657 on weekends or after regular business hours. We will evaluate your case for free and you will never pay us a dime unless we recover compensation for your injuries.

The Law Offices of Bobby Jones
6570 30th Avenue North
St. Pete, FL 33710

http://jlgtampabay.com/personal-injury/

References

[1] http://www.consumerfed.org/pdfs/Studies.ComputerClaims06-04-12.pdf

[2] http://www.postandcourier.com/article/20121202/PC16/121209871/storm-of-money-insider-tells-how-some-insurance-companies-rig-the-system&source=RSS

May 8

Motorcycle Laws in Florida

Motorcycle Laws in Florida

By: Heath C. Murphy + Motorcycle Accidents

I have noticed a disturbing trend in St. Petersburg. I have seen more and more riders wearing headphones or earbuds while riding their motorcycle or moped. It would seem to be commonsense that wearing earphones while riding a motorcycle would be inadvisable, but apparently it is not. It is illegal to ride a motorcycle or moped in Florida while wearing headphones.[1] Helmets with speakers and single earbud cell phone headsets may also be worn legally. I had a discussion with someone the other day about whether this was a stupid law. This person’s argument was premised on the fact that deaf people could get a license and ride, therefore, this law made no sense. I could not get them to grasp a couple of points. First, riders are safer if they are not wearing headphones. Secondly, the fact that deaf person can obtain a license does not give merit to the position of allowing all riders to ride without the benefit of hearing. People who are deaf are very much aware of their hearing limitations and are much more focused on their surroundings when riding.

Does Florida Require Motorcycle Headlights?

Yes, motorcycle riders are required to use headlights at all times while riding their motorcycle.[2] Since 1978, motorcycles have been wired so that the headlamp is always on when the bike is running. Florida allows modulating headlights to be utilized during daylight hours. Modulating headlamps are an aftermarket feature that cause the headlamp to flicker. Many riders believe that the modulating headlamps cause their motorcycle to be more visible than the standard “always on” headlight. The failure do so may be used to show the comparative fault of the rider, in the event that there is an accident.

Mandatory Equipment for Motorcycle Riders

Did you know that Florida law requires helmets and protective eye gear?[3] It is true. However, there is one exception to this law. If the rider is over the age of 21 and covered by an insurance policy providing at least $10,000 in medical benefits for injuries incurred as a result of a crash while operating or riding upon a motorcycle. All riders, under the age of 21, must wear a helmet at all times when operating or riding on a motorcycle. Eye protection is always required for motorcycle riders in Florida.

Florida Insurance Requirements for Motorcycles

Insurance is not required to register a motorcycle like it is for cars, but if a biker is at fault in an accident which causes property damage or bodily injury and is not carrying insurance the penalties can be severe. The penalties for such an accident include mandatory SR 22 insurance coverage for a period of three years and possible suspension of the at fault riders driver’s license. [4]

PIP Benefits for Motorcyclists

PIP or personal injury protection is mandatory coverage that must be maintained on all cars and trucks in Florida. In a nutshell, PIP coverage provides that your insurance company will pay the first $10,000.00 in medical bills. Obviously, this $10,000.00 can be exhausted rather quickly, but it does get some of the medical providers paid more quickly and provides incentive for medical providers to care for injured persons without health insurance.

That all sounds wonderful, right? Not so fast, because motorcycles are not covered under Florida’s PIP laws. Some insurance companies provide a PIP type coverage, but it is very important to read those policies because they are not governed by Florida’s PIP statute.

Ape Hangers in Florida

“Ape Hangers” are handlebars that extend upward so that the rider has to reach up to grab the grips. The video below shows some variations of ape hanger handlebars.

In Florida, the hand grips on the handlebars cannot extend above the shoulders. The handlebar laws, across the country, are a constant source of irritation for bikers. Some states set a maximum of 15 inches above the seat. Other states allow 30 inch handlebars. Some states require at the shoulder, some below and some a predetermined distance above the shoulder. Sixteen states have no restrictions on handlebar height. South Dakota, home of the Sturgis Motorcycle Rally, will be the seventeenth state on July 1, 2015. The South Dakota state legislature has voted to repeal their current restrictions on handlebar height. The multitude of laws makes it very difficult for a motorcycle rider whose chopper is fitted with ape hangers to travel across the country on road trip.

Lane Splitting in Florida

Lane splitting is the practice by motorcyclists in which rider will occupy the space between two cars in order to pass. The video below shows someone utilizing the practice of lane splitting.

Lane splitting or lane sharing is illegal in Florida. In fact, although it is legal in almost every country, it is still illegal in every state except California. Lane splitting takes motorcycles out of stop and go traffic where they are vulnerable and allows motorcycles to escape congested areas. There have been numerous studies which all seem to indicate that lane splitting is a practice that helps keep riders safe in congested urban areas. The American Motorcycle Association is in favor of allowing lane splitting in all states, but recognizes the need to educate motorists who do not understand the purpose of lane splitting and become aggravated when they witness a rider splitting lanes. However, the practice is strictly illegal in Florida and all riders should refrain from lane sharing.

Motorcycles Sharing the Same Lane in Florida

In Florida, two motorcycles may ride abreast in the same lane.[5] More than two motorcycles operating abreast in the same lane is prohibited. It is a practice that used to be illegal in many states, but riders fought back believing that it was simply a means for police to harass bikers over a practice that studies showed was safe. In fact, riding side by side allows riders to communicate more effectively.

Passenger Laws in Florida

In Florida, there are two basic laws regarding passengers on motorcycles. First, there has to be a seat for the passenger or the seat must be meant for two.[6] Secondly, there must be footrests for the passenger.[7]

Contact an Experienced Motorcycle Lawyer at The Law Offices of Bobby Jones

Have you or a loved one been injured in a motorcycle accident? Contact an experienced St. Petersburg motorcycle accident attorney at The Law Offices of Bobby Jones today. When you contact our office we will immediately set an appointment where you will meet your attorney and be provided with his/her personal contact information. If you do not have transportation or you cannot drive, your attorney will travel to meet you and discuss your case with you.

If you or a loved one has been injured in a motorcycle accident caused by the negligence of another, you should immediately call an experienced personal injury attorney in St. Petersburg at The Law Offices of Bobby Jones at (727) 571-1333 during regular business hours or (727) 753-8657 on weekends or after regular business hours. We will evaluate your case for free and you will never pay us a dime unless we recover compensation for your injuries.

The Law Offices of Bobby Jones
6570 30th Avenue North
St. Pete, FL 33710

http://jlgtampabay.com/personal-injury/

References:

[1] http://www.flsenate.gov/Laws/Statutes/2012/316.304

[2] http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0316/Sections/0316.405.html

[3] http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0316/Sections/0316.211.html

[4] http://www.flhsmv.gov/courts/latestinfo/Helmetseyeprotectioninsuranceinfractions.pdf

[5] http://www.flsenate.gov/Laws/Statutes/2012/316.209

[6] http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0316/Sections/0316.2085.html

[7] http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0316/Sections/0316.2095.html

May 7

How Does Failing to Wear Your Seatbelt Affect Your Personal Injury Case

How Does Failing to Wear Your Seatbelt Affect Your Personal Injury Case

By: Heath C. Murphy + Car Accidents

Almost everyone wears their seatbelts these days. It has become second nature to almost all drivers. As of today, there are 49 states that have enacted laws requiring motorists to wear seatbelts. New Hampshire is the lone hold out and even it requires drivers and passengers under the age of 18 to utilize a seatbelt. Some states, Florida included do not require adult passengers in the back seat to wear seatbelts, but it is undeniable that most people now strap in automatically whenever they get into a vehicle.

What is the Florida Safety Belt Law?

Florida law requires that all motorists occupying the front seat of any motor vehicle in Florida to utilized seatbelts.[1] The law also states,

A violation of the provisions of this section shall not constitute negligence per se, nor shall such violation be used as prima facie evidence of negligence or be considered in mitigation of damages, but such violation may be considered as evidence of comparative negligence, in any civil action.

This means that in the event that an unseatbelted driver is involved in a car accident which is otherwise not the fault of the unseatbelted driver, the at fault driver will raise a defense stating, that the failure to use the seatbelt either were the complete or partial cause of the driver’s injuries.

How Does the Defense of Failure to Wear a Seatbelt Affect My Personal Injury Case

This issue though long ago settled, still comes before Florida Courts in various forms. In Jones v. Alayon, the deceased driver was rear ended by an off duty police officer who fled the scene.[2] The off duty police officer then reported his car stolen. Testimony was heard that the deceased driver always wore his seatbelt, however, during the accident the deceased was ejected from the vehicle during the crash which seemed to indicate that he was not wearing his seatbelt at the time of the accident. Furthermore, the investigating officer stated that the clasp mechanism had coins or another obstruction preventing the deceased from using the seatbelt at the time of the accident.

The jury was never permitted to hear that the driver of the other car was an off duty police officer or that he had fled the scene of the crash. It was deemed to be too prejudicial for the jury to hear. However, the jury did hear that the deceased was not wearing a seatbelt and he likely died when he struck the road or when other cars struck him during his ejection from the vehicle. The jury found that the deceased was 70% at fault for his injuries and the other driver only 30% at fault. The jury returned with a verdict of a little more than $300,000 in damages which due to the apportionment of fault were reduced by 70%. Ultimately, the deceased’s family was awarded a little less than $100,000 in damages relating to the death of their husband/father.

Contact an Experienced St. Petersburg Car Accident Lawyer at The Law Offices of Bobby Jones

Have you or a loved one been injured in a car accident? Contact an experienced St. Petersburg car accident attorney at The Law Offices of Bobby Jones today. When you contact our office we will immediately set an appointment where you will meet your attorney and be provided with his/her personal contact information. If you do not have transportation or you cannot drive, your attorney will travel to meet you and discuss your case with you.

If you or a loved one has been injured in a car crash caused by the negligence of another, you should immediately call an experienced personal injury attorney in St. Petersburg at The Law Offices of Bobby Jones at (727) 571-1333 during regular business hours or (727) 753-8657 on weekends or after regular business hours. We will evaluate your case for free and you will never pay us a dime unless we recover compensation for your injuries.

The Law Offices of Bobby Jones
6570 30th Avenue North
St. Pete, FL 33710

http://jlgtampabay.com/personal-injury/

References:

[1] http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0316/Sections/0316.614.html

[2] http://www.4dca.org/opinions/April%202015/04-08-15/4D12-4546.op.pdf

May 6

Car Accidents in Florida

Car Accidents in Florida

By: Heath C. Murphy + Car Accidents

Every year Allstate rates the safest and most dangerous cities in which to drive. Allstate actuaries have studied the company’s claims data to determine the likelihood drivers in the largest 200 cities will experience a vehicle collision compared to the national average.[1] They use two years of data, so that a single bad year does not completely skew the data. A weighted average of the two-year numbers determined the annual percentages. The report defines an auto crash as any collision resulting in a property damage claim. Allstate insures roughly 10% of the country’s drivers which makes this annual study compelling.
How Often is the Average Driver in a Car Accident

According to the Allstate study, the average American driver will be involved in a traffic accident every 10 years. The Allstate study will determine the average time between accidents based upon what city’s drivers are used. Further, the study also examines the prevalence of accidents in each city as compared to the national average. For the 2014 iteration, Allstate considered other factors such as population density, weather etc in its rankings.
Where is the Safest City to Drive?

For the fourth time Fort Collins, Colorado was named the safest city in which to drive. In fact, in the 10 year history of the Allstate study, only 3 cities have ever held the top honor as America’s Safest City in Which to Drive; Fort Collins, CO, Sioux Falls, SD and Cedar Rapids, IA. Fort Collins’ drivers ranked either 1st or 2nd in every category studied by Allstate.

Where is the Safest City in Florida to Drive?

Cape Coral is the safest city in Florida for motorists. The average Cape Coral driver is 15.5% less likely to be involved in a car accident than the national average. Where the average driver is likely to be involved in a car accident every 10 years, Cape Coral drivers average 11.8 years between each car accident. Tallahassee also performed better than the national averages, but Cape Coral and Tallahassee were the lone Florida cities which rated significantly better than the national average.

Jacksonville and St. Petersburg

The drivers in Jacksonville and St. Petersburg are among the most improved drivers in Florida. Each city experienced a significant jump in their ranking and now both Jacksonville and St. Petersburg are, statistically speaking, about average. St. Petersburg drivers are especially adept at driving in less than ideal conditions.

Where are the Worst Drivers in Florida?

Statistically, the drivers in most of the other metropolitan areas in Florida are significantly more likely to experience an accident than the average American. Tampa, Orlando and Miami rank near the very bottom, nationwide, of safe driving cities. In Tampa, drivers are 30.5% more likely to be involved in a car accident than drivers in St. Petersburg. Tampa motorists can expect to be involved in an accident every 7.7 years. This difference means that the average Tampa driver can expect to be involved in 2-3 more accidents during their lifetime than the average driver from St. Petersburg.

Where are the Worst Drivers in America?

Massachusetts drivers appear to top the list of bad driving. Worcester, Boston and Springfield occupy 3 of the bottom 4 spots in Allstate’s rankings. Drivers in these cities are more than 100% more likely to be involved in a traffic accident than drivers in St. Petersburg. The average time between car accidents is less than 5 years.

Contact an Experienced St. Petersburg Car Accident Lawyer at The Law Offices of Bobby Jones

Have you or a loved one been injured in a car accident? Contact an experienced St. Petersburg car accident attorney at The Law Offices of Bobby Jones today. When you contact our office we will immediately set an appointment where you will meet your attorney and be provided with his/her personal contact information. If you do not have transportation or you cannot drive, your attorney will travel to meet you and discuss your case with you.

If you or a loved one has been injured in a car crash caused by the negligence of another, you should immediately call an experienced personal injury attorney in St. Petersburg at The Law Offices of Bobby Jones at (727) 571-1333 during regular business hours or (727) 753-8657 on weekends or after regular business hours. We will evaluate your case for free and you will never pay us a dime unless we recover compensation for your injuries.

The Law Offices of Bobby Jones
6570 30th Avenue North
St. Pete, FL 33710

http://jlgtampabay.com/personal-injury/

References:

[1] https://www.allstate.com/resources/Allstate/attachments/tools-and-resources/ABD-Report-2014.pdf

NEWER OLDER 1 2 28 29