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Timely Payment of Claims June 5, 2009

Posted by Attorney Jonathan Groth in Dog Attack Information, FAQ Personal Injury, Motorcycle Collisions, Personal Injury Law, Wisconsin Auto Accidents.
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There are a ton of laws.  That may be the biggest understatement I’ve ever written.

I mention this because it’s a reason to hire an attorney.  How many people have heard of the “Timely Payment of Claims” Statute.  It’s Section 628.46 of Wisconsin’s Statutes.  It applies to first party insurance payments and also third party insurance payments.  So, if you are injured by someone without insurance and you file an uninsured motorist claim this statute applies.   Because of the “recent” Kontowicz case it applies to claims against an at fault insurance company also.

Attorneys for injured people can push insurance companies to review and make offers to settle cases within 30 days of receiving all of the documents related to an injury.  If the insurance company drags its feet it may be subject to 12% interest.  Or, if the insurance company agrees to that a portion of an injury is definitely related to an accident that insurance company, under the statute, should pay the undisputed amount asap.

For your information the statutes says:

(1) Unless otherwise provided by law, an insurer shall promptly pay every insurance claim. A claim shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of the loss. If such written notice is not furnished to the insurer as to the entire claim, any partial amount supported by written notice is overdue if not paid within 30 days after such written notice is furnished to the insurer. Any part or all of the remainder of the claim that is subsequently supported by written notice is overdue if not paid within 30 days after written notice is furnished to the insurer. Any payment shall not be deemed overdue when the insurer has reasonable proof to establish that the insurer is not responsible for the payment, notwithstanding that written notice has been furnished to the insurer… All overdue payments shall bear simple interest at the rate of 12% per year.


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Who Is Looking? June 4, 2009

Posted by Attorney Jonathan Groth in Personal Injury Law, Wisconsin Auto Accidents.
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What happens if a medical facility releases your medical records to the general public?  What happens if an insurance company releases medical records to the general public?

Well, according to Section 146.84 Wisconsin Statutes that facility or person may be liable for tens of thousands of dollars in addition to actual damages and ACTUAL attorneys fees.  Believe me, that can be a lot of money.

I found an article from a few years ago written by a couple Michael, Best and Friedrich attorneys concerning this issue.  I hope it will continue to be available.    Finerty and Barlament state:

This statute may apply to entities other than health care entities. The statute’s penalty provisions for example, Wis. Stat. § 146.84, apply to “[a]ny person, including the state or any political subdivision of the state” who violates Wis. Stat. § 146.82 or 146.83. Wis. Stat. § 146.84(1)(b), (bm). Similarly, penalties (including a fine of up to $25,000 and up to 9 months in prison) can be applied to “[w]hoever” obtains certain confidential information under false pretenses or with knowledge that the disclosure is unlawful and not reasonably necessary to protect another from harm. Wis. Stat. § 146.84(2)(a).

I was thinking about this after a client asked me what protection she/he has when medical records are released to an at-fault insurance provider.  In all honesty the liability of the company who discloses to the public certain records depends on the authorization that was signed and the particular facts of the release of those records.  But, if a company or hospital releases records improperly at least this statute exists as a pretty significant penalty.

Take The Time To Read Your Policy February 17, 2009

Posted by Attorney Jonathan Groth in FAQ Personal Injury, Personal Injury Law.
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John Bryan a West Virginia Car Accident Attorney recently wrote about the effect of your personal auto policy on a rental car.  In short, he reminds everyone that just because you have auto insurance this does not mean your policy will cover you when you rent a vehicle.

Many of the policies out there cover rental cars being driven if their primary vehicle has broken-down or is otherwise being worked-on or out of commission.  However, many of those same policies do not cover rental cars being driven if the policyholder’s primary vehicle is operational – for instance if you rent a car while on vacation.  This means that if you choose not to purchase the insurance on the rental car and you are involved in an accident, you may be liable to the rental car company for the complete property damage to the rental car.  This is because you will be signing a contract with the rental car company agreeing to pay for any property damage that is not covered by insurance.

Before you rent a vehicle make sure you’ve read your auto insurance policy to see whether you have coverage.  Believe me, the last thing you want is to be driving around without any car insurance.

Update on Crazy Loophole December 21, 2008

Posted by Attorney Jonathan Groth in Personal Injury Law.
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I just blogged about this crazy loophole that Great American Insurance Company is trying to use to get out of paying for a number of wrongful deaths.

The Houston Chronicle’s Lisa Falkenberg wrote an opinion piece about this loophole:

Earlier this week, the Houston Chronicle’s Mary Flood reported that the Cincinnati-based insurer asked a federal court judge to help it avoid a potential $25 million liability in a Houston office fire last year that killed three people. Vocational nurse Misty Ann Weaver lit the fire to hide the fact that she hadn’t met a paperwork deadline.

Now Great American officials are trying to hide from responsibility in the deaths, which isn’t as shocking as the legal argument they’re trying to employ.

Families of the fire victims shouldn’t be compensated for their losses since the deaths were caused by smoke inhalation instead of actual flames, the company argued in a federal court brief.

I can see why the insurance company is trying to avoid paying based on this loophole.  They’ll save a ton of money.  Lisa did a little investigation:

And “fire, lightning and debris removal” were the No. 1 causes for homeowners’ insured losses nationwide at nearly 35 percent in 2006, the most recent year for which statistics were available from the New York-based Insurance Information Institute.

For the sake of the family of the victims I hope Great American Insurance doesn’t win.  Talk about adding insult to injury.

Jon Groth is a Wisconsin Personal Injury Attorney handling cases throughout Wisconsin and most recently in Fond du lac, West Bend, Kenosha and Wauwatosa.

Click here to submit a Case or Question.

Crazy Loophole December 20, 2008

Posted by Attorney Jonathan Groth in Personal Injury Law.
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Does this strike anyone else as outrageous? 

 An insurance company has asked a federal judge to dismiss it from several lawsuits arising from a 2007 office fire because smoke that killed occupants should be considered “pollution,” something not covered by its policy. Great American Insurance Company argues that its policy includes specific exclusions for certain types of pollution including smoke, fumes and soot. The insurer potentially faces $25 million in liability from the fire.  Mary Flood, Houston Chronicle  

Jon Groth is a Wisconsin Personal Injury Attorney handling cases throughout Wisconsin and most recently in West AllisSheboygan,  Plymouth,  and  Germantown.

If you’d like to submit a question or case please complete a case submission form.

How Insurance Companies Deny, Delay, Confuse and Refuse November 13, 2008

Posted by Attorney Jonathan Groth in FAQ Personal Injury, Personal Injury Law, Wisconsin Auto Accidents.
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A new report discusses how insurance companies make their money.  This shouldn’t be a surprise.  They take in as much as they can in premiums and pay out as little as possible in claims.

The problem is with some of the tactics that insurance companies use.  Here is an example:

Farmers, was in the business of

denying claims as a way to boost its bottom

line. Farmers even ran an employee incentive program,

“Quest for Gold,” that offered incentives, including $25

gift certificates and pizza parties, to adjusters who met

low payment goals. One Farmers’ executive told claims

representatives to stop paying claims, saying, “Teach

them to say, ‘Sorry, no more,’ with a toothy grin and mean it.”

Insurance companies are supposed to act in good faith with their insured and on behalf of their insured when dealing with someone their insured injures.  Arbitrary denials and low offers for no reason are not good faith.

Read the report.  You’ll get a feel for what personal injury attorneys deal with day in and day out.  You’ll understand why Allstate, Farmers, Progressive et al get on our nerves.

www.jonpgroth.com

 Jon Groth is a Wisconsin Personal Injury Attorney handling cases throughout Wisconsin and most recently in Milwaukee, Milton, Kenosha and Wauwatosa.

Click here to submit a Case or Question.

You’re Not Always in Good Hands October 13, 2008

Posted by Attorney Jonathan Groth in FAQ Personal Injury.
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Either take less money or wait years until Allstate is forced to settle.  That is what has been reported about Allstate’s claims practices.   (Remember the ad: when you have Allstate Insurance you are “Always in Good Hands”).

Yesterday, I was talking with a friend whose client was hesitant to hire a personal injury attorney.  Simply asking the powerful question, “Why?”

I think the answer to “Why hire an attorney” is answered in that story.  It discovered a few things about Allstate’s injury claims:

First, the company evaluates claims with a computer program designed to reduce payouts by as much as 20 percent of what the company once paid for the same injuries.

Second, Allstate pushes policyholders to accept quick settlements without the help of lawyers. Policyholders who try to fight for more money face Allstate attorneys coached to refuse to negotiate and to drag out litigation.

A former Allstate attorney described their tactics:

They put pressure on people by establishing that they are a bully in the market.

I recommend you read the article or other blogs about the article.  Many other insurance companies are now using Allstate’s computer program or programs just like it.  If you have any questions about their tactics feel free to post a comment or contact me.

Don’t forget to read my previous post entitled “Why Hire a Personal Injury Attorney.”

http://www.jonpgroth.com

Jon Groth is a Wisconsin Personal Injury Attorney handling cases throughout Wisconsin and most recently in West AllisCrivitzPlymouthand Germantown.

What’s In Your Homeowner’s Insurance? October 8, 2008

Posted by Attorney Jonathan Groth in FAQ Personal Injury.
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According to a recent study a majority of Americans don’t know what’s in their homeowners policy.  Does your insurance supplement your auto policy?  What is your deductible?  Is your insurance replacement value increased along with your home renovations?

Take this opportunity to look long and hard at your policy.  Review it before you need to use it!  Don’t forget to check out my previous post about umbrella coverage.

www.jonpgroth.com

Jon Groth is a Wisconsin Personal Injury Attorney handling cases throughout Wisconsin and most recently in Lomira, Twin Lakes,  Wauwatosa and Milton.

Personal Injury Paparazzi? October 7, 2008

Posted by Attorney Jonathan Groth in FAQ Personal Injury.
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It sounds kind of weird, doesn’t it?  Why have a professional photographer take pictures of a personal injury victim?   Well, in every case that involves scars, permanent bruises or disability the at fault insurance company asks for pictures to evaluate the claim.  

Why not have the injured victim just meet with the at fault adjuster? Many times the adjuster is in some far off office, hours from injured victim.  Usually, insurance companies have “round table” discussions about these types of injuries.  This means that a bunch of adjusters will get together one day and pass around photographs of scars, permanent bruises etc. and give their opinion of the “value” a jury would award for the injury.  That is how at fault adjusters come around to offering a personal injury settlement. 

So, back to the professional photographer.  An injured party needs to have pictures that truly represent the injuries.  Just as if they were standing there in the conference room with the adjusters “round tabling” the claim.  

Don’t get me wrong, nowadays many digital cameras will do a great job and take quality pictures.  But, in order to give the at fault adjuster as true a representation of the injuries I’d recommend a professional photographer.

http://www.jonpgroth.com

 Jon Groth is a Wisconsin Personal Injury Attorney handling cases throughout Wisconsin and most recently in Oostburg, Marinette, Wisconsin Dells and Wauwatosa.

Should I give a statement to the insurance company? September 24, 2008

Posted by Attorney Jonathan Groth in FAQ Personal Injury.
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If you were in a collision and the at fault driver had insurance I’m sure you’ve asked yourself this question.  That’s because one of the first questions out of the at fault insurance adjuster’s mouth is, “Can I record a statement?”

My standard answer to this questions is no.  Don’t give a statement.  If the at fault insurance company insists on a statement then wait until you hire a lawyer before giving a statement.  You hire a lawyer to stand by your side and serve as your advocate through the entire process.  Why give a statement before having that advocate by your side.  (Remember my April 21, 2008 post talking about Allstate’s Claim Manual saying that Allstate knows that victims with insurance settle for 2-3 times more than unrepresented victims). 

Remember, insurance companies are in the business of making money.  That is certainly not wrong or illigeal by any means.  But, what that means is they want to take in premiums and pay out as little as possible.  That’s just the basic economics of insurance.  So, insurance companies teach their insurance adjusters how to make sure they pay out as little as possible.  That starts right away after the collision with the recorded statement.  

This is especially important if liability it at issue.  The at fault insurance wants to pin as much fault on you as possible.  The facts are the facts but many times confusion, pain meds, frustration or other things get in the way of an injured person’s ability to clearly describe what happened.  

So, if you are involved in a collision I recommend talking with an attorney before you give that statement to the at fault insurance company.  I’m sure you’ll be glad you did.

http://www.jonpgroth.com

Jon Groth is a Wisconsin Personal Injury Attorney handling cases throughout Wisconsin and most recently in West AllisCrivitzPlymouthand Germantown.