June 5, 2008 by Zale.

If you’ve ever had an injury claim as a result of a car wreck, slip and fall or similar claim, I’m sure you’ve wondered how the insurance company can come up with some abstract number to offer you to settle the claim. Well, many factors come into play.

Coverage: Do they have enough coverage or the right coverage? If you have $50,000 in medical bills and the person or business at fault only had $25,000 in coverage, guess what, your offer won’t be the $50,000 plus you hoped it would be. It’s going to be the $25,000 coverage limit.

Liability: Did you contribute to the accident? Tennessee is a “modified comparative law” state. That means that the insurance company is not only trying to figure out what their insured did to cause the accident, but they are considering what you did to cause the accident. If a reasonable person could find you 10% at fault, you just lost 10% of your money.

Damage: Did you have a scratch to your bumper, but then ran up $6,000 in medical charges? Well, the insurance company, and any court, is going to have a hard time connecting that $6,000 in medical charges to the scratch on your bumper. This will have an impact on your offer from the insurance company.

A computer program: Did the adjuster tell you that the company had a system to evaluate your injury claim? Chances are, they are referring to a computer program called Colossus or ClaimIQ. Both programs allow the adjuster to load certain medical information into the program and it spits out a number. These evaluation processes usually produce a low amount to settle the claim. I’m really not sure why the insurance companies like to use these programs, because they will often deviate from them to settle the claim.    Many times, the adjuster doesn’t agree with the amount either, but they want a pay check, so they do as they are told.

Other factors:

• You may be in a situation to where your medical procedures simply don’t match the accident. For instance, if you try to get them to pay for wart removal due to a car wreck, chances are, they’re going to figure that out and not pay it.
• You may have ticked off the adjuster. Time after time people want to take their frustrations about the accident out on the adjuster. This is usually a foolish move. Why bite the hand that feeds you? If you want a check from this person, be nice to them.
• The insurance company may be taking a “Deny, Defend and Delay” approach. This has been done. Some insurance companies think it’s the right way to handle a claim. I don’t agree with them.

Whatever the reason is, you may need an attorney to work out the problem. If that is the case, please contact us. We would like to help you.

Posted in Injury Law, Insurance Practices, Insurance Law | No Comments »

June 5, 2008 by Zale.

I was sworn in before the Tennessee Supreme Court on Tuesday.  The firm went “live” yesterday.  I hope that you will contact us to see how we can help you.  The office is based out of White House, Tennessee (Sumner County side), but we cover most of Middle Tennessee and will be happy to make a “house call” if needed.

Posted in Insurance Practices, Injury Law, Insurance Law, Right To Life, Business Law, General Law | No Comments »