A good portion of our society believes that our justice system is out of control. There have been dozens and dozens reports by the media over the years about how some person received millions of dollars from a jury for what at first blush appears to be a minor injury or insignificant dispute. The McDonald’s Coffee Case comes to mind. Yet, the common misperception among the public that the justice system is a “lottery” where all you have to do is feign serious injury and the insurance company will pay you large amounts of cash to go away, is a myth.
Early in my career (10+ years ago), I used to get extremely mad about this common myth. I would often see that good, honest and trustworthy people who were somehow harmed by another person’s negligence, were then royally scr***d again by the insurance company when it came time to resolve the claim. In fact, most of my clients tell me that they are extremely surprised how hard and nasty the insurance company will fight to defeat legitimate accident injury claims. And when I say a legitimate claim, I’m talking about an accident that was clearly caused by someone else and where the injuries are fairly serious (surgery, broken bones, brain injury, etc.).
It is partly because of this common misperception among the public about accident claims that I chose to start the Seattle Accident Attorney blog and write about my experience as an attorney who represents people who have been seriously harmed by another.
Here is a perfect example of how unreasonable an insurance company can act. It involves a case that I’m working on right now. I represent a 55-year-old woman who was injured in a rear-end accident about 4 years ago. To maintain confidentiality, I will call this woman “Jane.” Jane is a very nice hard-working woman. She’s been married for nearly 20 years and has two grown children. This client is what I would call my “typical” client. That is, Jane is an honest, hard-working citizen who was injured through no fault of her own.
Jane’s injuries started out as a typical “whiplash” injury. The insurance industry likes to call this type of injury a “soft tissue” injury to suggest that the injury is extremely minor and insignificant because it only involves the “soft tissues.” In my experience, the insurance companies fight “whiplash” injuries very hard. They hire all kinds of medical experts to state that these injuries usually heal within 4 to 6 weeks, so any treatment or problems beyond this time frame is not related to the accident.
In any event, Jane’s whiplash injury progressively got worse over the years. She received all kinds of different treatment to help resolve her pain and make a full recovery. This included numerous family doctor consultations, physical therapy, massage therapy, xrays, injections, medications, MRI scans, and consultations with many different specialists about what was causing her symptoms.
It was not until more than one year following the accident that a cervical MRI was ordered. The scan showed some “disc abnormalities.” More physical therapy and medications were ordered. Then another MRI was ordered a few years later when Jane’s symptoms were getting worse and the injury was severely impacting her daily activities. This second MRI showed a “C4-5 disc angulation” or what may also be referred to as a “disc collapse” in the middle of her cervical spine. Jane consulted with 3 different surgeons who all stated that she needed immediate surgery or risk paralysis. The disc collapse also caused her cervical spine to curve in the opposite direction, which is called Kyphosis. The doctors told Jane that she needed a complicated procedure where they fuse three vertebrae together and insert a cage and titanium plates to stabilize her spine so the abnormal curvature could be reversed and that her spinal cord would not be damaged.
All of Jane’s doctors (at least 8 different doctors), including her surgeon at Harborview Medical Center, have stated that the problem was initially caused by the auto accident years earlier. The C4-5 disc collapsed started out minor and then as time progressed it got worse to the point that Jane’s spinal cord became precariously close to being permanently damaged.
Jane’s medical bills are approximately $230,000, which includes the surgery and facility bill of $190,000. Fortunately, the other driver was an insurance agent for State Farm and had $2.1 Million in auto coverage through her employer. Now, you would probably think that State Farm would do the right thing and offer a reasonable amount of compensation to take care of Jane’s past and future medical bills plus include some amount to compensate her for having a painful permanent and dangerous spine injury. Not.
Instead State Farm went fishing into Jane’s prior medical history. Jane, in her early 50’s, obviously had some prior injuries and doctor visits over the years. State Farm found out that Jane injured her neck at work while lifting boxes about 3 years before the accident. Even though Jane’s doctors determined that the injury was a “minor strain” that fully resolved within 6-8 mos., State Farm found this injury highly significant.
State Farm also discovered that Jane injured her low back at work moving furniture about a year before the accident. Even though Jane’s doctor stated under oath that this low back injury had nothing to do with her neck, State Farm found it significant that Jane’s massage therapist following this injury stated that she had “neck tightness” along with low back pain. Jane’s last massage therapy for her low back injury ended more than 6 mos. before the auto accident. But State Farm didn’t care. It hired a well-known defense medical expert (he’s admitted to earning more than $3 Million over the past 15+ years working for insurance companies and against injured victims) to state that Jane’s auto accident injury was mild, should have resolved within 8 weeks, and that her current problem and resulting surgery was all entirely due to Jane’s pre-existing cervical spine condition. It did not matter to State Farm that this expert was the only expert out of 8+ reputable doctors who held these opinions.
Jane and I participated in mediation last week with State Farm in an effort to resolve the case short of a jury trial. You would think that State Farm might offer an amount that most would think was close to being reasonable? Nope. State Farm’s final offer was $50,000. Not even enough to cover 25% of Jane’s medical bills to date. Add to this fact that Jane has now incurred over $20,000 in litigation costs (doesn’t include attorney fees), and you can see that Jane’s only real option is to go to trial.
The insurance industry wants the public to believe that most trials involving injuries are necessary because the victims and their lawyers unreasonably demand millions of dollars to settle. I just don’t see that in my line of work. In fact, it is usually the other way around. The insurance company offers such an unreasonably low settlement that the victim is left with only one real option: try the case in court and let a jury decide. Jane’s case is a perfect example of this.