August 18, 2012 (Original publish date) • By Dennis Beaver
We’ve all seen the excellent University of Farmers Insurance commercials featuring a lovable, yet gruff Professor Nathaniel Burke, played by character actor J.K. Simmons. The professor adds humor and a touch of sarcasm to questions he asks “agents-in-training.”
Today, it is our pleasure to welcome readers to a lecture conducted by “Professor” H. Dennis Beaver from the University of Beaverland, and we begin with a series of questions followed by an email from Patricia, a reader who felt something was strange about her auto accident case.
1) How bad a rear-end accident was it?
2) If you looked at her car, what would you expect to see?
3) Roughly, what would repair costs run if the car could be repaired, or was it a “total”?
‘My lawyer called me in a panic’
“My daughter and myself have just finished treatment for an accident we had in December 2011. Our lawyer just called me in a panic, explaining that the driver who caused the accident only has bodily injury liability coverage of $25,000 per person or $50,000 per occurrence, but my medical bills are $35,000, and my daughter’s total is $24,000.
“Even though this exceeds the maximum of what insurance would pay, he said that we would receive $1,000 each and wants us to come into his office and pick up the check. He also wants us to now tell the doctors to bill our health insurance, but has assured us that we will not be responsible for any unpaid medical bills because he claims to have a very good relationship with the doctors he sent us to.
“All of us are insured by the same company. When I contacted my claims adjuster and told him our lawyer’s comments about coverage limits and getting only $1,000, his tone of voice communicated that something was very wrong.
“I never authorized settlement of the case and have not signed a release nor have I seen a settlement check. I’m not sure what to think or to do next.”
‘They told me I needed all of these treatments’
“Following the accident, my right arm had a strange ache and a tingling sensation. My lower back was a bit tender, but overall I did not have much discomfort. To be checked out, I went to a chiropractor, but he told me that I did have neck and lower back injuries, needed treatment and should hire his attorney friend, which I did immediately. After two months with the chiropractor, my lawyer sent me to a pain management physician.
“From March to June 2012, I used up all of my overtime and sick pay because the doctors told me I had to have these chiropractic adjustments, ultrasound, several expensive MRI and X-ray studies, painful nerve conduction tests, epidural injections and on and on.
“My bill came to over $33,000, and $25,000 for my adult daughter who had almost identical treatments. Neither of us had ever hired a lawyer before, and we just did what we were told to do,” our reader explained.
“In looking back, something just didn’t seem right. We wondered if all of these doctor visits, X-rays and tests were really necessary. But we had never been through anything like this before, and honestly didn’t know what to expect, but now feel that we were just a way for them to run up a huge bill.”
Experts in insurance fraud would agree with Patricia.
The clue that something is wrong
“At some point, the client is being pushed in a direction that she does not like. This is a clue to stop and take a breath. Ask yourself, ‘Is this something that really needs treatment? Or am I being used as a moneymaker for others?’” says Frank Scafidi, director of public affairs for the National Insurance Crime Bureau based in Des Plaines, Ill.
“There is a correlation between property damage and bodily injury. Photographs of damaged vehicles are admissible in most courts where the reality or extent of injuries are questioned. If you are in an accident where there is no, or virtually no property damage, and a health care professional says, ‘Hold on, let me send you to this law firm because they specialize in accidents and will take care of you,’ right there and then, things are bad,” warns Scafidi.
So, what was the property damage to our reader’s 2007 Toyota Camry?
“The rear bumper had a scratch and was pushed in slightly. They gave me $710 to fix it,” Patricia told us.
A trusting patient and client had been sucked into an insurance scam, unaware of the warning signs or how, in the future, she could easily be seen as “the boy who cried wolf.” We’ll explain why next time.
Dennis Beaver practices law in Bakersfield and enjoys hearing from his readers. Contact Dennis Beaver.