Recently, a gentleman called our office because his wife had fractured her arm in a boating accident. He said that he and his wife made a claim with Progressive Insurance Company and were assured by the Progressive adjuster that a fair settlement could be reached without the need for attorneys to be involved. Ultimately, Progressive offered to pay $5,000 for medical bills and 50,000 for her pain and suffering. He and his wife felt that the offer was fair, settled the claim with Progressive and signed paperwork releasing Progressive and the at fault person for any future claims.
Unfortunately, his wife's health insurance company paid $100,000 in medical bills and demanded to be paid out of the settlement proceeds. Progressive did not inform the man and his wife of their obligations to pay the health insurance company out of the settlement. The law in Ohio requires repayment of medical bills from settlements. Sadly, these people had already signed a settlement release which precluded their ability to obtain more money from Progressive to satisfy the health insurance company's lien.
We take calls frequently after a person has attempted to negotiate settlement and are not able to undertake representation because deadlines have passed. You should consult with an attorney when dealing with liability insurance companies - even when it is your own company - as early in the process as possible. Insurance companies are interested in saving themselves money and will attempt to resolve cases as quickly and cheaply as possible.
If we had represented this man and his wife, we would have presented the lien to Progressive and demanded that insurance pay it in addition to pain and suffering, lost wages and other compensation. On top of that, we would have worked on the other side of the claim and negotiated with the medical providers and health insurance company to reduce the money owed out of the settlement, including the health insurance lien, to maximize our client's recovery. Both negotiations and settlements take place before a release is executed.
Liability insurance companies love to handle claims with unrepresented people and encourage people to handle claims on their own, asserting that they will be fair, meaning there is no need to pay an attorney. They do this knowing it will save them lots of money. Studies have shown that persons who hire attorneys to handle accident claims recover 5-7 times more than people who handle claims themselves, even after attorney fees are paid. For this reason, the last thing a liability carrier wants to see is a letter of representation from a respected, established attorney.
A good attorney will prevent the carrier from taking advantage of accident victims and secure a fair result. At Rittgers we strive to obtain the best results for our clients. Before you are tempted to work with a liability insurance company on your own to settle your claim, please call us. We will be happy to provide a free consult.