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Seatback Failures
Front occupant seatbacks play a vital safety role in rear-end crashes, similar to the purpose of airbags and seatbelts in frontal impacts. In a rear impact, a front seat should be designed to absorb energy and contain the occupant in the front seating space. Weak, defective front seats can fail, collapse and cause front occupants […]
Workers Compensation Bad Faith Issues Resolved By AZ Insurance Bad Faith Lawyer
In this article, our Arizona insurance bad faith lawyer will dispel a few common misunderstandings associated with Arizona’s workers’ compensation laws as they pertain to insurance bad faith. Most importantly, you need to understand that the Arizona Workers’ Compensation Act was supposed to create a no-fault compensation system. Any covered employee under the act who is injured or killed in an employment-related activity has a right to compensation under Arizona law.
That employee (or if killed in a work accident, then his or her dependents) “shall be entitled to receive and shall be paid such compensation for loss sustained on account of the injury or death, such medical, nurse and hospital services and medicines, and such amount of funeral expenses in the event of death…” A.R.S. § 23-1021.
Does it matter who caused the work-related accident and injury? NO!
A common misconception about workers’ compensation in Arizona is that workers who suffer a work-related injured as a result of their own negligent act or omission will be denied compensation. That is not the law! With no fault workers compensation in Arizona, anytime a covered employee is injured at work, he or she has a right to medical care and compensation without regard to blame or responsibility for the accident and injury. Furthermore, the workers’ compensation insurance company cannot offer less compensation because that worker was at fault, either wholly or partially, for the work injury.
Can you be fired for filing a legitimate workers’ compensation claim? NO!
Many employees are led to believe that, should they dare file a workers’ compensation insurance claim following their workplace injury, they can be fired. A worker could be wrongly accused of being a troublemaker, of not being a team player, of costing the company too much money, of reporting the injury too late, of filing a fraudulent claim, and so on. Some insurers will pull out all the stops in their efforts to persuade employees that they should never file a workers’ compensation insurance claim for job-related injuries. If you need assistance with the underlying workers’ compensation claim, please do not hesitate to call an Arizona insurance bad faith lawyer who can refer you to an experienced, specialized workers’ compensation attorney.
Can the insurer reject your claim without conducting an investigation? NO!
Some insurers have developed bad reputations for failing to conduct investigations and failing to fairly evaluate employees’ workers’ compensation claims. Arizona insurance bad faith lawyers assure you that every insurance company, even those involved in the handling of workers’ compensation claims, must conduct a thorough investigation and must fairly evaluate the claim. Just as the insurer is prohibited from practicing intimidation to bully a worker into accepting less compensation than he or she has a right to, the insurer cannot refuse to properly process the claim or attempt to let the case die-on-the vine through inaction and delay.
Our Arizona insurance bad faith lawyers are all too familiar with the extreme lengths that insurance companies will take to avoid paying workers’ compensation benefits. Attorney Shane L. Harward has been challenging insurance companies since 1995. As an experienced Arizona insurance bad faith lawyer, he is committed to helping his clients get what they deserve in compensation from the insurance company. As soon after the injury as possible, we encourage you to email or call us at 480.874.2918 today for a free telephone consultation. Remember – you have a powerful ally in the Law Offices of Shane L. Harward.
The Role of Subrogation in Scottsdale Personal Injury Insurance Claims
While your Scottsdale personal injury claim, an insurance claim against the at-fault party’s insurance company, is being processed, you should take a moment to learn how a personal injury claim or lawsuit could be affected by insurance subrogation.
Subrogation Affects Scottsdale Personal Injury Insurance Claims
You were injured in an accident that was not your fault. The other person’s insurance company rarely will pay your medical expenses as they are incurred. And, because Arizona does not recognize true third-party (“third-party” simply refers to someone else’s insurance company) bad faith rights against another person’s insurance company for treating you unfairly in its handling of a personal injury insurance claim, these personal injury insurance claims can take a substantial amount of time to resolve.
So, your insurance company pays for the medical treatments and other related first-party (“first-party” simply refers to your own insurance company) insurance benefits. But now there is a personal injury settlement against the person who was at fault in the accident. Will you be required to pay a portion of your personal injury settlement to your own insurance company? It is not a simple question as it depends upon the type of first-party insurance benefits, but potentially yes.
Subrogation in very simple terms refers to your insurance company’s right of reimbursement for the money that it paid out to cover your (or your family member’s) medical treatment, losses, or other benefits due to the negligence of someone else. Reimbursement flows through the successful settlement of your personal injury insurance claim, which typically occurs long after your own insurance claims were processed.
Scottsdale Insurance Subrogation Claims Followed By Personal Injury Lawsuits
When you are injured, your health insurance or automobile medical payment benefit (“Medpay” and sometimes known as Personal Injury Protection “PIP” depending upon the area of the country) insurance covers the medical expenses incurred in treating your injuries. Your health insurer or medpay insurer may claim reimbursement should a personal injury lawsuit and settlement result against the defendant who was at-fault in causing the accident. Consequently, your insurance company, usually through a debt collection company such as Ingenix, will notify the defendant and defendant’s insurer that it will assert a claim of subrogation or reimbursement against your settlement, award, or judgment. And, in some cases, your own insurance company will record liens against you simply for utilizing the insurance coverage for which you paid insurance premiums and that you are entitled to use.
What Does That Mean for Your Scottsdale Personal Injury Insurance Claims?
What subrogation means is your insurance company will attempt to collect from, and eventually reduce, your personal injury settlement. Yet, your insurance company will not reimburse you for the insurance premiums which you have paid for those covered expenses. It is a windfall to the insurance company at the expense of the insurance consumer who is a victim of an accident. The insurance consumer does not get the benefit of his or her foresight in obtaining first-party insurance protection. However, even when a valid subrogation insurance claim exists, your attorney might be able to negotiate a compromise so it is very important that you have an attorney involved in the subrogation process early on.
Not Every Insurance Company’s Claim for Subrogation Is Valid
After your Scottsdale insurance claims are processed, if you file a personal injury lawsuit against the party who was at fault for your or your family member’s injuries or losses, you will then be given a form to complete. To process the insurance subrogation, you will be asked to complete a type of insurance subrogation questionnaire. This form seeks in-depth answers to questions about the incident that led to the injuries or losses suffered and, importantly, whether you’ve retained a Scottsdale personal injury insurance attorney. Depending upon your insurance policy language, your insurance company may or may not be entitled to the form. And, in some cases, if the form is not completed, your insurance company may withhold your benefits.
As an experienced Scottsdale personal injury insurance attorney will explain, not every insurer has a legitimate subrogation claim. Fraudulent subrogation claims are perhaps as common, if not more so, than legitimate claims. In some instances, the insurer asserting a right of reimbursement may attempt to claim more than it is entitled to from the settlement. The validity of a subrogation claim depends upon a variety of factors including, but not limited to: what type of first-party benefits were paid; whether appropriate liens have been recorded and notice given; whether the first-party insurance policy has language allowing subrogation and reimbursement; or whether the first-party insurance coverage is a government plan, private plan, or ERISA plan.
In subrogation, you really need a legal advocate protecting your rights. Should you receive a subrogation questionnaire following your personal injury claim and treatment, take that form along with your insurance policy, expense records, police or fire department reports, and any other related documents directly to our Scottsdale insurance and personal injury attorney.
To assure that you receive everything you should in your personal injury settlement, make sure that your attorney is involved early on with not only the at-fault party’s insurance company, but your own insurance companies as well. In this way, your attorney can identify any valid insurance subrogation claims and rights, and protect you from those subrogation claims that are not legitimate.
Subrogation issues in Scottsdale personal injury insurance claims make up a very technical area of insurance law that is a part of every personal injury practice. If you find yourself in a situation that could involve an insurer’s subrogation rights, then contact the Law Offices of Shane L. Harward, PLC, today or call 480.874.2918 for a FREE telephone consultation. Our Scottsdale insurance attorney will determine the extent of your insurer’s right to reimbursement and precisely what that insurer should receive from your settlement if anything.
Scottsdale Insurance Bad Faith Attorney Exposes Insurance Company Excuses
It is time to speak with a Scottsdale insurance bad faith attorney if your insurance company is attempting to use any of the following to justify or excuse its payment of an insurance claim:
1. There was an ambiguity in the way the insurance policy was written, so the insurance company didn’t believe it was obligated to pay on the claim.
The insurance company drafts these insurance policies and any ambiguity will be construed against it as the draftsman. Claiming that its own policy was too ambiguous for it to fulfill its obligation is not a winning defense. If insurance companies were permitted to escape liability with that thinly veiled argument, then insurance companies would concentrate their efforts on writing nothing but ambiguous policy provisions to avoid paying insurance benefits on any claims.
2. The insurance company acted in accordance with what is customary in the insurance industry, so it didn’t pay on the claim.
Defending itself because that’s what everyone else does is a questionable defense at best. Although acting in accordance with what is customary in the insurance industry could be useful in determining whether this insurer intentionally acted in bad faith, it is by no means an absolute, or complete, defense to liability for the improper failure to timely pay owed insurance benefits.
3. The law as applied to these circumstances is an unsettled matter, so the insurance company could not act on the claim.
Sometimes the law as applied to the particular circumstances is still an unsettled matter and insurance companies rely on this to force the insurance consumer to take action (or back down). A lawsuit for declaratory judgment on a question of the law may not in itself be an act of insurance bad faith. However, depending upon the circumstances, e.g., the insurance company effectively left the insurance consumer with no other option but to litigate the unsettled legal question, the insurance company’s conduct may be considered to have breached the duty of good faith and fair dealing.
4. Allegation that you as the insurance consumer breached the duty of good faith and fair dealing, so the insurance company isn’t liable for its failure or refusal to properly handle the claim.
Arizona law currently does not recognize comparative breaches of the duty of good faith and fair dealing. The insurance relationship is based on a contract, the insurance policy. Both parties – insured and insurer – to the agreement have obligations to the other party. The insurance policy holder must reasonably cooperate with the insurance company’s investigation of the claim. This is known as the cooperation clause of the insurance policy. If the insurance policyholder does not reasonably cooperate, this could reduce or eliminate the insurance company’s obligation to pay the insurance benefits. However, the insurance company’s obligation to still handle the insurance claim in good faith and fairly is not excused.
If your insurer has rejected your Arizona insurance claim, has delayed or failed to investigate your claim, has offered you a small settlement that is below what you are deserving of, or has otherwise engaged in acts of that might be considered bad faith, then you need to seek experienced legal representation.
Being prepared to aggressively argue against every defense, justification, or excuse that the insurance company will offer is a vital component of the Scottsdale insurance bad faith attorney’s legal strategy. These insurance cases can be very complex and technical in nature, so having experienced counsel is important if you hope to achieve the best possible outcome with your insurance claim. If you have any suspicions that your insurance company is acting improperly, then contact the Law Offices of Shane L. Harward immediately by calling 480.874.2918 for your Free confidential telephone consultation. No one should feel like a victim of their own insurance company!
Arizona Insurance Issues Plague Scottsdale and Phoenix Metro Homeowners
Do you really know what loss or damage your Scottsdale Arizona insurance homeowner policy will cover?
Will your insurance policy compensate you sufficiently to replace damaged personal property and belongings in your Cave Creek or Carefree Arizona home?
Will your Phoenix Arizona insurance policy cover all of the structural damage to your home, regardless of causation?
If you work from home, will your home office and expensive computer equipment upon which your livelihood depends be covered by your Fountain Hills Arizona insurance policy?
When you enter into an insurance policy agreement with an insurance company, you agree to pay insurance premiums and the homeowner insurance company agrees to provide protection should a covered event occur. You would expect your insurance policy to cover home damage from fire, mold, roof damage, foundation cracks, water damage, hail damage, and theft. And when someone is injured on your property, you would expect your homeowners’ insurance company to promptly pay any legitimate insurance claim, to protect you for a claim in excess of your insurance policy benefits, and to defend you in any resulting lawsuit over a disputed insurance claim.
Some of the Most Common Reason for Denial of Homeowners Insurance Claims
The primary reason why homeowner insurance claims are denied is because the insurance policy didn’t cover the type of damage or loss that occurred. This can mean that the insurance policyholder either didn’t really understand the insurance policy terms, or was led to believe the insurance policy contained provisions for compensation over specific losses, damages, and repairs when in fact it did not.
Typically, an Arizona insurance policy for the homeowner will provide coverage for:
● Home property damage claims
● Homeowner theft claims
● Liability claims
● Medical payment benefit claims
Under each of these insurance policy provisions, you should read your homeowner insurance declaration, insurance policy, and insurance policy endorsements very carefully to understand the full scope of the insurance coverage provided. The problem is that you probably won’t learn much from reading the policy unless you are an insurance claims attorney. The comprehension level required to understand most insurance policies is slightly above that needed to understand Einstein’s theory of relativity. Insurance companies do this deliberately so that they can try to interpret the language to their advantage.
Practical Tips for Pursuing a Homeowners Insurance Claim
Insurance can be boring and the process of getting your homeowners insurance claim fairly paid tedious. To make matters worse, you usually have to steer through a complicated maze of endless claims forms.
The first thing you should know is our courts have generally held that where those incomprehensible insurance policies have unclear language, the language will be construed against the insurance company and in favor the insurance consumer. So, if you are in a dispute with the insurance company, do not simply take the insurance company’s word for the meaning of certain language or phrases in your insurance policy.
Second, Arizona insurance law has adopted the “reasonable expectation” doctrine. Although this can be a complicated legal theory with many nuances, it generally means that you get the coverage you expected, so long as your expectation was reasonable under the circumstances. This insurance coverage may exist even if the insurance company attempts to exclude it through some fine print in the insurance policy that is to the contrary.
Third, most courts have held that exclusions in insurance policies must be phrased in plain, clear, and conspicuous language. Most insurance claim denials are based upon exclusions – language usually on the last pages of your policy that attempts to take away the coverage that appears on the first pages of your policy. Many insurance consumers are not aware of these exclusions and many exclusion clauses are difficult to understand. Because of this, most courts have created legal rules to aid the insurance policyholders.
Finally, if the insurance company denies your claim, the insurance consumer should demand a written explanation as to the basis for the denial. Do not settle for a simple, verbal denial from the insurance claim adjuster. Once you receive the insurance claim denial in writing with the basis for the denial, you should read your insurance policy again because you may not agree with the insurance company’s interpretation of the insurance policy language. In short, make sure the denial of your insurance claim is legitimate.
When Your Scottsdale Arizona Insurance Claim Is Wrongfully Denied
Beware! Insurance companies acting in bad faith may delay homeowner claims processing, underpay on claims, treat you and your family unfairly, offer unreasonably low settlements, and wrongfully deny Scottsdale and Phoenix Arizona insurance claims altogether.
If you suspect any of the following acts or omissions have occurred in the denial of your homeowner’s claim, then your Scottsdale and Phoenix Arizona insurance company may have violated the law:
● While conducting its investigation, your insurer intimidates or harasses you and your family, or unreasonably disturbs your neighbors, friends, clients or co-workers.
● Your insurer unnecessarily delays its investigation and neglects evaluating your claim.
● Your insurer conducts its investigation, but then offers you an unreasonably low settlement figure, something far below the policy limits; or attempts to bully you into accepting a low-ball settlement just to put an end to the conflict.
● Your insurer denies your claim for fire damage or theft by unfairly accusing you of insurance fraud, false claims, or even arson.
● Your insurer denies all or part of your claim without ever clearly explaining the reason why it was rejected.
You Don’t Have to Fight a Bad Faith Insurer on Your Own!
Get help from Shane L. Harward – he’s the Scottsdale attorney who has been challenging insurance companies that violate insurance policyholders’ rights since 1995. When you call 480.874.2918, you’ll get a FREE initial telephone consultation about your homeowner insurance claim to see if we might assist you. Shane L. Harward will aggressively challenge any bad faith insurer’s unscrupulous tactics so you get the full compensation you deserve.
Phoenix Insurance Bad Faith Attorney Discusses INSURANCE BAD FAITH DAMAGES
Experienced Phoenix insurance bad faith attorneys like Shane L. Harward will seek different kinds of damages from the insurance company that acted in bad faith. If you are considering legal action against your insurer for bad faith intentional claim denial, unreasonable delay or nonpayment on a claim, and so on, then this article is for you.
In today’s post we’ll talk about the types of damages you may expect to recover in a bad faith insurance lawsuit: contract based damages, emotional distress damages, punitive damages, and attorneys’ fees.
Arizona Revised Jury Instructions (Civil) Fourth Edition – Insurance Bad Faith
INSURANCE COMPANY DUTY OF GOOD FAITH AND FAIR DEALING
INSURANCE BAD FAITH
Duty of Good Faith and Fair Dealing In Insurance Policy
There is an implied duty of good faith and fair dealing in every insurance policy.
To prove that an insurance company breached the duty of good faith and fair dealing, the insured must prove: (1) the insurance company intentionally denied the claim, failed to pay the claim, or delayed payment of the claim without a reasonable basis for such action; and (2) the insurance company knew that it acted without a reasonable basis, or the insurance company failed to perform an investigation or evaluation adequate to determine whether its action was supported by a reasonable basis.
INSURANCE BAD FAITH
Measure of Damages For Insurance Company’s Breach of Duty of Good Faith and Fair Dealing
If you find that the insurance company is liable to their insured for breaching the duty of good faith and fair dealing contained within the insurance policy, you must then decide the full amount of money that will reasonably and fairly compensate the insured for each of the following elements of damage proved by the evidence to have resulted from the insurance company’s breach of the duty of good faith and fair dealing: (1) The unpaid benefits of the policy; (2) Monetary loss or damage to credit reputation experienced and reasonably probable to be experienced in the future; and (3) Emotional distress, humiliation, inconvenience, and anxiety experienced, and reasonably probable to be experienced in the future.
● Contract Based Damages – Unpaid Benefits Of The Policy and more
The plaintiff (insurance consumer) who is successful in a lawsuit against the defendant insurance company can recover the benefits under the policy terms. These damages have their legal basis in breach of contract. The insurance policy is contractual in nature and binds the parties, the insurance consumer (who pays the premiums) and the insurance company (who provides benefits on the occurrence of certain events). The plaintiff can also recover losses that were a consequence of the insurer’s bad faith claim denial. These consequential damages are considered foreseeable, meaning the insurer should have anticipated that the insured would suffer these consequences when it breached the policy agreement and failed to pay on a claim.
● Emotional Distress, Humiliation, Inconvenience, and Anxiety Damages
Recovery for emotional distress has its basis in tort law or personal injury law. Inconvenience, suffering, humiliation, anxiety, and mental pain associated with a substantial invasion of the insured’s property interests characterize emotional distress insurance damages. The plaintiff insurance consumer can recover emotional distress damages when his or her property rights were interfered with as a result of the insurance company’s bad faith failure to pay on the owed insurance benefits.
● Punitive Damages
As with emotional distress, recovery for punitive damages has its basis in personal injury law. These damages go to the issue of a intentional bad faith breach of the insurer’s covenant of good faith or the insurance company’s conscious disregard of harm to an insurance consumer. Punitive damages are meant to punish and deter future instances of such bad faith behavior. As Phoenix insurance bad faith attorneys know, it takes more than simple negligence or failure to investigate the claim on the part of the insurer to prevail on a claim by the insured for punitive damages. But when the insurer was motivated by evil intent to cause harm to the insured, knew that it was creating a substantial risk of harm to the insured, had reckless, conscious disregard for the insured, or was overtly dishonest or fraudulent, among other things, then punitive damages may be awarded.
● Attorneys Fees
The statute controlling the recovery of attorneys fees on contested insurance contract claims is A.R.S. § 12-341.01. As applied to lawsuits to recover from acts of bad faith by an insurer, the plaintiff (insurance consumer) may seek to recover the costs of hiring an attorney when the insurer unreasonably withheld benefits under an enforceable insurance policy.
At the Law Offices of Shane L. Harward, our insurance bad faith attorney represent clients throughout Phoenix and its surrounding Arizona communities including Tempe, Mesa, Scottsdale, Chandler, Peoria, Glendale, and Paradise Valley, to name only a few. When you need a strong legal advocate – when you want to know what kinds of damages your case may involve – call 480.874.2918 or email us for a free confidential telephone consultation.
Insurance Consumer Attorney – Arizona Residents Battle Bad Faith Insurance Companies
When was the last time you purchased an insurance policy? Did you get explanations that were fully comprehensible to you and not so much “insurance legalese”? Did you take time to carefully read through the printed policy terms before you signed and paid the premium? Did you feel free to negotiate with the insurance agent on a policy that really met your needs and the needs of your family? Did you get to bargain for the insurance policy language you preferred or did the insurance company offer you an insurance policy to either take or leave without any input from you on the insurance policy language? If not, you are not alone. Most individuals rely exclusively on their insurance agent’s verbal assertions, descriptions, and promises about what the policy will cover.
Did you know enough about the policy terms to allow you to comparison shop for a better deal with a different insurer? According to our insurance bad faith attorney, Arizona consumers seldom get detailed answers to their questions about policy coverage before they enter into the insurance contract. Arizonans typically fill-out the insurance application, dutifully pay the premium, and then place the written declaration of insurance away in a file or safe box. The only time the policyholder reviews the coverage is following an accident, property loss, emergency hospitalization, or some other incident. When the insurance consumer finally sits down to read the insurance policy, they will discover that it is not easily understood.
From an Insurance Bad Faith Attorney, AZ Consumers Should Always Seek an Independent Legal Opinion
Shane L. Harward knows that, as a practicing insurance attorney, Arizonans routinely purchase insurance without thoroughly investigating the coverage details presented in the policy.
The most important aspect of any insurance policy is what it will and will not cover. Most claims denials are based upon exclusions in the insurance policy. Exclusions usually appear on the last several pages of the insurance policy and attempt to take away the coverage that appears on the first couple pages of the insurance policy. Many insurance consumers are unaware of these exclusions and frankly, the exclusions are usually difficult to understand even if the insurance consumer is aware of them.
Unfortunately, most policyholders don’t find out what is actually covered until they file a claim. After paying premiums for years, sometimes decades, when Arizona insurance consumers actually file bona fide insurance claims they may be notified by their insurers that the policies bought and paid for don’t cover their medical expenses or damages originally thought. When you don’t really understand your policy provisions, how will you know if your insurer wrongfully denies your claim? You need an independent legal opinion to determine if the claim denial was violates Arizona’s duty of good faith and fair dealing.
Compounding the problem, Arizona residents who lack a clear understanding of their insurance policy coverage are much more vulnerable to the wrongful denial of claims. Those consumers may not know how to challenge their insurance company’s bad faith refusal to pay insurance benefits. And in some cases, the insurance company will attempt to rescind, or cancel, the policyholder’s insurance altogether in a blatant refusal to cover medical expenses from illness, injury, or hospitalization. Insurance consumers often believe they have no rights to insurance proceeds when insurers, acting in bad faith, pull out all the stops to avoid paying on legitimate claims.
Although the insurance policy represents a contract between the insurer and the insured, insurance policies are what the law calls adhesion contracts because the policy language is not subject to bargaining by equally positioned parties. Insurance consumers are almost always in the weaker bargaining position and take what is offered. The insurance company is at a distinct bargaining advantage, and they know it. They are the insurance experts. They draft the insurance policies. They investigate the claims. They control the money. They decide how much to pay or not pay. If you suspect that your insurance company is acting in bad faith and breaching the terms of your insurance policy agreement, that’s when you need aggressive legal representation and advocacy.
Your Bad Faith Insurance Attorney in Arizona
Do you feel pressed or intimidated into accepting less than what you feel that your insurance company agreed to pay under the insurance policy? When your insurer has rejected your claim or minimized coverage for your losses, call Shane L. Harward – Insurance Bad Faith Attorney, Arizona – at 480.874.2918. Don’t let the insurance company double-talk you out of the full value of your legitimate claim. When you suspect bad faith on the part of your insurer, contact the Law Offices of Shane L. Harward, PLC, today and protect your rights to full recovery.
Nationwide is “Not” on Your Side
Well that’s what two of their insurance policy holders think. Here is an example of the type of insurance bad faith claim I routinely handle. The case involves Nationwide Insurance and highlights the poor treatment that two insurance policy holders received from them…
“At the beginning of a long awaited family trip to Idaho in September of 2006, a Nationwide Insurance policy holder and her mother were the victims of a high-speed, hit-and-run collision. Both were forced to file an uninsured motorist claim with their insurance company, Nationwide Insurance Company of America / Allied Insurance Company. Based upon their experience, it was their opinion that the advertising slogan of “Nationwide on Your Side” may be an effective marketing campaign with no substance when a valid claim is attempted to be resolved by those who pay premiums to Nationwide Insurance Company.
Just a few miles from the Phoenix, Arizona (Sky Harbor) airport, a vehicle traveling approximately 90-95 miles per hour smashed into the back of their vehicle, and fled the scene of the collision. The vehicle suffered over $10,000.00 in property damage and both were injured. Because this family trip had been planned for several months and was extremely important for not only them, but their family (The injured mother had two daughters taking the trip besides her injured daughter) as well, they attempted to continue on with the family trip as planned. Shortly after arriving in Idaho, because the pain became so severe, they sought treatment at an Idaho Urgent Care facility. At that time, the daughter’s main problem was noted as neck and low back pain. Her mother suffered from pain in her neck, back, and right shoulder. The Urgent Care doctor prescribed anti-inflammatory and pain medication for both of them and instructed them to follow up with their primary care physician when they returned home to Arizona. Both followed up with their primary care physician at the Mayo Clinic and Hospital. The injured mother suffered from severe low back pain for over two years and tried multiple rehabilitative efforts including therapy, modalities, manual techniques, exercise instruction, and SI joint injections. She, to this day, continues to suffer from severe low back pain which at times radiates down her right side. She incurred approximately $6,000 in medical expenses because of treatment related to this incident.
Prior to this collision, she was an extremely healthy, active, and independent 82-year old mother, grandmother, and great-grandmother. Sadly, she not only lost her health and activity, but her independence. She regularly volunteered at a local elementary school and assisted one of the first grade teachers. This volunteer work was incredibly important to not only her, but also to all the children. Following the collision, she tried to assist with her first-grade class but was unable to do so because of the severe back pain.
The daughter suffered from cervical pain, pain in the mid to low thoracic area, and increasing pain and instability to her left knee. She had extensive treatment including prescription medication, physical therapy, and two surgeries on her left knee. She incurred approximately $38,000.00 in medical expenses because of the treatment related to this incident.
Nationwide Insurance Company assigned adjuster Courtney Martin to handle the uninsured motorist claim. Nationwide refused to consider the injuries to the daughter’s knee as part of the claim. Nationwide also refused to explain the factual or legal basis for its position and during the claim, Ms. Martin misrepresented conversations she had with both insureds.
On November 28, 2007, Nationwide offered the daughter $8,190.00 to settle the personal injury claim and $6,194.00 to settle the mother’s personal injury claim. Ms. Martin represented that these offers were based, at least in part, on Nationwide’s use of a nurse practitioner evaluation. Despite multiple requests, Nationwide refused to put the factual and legal basis for its evaluations in writing and refused to disclose the nurse practitioner report upon which it apparently relied. Instead, on February 26, 2008, Nationwide increased the offers to $12,660.36 for the daughter and $9,471.46 for the mother respectively. Again, Nationwide refused to disclose to its insureds the basis for these offers and its change in position. Thus, Nationwide Insurance Company’s insureds were forced to request arbitration pursuant to their insurance contract with Nationwide Insurance Company.
Nationwide Insurance Company’s insureds requested arbitration on March 12, 2008, but Nationwide did not provide the name of its attorney until June 9, 2008 or its arbitrator until June 16, 2008. As part of the arbitration process, Nationwide hired a well-known defense medical examiner, Dr. Ronald Lampert, to examine and issue a negative report against the daughter. Dr. Lampert issued his standard report calling the daughter a “symptom exaggerator.” Dr. Lampert testified on behalf of Nationwide during the arbitration hearing. Dr. Lampert claimed to have performed testing on her that the arbitrators determined did not take place during his examination. Luckily, the examination was videotaped.
Interestingly, a couple days prior to the scheduled arbitration hearing on October 23, 2008, Nationwide presented, once again without any explanation as to the change in its evaluation, an offer that was nearly twice what it had previously offered on these claims. The arbitration was completed on October 23, 2008.
Nationwide’s Insured (the injured mother) was awarded $106,000.00.
Nationwide’s Insured (the injured daughter) was awarded $163,000.00.
In addition, Nationwide Insurance Company paid $30,000.00 and $55,000.00 respectively for extra-contractual, insurance bad faith damages.”
Warning: Case decisions are often subject to further review by other courts and thus may be affirmed, overturned, or modified in later proceedings; therefore the reader should exercise caution in the reading and interpretation of these cases as the current status of case law and/or statutory law may have changed by the time you read this. Please consult with a licensed attorney in the proper jurisdiction before you take any action based on what you read on this or any other website.
Additional Representative Civil Cases involving Insurance Bad Faith and Consumer Fraud Allegations are found here.
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9735 E. Shea Blvd.
Suite 100
Scottsdale, Arizona 85259
Telephone 480-874-2918
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The Arizona personal injury, accident, and insurance bad faith dispute lawyers at the Law Offices of Shane L. Harward PLC represent insurance, personal injury and accident victims throughout the state of Arizona (AZ) including, but not limited to, Phoenix, Scottsdale, Mesa, Tempe, Chandler, Glendale, Gilbert, Sun West, Sun City, Tucson, Flagstaff, Kingman, Bullhead City, Yuma, Lake Havasu, Fountain Hills, Anthem, Ahwatukee, Carefree, Cave Creek, Gold Canyon, Bisbee, Sierra Vista, Cochise, Paradise Valley, East Valley, Maricopa, Pima, Pinal, Gila, White Mountain, Heber, Payson, Prescott, Forest Lakes, Apache Junction, Avondale, Queen Creek, Benson, Black Canyon City, New River, Buckeye, Casa Grande, Coolidge, Cottonwood, Douglas, Florence, Gila Bend, Goodyear, Greer, Glendale, Lakeside, Guadalupe, Holbrook, Huachuca City, Oro Valley, Overgaard, Avra Valley, Parker, Peoria, Pinetop, Pine, Prescott Valley, Quartzite, Strawberry, Safford, Show Low, Sun City West, Sun Lakes, Superior, Surprise, Snowflake, Tombstone, Wickenburg, Winslow, Wilcox, Williams, Young, Youngtown, and surrounding areas.