When Insurance Companies Don’t Fight Fair

Unless you spend a lot of time in courtrooms, you may not understand how auto insurance litigation works. You may wrongly assume that insurance companies simply pay the damages as they should—after all, that’s why we pay for liability insurance policies. Unfortunately, it rarely happens that way.

Usually, insurance companies do everything they can to pay the very least amount possible to settle a claim. In the world of corporate insurance, profits matter more than people.
The following summaries of a few real cases demonstrate how difficult it can be to get compensation for what has been lost in an accident.

Hughes v. First Acceptance Ins. Co. of Ga., Inc. was a complicated case that should have been straightforward: 343 Ga. App. 693 (2017).

In 2008 a five-car collision resulted in the death of the person who caused the accident well as injuries to others. One of the victims sued on behalf of herself and her minor child who sustained traumatic brain injury as a result of the accident.

Nearly a year later, in July of 2009, the victim’s attorneys sent two letters by fax to the insurance company’s attorney stating that they wanted to get their case settled within thirty days according to the limits of the policy.

When the insurance company did not respond in a timely way, the injured parties filed suit for $5 million dollars. They were granted this amount in July of 2012 when the Court entered an order for Summary Judgment in favor of the plaintiffs. The victims then sued the insurance company to collect the $5 million verdict.

Georgia law allows victims to collect the entire verdict (hence the $5 Million) if and when an insurer is found to be guilty of intentionally delaying the settlement or otherwise bargaining in bad faith.

The initial result of the second lawsuit was that the trial court granted the insurance company’s motion for summary judgment, holding that there was no evidence that the insurance company knew there was a thirty-day deadline to settle the claim or that they could have settled the matter within the limits of the policy.

The victims appealed, and the Georgia Court of Appeals sent the case back to the Trial Court, ruling that a jury could best determine whether or not the victim’s letters through the insurance company’s attorney actually constituted a demand for settlement. Ultimately, the Insurance Company stood exposed to being required to pay the entire $5 million verdict, instead of the mere $25,000 it could have paid had it not stubbornly dragged out the claim.

Profit First – People Last

People who are elderly or mentally infirm are particularly vulnerable to injuries caused by the negligence of others. Unfortunately, when such handicapped or otherwise afflicted individuals are injured, they are often also misled by people who take advantage of the disabilities of others.

A case heard by the Georgia Court of Appeals in 1956 illustrates this horrible truth perfectly.

An elderly woman and her husband who were driving to Atlanta stopped to use the telephone at a trucking company along the way. As they were parking the car to enter the building, a truck backed into their car, causing damage to the vehicle and injury to the woman. She was getting out of her car to go inside when the truck slammed into the car. The car door forcefully impacted the woman’s back, causing her to suffer excruciating pain. (This was long before the advent of medical tests like MRIs and ultrasound, so the details about her medical condition are not clearly understood.)

An employee of the trucking company witnessed the accident. The witness told the woman she could not expect to collect money from the trucking company for the damages to the car or her broken eyeglasses since the accident took place on the trucking company’s private property. This information sent the seventy-six-year-old lady into panic and inconsolable distress.

She went home and took to her bed, using hot water bottles to ease her pain. She was racked with physical pain and distraught that she would be unable to recover what had been lost to her.

Perpetuating a Profitable Lie

In the days that followed, representatives from the trucking company visited her. While they demonstrated concern over her injuries, they seemed to share in her sorrow that she had no expectation for recovery. Eventually they raised the hope that the trucking company’s insurance company might help her replace her glasses and fix her car out of the goodness of their hearts.

The court record containing the woman’s signed statement and deposition includes a document obtained by a representative of the trucking company’s insurance carrier in the weeks after the accident. The document shows that the insurance representative gave the injured woman a check for $125.00 in return for her signature on a release and settlement of her claim.

The Lawsuit Filed Seven Years Later

Some years later, when she was eighty-three and still in horrible pain, the woman filed suit against the trucking company.

When it became evident that the elderly woman’s trial court testimony was somewhat different from the initial statement she had made in the days after the accident, the trial court issued a directed judgment in favor of the trucking company. (A directed judgment is one in which the judge arrives at the verdict without allowing the jury to consider the facts and arrive at a verdict of their own.)

The plaintiffs appealed.

In 1956, when the appeals court reviewed the case, they found that while there were inconsistencies in the woman’s testimony, the stories were generally consistent. The appellate judge overruled the trial court’s verdict, finding that the woman’s advanced age, failing vision, and her mental anguish at the time caused her to be confused about some of the facts. Of course, her age and mental state should have been taken into consideration and left for the jury to decide.

History Repeats Itself

Though this case is over sixty years old, the scenario is oft repeated. Human beings often make decisions, as this lady did, to make the best of the situation we’re in. We usually take the best option available. This woman just wanted to fix her car and buy a new set of glasses, so she chose to believe the trucking company’s representatives and take the word of an insurance adjuster who plainly did not mind deceiving her.

Good Samaritans Beware

Here’s another case. Many people today attempt to cut down on their personal ‘carbon footprint.’ Some, for example, carpool to and from work, or ferry neighbor children with our own to and from school or sports practice.

Other thoughtful neighbors transport the elderly woman across the street to the grocery store or doctor’s appointment. You may have demonstrated such kindness yourself. What would you do if, in the event of an accident, your insurance carrier refused to pay, declaring that you were using your vehicle as a taxi cab?

In one case, an elderly woman was in the habit of paying for her neighbor’s gas when he gave her a lift to the store. On one of these occasions, as he was pulling into a parking spot, the person in the adjacent slot opened his car door, causing a collision. The man driving the woman to town sustained an injury to his neck as a result.

When his insurance refused to pay his uninsured motorist coverage, he sued his insurance carrier.

The insurance company took the position that the man was providing a public transportation or livery conveyance service at the time of the accident, which excluded his coverage.

The trial court denied the insurance company’s motion for summary judgment. (Meaning the insurance company wanted the judge to dismiss the case, and the court refused to do so.) At this point the insurance company appealed.

The review undertaken by the appellate court systematically proved that the man was simply offering a friend an occasional ride to town and his actions did not meet the law’s definition of a public or livery conveyance. (“Public” is defined as “of, relating to, or affecting all the people,” or “accessible to or shared by all members of the community.”)

This case demonstrates the lengths to which some insurance carriers will go to avoid paying a legitimate claim.

We pay our insurance premiums faithfully and the insurance companies—just as faithfully— accept our money. But when a claim occurs, some insurance companies prove to be quite faithless. Fortunately for this neighborly fellow, the law stood on the side of the plain and common language of the law.

Outdated Policy Language Complicates Claim

In the following case an insurance company clung to old, outdated policy language in hope of denying a legitimate claim. The case is Sanders v. Georgia Farm Bureau, and it was decided in 1987.

A seventeen-year-old driver of a pickup truck was involved in an accident. The teenage driver and his passenger were both injured, and both made claims under the driver’s insurance. Naturally, everybody involved expected the insurance company to do the right thing and pay the claim.

Insurance companies may spend billions of dollars advertising that they are “on your side” and are “your good neighbor,” but they don’t always behave like good neighbors.

Imagine this nightmare scenario: Just before the accident this particular teenage driver had been living with his mother, but had decided to move in with his father. Mom’s insurance company refused to pay because the teen no longer lived with his mother. Dad’s insurance company also refused to pay the claims because the teen was driving a “pickup truck.” The insurance company that had insured the truck pointed to case law from back in the 1960s, arguing that a pickup-truck was not a private passenger vehicle covered by auto insurance.

Lower Court Ruling

After both insurance companies refused to pay, it was up to a Georgia Court to decide what to do. The Lower Court decided there was no coverage at all, finding that the driver had permanently moved out of his mother’s house—holding that the teen was no longer insured under his mother’s policy. Then, the Lower Court found that there was no coverage for a pickup truck under his father’s policy because of policy language written back in the day that said pick-up trucks were usually only found on farms or construction sites.

Pickups Can Be Passenger Vehicles After All

The driver and passenger appealed the ruling to the Georgia Court of Appeals. The Court of Appeals agreed that Mom’s policy did not cover the teen because he had permanently moved out of her house with no plans to return.

However, the Court of Appeals ruled that the idea that a pickup truck can never be a “private passenger vehicle” was outdated. The court held that pickup trucks are now everywhere and are no longer confined to farms or only used for business. The court further found that people may reasonably expect their automobile insurance company to cover a pickup truck accident as long as the truck is not being used for business purposes.

The Court of Appeals then overturned the 1960’s case and sent the case of the teenaged driver back to the Lower Court for a jury to decide whether, at the time of the accident, the teen was using the pickup for private transportation or for commercial use. We don’t have a record of what happened when the case went back to the Lower Court, but assuming the judge or jury found that the teen was not driving the pickup for a business purpose, he was covered under his father’s policy. Justice was finally done.

The Winning Strategy

The cases above demonstrate how insurance companies can twist and contort the language in their own policies—or even in the law itself—to avoid paying legitimate claims. Insurance companies have entire teams of highly-paid lawyers on staff. Those attorneys get paid to find any way they can to keep insurance company money out of your hands no matter how entitled to it you are.

When you are negotiating with an insurance company, you often face a giant with untold resources to use against you. At The Millar Law Firm, we deal every day with adversaries whose goal is to keep you from getting paid. Because we’ve been doing battle with Goliath for decades, we know his tricks and how to keep him from cheating you out of your settlement.

Call The Millar Law Firm today and make an appointment for a free case evaluation. We will review your case and let you know what your claim is worth.

We’ll also help you know what you’re up against and prepare the best case for you. If you must go to battle with a giant, be well prepared, and you’ll walk away with the compensation you deserve. Call us today: (770) 400-0000