Insurance Bad Faith and Disability Lawyer

A few thoughts on Occupy Wall Street

2012-01-17T14:18:00.000-08:00

A few thoughts on Occupy Wall Street, "Capitalism only as good or bad as its Adherents" by Stephan E. Silver from The Santa Fe New Mexican.com, January 1, 2012.
Link to the entire article: http://www.santafenewmexican.com/Opinion/My-View--Stephen-E--Silver-Capitalism-only-as-good--or-bad--as-

The alleged victims of Jerry Sandusky may not receive insurance coverage from Jerry Sandusky's insurance carrier.

2012-01-16T12:31:00.000-08:00

The alleged victims of Jerry Sandusky may not receive insurance coverage from Jerry Sandusky's insurance carrier.
http://insurancenewsnet.com/article.aspx?id=319866&type=lifehealth

Allstate's new program for policyholders dissatisfied with claims process

2012-01-11T13:20:00.000-08:00

As of January 2, in 31 states, Allstate has instituted a program that will credit policyholders' automobile policy if the policyholder is dissatisfied with the company's claims process.
Link to Marie Suszynski’s article: “Allstate's Claim Satisfaction Guarantee Signals Heated Competition in the Marketplace” http://insurancenewsnet.com/article.aspx?id=325025&type=more&inl=1

Judge, in bad faith case quotes from the movie "A Few Good Men"

2011-10-21T14:31:00.000-07:00

Decided on October 17, 2011, Supreme Court, Kings County, 2011 NY Slip Op 51831(U),
Jesus Taveras, AS ASSIGNEE OF THE RIGHTS OF MUHAMMAD A. AMIR, Plaintiff,
against
American Transit Insurance Company, EDWARD T. McGETTIGAN, JR., RALPH A. BISCEGLIA, RICHARD T. CARROLL, STEVEN HAMILL, RICK PERSAUD AND IRIS HERNANDEZ, Defendants.

In this insurance bad faith action the conduct of defendant AMERICAN TRANSIT
INSURANCE COMPANY (AT) reminds the Court of the testimony given by Jack Nicholson's character, Marine Colonel Nathan Jessup, in the 1991 film, A Few Good Men. When examined by a defense attorney, the Tom Cruise character, Navy Lieutenant Daniel Kaffee, about whether Colonel Jessup ordered the hazing of a Marine, which went awry, at the Guantanamo Bay Naval [*2]Base, the lawyer and witness had the following colloquy:

Col. Jessup:You want answers?
Lt. Kaffee:I think I'm entitled to them.
Col. Jessup:You want answers?
Lt. Kaffee:I want the truth!
Col. Jessup:You can't handle the truth!

Defendant AT, in the instant action, refuses not only to acknowledge the truth, but to handle the truth!

http://www.courts.state.ny.us/reporter/3dseries/2011/2011_51831.htm

DePuy Hip Replacement Recall

2011-10-18T09:16:00.001-07:00

Austin Mehr Law Offices, P.S.C., is representing claimants who have been affected by the recent recall of the DePuy ASR Articular Surface Replacement and ASR XL Acetabular System Recall. If you or a loved one has had this hip replacement, you can get a free consultation to help you understand the legal effect of the recall. PARTICULARLY IF YOU HAVE EXPERIENCED NO SYMPTOMS, legal consultation is important to obtain early.

Austin Mehr wins multimillion dollar verdict for his client

2011-08-15T14:49:00.000-07:00

Tom and Teresa Howard, of Middlesboro had a $100,000 UIM policy. Their adult son, Mikel, was killed in a car wreck. He was 26 years old, healthy and working doing some remodeling for $6 an hour at the time of his death.

The underlying policy limits of the driver (also 100,000) were quickly exhausted, there being another death and another injury in the car that had 4 occupants. Mikel was a passenger. The driver of this one car accident also died. The car ran off the road, and flipped upside down in water, drowning three of the occupants. Mikel's estate took $45,000 out of the driver's limits, agreeing to share with the other estate and injured passenger.

So Tom, the father, filed his UIM claim with Kentucky National, who denied the claim, saying that "the payments from the underlying limits ($45,000) represent full value of the claim". An interesting twist was that Tom, the father is also a Kentucky National agent, who sold the policy to himself. He also sold an identical policy (same terms, same $100,000 limit) to his in-laws, the Heaths. Mikel, who had just finished serving 5 years in Eddyville for drugs and stealing, had been "home" in Bell County for only about 6 weeks when he was killed. Mikel had no apartment or house to live in and, as one might expect, resided with his parents, but also sleeping some of the time at his grandparents’ house, a few miles away. The grandparents sent a letter to KY National saying they considered Mikel to be living with them, but Tom said that he considered Mikel to live with him and his wife. All this information was passed onto Ky National through Tom, the dad and agent, who simply supplied the facts from which Ky National could conclude that Mikel lived at one place or the other. It, of course, did not matter whether he lived with his parents or his grandparents, since the payment would be the same, and both households were insured by the same company.

The underlying UIM claim was tried last year and the jury assessed the wrongful death damages at $533,000, and found Mikel lived with his parents, the Howards. So it was way over the 100,000 policy limits. Judgment was entered for the policy limits of $100,000 in July 2010. Still to this day there has been no payment of the UIM claim, since Ky National appealed the verdict. The first verdict came into evidence in the trial of the bad faith phase.

As it turned out, Ky National, in their 45 page claim file, picked the grandparents’ house over the parents’ because they thought, mistakenly, that picking the grandparents’ house would give them an offset, under Tennessee law, reducing the policy limits from $100,000 to $55,000. Aside from this being a wrong conclusion (the grandparents’ policy was a Kentucky policy), Ky National went on to just deny the UIM/Wrongful death claim saying that the underlying limits of $45,000 was full payment. The adjuster, William Plucinski, who signed this letter, testified by video deposition about how he arrived at his conclusion that 45,000 was adequate payment. Among other things, he said that the measure of damages for a wrongful death case was "contribution to the household of the policy holder" and, that if Mikel was not going to support his grandparents, then the wrongful death damages would be essentially zero. In other words, the adjuster had measured wrongful death damages as a PIP claim for Survivor Economic Loss. No one testified live at the bad faith trial for Ky National.

Another interesting twist was that the claim file that was produced in discovery stopped at May 25, 2005, the day that the claim was denied. When pressed for an updated file, Ky. National said there was none, despite there being ongoing litigation, and a trial and verdict on the underlying UIM claim. I decided not to move to compel the rest of the file, because they said in a request for admission that there was no activity in the claim file since May 25, 2005. Because the Defendant had chosen to not maintain a claim file (or at least not be willing to produce it in discovery), the judge forbid them from defending the bad faith phase of the trial on the basis of anything that they had received from the underlying attorneys. They repeatedly suggested to the jury that the "claim activity period" was somehow limited to that first 5 months of 2005. We of course countered that the claim adjustment was on-going, and that we were still, today, waiting for a check. Ky National then told the jury that we did not have to worry about getting paid because Ky National have been good enough to post a full case bond that would pay the claim if it was upheld on appeal. They did not, because of the judge's ruling, offer any opinion about their chances on appeal of the underlying. I pointed out in closing that the full case bond was not a favor they Ky National did for us, but rather a legal mechanism to prevent us from collecting on our judgment for what we were owed, all according to another Bell county jury.

The bad faith verdict was $200,000 for inconvenience and 2,000,000 for punitive. The verdict was unanimous on all counts. We also won on a Consumer Protection Act claim, so we may get attorneys fees for the bad faith phase. We waived the claim for emotional distress when they tried to schedule an IME with Dr. Granacher. There are motions to be filed for attorney’s fees (incurred for the underlying claim litigation) and 12% interest under KRS 304.12-235.

AMLO obtains $2.2 million verdict against Insurance Co.

2011-08-07T06:56:00.000-07:00

Austin Mehr Law Offices obtained a $2.2 million jury verdict against an insurance company for their treatment of their insured.

GENERAL TIPS -- INSURANCE CLAIMS

2011-07-13T10:56:00.000-07:00

1. Obtain a copy of your insurance policy and declarations page as soon as possible. Check the amount of coverage available regarding the claim you have submitted. Make sure to report your claim promptly to your insurance company.

2. Maintain a diary regarding your claim. This should entail keeping detailed notes regarding conversations with the insurance company or its agents. The diary should contain the date, person’s name, phone number, job title, and address.

3. Document your loss. Proof of items destroyed, such as, pictures and receipts, may have been lost in a fire. One should consider keeping receipts, photographs, warranty information, etc., stored off site or in a fire retardant safe. When documenting your loss, you may wish to obtain statements from witnesses, family members, neighbors, friends, or other individuals that have knowledge regarding items that were lost or destroyed. You may also contact your credit card companies, retailers, or banking institutions to obtain documentation of purchase.

4. Read your policy. Know your policy. An insurance policy may provide payment under an actual cash value or replacement cost value. An individual may also be unaware of coverages available under the insurance policy, such as, additional living expenses, debris removal, etc., and may have limits for scheduled personal property, such as artwork, jewelry, or other valuables. The policy may also dictate your duties after a loss.

5. Obtain an independent estimate. One should obtain a written estimate of the true cost of replacement or repairing your losses from an independent professional whom you would hire to do the actual work. An insurance company may not always attempt to pay your claim for a fair value and may attempt to “lowball” your claim.

6. Do not sign any release until you know your rights. If an insurance company wants you to sign a release, then find out why this is needed. You should be cautious about signing away any rights you may have under your insurance policy. You may wish to seek legal counsel before signing any release.

Austin Mehr Law Offices wins award of attorney’s fees and cost for disabled shop equipment manager and ERISA claimant.

2011-06-22T11:22:00.000-07:00

Austin Mehr Law Offices recently was successful in having the United States District Court for the Eastern District of Kentucky order Reliance Standard Life Insurance Company to pay a client’s attorney’s fees and costs. After the Court determined that Reliance Standard had improperly denied a client’s ERISA long-term disability claim, Austin Mehr Law Offices asked the Court to order Reliance Standard to pay for the client’s attorney’s fees and costs for pursuing the case. The Court agreed and ordered that Reliance Standard pay the client’s fees.

Potential Pitfalls for Homeowners regarding Claims under their Homeowner’s Insurance Policy

2011-06-03T10:40:00.000-07:00

Many homeowners are unaware of policy provisions contained within their homeowner’s insurance policy that may result in the insurance company voiding their insurance coverage after a claim is tendered to one’s insurance company. As such, it is important for a homeowner to obtain a copy of his or her insurance policy when making a claim to be aware of any pitfalls that may result in coverage being voided.

First, the insurance policy may require that you send to your insurance company, within 60 days, a signed sworn proof of loss setting forth your damages and support for your claimed damages. Failure to comply may result in your insurance coverage being voided. Support for your claim could include bills, receipts, and related documents that justify the figures submitted for payment. A homeowner may consider taking photographs of one’s dwelling and personal property and keeping said documentation, along with receipts, in a safe place in case of an unfortunate event in the future. This would allow the homeowner to better recollect property lost or damaged and provide proof to the insurance company regarding these property items.

Second, your insurance company may request that you attend an Examination Under Oath. During the examination the insurance company, or its legal counsel, may question you regarding many aspects of your claim. While you should always be honest in all of your answers, it is important to note that some policies may void coverage if the insured conceals or misrepresents any facts, whether material or not, or engages in fraudulent conduct, or makes false statements relating to their insurance claim. Kentucky courts have held that misrepresentations regarding a loss may void your entire insurance policy. Hence, it is critical that the insured understand the questions being posed and answer the question honestly. If an individual does not understand the question being asked or does not know the answer, then he or she should not guess, as it could be wrong and this answer could be viewed as a misrepresentation or false statement that could void your insurance coverage.

And don’t think that the nice courteous lawyer is really just seeking information from you. Chances are that he or she already knows a lot more about you than they will let on. The goal may really be to get you to trip up in your examination, because you failed to state that you had a bankruptcy in your past, for instance. Then you will have an insurance company that says your claim is VOID, even though your misstatement was irrelevant.

One should also review their insurance policy to better understand whether there are any special limits for select personal property, and whether the policy may provide coverage for damages the insured may be unaware of at the time of loss. For example, if one has a fire loss, the policy may provide for additional living expenses, paying off your mortgage, debris removal, land restoration, etc.

If you are having issues with your insurance company regarding an insurance claim, please feel free to contact Austin Mehr Law Offices, P.S.C. at (859) 225-3731 for a free consultation.

Austin Mehr selected for inclusion in 2011 Top 100 trial lawyers for Kentucky

2010-12-23T07:41:00.000-08:00

Austin Mehr has again been selected this year for inclusion in the 2011 Top 100 trial lawyers for the state of Kentucky. The American Trial Lawyers Association is a professional organization of America’s top trial lawyers. Membership is by invitation and is extended only to those attorneys who exemplify superior qualifications, trial results, leadership, influence, reputation, stature and profile in the trial attorney community as viewed by the organization, other trial lawyers, members of the bench and the public at large.

AMLO gets long term disability benefits reinstated for a Kentucky factory worker.

2010-09-28T08:59:00.000-07:00

Long-term disability insurance company terminated AMLO’s client’s disability benefits. AMLO client’s disabling condition was failed back syndrome. AMLO disagreed with the insurance company’s decision to terminate benefits and appealed on the client’s behalf. The insurance company then reinstated client’s long term disability benefits.

Austin's latest bad faith article

2010-09-28T08:29:00.000-07:00

Austin Mehr’s Primer on Bad Faith Cases article has been published in the Sept/Oct issue of The Advocate, the Kentucky Justice Association’s magazine.

AMLO receives jury verdict for $534,000 on an underinsured motorist insurance claim.

2010-07-01T10:53:00.000-07:00

AMLO receives jury verdict for $534,000 on an UIM claim. The policy limits were only $100,000 and the payment by the negligent motorist was $45,000. The UIM carrier had denied the claim saying $45,000 was adequate compensation. This was the value placed by Kentucky National Insurance Company on a 26-year-old able-bodied man who died while a passenger in a car wreck.
The bad faith case is still pending and now moving forward rapidly.

AMLO wins another critical discovery order against State Farm Insurance Company in a bad faith case.

2010-04-29T12:22:00.000-07:00

AMLO pioneered the ability to discover vital information, to obtain the true operations and motives of insurance companies in the KY Supreme Court decision of Grange v. Trude. 151 S.W. 3d 803 ( 2004). AMLO has now obtained yet another detailed decision by a Federal Magistrate Judge following nearly all the rulings in the Grange case. State Farm is ordered to produce the personnel files of its adjuster, certain quarterly newsletters, internal costs savings documents, and a list of other bad faith cases for a period of five years before AMLO's client was injured.

ATLA invitation to become a member of 2009-2010 Top 100 Trial lawyers for Kentucky

2010-03-08T12:13:00.000-08:00

Austin Mehr has been invited to become a member of the American Trial Lawyers Association, 2009-2010 Top 100 Trial Lawyers for the state of Kentucky.

AMLO obtains UIM settlement for client

2010-02-19T09:16:00.000-08:00

AMLO successfully negotiated a UIM settlement for our client injured in a Lexington motor vehicle accident.

AMLO negotiated settlements for two mva clients

2010-02-19T09:13:00.000-08:00

AMLO successfully negotiated settlements for clients for injuries sustained in a rear end collision in Lexington, KY.

Austin Mehr has been re-elected as treasurer of the AAJ Bad Faith Insurance Litigation Group

2010-02-19T09:12:00.000-08:00

Austin Mehr is pleased to announce that he has been re-elected as Treasurer of the AAJ's Bad Faith Litigation Group for the 6th consecutive year.

Austin Mehr has been invited to speak at the KJA Insurance Claims Handling Practices Seminar

2010-02-19T09:08:00.000-08:00

Austin Mehr will be speaking on two matters at the KJA Insurance Claims Handling Practices Seminar, on April 16. Austin will be presenting a general session on Kentucky's Unfair Claims Settlement Practices Act and discussing claims practices in disability insurance claims.

AMLO wins against Reliance Standard for disabled client--- Federal Judge issues opinion critical of Reliance Standard's procedure for denying claim

2010-01-12T06:50:00.000-08:00

The federal judge rightfully was critical of the handling of the claim, ordering Reliance Insurance to re-evaluate the claim. The Federal opinion said:
Reliance Standard’s ignoring Ron’s Social Security disability determination weighs against finding that Reliance ever engaged in a “deliberate, principled reasoning process.”
Having benefited financially from the government’s determination that Ron was totally disabled, Reliance Standard Insurance Co. was obligated to weigh that determination, which it did not even consider.
In the instant case, the fact that the defendant benefited financially from the SSA determination and later ignored the Agency’s findings justifies a higher degree of concern about a conflict of interest because Reliance is both deciding whether to pay and also the entity that is to pay the benefits.
By failing to provide its reviewers with all relevant medical records, Reliance undermined the integrity of its own “Residual Employability Analysis” upon which it relied, which in turn undermines the integrity of its decision-making process. Reliance failed to consider Pemberton’s SSA determination at each stage of its decision-making process. This failure increases the significance of Reliance’s conflict of interest inherent in its determining eligibility and also being the entity that pays benefits. The fact that the second REA was based on insufficient information further undermines the integrity of Reliance’s decision-making process.

Austin Mehr's latest bad faith article

2009-10-27T12:23:00.000-07:00

Austin Mehr’s bad faith case review article will be published in the next edition of the Kentucky Justice Association’s magazine, The Advocate.

Austin Mehr announces plans for a new book

2009-10-27T12:20:00.000-07:00

Austin Mehr has announced plans for a new book on the topic a guide for trial judges on bad faith litigation.

Austin Mehr wins disability benefits for client

2009-10-26T12:17:00.000-07:00

Austin Mehr Law Offices, P.S.C., wins disability benefits for client from Kentucky Retirement Systems.

Austin Mehr Law Offices.P.S.C., opens Northern Kentucky office

2009-10-26T12:14:00.000-07:00

Austin Mehr Law Offices, P.S.C.’s new satellite office in Northern Kentucky is now open! We are pleased to have an office in northern Kentucky, as well as our office in the heart of downtown Lexington. Call 1-800-249-3731 for personal injury, disability insurance claims, insurance bad faith claims, Social Security claims.

AMLO wins 5th victory in a row against Hamilton Mutual

2009-10-20T12:20:00.000-07:00

The Kentucky Supreme Court upheld Austin Mehr Law Offices' victory against Hamilton Mutual Insurance, forcing this company to pay AMLO's client for its bad faith conduct. This is the fifth time (out of five rulings) that AMLO has won against this company!

Mehr Law Group wins for the 3rd time against Hamilton Mutual:

2008-08-22T05:59:00.000-07:00

The Kentucky Court of Appeals unanimously upholds a second punitive damage verdict from 2006 against Hamilton Mutual obtained by Mehr Law Group. The three judge panel agreed that Hamilton Mutual should indeed be punished for its conduct with its own insured, Mr. Barnett and upholds a verdict of $950,000.
Barnett v. Hamilton Mutual, Kentucky Court of Appeals Case Numbers 2007-CA-29 and 2007-CA-64.