Dealing with Common Insurance Company Attempts to Reduce the Value of Your Personal Injury Claim

At James F. O’Rourke, Jr. and Associates we have a simple philosophy about documenting client’s injuries in personal injury cases: we instruct our clients carefully identify and describe their injuries to medical treatment providers; we have them engage in a reasonable course of medical treatment for those injuries.  After our clients become medically stationary we pursue payment of the fair value of the client’s claim.

Here are two common situations that insurance companies use to reduce the value of their claims.

Identifying Your Injuries

The first few visits to the doctor after your accident are important.  Ideally, if you are injured in an accident you will be careful to tell your doctor about all of your injuries in the first examination, starting with the tip of your head and going down to your toes.  Then, the doctor can decide if you are injured and recommend a reasonable medical treatment.

But, people don’t want to be hurt, so often they will not fully describe the extent of their injuries in that first visit.   Other times, an injury may seem minor and get worse over time.

If you don’t tell you doctor about your sore shoulder from being restrained by your seatbelt, the doctor isn’t going to assess the possibility of a rotator cuff injury.  If you don’t tell the doctor about the headache from striking your airbag, the doctor won’t look for signs of post-concussion syndrome.  If you wait to tell your doctor about these symptoms, the insurance company may argue that your injuries are not related to the accident.

Just because an injury isn’t documented perfectly in the first medical examination doesn’t mean that it isn’t related to the accident.  At James F. O’Rourke Jr. and Associates we can deal with these kind of issues and obtain a full and fair value for our client’s injuries.

Following  Medical Advice

In a perfect world, when you are injured and the doctor recommends physical therapy, you will go to every physical therapy session exactly as scheduled.  But, if you miss appointments the insurance company may take it as evidence that you are not hurt.

Ideally, you will make every appointment with your doctor without fail.  But people have busy lives.  It is not always possible to make every appointment.  Insurance companies try to use gaps in treatment to claim that you are not hurt or, at least, not hurt as badly as you may be.

As an Oregon Personal Injury Attorney James F. O’Rourke Jr. can take your case through the claims process and deal with the insurance company attempts to reduce the value of your claim.  At the end of your case, we want two things: a healthy client; and payment of a fair value for the claim.

Legislature Raises Liability Limit for the State and Local Public Bodies

The 2009 Legislature, acting on the recommendations of a review task force set up in 2008, adjusted liability limits for the state and local public bodies for lawsuits against them for personal injury and property damage.

Since 1967, the Oregon Tort Claims Act has governed lawsuits against the state and other public bodies.  In addition to special notice requirements, the Act set limits for the amounts a person could recover for injuries caused by the negligence of a person employed by a public body.  Prior to 2009, a person was limited to a claim of $100,000 and up to $200,000 under certain circumstances.

The 2009 Legislature recognized that these limits had not been adjusted for inflation and they needed to be increased in order to provide fair compensation for persons injured by the negligence of a public body.

The new limits are different for the state and local public bodies.  Now, for lawsuits against the state for injuries caused between December of 2007 and July 1, 2010 the limit is  $1,500,000 for a single claimant and up to $3,000,000 for injuries to multiple people in a single event.  For local public bodies, like cities and counties, the limit is now $500,000 for a single claimant and up to $1,000,000 for injuries to multiple people in a single event.  The property damage limit was raised from $50,000 to $100,000.

The good news is that the Legislature set incremental increases in the limits for both the state and local public bodies over the next five years.  After that, the limits will increase annually according to inflation, as determined by the Consumer Price Index (CPI).

This is a significant step to ensure fairness for persons injured through the negligence of a public entity.  As an Oregon Personal Injury Attorney, James F.  O’Rourke, Jr. aggressively pursues claims on behalf of those injured by the negligence of the state or other public bodies.

Oregon Legislature Ends Reduced Coverage of Family Members

Until 2007, insurance companies routinely provided an “exclusion” for coverage of family members how were injured in accidents in which another family member was at fault.

Essentially, insurance companies would sell a policy with, for example, $100,000 of coverage for bodily injuries caused by the insured persons negligence.  However, these policies contained an “exclusion” that provided no bodily injury coverage for other persons who were also insured under the same policy.  In cases where the insured person was at fault and involved in an accident that caused injury to a family member who was a passenger, that family member was, technically, also an insured person under the policy.  The only saving grace for this exclusion was that it didn’t affect the mandatory minimum coverage required under Oregon law: $25,000 of coverage per person and $50,000 per accident.  So, in this scenario, a family member injured by another family member in an accident would have only $25,000 in coverage available instead of $100,000.

Most people didn’t discover this hidden exclusion until they tried to collect the full amount of the coverage, since this language was buried in the policy fine print.

In 1991, the Oregon Supreme Court, in the case of Collins v. Farmers Insurance, held that this type of exclusion was allowed under Oregon law.

In 2007, the Oregon Trial Lawyers Association successfully lobbied the legislature to put an end to this practice.  House Bill 3086 expressly amended Oregon law to forbid insurance companies from sneaking in liability limitations for family members.  That law has been in effect for all policies issued after the law went into effect.

As an Oregon Personal Injury Lawyer, James F. O’Rourke, Jr. helps defend injured people from unfair and deceptive practices by insurance companies.  We aggressively pursue all available insurance policies in seeking fair compensation for our clients.

The Consequences of an Uninsured Oregon Automobile Accident

Many people who have an auto collision while uninsured experience a rude awakening when they make a claim for damages against the other party’s insurance. Since 1999, Oregon law has provided that an uninsured person who is injured through the negligence of another in an auto collision can only recover their economic loss from the at fault party. That means that such a person is barred from recovering damages for pain and suffering, which constitutes a significant portion of a personal injury claim.

There are exceptions to this rule limiting damages. If the at fault party was also uninsured, the limit does not apply. Also, if the at fault party was engaged in the commission of a felony, driving under the influence of intoxicants or driving recklessly at the time of the collision, there is no bar to recovery of pain and suffering.

The most significant exception is for people who have recently had insurance but allowed their insurance policy to lapse. If a person has been insured in the 180 days preceding the collision, and not been cited for driving without insurance for the year preceding the collision, there is no limitation on recovery.

James F. O’Rourke Jr. Is an experienced Portland Personal Injury Lawyer and explores every possible means of avoiding the damage limitation for our uninsured clients who are injured through the negligence of another in an automobile collision.

Oregon Supreme Court Settles Question about Limits of Underinsured Motorist Coverage

It is fair to say that most people have little understanding about how their Underinsured Motorist (UIM) coverage works in practical application.  UIM coverage is required under Oregon law as a protection against damages cause by an underinsured motorist.  In a way, it is the part of your insurance policy that you buy to protect yourself from those with inadequate insurance coverage.
However, until July of 2009 even Oregon personal injury attorneys were in the dark about how much the UIM policy had to pay in certain cases.

Typically, a person will have a minimum of $25,000.00 in UIM coverage as a part of a basic insurance policy, although smart drivers purchase more.  If a person gets in an accident with a driver with a $25,000.00 minimum liability policy and sustains over $25,000.00 in damages, he can pursue a UIM claim under his own policy.  Most people seeing the $25,000.00 in coverage would assume that they are entitled to up to an additional $25,000.00 under their own policy.

The Oregon Supreme Court has definitively said that assumption is wrong.

In Vogelin v. American Family Insurance, the high court said that UIM coverage works in a much different and more miserly way.  Ms. Vogelin was seriously injured in a car accident, suffering over $300,000.00 in damages.  The at fault driver had a minimum liability policy of $25,000.00.  Ms. Vogelin had UIM coverage of $100,000.00.  The Supreme Court held, in interpreting the statute governing UIM benefits, that Ms. Vogelin was entitled to recover only $75,000.00 from her UIM carrier, because the law required her to deduct the amount she had recovered from the at fault party from her policy limits.

Oregon’s statutory scheme governing auto insurance coverage is a byzantine maze of rules and regulations, most written by the insurance industry and slipped into the laws over time.  The law as a whole is filled with special considerations for the insurance industry so the result in Vogelin is hardly surprising.

But what of the consumer who finds out his “$100,000.00″ UIM policy is really not worth its face value and may be worth nothing at all?

The lesson is this: know your coverage and think ahead.  We handle many tragic cases where we have seriously injured persons who are entitled to substantial compensation, but there is only fraction of the just compensation available under the available insurance policies.  UIM insurance is the coverage you buy to help YOU if the unthinkable happens.  Insure yourself against other people’s negligence at least as well as you insure other people against your negligence.

As experienced Oregon Personal Injury Lawyers, we recommend to our clients that they carry at least $300,000 of Uninsured and Underinsured Motorist coverage.