Washington Personal Injury Lawyer & Attorney : Regan Zambri & Long Law Firm : DC Metro Area Personal Injury Law Blog

By Victor E. Long, Esq.

More than half of Maryland's auto insurance companies have had to pay hundreds of thousands in administrative penalties and restitution to their policyholders after mishandling claims when vehicles are declared a total loss, according to the Maryland Insurance Administration.

According to the Baltimore Sun,  a year-long review has revealed that  67 companies were undercompensating drivers by not correctly calculating the value of these vehicles, given the increase in Maryland's sales tax as well as increasing Motor Vehicle Administration fees, such as the title fee.

"To date, the MIA has fined the offending companies $235,000.00 and has instructed them to pay a total of $442,590.38 in restitution to 4,120 Maryland citizens,” said Ralph S. Tyler, the state insurance commissioner in a statement. “We are still in the process of examining seven companies, but we are committed to getting vehicle owners what they are guaranteed under the law."
 

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Posted by: Salvatore J. Zambri, Esquire and Catherine Bertram, Esquire

Uninsured motorist coverage is needed most especially during a recession.  According to a report by NewsOn6.com, The Insurance Research Council (IRC) indicates that one in seven drivers is presently  without automobile insurance, and reports a "strong correlation" between unemployment rates and number of uninsured drivers.  The site reports that "if economic struggles persist, the IRC estimates one in six drivers will be uninsured by 2010 -- an all-time high."

To read the entire report, please click here.

Mr. Zambri, senior partner of Regan Zambri & Long, and Past-President of the Trial Lawyers Association of Metropolitan Washington, D.C., wrote an article about uninsured motorist benefits and the importance of having appropriate insurance coverage.  Here is a reproduction of the article:

                                          Uninsured/Underinsured Motorist Coverage

    Almost everywhere in this country, if you own a car, it must be insured.  If it isn’t, you could face fines or even jail time.  Unfortunately, in practice, not everyone complies with the law.  Consequently, there are many vehicles on the road without insurance coverage.  Also, many of whom abide by the law and purchase insurance coverage, cannot afford substantial coverage.  For these reasons, we highly recommend that your automobile insurance coverage include uninsured/underinsured motorist coverage.

    Uninsured motorist (UM) coverage applies when you are in an accident caused by the fault of another driver and the other driver has no liability coverage.  Underinsured motorist (UIM) coverage, often purchased along with uninsured motorist coverage, applies when the damages you’ve suffered as a result of an accident exceed the liability coverage provided by the at-fault driver’s policy.  Under these circumstances, the UM/UIM coverage limits of your policy are effectively transferred to the other driver as liability limits.

    Consider a circumstance in which you are rear-ended by an uninsured motorist and are hospitalized as a result of serious bodily injuries.  If you do not have UM/UIM coverage, your only option is to pursue a claim against the at-fault driver and attempt to collect from his personal assets.  This is hardly an attractive, cheap, or easy option for recouping your losses.  If a person is willing to break the law and not pay for liability coverage, it is not likely that person will have enough assets from which you can collect a fair recovery.  Consequently, you would be left paying out-of-pocket for an accident that wasn’t your fault and you would not recover a penny for your pain and suffering.

    In determining how much UM/UIM coverage to purchase from your automobile insurance provider, consider how these coverages apply.  If you’re in an accident and end up with $50,000.00 in medical bills and the at-fault driver’s insurance has a liability policy limit of $25,000.00, you will be able to recover the policy limit.  However, if you do not have UIM coverage, you would be forced to collect any additional amount against the other driver directly, which, as described above, is not likely to be productive.  If, on the other hand, you had $50,000.00 of UIM coverage, then in most states you would be able to recover the $25,000.00 policy limit from the other driver’s carrier, plus an additional $25,000.00 from your carrier (note that your insurance carrier is entitled to a dollar-for-dollar credit for the payments made by the other driver’s insurance company).  In this example, however, even if you had $50,000.00 of UIM coverage, you would only be getting reimbursed $50,000.00 total, which just covers your medical bills and pays you nothing for your lost wages, pain, or suffering.  Therefore, we encourage you to consider having substantially higher coverage, especially because the cost of the additional coverage is not great.

    Please feel free to contact Mr. Zambri at szambri@reganfirm.com, or call him at 202-822-1899, if you have questions about the coverages you’ve purchased from your automobile insurance carrier. 

Many Americans are killed or injured each year in traffic collisions.  If you want more information about your legal rights, please click here or call the law firm of Regan Zambri & Long, PLLC  at 202-463-3030.  

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In most jurisdictions, including the District of Columbia, if a plaintiff claims an injury, the defendant has the right to have the injured plaintiff examined by a physician.  These examinations are often referred to as "independent medical examinations."  However, a recent New York Times article demonstrates that these examinations are anything but "independent." 

NYT reporter N.R. Kleinfeld's review of worker's compensation cases in New York revealed "that the exam reports are routinely tilted to benefit insurers by minimizing or dismissing injuries."  This not surprising since the insurance company is paying for the examination.   

Incredibly, Dr. Hershel Samuels admitted that: “If you did a truly pure report, you’d be out on your ears and the insurers wouldn’t pay for it. You have to give them what they want, or you’re in Florida. That’s the game, baby.”   

It seems that a fair and accurate solution to this problem would be to force the defendant to select a truly independent physician from a list of medical providers compiled by the court.   

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The following is a reproduction of portions of an article published by Salvatore Zambri, senior partner at Regan Zambri & Long, which he wrote while he served as President of the Trial Lawyers Association of Metropolitan Washington, D.C.  Although he wrote the article in 2007, it is appropriate to publish it again since this year's Law Day will be celebrated by our nation tomorrow, on May 1, 2009.

A LOT TO CELEBRATE:

On May 1, our nation commemorated Law Day, the brain-child of Attorney Charles Rhyne.  In 1958, Mr. Rhyne drafted a proposed U.S. Presidential Proclamation and presented it to President Eisenhower’s Chief of Staff, Sherman Adams.  The proposal, however, did not make its way out of Mr. Adams’ office.

Mr. Rhyne eventually went to visit Mr. Adams.  Having been assured by Mr. Adams that President Eisenhower would “not sign a proclamation praising lawyers,” Mr. Rhyne described what happened next:  “I strode down to the Oval Office and handed it to President Eisenhower himself.  As he stood there reading it, Adams burst in yelling, ‘Do not sign that paper praising lawyers!’”  President Eisenhower signed the proclamation over Mr. Adams’ objection, believing that the freedoms enjoyed by Americans and the rule of law should be commemorated.

“Now, therefore, I, Dwight D. Eisenhower, President of the United States of America, do hereby designate Thursday, May 1, 1958, as Law Day – U.S.A.  I urge the people of the United States to observe the designated day with appropriate ceremonies and activities; and I especially urge the legal profession, the press and the radio, television and the motion picture industries to promote and to participate in the observance of that day.”

The 2007 Law Day theme was “Liberty Under Law:  Empowering Youth, Assuring Democracy.”  The theme clearly recognizes that our children will shape our country’s future.  Consequently, we have the responsibility to teach them about the justice system, the process of the law, and the liberties we enjoy.

Three days after Law Day, at the United States Supreme Court, I had the privilege of speaking to a group of 6th Grade winners of an annual essay contest sponsored by the National Capital Lawyers’ Auxiliary.  I seized upon the theme of the 2007 Law Day Proclamation and suggested that no matter what profession we choose, we must all be intolerant of social injustice and that the privilege of freedom, earned through the courage of those who came before us, must not be taken for granted.  I challenged them to advance America’s promise of equal and fair justice for all.  Having heard their essays, I was inspired . . .

About a week ago, all Americans celebrated the 4th of July holiday, commemorating the signing of the Declaration of Independence.  That document, you will remember, was drafted by merchants, clergy, farmers, soldiers, lawyers, and physicians.  This diverse group joined together and declared:  “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the Pursuit of Happiness….”

Lawyer Thomas Jefferson, who initially drafted the declaration, remarked in his first inaugural address:  “It is proper you should understand what I deem the essential principles of our Government, . . . freedom of religion; freedom of the press; freedom of person under the protection of the habeas corpus and trial by juries impartially selected.”

In July 1776, the clangs of the Liberty Bell resonated throughout the world.  In recent years, many have seemingly forgotten the lessons bestowed upon us by that diverse assembly of representatives.  Special interest groups and those with personal agendas seek to redefine the civil justice system, forcing victims of wrongdoing to be treated differently and unequal under the law.  They need a refresher course on American history. . .

If you have any questions about the law or your legal rights, please feel free to contact Mr. Zambri at szambri@reganfirm.com, or call him at 202-822-1899.

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Posted by: Salvatore J. Zambri, Esquire and Catherine Bertram, Esquire

In 2007, more than 5,100 people were killed in crashes involving large trucks and buses, according to the Department of Transportation.  There were also approximately 100,000 Americans injured in collisions involving both large trucks and buses. The American Association for Justice (AAJ) has urged Congress to take needed steps to reduce highway fatalities and injuries by enhancing safety measures and rules for the commercial vehicle industry. 

“Stricter safety standards, including roof crush resistance, added seatbelt standards and enhanced driver fatigue monitoring, could protect consumers by reducing the severity of motor carrier accidents,” said AAJ Director of Regulatory Affairs Gerie Voss.  “The brakes have been on vehicle safety standards for too long.  Safety features are not a luxury, we hope this administration will accelerate consumer safety to reduce fatalities and injuries.” 

To read the full AAJ report, click here.

For information about your legal rights, please click here or call the law firm of Regan Zambri & Long, PLLC  at 202-463-3030.   

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Posted by: Salvatore J. Zambri, Esquire and Catherine Bertram, Esquire

Many brave women and men serve our country today in Afghanistan and Iraq, as well as other places in the world very far from home.  Most are soldiers.  Many are civilian contractors.  The last thing they need to think about is a wrongful denial of insurance benefits in the event they are severely injured.

According to a recent report in the Los Angeles Times, Congress has begun a probe into whether insurance giant American Insurance Group, Inc. and other insurance companies have been  inappropriately denying and delaying coverage and benefits to these men and women who serve our country so selflessly.  Rep. Elijah E. Cummings (D-Md.) said there were “serious deficiencies in the health coverage of civilian employees who have been injured while working overseas,”  the Times reports.

To read the entire article, please click here.

Many Americans are killed or injured each year as a result of work-place and service-related incidents.  Regrettably, many are wrongfully denied benefits and others are paid only after egregious delays, turning the lives of injured victims and their families upside-down. 

If you want more information about your legal rights, please click here or call the law firm of Regan Zambri & Long, PLLC  at 202-463-3030.  

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 The term "insurance fraud" is usually attributed to the consumer but a recent article by the American Association for Justice has outlined an increasing problem of Insurance companies committing the insurance fraud.

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American Association for Justice (AAJ) recently released a comprehensive research report, "The Ten Worst Insurance Companies in America: How They Raise Premiums, Deny Claims, and Refuse Insurance to Those Who Need It Most."

The top ten list includes Allstate, UNUM, AIG, State Farm, Conseco, WellPoint, Farmers, UnitedHealth, Torchmark, and Liberty Mutual.   AAJ's summary report is reproduced below in its entirety:

      "ALLSTATE RANKS AS WORST INSURER FOR CONSUMERS

Insurance Industry Employs "Deny, Delay, Defend" Strategy,
Puts Profits Over Policyholders

WASHINGTON, DC – Allstate ranks as the worst insurer for consumers, according to a comprehensive investigation of thousands of legal documents and financial filings.

The rankings show a distinct pattern of insurance industry greed amongst 10 companies that refuse to pay just claims, employ hardball tactics against policyholders, reward executives with extravagant salaries, and raise premiums while hoarding excessive profits.

"While Allstate publicly touts its 'good hands' approach, it has instead privately instructed its agents to employ a 'boxing gloves' strategy against its policyholders," said American Association for Justice CEO Jon Haber. "Allstate ducks, bobs and weaves to avoid paying claims to increase its profits."

Allstate (NYSE: ALL) set the standard for insurance company greed and placing profits over policyholders. Allstate contracted with consulting giant McKinsey & Co. in the mid-1990s to systematically force consumers to accept lowball claims or face its "boxing gloves," an aggressive strategy designed to deny claims at any cost. One Allstate employee reported that supervisors told agents to lie and blame fires on arson, and in turn, were rewarded with portable fridges. 

Thousands of court documents, materials uncovered from litigation and discovery, testimony, complaints filed with state insurance departments, SEC and FBI records, and news accounts were reviewed to compile the rankings and statistics.

The rest of the rankings are as follows:

• 2.   Unum (NYSE: UNM) – Unum's actions are even more shameful considering the type of insurance it sells: disability.  Unum's behavior was epitomized when it denied the claim of a woman with multiple sclerosis for three years, stating her conditions were "self-reported," contrary to doctors' evaluations. In 2005, Unum agreed to a settlement with insurance commissioners from 48 states over their practices.

• 3.   AIG (NYSE: AIG) – The world's biggest insurer, AIG's slogan was "we know money." AIG, described by commentators as "the new Enron," has engaged in massive corporate fraud and claims abuses. In 2006, the company paid $1.6 billion to settle a host of charges.

• 4.   State Farm – State Farm is notorious for its deny and delay tactics, and like Allstate, hired McKinsey consultants. State Farm's true motives became apparent during Hurricane Katrina; for example, it employed multiple engineering firms until they could deny the claims of the Nguyen family of Mississippi. In April 2007, State Farm agreed to re-evaluate more than 3,000 Hurricane Katrina claims.

• 5.   Conseco (NYSE: CNO) – Conseco sells long-term care policies, typically to the elderly. Amongst its egregious behavior, the insurer "made it so hard to make a claim that people either died or gave up," said a former Conseco-subsidiary agent. Former Conseco executives were fined when they admitted to filing misleading financial statements with regulators.

• 6.   WellPoint (NYSE: WLP) – Health insurer WellPoint has a long history of putting profits ahead of policyholders. For instance, California fined a WellPoint subsidiary in March 2007 after an investigation revealed that the insurer routinely canceled policies of pregnant women and chronically ill patients.

• 7.   Farmers – Swiss-owned Farmers Insurance Group consistently ranks at or near the bottom of homeowner satisfaction surveys, and for good reason.  For example, Farmers had an incentive program called "Quest for Gold" that offered pizza parties to its adjusters that met low claims payments goals. Like Allstate, it also hired the McKinsey consultants.

• 8.   UnitedHealth (NYSE: UNH) – The SEC opened an investigation into former UnitedHealth CEO William McGuire for stock backdating, which ultimately led to his ouster in 2006 and returning $620 million in stock gains and retirement compensation. Physicians have also reported that their reimbursements are so low and delayed by the company that patient health is being compromised.

• 9.   Torchmark (NYSE: TMK) – According to Hoover's In-Depth Company Records, Torchmark's very origins were little more than a scam devised to enrich its founder, Frank Samford. Torchmark has preyed on low-income Southern residents and charged minority policyholders more than whites on burial policies.

• 10. Liberty Mutual – Like Allstate and State Farm, Liberty Mutual hired consulting giant McKinsey to adopt aggressive tactics. Liberty's tactics were highlighted when a New York couple's insurance was "nonrenewed" by Liberty, even though they lived 12 miles from the coast and never experienced weather-related flooding.

Financial documents also revealed extravagant profits and executive compensation while policyholders' claims were routinely delayed and denied: 

• Over the last 10 years, the property / casualty and life / health insurance industries have each enjoyed annual profits exceeding $30 billion.

• The insurance industry takes in over $1 trillion in premiums every year. It has $3.8 trillion in assets, more than the GDPs of all but two countries.

• The CEOs of the top 10 property / casualty firms earned an average of $8.9 million in 2007. The CEOs of the top 10 life / health insurance earned an average of $9.1 million.

• The median insurance CEO's cash compensation is $1.6 million per year, leading all industries.

To see how consumers can hold the insurance industry accountable and view a full copy of the study, visit http://www.justice.org/docs/TenWorstInsuranceCompanies.pdf."

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Many Americans put their faith in health insurance companies, paying hefty premiums to be protected in the event of catastrophic or chronic illness.  Too frequently, in times of need, their claims are denied for technical or procedural reasons, or no good reason at all.  A recent article published in CNN Medical News chronicles the story of one family's unjust treatment by an insurer, and includes the following advice for leveraging your position and negotiating more successfully with insurance companies regarding claim denials:

1. Get help.  Your doctor, hospital business office, and employee benefits office can be much more powerful than you are. 
   
2. Be persistent.  File appeals again and again, and to several different levels until you get a favorable resolution. 
   
3. Use the right words.  Certain words, like "cosmetic," or "to enhance esteem," may trigger a denial, while appeals that include specific problems with "biting," "chewing," or "swallowing" may work to your advantage. 
   
4. Ask your doctor to try again.  If a particular drug or procedure serves two purposes (for instance, it enhances the effectiveness of your chemotherapy, and also treats your anemia), then mention the second when you appeal a denial of the first. 
   
5. You may need a lawyer.  The threat of a lawsuit with attorneys copied on your correspondence may get your claim the close attention it deserves.
   

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New Medicare beneficiaries who have previously been uninsured -- particularly those with diabetes or cardiovascular disease -- cost the Medicare program significantly more than those who were insured earlier, according to a new study in the New England Journal of Medicine. 

According to researchers, the costs associated with treating chronic disease complications are much greater than the costs of routine disease management or prevention.  Because most previously uninsured enrollees tend to comply with physician visits and medical procedures once they are eligible, researchers believe they probably would have addressed their health problems earlier had they been insured.
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For many years, hospitals, pharmaceutical companies, insurance companies, and defendants generally have settled cases with the caveat that the settlement and facts of the case be kept secret forever. Although their wrongdoing may have seriously, if not fatally, injured victims, their goal was to shield the rest of the world from their misconduct. In a recent decision governing the professional conduct of lawyers, the District of Columbia Office of Bar Counsel has made clear that a settlement agreement “may not compel counsel to keep confidential . . . public information about the case, such as the name of the opponent, the allegations set forth in the complaint on file, or the fact that the case has settled.” Bar Counsel rightly determined that, among other things, suppression of this information works to keep important information from other victims who deserve to know that their injuries may have been caused by the wrongdoing of others.

For the complete text of the rule governing lawyer conduct, please click here.

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D.C., Virginia, and Maryland have specific requirements for motorists if their automobile liability insurance lapses.

D.C. requires all vehicle owners with lapsed or expired automobile liability insurance to immediately surrender their license plates and registration. In addition, all drivers who are stopped by a police officer in the District of Columbia are required to display license, registration, and proof of insurance, or face a fine.

Virginia allows uninsured vehicles to register and be driven, at the driver’s sole risk, for a $500 fee. Insurance carriers notify the DMV of vehicles whose insurance has lapsed. Uninsured motorists who fail to pay this additional fee will have their licenses and registration suspended.

Maryland uninsured drivers can lose their license and registration and even be required to pay a $150 fine for the first 30 days and $7 per day after that.

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In order to protect your rights and your personal assets, every driver needs to understand his or her automobile insurance policy BEFORE being involved in an accident.

Bodily Injury and Liability Insurance: This term defines how much coverage the insurance agency will be liable for if you cause an accident occurs and someone is injured. Usually split into two numbers, the first covers the maximum they will pay for one person’s injuries and the second is the maximum they will pay for all injuries sustained in the accident. 

Almost all states require a minimum level of bodily injury and liability coverage.  Examples of such include:

• District of Columbia: $25,000/$50,000
• Maryland: $20,000/$40,000
• Virginia: $25,000/$50,000

Collision Insurance: This term defines how much an insurance company will pay for damage to your vehicle if it is damaged by another vehicle or fixed object (tree, stop sign). 

Comprehensive Coverage Insurance: This term, sometimes called “fire and theft” coverage, covers all damages to your car that are not caused by a collision. For example, it may cover tornadoes, floods, fire, theft, hitting a deer, etc.

Car Rental: If your car is in the shop for more than a day, many insurers will pay a per diem for your rental car while you wait for repairs, if you have this coverage.

Full Glass Coverage: Full glass coverage eliminates any deductible payments for broken glass on the car. In most states there is no deductible for windshield damage (because it is illegal to drive with a broken windshield), but for all other window damage to the car, you will have to pay the deductible for comprehensive coverage. Full glass coverage is an extra feature that you can buy to eliminate the deductible payment.

Medical Benefits Coverage: Covers medical expenses that you and your passengers sustained during an accident, no matter who was at fault.

No Fault Insurance: No Fault insurance currently exists in 12 states and Puerto Rico.  Essentially, "no fault" means that, if injured, you can recover certain damages from your own insurance company.  However, you cannot sue the other party unless your injuries rise to a certain level.  If you  live in Florida, Michigan , New York, New Jersey, Hawaii, Kansas, Kentucky, Pennsylvania, Massachusetts, Minnesota, North Dakota, Utah, or Puerto Rico, be sure to ask you insurance agency about your state's laws.

Personal Injury Protection: Personal Injury Protection (PIP) covers medical and rehabilitation expenses, work loss, funeral, and other expenses incurred by you, your family, or passengers in your vehicle. PIP pays for those damages no matter who was at fault. 

Uninsured or Underinsured Motorist Coverage: This coverage pays for your injuries in a crash where the other motorist either does not have insurance or does not have enough insurance to cover your damages. For instance, if the other driver has the minimum coverage in Virginia ($25,000) and your damages are $75,000, his insurance company will pay for the first $25,000 of your injuries and you may or may not be able to collect the remaining $50,000 from him. If, however, you have underinsured or motorist coverage, you can make a claim against your uninsured motorist coverage carrier for the remaining portion. This coverage often covers hit-and-run drivers as well.

Resources:  Virginia Auto Insurance Requirements
                        Virginia Auto Insurance Consumer Guide
                        DC Auto Insurance Requirements
                        Maryland Department of Motor Vehicle
                        Maryland Auto Insurance Consumer Guide

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Not just your driving record and type of car you drive can affect your insurance rates. 

Consumer Reports has found that insurance companies are now using bill paying and loan data collected from major credit companies to determine what your monthly payment will be, in some cases raising rates as much as 25-47%.

Even though the data from which these scores are derived is often out-dated and inaccurate, most states allow insurance companies to use it for credit scoring purposes. Consumer advocates are trying to get legislatures to ban this sort of scoring, but so far they have been unsuccessful. Lobbyists for the insurance industry, on the other hand, have succeeded in stopping such legislation in Colorado, Delaware, and Minnesota.

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