Showing posts with label claims. Show all posts
Showing posts with label claims. Show all posts

Tuesday, February 14, 2012

CEO vs. Plaintiff Lawyer

CEO vs. Plaintiff Lawyer
A CEO’s job duties include the following:
a. Determining strategy of how the company will progress;
b. Making sure that strategy is understood throughout the company;
c. Hiring and firing a group of personnel which can bring the strategy to life;
d. Creating a path for the company to get from strategy to realization of goal;
e. Setting budgets to manage the growth of the company while maximizing return;
f. Creating a net profit for the shareholders.
For this job major CEOs are paid millions of dollars upfront along with stock options, retirement plans and benefits. If the company fails to make a profit, the CEO is usually fired or resigns with a severance package, full benefits and stock options amounting to millions of dollars. This despite the fact he failed in his or her job and the company and shareholders lost money. Additionally, none of the money budgeted or spent came out of his or her pocket.

A Plaintiff’s personal injury trial lawyer job duties include the following:
a. Determining strategy of how a case will progress from intake through trial;
b. Making sure that strategy is understood throughout the firm;
c. Hiring and firing a group of personnel which can bring the strategy to trial;
d. Creating a path for the firm to get from strategy to resolution of claim through settlement or trial
e. Setting budgets to investigate and develop of the case while maximizing return;
f. Recovering damages for the client to compensate for injuries caused by others.
For this job personal injury trial lawyer is paid nothing upfront. They receive no stock, no options, retirement plans or benefits. If the attorney fails to make a recovery for whatever reason, he or she gets nothing. This despite the fact he or she paid for all expenses out of pocket which could result of tens of thousands of dollars spent. If they do receive an offer to resolve the claim, the client has the ultimate decision on whether to accept the offer or to continue to trial. If the case is resolved the attorney will receive a percentage of the recovery which the client has approved and which the client authorizes prior to the settlement being completed.
Instead of attacking the way personal injury lawyers are paid perhaps we should have the CEO’s work on a similar structure. I would think they could even take a base salary of a $100k (since most of them do not seem to have enough confidence in their ability to do it without a base as personal injury attorneys do on a daily basis) plus a percentage of profit generated.
If CEO’s did this maybe they would consider what is best for the shareholder and company as it would directly impact their salary. They would not be spending shareholder money on expenses which do nothing for the bottom line profit of the company and they would be more selective in the risks they are willing to take with the company money. It still isn’t directly their money, but at least it will have some impact on their salary.
So next time you hear about those greedy trial lawyers why don’t you see if the person would be willing to take the same compensation package and be willing to have full accountability to their customers/shareholders.

Tuesday, July 12, 2011

Court allows Drunks to reduce how much they pay

Texas Supreme Court allows drunk drivers and others who cause car wrecks to reduce how much they will have to pay. Drunk Drivers get benefit of your premiums for health Insurance by getting credit for the negotiated rate.

This should have been front page news in papers across Texas this past week as our Supreme Court issued its opinion in the case Haygood v. Escabedo. Did you see a single paper discuss this ruling? Have you heard any of the radio or TV talk shows discuss this case? Why not? Where is the outrage?

I hear comments from people every month who call me about a workers compensation claim, medical malpractice or other issues. I tell them I can’t handle it because the law has made it almost impossible. They almost invariably tell me that it wasn’t supposed to impact their case only those frivolous ones. When I ask them why they weren’t mad and outraged when the laws were being passed or the Supreme Court was “interpreting” them, they always say it didn’t impact me so I didn’t pay attention. The only outrage about our rights being taken away nationally and in Texas seems to be coming from the trial lawyers. I am proud to be in the outraged group.

So what has the Texas Supreme Court done in its latest piece of judicial activism? Their twists and turns distort the law so much it would make a contortionist envious.

The Court's decision in Haywood v. Escobedo allows the person or company who harms you or your family to benefit from the health insurance you have paid premiums for all these years.

The Court argues there ruling is necessary to prevent a “windfall” to the claimant (that would be the person injured, maimed or killed by the drunk or other reckless driver to us normal people).

They also argue they are just interpreting the law as the Texas legislature wanted. Hard to believe that is the case when the legislature actually tried to repeal the law they are “interpreting” the session after they passed it as they realized what it truly was -- which is a windfall for the drunks, reckless drivers and their insurance companies. However Governor Perry vetoed the repeal of the bill so it is still on the books.

So here we are with an Activist Court that needs to protect the drunks and insurance companies, but how? They have already overturned virtually every jury verdict for any Plaintiff that comes their way. So rather than wait until a jury hears all the evidence and votes to compensate the injured person, they have decided to limit what the jury can hear so the compensation will be even lower and the insurance companies will have to pay less, make more profits and be able to contribute to all the expensive political campaigns.

Here is how the Court accomplished this with their latest decision: Let’s start with a situation where you are hit by a drunk who has a policy of $50,000.00. You are taken by life flight to the hospital where you stay for a week. You then have to go through rehabilitation. After about four months you are mostly better. You missed a month of work and still can’t do everything, but hopefully you will get where you can sleep through the night and play with your kids without having to tell them Daddy needs to rest. You have worked hard for years and paid for your health insurance at the cost of some vacations you wanted to take, but you knew how important it was for you to provide coverage for you and your family in case a situation like this happened. The medical bills were over $100,000.00, but because of your group plan they managed to reduce the total to $35,000.00 and since you met your deductible earlier in the year, you don’t owe anything else.

You send the bills to the drunks’ insurance carrier and ask that they pay the $50,000.00 policy limits because your medical bills alone are over $100k. Pretty straight forward right? You shouldn’t even need to get an attorney to settle this case. The operative word there is shouldn’t.

The reality is the insurance company will tell you we don’t owe $100k in medical because we get to take credit for your health insurance premiums and negotiated rate so all we will owe is $35k and we don’t think all of that is related because we know you hurt your neck 15 years ago when you were putting in fence posts and saw a chiropractor one time so we think all your neck issues are related to that and not this head on collision. So with the paid amount being $35k and us taking out some of the neck issue which we believe is not related (and because we can), we are willing to settle your case for $28,500.00.

What gives them the right to get the benefit of your paying premiums all those years: “Home Office” which is what they consider the Texas Supreme Court. Why shouldn’t they? They have won virtually every case that makes it there. Now the Texas Supreme Court has ruled that the only evidence a jury may consider in determining medical expenses are those amounts which were actually paid or will be owed by the person injured. So all those years of paying premiums and making sacrifices for you and your family to be covered is now benefitting the person who caused the wreck. The jury is not allowed to hear about how the bills were over $100k and because you had insurance it was reduced to $35k. They are not allowed to hear about the premiums you have paid to make that reduction possible. They may not even be allowed to hear about the deductible if it was met before this wreck. All because our Supreme Court has determined that it would be a “windfall”. How is it they never seem to be have a problem when insurance companies have a windfall of profits.

So if you happen to serve on a jury or hear about someone on a jury who talks about how this person was in a wreck but only had xxx in medical you can be fairly certain that it is at least 3x that amount of actual medical charges.

For my lawyer friends we know there are also significant issues regarding how Section 18.001 will be impacted and other battles over what constitutes paid --Is a deductible to be considered? Co-pay?

Some of you may know that I spent my senior year of high school attending gymnasium in Germany (which is the German equivalent of our U.S. high school). One of the things required in history classes was a complete study of the Nazi takeover both in political and military terms, which included the apathy and violence. The rational was if you never forget you will never repeat. If you were to ask someone who lived through that time how they could let it happen they would tell you it was not a sudden change. Rights were taken away one by one and it always was something that didn’t concern them. If someone was complaining about this or that they didn’t care because it didn’t impact them. Until one day it did. Then it was too late. Everyone asked how could “they” let this have happened? And then it became clear they were the “they” who allowed it.

As always I welcome comments.

Thursday, September 30, 2010

Where did our premiums go?

Texas Windstorm Insurance Association (TWIA) is in court in Galveston attempting to convince the Judge to order the Plaintiffs attorneys to turn over the total amount of fees they have made in representing people who had their hurricane claims denied or underpaid. The TWIA has already tried to set the stage against the “greedy” plaintiffs lawyer. There has also been talk about the legislature needing to know the amount of fees so they can possibly do something about them. Here's another crazy idea TWIA -- evaluate the claims fairly and pay them timely and guess what there would be NO attorney fees. What a novel idea. An insurance company actually paying a claim. I realize it is a shock to the insurance world that someone would ever suggest that they do anything other than collect premiums, but normal people actually expect to be covered in exchange for all the money they have paid over the years and they get a little upset when after having their $150,00.00 home destroyed that you want to write them a check for well below the value or that you tell them that the fact that their roof blew off is just a coincidence that it happened after a hurricane.
Sorry I drifted off into the world of how normal people think and not the land of insurance where intelligent life is scarce. So instead of just paying the claims and avoiding the lawsuits and attorney fees completely, the insurance companies whine and moan about how much money the attorneys who are representing their insured’s are making. They want to start an investigation into the amount of fees and make it all public. What they really want to do is create a smoke screen where they can hide. They want to use their same old “greedy lawyers” argument and hope that it gets people to forget that they have made millions (if not billions) of dollars off the people of this state in premiums and then refused to pay the claims.
The only time you generally need insurance is when something bad happens. The only time you generally need a lawyer is when someone has done something they shouldn’t have. I see a correlation here. It does not seem to be apparent to the insurance industry. So why should that surprise us? Instead of hearings on attorney fees paid out, how about hearings and an investigation into how to prevent this type of abuse by the insurance companies in the future. Make the failure of an insurance company to pay a valid claim a claim in which not only can the person who paid their premiums get their attorney fees and the real value of the claim, but punitive damages or an automatic 10x the claim value. Maybe that will get the insurance companies to do what is right in the first place.
I do have some questions of my own: How much did the insurance companies make off of Texans in the last 10 years? How much did they make off of interest in the premiums they have kept and money they have not paid out for the hurricane claims? How much do they pay their lobbyists and others who try and convince our representatives to “protect” them (in other words don’t make us actually pay any claims or worst case let us delay them for years and then only pay the very minimum)? Which representatives received money from the insurance companies and how much?