California Personal Injury and Insurance Blog

Property Damage Estimates

Please do not just take the insurance company estimate and assume it is right. It may not be.

I recently had a client who had an estimate from her insurance company. The insurance company wanted to repair the bumper on her one year old car. They were going to fix the dents and paint it to match. (Anyone want to take a wager on whether that could actually be done?)

Two body shops looked at the car and both decided to replace the bumper. Why? First, because it would look better. Remember, the body shop wants you as a satisfied customer so you will tell your friends. And most body shops guarantee their work so they don't want you to keep coming back to get it fixed. Second, because it was cheaper. In this case, it was about $500 less expensive to do a replacement than a repair.

I tried telling this to the appraiser during the inspection. However, she wanted nothing to do with a replacement. She was adamant everyone would do the repair.

Even if you are not going to have your car fixed, make sure you get an estimate from a reputable body shop so you can make sure the insurance company is paying for your car to be fixed properly.

Do you have a MIST case?

Do you even know what MIST means? Probably not. MIST cases are an acronym for:

Minimum
Impact
Soft
Tissue

The "minimum impact" part usually means there is less than $1,500 in damage to your car. This does vary by insurance company.

The "soft tissue" part means that you have what is commonly called whiplash. You have a neck and back injury. Simple enough.

MIST cases are different from other cases. Insurance companies take these cases very seriously. They spend a lot of money defending them, investigating them and paying "expert witnesses" for their opinions. Insurance companies hate paying out on these.

So, what do you do? Hire an attorney who handles these - a lot. Or better yet, hire someone who actually teaches other attorneys how to handle them.

I just released a new book for attorney on litigating MIST cases. If you have a MIST case, you should talk to someone who has experience like this.

Reimbursement of your health insurer

Thankfully, we do not live in Texas. The Texas Supreme Court recently ruled that when a plaintiff sues a defendant, the plaintiff's health insurer gets reimbursed before the plaintiff. So, you pay those health insurance premiums in Texas, you use your benefits after a car crash, you sue for medical bills and "pain and suffering" and most of the money is going back to your health insurer, who you already paid for the coverage in the first place.

Thankfully, in California, the courts enforce the "make whole" doctrine. This basically says you have to be made whole before you have to pay back your health insurer. There is still some dispute about it, but you are much better off in California right now than you are in Texas. The Supreme Court there is doing a number on plaintiffs.

Your Social Security Number

Have you ever wondered why the insurance company wants your social security number? It is not because they need to verify your ability to work in this country!

They need it, well, they want it because they want to track you. Think George Orwell's "1984." The insurance companies have databases with information on everyone who files a claim. The problem, however, is that there are a lot of people named "Jonathan Stein." Heck, there are a lot of attorneys named Jonathan Stein and a lot in California, even!

So, how do they know if it is me, the guy in the next city or the guy in San Diego? Easy. They use your social security number to track it. This is why it is imperative that you do NOT give them your social security number. They don't need it. They just want to be able to track you.

What is a third party claim?

There seems to be confusion about what constitutes a third party claim. For example, if your vehicle is struck by someone else and you have damage to your car, a rental expense, an injury, wage loss, and medical bills, which of those is a claim?

The answer is to break it down by type of damage. Okay, so how do you do that? Fortunately, you do not have to do that. The other person's insurance company will do it for you, if the other person was at fault. But, let me explain what they consider a claim. (It is different with your own insurance, but we will discuss that another time.)

Property damage: this includes damage to your car and any rental expense incurred.

Bodily injury: this includes the wage loss, medical expenses and "pain and suffering." These are not three separate claims, but rather one claim. Each person has their own claim. So, if you and Junior are involved in a collision, you have a bodily injury claim and your child has a separate bodily injury claim.

I hope this helps answer this question.

Low Cost Auto Insurance Program To Expand

From the Department of Insurance, some good news.

Insurance Commissioner Steve Poizner to Expand Low Cost Automobile Insurance Program to Nine Additional Counties

 

Commissioner Poizner announced his final determination of need for the program in: Solano, Marin, Santa Cruz, Madera, Napa, Yolo, Mendocino, Kings and Lake Counties

SACRAMENTO - Insurance Commissioner Steve Poizner today announced his final determination of need for the California Low Cost Automobile Insurance program in Solano, Marin, Santa Cruz, Madera, Napa, Yolo, Mendocino, Kings and Lake Counties. The program is expected to go into effect in early September, once rates are set in each of the newly added counties.

Commissioner Poizner's announcement follows a series of community town hall meetings in each of the nine counties to examine the need for the program. Based on those meetings and a determination of need analysis conducted by the California Department of Insurance (CDI), the Commissioner determined that the program should be expanded to include these nine additional counties.

"Driving without insurance is illegal, and nearly 100,000 motorists in these nine counties are uninsured," said Commissioner Poizner. "Many drivers simply cannot afford insurance, but uninsured drivers put all travelers at risk. The expansion of this program in nine additional counties will better enable Californians to comply with the law and protect all motorists from potential losses."

Motorists driving without insurance can have their vehicle registrations suspended as part of SB 1500, a new law designed to reduce the risk of economic losses sustained as the result of collisions involving uninsured motorists.

The low cost auto insurance program provides eligible low-income good drivers with auto liability coverage for under $400 a year and as little as under $300 a year in many counties.

The California Low Cost Automobile Insurance Program initially begun in 1999 as a pilot program in Los Angeles and San Francisco. A new law, SB 20, also authorized the Commissioner to launch the program throughout the state upon his determination of need in each county. Beginning in April 2006, the department began expanding the program statewide. The program is now available in Los Angeles, San Francisco, Alameda, Fresno, Orange, Riverside, San Bernardino, San Diego, Contra Costa, Imperial, Kern, Sacramento, San Joaquin, San Mateo, Santa Clara, Stanislaus, Merced, Monterey, Santa Barbara, Sonoma, Tulare, and Ventura Counties. With the inclusion of Solano, Marin, Santa Cruz, Madera, Napa, Yolo, Mendocino, Kings and Lake Counties, the Low Cost Auto Insurance Program will be available in 31 California counties.

Since its inception, over 33,000 policies have been issued. Program policies are issued by California licensed insurers and the program is administered by the California Automobile Assigned Risk Plan. Rates are set in each county so that premiums are sufficient to cover losses and expenses in each county to ensure the program is self-sustaining.

To be eligible for the program, an applicant must be a "good driver" - no more than one at-fault property damage only accident, or one point for a moving violation in the past three years; and no at-fault accident involving bodily injury or death in the past three years; and no felony or misdemeanor conviction for a violation of the Vehicle Code.

Additionally, family income cannot exceed 250 percent of the federal poverty level ($25,525 for a single person, $34,225 for two persons and $51,625 for a family of four). The value of an insured vehicle must not exceed $20,000. For more information about the program, call 1-866-60-AUTO-1 (1-866-602-8861)

Now, my caveat: if you can afford a different policy, get it. This policy does not provide a lot of protection for you, but it is better than not having insurance at all!

Higher Auto Insurance Rates?

Based on a recent California Supreme Court refusal to hear a case, higher rates may be coming. The Auto Club charges fees to insureds for paying in installments. There is a debate over whether these fees are premium or added fees.

The moral of the story: when you are going to pay your insurance in payments, ask about any fees. Not all carriers charge these fees.

DOI Busts Contractors in Tahoe

The California Dept. of Insurance announced a bust of contractors in the South Lake Tahoe area after the Angora fire. People are still trying to figure out what to do, but the unlicensed contractors are flocking to the area. Here is the Press Release in its entirety:

SACRAMENTO - Today Insurance Commissioner Steve Poizner announced the results of the first undercover "sting" operation stemming from the Angora Fire in South Lake Tahoe. The operation took place at a residence in the disaster area that was damaged by fire, but not destroyed.

On July 4, the California Department of Insurance's Enforcement Branch partnered with investigators from the El Dorado County District Attorney's Office and the California Contractors State License Board to identify unlicensed public adjusters as well as unlicensed and uninsured contractors. The operation resulted in five arrests. The El Dorado County District Attorney's Office is prosecuting the cases.

"Preying on fire survivors is unconscionable," said Commissioner Poizner. "My department will continue to do everything possible to ensure residents aren't burned twice by contractors unwilling to protect their employees and customers from unnecessary liability."

None of those arrested possessed either a city/county business license (a misdemeanor) or a contractor's license (a misdemeanor enhanced to a felony since it occurred in a disaster area). Furthermore, two arrestees did not have workers' compensation insurance, a misdemeanor. Suspects arrested were: 

• Steve Killion, 47, Marysville, CA, co-owner of Rossier Home Restoration
• Kurt Edward Kimm, 40, Placerville, CA, owner of Kurt Kim Trucking and Equipment
• Troy Meadows, 37, Gardnerville, NV, co-owner of B&T Services
• Chase Rossier, 27, Yuba City, CA, co-owner of Rossier Home Restoration
• William Tanner, 33, Gardnerville, NV, co-owner of B&T Services

In recent days, investigators have also been providing residents of the disaster area with tips on spotting and reporting unlicensed and/or uninsured contractors and public adjusters. Furthermore, the investigators have been sweeping the disaster area to verify the license and insurance status of persons identifying themselves as public adjusters or contractors.

My moral for you: do not do business with anyone, sign any contracts, or enter in to any agreements with a contractor or independent adjuster until you have checked them out with the Department of Insurance or Contractors State License Board.

Blue Cross At It Again

So on Tuesday, I railed about Blue Cross sending customers a bill so that they can get a bill. Sheesh. Well, it turns out Blue Cross probably was not rescinding policies correctly. Amazingly, they even rescinded at least one policy for an undisclosed prior condition that was disclosed on the application.

One might think it is amazing that this happens, but, alas, it is not. Interestingly, most insurance companies do not look at the policy or the application until a claim is filed. At that point, the application is pulled and the insurance company goes through the application to see if there is grounds to rescind the policy. Seems a bit backwards to me.

You can read more about this and some additional commentary at Injuryboard.

Happy 4th of July

I just wanted to wish all of you a Happy 4th of July.