Sometimes we find ourselves representing a client whom we represented in a personal injury claim 10 or 15 years ago.  These clients are invariably amazed at the shear number and complexity of additional insurance wrinkles that have sprung up over the intervening years.  One of the most irritating recent wrinkles involves health insurance. 

For those of us who have paid health insurance premiums for a number of years, we have seen years of double-digit percent increases in our premiums.  Thousands of dollars of our income go toward paying a health insurance company for the sole reason that it pay our medical bills.  And once a premium dollar is paid, you never get it back.  Your premiums are non-refundable.

But the rules just keep getting better for the health insurance companies.  If they pay a medical bill on your behalf, as required by the policy you’re paying for, most of them will now leave no stone unturned in a search to get that money paid back out of any injury claim you may have.  The end result is that any recovery you’re pursuing against a wrongdoer could be completely gobbled up by your health insurance company – to repay them… for bills… you paid them premiums… to pay in the first place! 

And don’t bother asking them for your premiums back – remember? Those are non-refundable. 

All of this is head-spinning, wrong, and yet perfectly legal.  In fact, the Ohio Supreme Court recently strengthened the insurance companies’ rights even further.  Question:  If an insurance company collects your hard-earned dollars to provide you insurance, pays your bills as a result, and then gets all of that money back at your expense, is that insurance anymore?

It gets worse.  We all know that different folks are insured at different premium levels, depending on factors such as age, health, number of dependents, etc.  All of these factors are considered in the underwriting process that ultimately determines how much premium you have to pay for your policy.  Insurance executives have testified under oath that the possibility of getting their money back in an injury claim is not factored into underwriting.  If it were, it would certainly reduce premium to some degree.  Because any money recovered as part of  a victims legal action is not considered during underwriting; it represents a complete windfall to the insurance companies.  They charge a full premium based on normal risk factors.  When a claim is made, if they’re “fortunate” enough to identify an auto insurance policy to get money from instead for medical bills that they are contracted to pay, it’s  pure windfall profit.

While this is all a big boost to the bottom line of the insurance company, it comes at your expense.  As an example, if there were $50,000 available to pay you for your injury claim but your health insurance company paid $60,000 for your medical bills, you are literally looking at a situation in which, on paper, you as the injured person get nothing.  Now at this point, most of the health  insurance companies will offer to reduce their lien and “only” recover one-third to one-half of the $50,000 available.  In so doing, they portray themselves as good Samaritans taking a hit on your behalf.  (Remember, this is all pure profit to them). 

Most clients we talk to about this get pretty worked up.  Well, so do we.  The ultimate irony is that this issue hurts the most seriously injured the worst.  Those whose lives have been forever altered by permanent injuries, and who have experienced hundreds of thousands of dollars in medical treatments, are the same ones who face the prospect of losing hundreds of thousands of dollars of their claim only to be turned over to an insurance company to boost its bottom line. 

Fortunately, the law requires insurance companies to take certain affirmative steps to secure these rights, and  we have had success demonstrating that the insurance companies have not done everything they were required to do.  This boils down to half gum-shoe detective work and half legal scholarship.  We have to make sure we have the correct policy and that the insurance company has actually written into the policy necessary language to even accomplish this.

Especially on permanent injury or catastrophic loss cases, this issue can be as important as all other issues combined.  We have had cases where liability was clear, injuries were permanent,  insurance coverage was limited to $100,000, and the at-fault insurance carrier promptly offered those limits… to the health insurance company!  The fight then becomes doing everything we can to put every dollar possible in our client’s pocket.

This fight is not for the faint of heart, and it is aggravating for us to be the bearer of bad news when we so strongly disagree with this policy.  However, we have found success, and we find it personally fulfilling, to battle back these liens in defense of our client.

The law firm of Willis & Willis is not a general practice law firm. We concentrate our efforts on representing individuals who’ve been injured physically and/or financially by someone else’s wrongdoing. Attorney Mark Willis is licensed to practice before all state courts in Ohio and West Virginia. Attorney Todd Willis is licensed to practice before all state courts in Ohio and Pennsylvania. Both are also licensed to practice in the United States federal courts. Mark Willis has been practicing law for over 22 years and Todd Willis for 11. Together they have represented thousands of injured individuals at all levels of the judicial system. In recognition of his expertise in representing injured individuals Mark Willis has been asked to represent the American Association for Justice on issues in other states. In addition to representing individuals, both Mark and Todd have been asked to represent the Ohio Association for Justice on issues pending in this state, including issues pending before the Ohio Supreme Court and in legislative committee hearings. Both Mark and Todd have been recruited to teach other lawyers in continuing legal education seminars on various topics related to representing injured individuals. Both Mark and Todd have served as the president of the Summit County Association for Justice. Mark Willis has served on the board of Ohio’s Association for Justice and was instrumental in beginning a section dedicated to helping injured consumers. Todd Willis has also served on the board of Ohio’s Association for Justice and served as the section chair relating to representing injured consumers.  

Our philosophy has always been to represent clients one at a time, in a custom-tailored process, to maximize the benefits for each client. We have consciously rejected the approach some lawyers have taken in recent years, which embraces solicitations, mass mailings and advertising while reducing the practice of law to assembly-line claims adjusting. Our motto is we take care of our clients and our clients will take care of us. We strive to earn each client’s trust and our goal is to obtain the best possible outcome for each client. As a result, almost all of our clients come to us as a referral from another client, another lawyer, or a judge.

Have you ever received paperwork from your insurance company telling how they’ve changed your policy? Have you ever wondered why insurance companies have the right to just change their coverage at any time? If you and I entered into an agreement where I would pay you $100.00 to paint my barn, I cannot unilaterally just change my mind in the middle of the job and tell you I’m only going to pay you $50.00.

Why is it that insurance companies have the right to change coverage whenever they feel like it? We recently had a client who had auto insurance coverage with a major insurance company. (You’ve seen their ads on T.V.) They sent him paperwork changing his policy. This particular change clearly affected his rights under the policy as it pertained to injuries he sustained in a collision. Ohio has statutory regulations, enforced by the Ohio Department of Insurance, specifying how insurance companies can modify their policies. Through extensive research through the records at the Ohio Department of Insurance in Columbus we were able to establish that the insurance company had not followed the legally required procedures to change the policy language. The court ruled in our client’s favor finding that the original policy language governed. This case involved our firm spending significant time and energy chasing down a long-shot lead to better advocate for our client. 

In a case where a woman was killed when she was struck by a vehicle on private property, we were successful in establishing that the vehicle’s driver’s insurance provided coverage for funeral expenses and medical bills. Allstate Insurance Company insured the driver and argued that she should not have been considered an insured under their policy. The language, however, of the Allstate policy and the existing case law established that she was in fact an insured. The court ruled in our client’s favor.         

In the same case, American Family insured the woman who was killed. We were successful in arguing that American Family provided coverage to her family. American Family argued they did not owe coverage to the family members. The court ruled in the family’s favor citing the language used by American Family in their policy and found that the total $325,000 limits in coverage was applicable. 

In another case, a client purchased a used car from a dealer with a 30-day warranty and the car immediately experienced problems that the dealer couldn’t or didn’t repair. After many repair attempts, our client left the vehicle at the dealership and demanded her money back since the dealer could not get the vehicle to run properly. The dealership refused to refund her money but turned around and sold the car to someone else.  The court agreed with us and held that the dealership’s actions violated several provisions of Ohio’s Consumer Sales Practices Act. The court awarded our client all of her money back plus her damages. This amount was tripled per the statute, as the Defendant had engaged in the wrongful conduct knowingly, and our client recovered her attorney fees. All of this totaled $58,000.00.

   We recently tried a rear-end automobile collision wherein the plaintiff claimed permanent and significant neck injuries and the defense claimed that it was a mild collision causing hardly any damage to the vehicle let alone to the driver. Our client turned down an insurance company offer of $20,000.00. The jury only awarded $11,015.00.

   We recently arbitrated a case where our client was injured in a multi-car rear-end collision while on the job. Our client had significant shoulder injuries and Worker’s Compensation paid her medical bills and lost wages. We were successful in getting the main defendant’s insurance company to pay their limits of $50,000.00 to our client. We then pursued an underinsured motorist claim under our client’s insurance policy and forced the case to arbitration. Our client’s insurer claimed the $50,000.00 already paid was all the claim was worth. The arbitration panel awarded an additional $32,500.00. We were also successful in negotiating a reduction of the amount of money Worker’s Compensation wanted returned. 

Few images can inspire distrust more than a used car salesperson, who in popular myth is usually wearing a cheap suit and eagerly eyeing your wallet. In Gallup’s annual Honesty and Ethics of Professions survey, most recently conducted in November 2008, Americans’ opinion of car salesmen ranks at rock bottom, with only telemarketers and lobbyists keeping them company. For a dishonest car dealer, there is no greater opportunity for fraud and unjust profit than with a late model used car. A “clean” late model car is still worth quite a lot of money to a potential buyer. So if a dealer buys a troubled but popular car at a steep discount, and is able to pass the car off as “clean” to the public, he or she can make thousands more in profits – on one sale! A few examples of problematic used cars are: a vehicle seriously wrecked, a flood damaged vehicle, a vehicle branded as a “lemon,” or a vehicle that was used as a fleet rental.

In one recent case, our clients purchased a three-year-old Dodge Ram 3500 pickup from a dealership in Northeast Ohio with approximately 39,000 miles on the odometer. The dealership advertised the vehicle as a reliable and safe truck, with a clean title history, and told our clients the same thing. Our clients proceeded to purchase the truck, and paid full value. In reality, the vehicle had been determined to be a lemon, and its title had been branded as a lemon in the state of Wisconsin. The vehicle had then been “washed” through a dealer-only auction and magically emerged with a clean Ohio title with a much higher price tag. Only later did our clients become aware of the lemon title, and the thousands of dollars stolen from them.

Even worse, when our clients confronted the dealership, they went into clumsy cover-up mode, and faxed them a form supposedly disclosing the history of the vehicle, complete with their forged signature. Various inaccuracies with dates on this form proved the lie. Thus the dealership compounded the problem by refusing to meet its responsibility and attempting to obfuscate the truth. In Ohio, a dealership’s stalling and evading of its responsibility, such as in this case, creates further grounds for relief.

The fraud in this case was limited solely to ill-gotten gains and cover-ups, so no one’s safety was put at risk. In many similar cases, however, the fraud can and does extend to endangering the safety of the consumer, his or her friends and family, and the rest of the motoring public. Cars that have been totaled are sometimes resold when they should legally be going to the scrap heap. The cars are slapped back together in illegal chop shops and injected back into the marketplace. Our firm has extensive experience handling these “rebuilt wreck” cases. In addition, this subject will be further addressed in a future issue of our newsletter. For more information, please check out our website at www.willislegal.com.

With millions out of work and the unemployment rate at record levels everyone seems to be affected or suffering from the weakened/depressed economy. Or are they? CEO’s of top health and auto insurance companies seem immune. Let’s take a look at the salaries of CEO’s in the health and auto insurance industries. The last reported data is from 2007.

Companypay.com
Executive Compensation
CEO Salaries, Bonuses, Stock Options

2007
Total Salary

9,425,341 Allstate Corp.
7,343,408 Unum Group
19,781,031 Travelers Companies, Inc.
2,529,992 State Auto Financial Corp.
6,013,752 Safeco Corp.
3,828,496 Selective Insurance Group Inc.
4,994,121 Progressive Corp.
30,160,000 Cigna
8,880,000 Aetna
13,164,529 Unitedhealth Group Inc.
16,650,000 Heath Net
10,312,557 Humana Inc.

While looking at the statistics of the average auto insurance CEO salary may be staggering, realizing that we’re paying for it and not seeing the benefits that we pay for, is inexcusable. The unfair and often unlawful tactics insurance companies use in the treatment of their policyholders can’t be rectified by the number of cases that they fight to keep insureds from getting what they deserve: the right to their benefits.

Auto insurance coverage is required for drivers. It’s important to know and understand what is in your policy and understand your rights when/if an accident occurs. Insurance companies have their own best interest at heart. When you don’t know or understand your policy, you’re at a disadvantage. Consider how the CEO’s of insurance companies are able to get high salaries and bonuses: because the money you’re not getting in good faith from your settlement (what you’re entitled to) is going to them. Put the money back in your pocket. Know what’s in your policy. Contact an attorney immediately following an accident and do not give a recorded statement to an insurance adjuster.

In our Winter/Spring quarterly newsletter mailing in April, we held a contest for client testimonials. We offered two $50 gas cards to two lucky contestants and on June 1st we gave away those gas cards to two of our clients who submitted their testimonials telling us about their experience with our law firm. We’d like to share the testimonials of the two winners along with a few others.

“I have been a client of Willis & Willis for a number of years. Every claim handled for me was done with knowledge and compassion. I feel that my family, friends, and I were treated like relatives of the firm. I sing nothing but praises for Mark and Todd Willis and will refer them to anyone seeking a fair shake from the law.”
Cylla – Akron, Ohio

“I’ve retained four attorneys prior to being referred to Willis & Willis and by far they are the best. They always answer your calls, will go step by step with you about your case, and are very professional. I will recommend this firm to anyone who needs a good attorney.”
Celeste – Stow, Ohio

Here’s what others said about their experience at Willis & Willis Co., L.P.A.:

“We were very happy with the way we were treated by Mark. He was there to answer all questions, take us to the courthouse and got us the best settlement possible. He’s the only lawyer we will call when we are in need.”
Sam & Mattie – Akron, Ohio

“I’m very pleased with the service I received on my case. Mark Willis is a nice person. He puts his whole heart in the work for his clients.”
Betty – Chesapeake, Ohio

“Mark Willis was referred to me by my friend Cynthia (a former client of Mark’s). I feel that he handled my case very professional and in a timely manner, I have recommended him to my mother-in-law, and I will continue to refer him to anyone I know. “Thanks Mark, keep up the good work.”
Gina – Akron, Ohio

The situation is all too common: Your vehicle has been seriously damaged in a collision. The insurance adjuster informs you that it’s a total loss. You check with your lender to see how much you owe on your vehicle and find out that you owe more on the vehicle loan than the insurance company is offering to pay you for the vehicle. As a result, the entire insurance company check goes to the lender as a payment toward your vehicle loan but does not pay it off and leaves you with a balance and no vehicle. Congratulations, you have fallen into the GAP: You have lost your vehicle, you still owe the lender money, and you have to worry about paying for the replacement vehicle.

Unfortunately, insurance companies only owe you the fair market value of the vehicle that has been totaled. They do not owe you the balance on your vehicle loan. The best way to avoid the GAP is to make sure when you purchase a vehicle that you are not borrowing more than the vehicle is worth. If you have a reasonable loan on a vehicle and the vehicle’s value is greater than the amount of the loan at its inception, you should be safe throughout the life of the loan that the vehicle will not be worth less than the amount owed on the loan. If, however, you are rolling over negative equity from another loan, you may owe more on the loan than the vehicle is worth. In those situations, fortunately, GAP insurance is an easy fix to this problem. Many dealerships will sell you GAP insurance at the time you purchase the vehicle. However, if you don’t have GAP insurance on the loan, you should contact your insurance agent and see about adding GAP insurance to your auto policy. Some insurance companies offer this coverage, some insurance companies don’t. If your insurance company will not offer you GAP insurance, and you owe a significant amount of money on your car, it’s in your interest to shop around to find a company that will provide you this coverage.

In order to expand his understanding of what many of our injured clients go through and give back to the community Attorney Mark Willis recently completed all of the classes and training and passed all the exams to become a certified Emergency Medical Technician – Basic and a Level 1 Firefighter. This entailed hundreds of hours of classes and clinics at: Summa Health System, Children’s Hospital of Akron, University of Akron, Cuyahoga Community College, and the Medina County Career Center. He is certified by The National Registry of Emergency Medical Technicians, Ohio Department of Health, Ohio Department of Public Service, and The Federal Emergency Management Agency. This spring, the Village of Richfield swore Mark Willis in as a volunteer/part-time Firefighter/EMT. The Richfield Fire Department provides EMS and Fire service to the Village of Richfield, Richfield Township in the northwest corner of Summit County and mutual aid to surrounding communities.

Todd L. Willis was recently recognized by his peers for his service as President of the Summit County Association for Justice during the 2008-2009 terms. The Summit County Association for Justice is a citizens’ rights advocacy organization, comprised of local attorneys dedicated to promoting the public good and strengthening the civil justice system. The association’s mission is to safeguard the ability of deserving individuals to obtain justice and ensure that wrongdoers may be held accountable for their actions.

Todd received the recognition at a judicial reception last month, which brought together several current judges in the Northeast Ohio region and many of the leading Plaintiffs’ lawyers in Summit County.

Imagine you’re the coach of a football team. The problem is you only have 11 players on your entire team. Now, technically, you can field your team, but every player will have to play every down on offense, defense, and special teams. Would you say you have a full roster? (By comparison, NFL teams have an active roster of over 40 players.)

In insurance cases we often hear drivers say that they have “full coverage.” What is full coverage? In reality, this notion of full coverage is one of the biggest sources of confusion for consumers of auto insurance. When we hear “full coverage” it often turns out to be the bare minimum required by state law to keep a driver legal. In truth, there probably is no such thing as full coverage: Think about a situation in which, God forbid, you suffer a severe back injury as a result of an auto collision caused by a driver without any insurance. The injury requires expensive surgery. You would require an extended period of very expensive medical care, and your family would be without your income for months. Such an event could easily cost $100,000.00 or more in medical bills and lost income alone. Does your insurance policy cover that type of event? What if you were paralyzed? To get you and your family closer to “full” coverage, it is important to look at both the types of coverages you have and the amounts of those coverages.

You are already paying a lot of hard-earned dollars to your insurance company every time you pay your premium. It is well worth it to make sure those dollars are working for you.

Below is a list of the most important coverages you should have to protect you and your family – and many of them are very affordable:

1. Liability Coverage:
This is the coverage required by state law and the only risk it covers is if you cause injury to someone else. The state only requires Ohio drivers to be insured for $12,500.00 (an amount that has not changed in almost 40 years). $12,500.00 will only cover the most basic of medical care. To reverse the example above, if, you were to cause a motor vehicle accident in which someone else was paralyzed, your insurance company would only cover $12,500.00, and that severely injured person would be looking to your personal assets for the remainder. While there is no formula for determining the right amount of coverage for you, policy limits of $50,000.00 or $100,000.00 are often very affordable. You should discuss your specific situation with your insurance agent.

2. Uninsured/Underinsured Motorist Coverage:
In most accidents, this is the coverage that actually “insures” that you and your loved ones will be compensated. If someone else causes the accident and they’re insured, their insurance will cover the loss, but all too often the responsible driver is either uninsured (in which case your uninsured coverage is triggered), or has a policy that is too small to cover the loss (in which case your underinsured motorist coverage may be triggered). Ohio state law does not require that this coverage even be offered any more. Therefore, it’s very important that you verify with your insurance agent that you have as much uninsured/underinsured motorist coverage as you and your family can afford.

3. Medical Payments Coverage:
“Med-pay” coverage can step in and begin paying your medical bills even before you’re fully recovered. As such it can help begin easing the financial impact of an accident before you’re ready to settle. This coverage has always been very important to those without health insurance; now it is equally important for individuals with health insurance. This is because in the last few years, health insurance plans have changed their policies so that medical bills related to an accident are to be paid first through auto insurance, and health insurance will not pay until auto insurance is exhausted. Many folks are not aware that this change has occurred and assume that their health insurance will pay. What is actually going on behind the scenes is a three-way argument among the medical provider, the health insurer, and the auto insurer. This fight is usually not resolved quickly. As a result, a person who has been injured in a car accident can actually suffer injury to their credit as well while the insurance companies point fingers and the bills begin to age.

Please call your insurance agent to discuss these coverage’s. Oftentimes, the amount of uninsured/underinsured motorist coverage, as well as the amount of medical payments coverage, can be dramatically increased on your policy without significantly increasing your premiums. Make sure those premiums dollars are working for you.