Philadelphia Injury Attorney Blog

Third party legal cases that involve first party medical payment plans and subrogation interests can be tough to resolve. Quite often, a medical payer will assert a subrogation interest and lien on a third party liability claim, in an effort recover the full payment of medical bills. As Pennsylvania catastrophic injury and car accident lawyers, we believe that all plans, even self-funded ERISA plans, should be forced to reduce such medical liens in proportion to the amount spent on attorneys’ fees for third party recovery.

In the case of US Airways, Inc. v. McCutchen, 663 F.3d 671 (3rd Cir. 2011), the Third Circuit Court reversed, on appeal, the decision of a Western Pennsylvania trial court ruling that a lien had to be repaid in full, with no reduction. The case involved a self-funded ERISA plan, to which the Court applied the traditional equity principle of unjust enrichment. It held that any judgment requiring the victim or plaintiff to provide a full reimbursement to the employer—in this case, US Airways—would constitute inequitable relief, because the amount exceeded the net amount of the victim’s third party liability recovery. The Court ruled that requiring the victim to fully reimburse his or her employer’s health plan would result in a windfall for the employer—who had contributed nothing to the cost of obtaining a third party recovery. Noting that “equity abhors a windfall,” the Court concluded that equity applies to subrogation rights under an ERISA plan. In the case of McCutchen, Counsel successfully argued that, if legal fees or costs were not taken into account, the employer , US Airways, would effectively be reaching into its beneficiary’s pocket—thereby placing the beneficiary in a worse position than if he or she had not pursued a third party recovery in the first place.

A third party lien holder that attempts the full recovery of a subrogation interest, and wrongfully seizes or attaches the funds of another for its own purposes, is committing what is known as a theft- by-conversion. Conversion is when a defendant assumes and exercises ownership or control over property or funds belonging to someone else —without authorization—thereby depriving the other person of property or funds. Whenever a third party lien holder or medical plan claims the right to full recovery, and either refuses to reduce its recovery, or insists on a minimal reduction, the victim needs aggressive legal protection to ensure that he or she will not be cheated by an insurance carrier, adjuster, or independent adjuster who violates the law.

This principle applies to many personal injury cases—particularly, settlements involving a spouse’s right of compensation and/or recovery for loss of consortium—which are “off limits” for the recovery of subrogation interests. In one case, that of ACS Recovery Services Inc. v. Griffin, 676 F.3d 512 (5th Cir. 2012), the Court stated that—unless the plan agreement states specifically that it can seek reimbursement from an award for loss of consortium made to a beneficiary’s spouse—it cannot recover such funds. In other words, the plan, or third party lien holder, would have no rights to recovery on any portion of the spouse’s settlement.

Jeffrey Reiff is a catastrophic injury and car accident lawyer in Pennsylvania who has been recognized as one of the Top 100 Lawyers in Philadelphia and one of the Top Northeast Lawyers. He has regularly been named a Pennsylvania Super Lawyer, and has consistently been rated Superb by Avvo.com.

In 2010, the Supreme Court ruling in Citizens United v. Federal Election Commission indicated that corporations could spend unlimited amounts of money to influence elections for or against candidates.

As an experienced trial lawyer since 1979, I have spent my career fighting on behalf of victims against large corporation and insurance company interests. In many jurisdictions throughout the United States, corporations have attempted to stack the judiciary and political offices with individuals more aligned with their interests attempting to throw roadblocks in the way of injured victims. Super PACs contributed to various campaigns throughout the country that were closely aligned with their interests. Most of the big money flowed to conservative Super PACs who raised twice as much money as Democratic leaning Super PACs.

It is reported that $661 million dollars of this election cycle was brought in by Super PACs with $417 million going to conservative advocacy groups.

As a consumer safety attorney who has represented thousands of victims who have been injured by defective products or the wrongs of others, I have been aware for a long time that corporate interests and insurance companies have systematically and deliberately squeezed consumers by attempting to contribute to politicians and judges who would protect their interests.

Continue reading "The People Have Spoken and the Election Results Reveal that the Interests of Big Corporations and their Money Have Limits" »

Earlier this summer, I decided to take a trip with my wife to Santa Fe, New Mexico. I purchased a ticket on Orbitz and also purchased separately on the same website travel insurance from “Access America" on behalf of my wife. At the time of the trip, my wife was medically unable to travel under doctor’s orders and after the trip, promptly submitted an insurance claim for the unused flight ticket in the amount of $300 to Access America supplying both the requested ticket value and written doctor verification stating inability to travel. Always giving one excuse after the other, Access America has repeatedly failed, refused, and neglected to pay the claim and denies payment on the basis of senseless objections.

Insurance policies are intended to protect one from life’s many mishaps and when you pay a premium, it is expected that you will get help when you need it from the insurance company. Pennsylvania law recognizes that the objective of an insurance company is to protect you rather than to avoid paying justified claims and improve their own profits. In a bit of curiosity, I went to the website www.travelinsurancereview.net/access-america-travel-insurance/ and noticed that I was not alone in my difficulty getting payment for my claims. Individuals had referred to this company as “bogus," “slimy," and in the approximately 175 reviews that I read, it appeared to me that there was an overwhelming number of negative reviews. Personally speaking as an attorney who has battled insurance companies for over 30 years, I have decided to file a lawsuit against this company on behalf of my wife in an attempt to prevent others from being taken advantage of in a similar fashion. Consumers need to be protected from companies like this who apparently seem to thrive on aggressive and abusive claim denial as evidenced by their actions of deny, delay, and defend.

According to a recent study from the National Insurance Crimes Bureau (NICB), Philadelphia and other cities are trending to reveal more slip and fall cases and premises liability cases targeting businesses, and henceforth, the insurance companies are scrutinizing these claims more carefully for potential fraud. Analysis of questionable slip and fall and premises liability cases showed a 57% increase in the number of fraud referrals for investigation over the past two and a half years.

At the Pennsylvania premises liability law firm of Reiff & Bily, we are well aware that many individuals will try to beat the system with a fraudulent claim. Insurance fraud is a serious criminal offense with stiff punishment if the perpetrator is proven guilty. This is the reason that we screen each case so carefully and perform a diligent background check on every client that comes into our office. We recognize that most people have legitimate accidents in stores and businesses and we take the prevention of insurance fraud claims very seriously.

I have met many lawyers who fail to carefully investigate their case and will settle a case for nuisance value making a small win/win for the lawyer and client. Many times insurance companies or businesses will pay a small claim to avoid the cost of litigation. Often after a case is settled, a fraud investigation continues and if it can be proven that the recipient knowingly or intentionally defrauded any insurer or self-insured, they may be prosecuted. However, any responsible and experienced personal injury lawyer or premises liability lawyer will recognize that legitimate slip and fall cases are often very difficult to prove and will not commit the firm’s resources without proper analysis or background information.

At the Philadelphia premise liability and slip and fall accident law firm of Reiff & Bily, we offer a no fee, no recovery guarantee which means we don’t get paid unless there is a successful recovery, and therefore, we must be extremely selective in the cases we accept.

Approximately one year ago, The American Association For Justice released a report citing the 10 worst insurance companies in American noting how insurance companies raised premiums, denied claims and refused insurance to those who need it most. With healthcare insurance reform on the horizon, former head of Public Relations for Cigna, one of the nation’s largest insurance companies decided to speak out against the industry. Bill Potter told Bill Moyers, “I did not intend to speak out until it became clear to me that the industry is resorting to the same tactics they have used over the years particularly back in the 90's when they began leading the efforts to kill the Clinton healthcare plan." Potter explained that the insurance industry has been corrupted by Wall Street expectations and greed and that insurance companies have every incentive to deny coverage - every dollar they don’t pay out to a claim, is a dollar they can add to their profits and Wall Street investors demand that insurance companies pay out less every year.

As an experienced personal injury and insurance claims attorney who has been fighting insurance companies aggressively since 1979, I am all too familiar with the “boxing gloves" strategy used by insurance companies against their policyholders. Common insurance company practices of unfairly defending, denying and delaying claims has reached a crescendo. It appears to this experienced insurance claims lawyer that the insurance companies have hijacked the public and are now attempting to hijack the government, trade associations and insurance industry finance coalitions, many of which are nothing but fund groups for insurance companies. I have met with lobbyists and physicians who are “scared to death" about the future of healthcare reform and are very active in behind the scenes PR and lobbying campaigns to kill or weaken healthcare reform efforts.

Continue reading "Insurance Industry Continues The Same Old Games Putting Profits Before Patients and Insureds’ Interests - Experienced Injury Lawyer Speaks Out" »

The Philadelphia personal injury and insurance claim lawyers at Reiff & Bily call your attention to a recent ruling by the Supreme Court of Pennsylvania in Ace American Insurance Company v. Underwriters at Lloyds and Companies which upheld the importance of enforcing the plain and clear meaning of insurance contract language.

In the case at hand, Ace purchased a claims made and reported policy with Lloyds and the terms specifically stated that Ace must file a report or it must report a claim as soon as practicable and in no event no later than 90 days after the expiration date of the policy. The insurance company denied payment claiming that Ace failed to timely comply with the errors and omissions policy’s specific notice of claim requirements. Ace argued that the insurance company could not be denied a claim based upon late notice unless it could show harm or prejudice.

Claims made insurance policies provide an insurer a clear and certain cutoff date for coverage. In return, the insured typically pays a lower premium. Based on actual data, a claims made policy can be as much as 32% cheaper than an occurrence policy premium according to public records.

Continue reading "The Pennsylvania Supreme Court Renders Important Decision Upholding Denial Of Coverage For Late Notice" »

Since 1979, the Philadelphia catastrophic injury lawyers at Reiff & Bily have effectuated many structured settlements on behalf of catastrophically injured clients. Recently, we have received calls from clients that are concerned about the security of their structured investment. In light of the recent downturn of world capital markets, these calls are no surprise. Briefly put, events on Wall Street seem to put more credibility than ever in every structured annuity entered into on behalf of a client. According to authorities while world stock markets have lost trillions of dollars in the last few months, not a single dollar was lost in any structured settlement written. For the most part, they are guaranteed, safe, secure, low risk and offer the best rate of return around. Every structured annuity issued in this country must be backed dollar for dollar by a secure and liquid asset in the insurance companies general account. The majority of the assets backing up each annuity are the safest possible assets, namely U.S. Treasury Bonds.

Continue reading "Is The Structured Settlement That I Entered Into When My Catastrophic Injury Case Was Settled Safe In Today’s Economy?" »

Experienced Philadelphia Catastrophic Personal Injury Lawyer, Jeffrey Reiff has been combating insurance companies since 1979. The experienced Philadelphia car accident lawyers at Reiff & Bily offer the following tips on how to best protect yourself from an insurance company that may not be willing to pay a claim when you need it most!

1. Read your policy carefully - you should know what is covered and how to appeal a denial by your insurance company.

2. Be very careful filling out forms - even if you make an honest mistake your insurance company may seize on that as a reason to retroactively deny your coverage.

3. Do not cash a premium refund check - if your insurance company rescinds your insurance, they may send you a refund for the premiums you paid. Cashing it may be interpreted as accepting their decision.

4. Put everything in writing - Calling your insurance company will most likely be an unpleasant experience and you will not be able to prove anything that a company representative tells you over the phone. Always keep records of all bills and correspondence.

5. Contact your state insurance department - they may be able to help you but they will not represent you in a private matter. So if all else fails, you may need to consult with an experienced insurance claims lawyer.

6. Most importantly never ever ever give up - insurance companies count on you giving up. It is important that you fight for your rights.

They will deny, delay and refuse payments. The bottom line is insurance companies make money when they don't pay claims. Trust me, I know. I have been in the same boat as you and every day I fight insurance companies on behalf of policyholders that are getting screwed because of corporate greed and incompetence of insurance company representatives.

If you believe that your insurance company is wrongfully denying benefits that you are owed, please contact the experienced Philadelphia insurance claim lawyers at the Pennsylvania personal injury law firm of Reiff & Bily at 1-800-421-9595 or online at www.reiffand bily.com.

As an experienced Philadelphia personal injury attorney, I am confronted with clients who come into my office after a catastrophic automobile accident and they tell me that they have full automobile insurance coverage. Unfortunately, many times there is a car accident resulting in a fatality and the family is left without funds to pay for a proper funeral and when they look at their insurance policy, they learn that they are not covered for death benefits. Approximately once a week I am visited by clients involved in a Philadelphia car accident who believe that they have full coverage, including but not limited to full tort insurance coverage. Most of the time, these individuals were sold minimal policies by insurance agents that contain anything but full coverage.

Recently, an unfortunate story came across the wires involving the Mullen family in Athens, Pennsylvania who found out the hard way that their insurance did not cover them for death benefits. In that case, Missy Mullen’s daughter, Stephanie Mullen, was killed in a car accident on State Route 4014 in Smithville Township, Pennsylvania approximately one month ago. Missy Mullen learned that Stephanie’s Pennsylvania auto insurance policy did not have death benefits. The $5,000 cost for Stephanie’s funeral was paid by family and friends. Stephanie was cremated and now her ashes lay in a box on her bed at home and her family is in need of an additional $2,500 for the burial. Missy Mullen stated that she wanted more people to be aware of their insurance coverage so they would not have to go through something like this. (news article)

In most states, car insurance policies contain death benefits. However, in the Commonwealth of Pennsylvania only liability medical is required. We urge all of you to carefully examine your policies and if you have any questions regarding coverage, please do not hesitate to contact us for a free consultation.

If you or a loved one has been catastrophically injured in an accident, please contact us at 1-800-421-9595 or online at www.reiffandbily.com.

Long term care insurance refers to the insurance for care taking and services beyond medical care and is used by people who have a disability or chronic illness or plainly just in their “golden years". People are living longer these days and, unfortunately, normal health insurance policies and Medicare do not pay for long term care expenses. Long term care insurance typically covers the cost of health in your home with daily activities like bathing, dressing, eating, cleaning, adult daycare, visiting nurses, care in a nursing home or assisted living programs and services that are provided in a special residential setting other than in your home which services may include meals, health monitoring and help with daily activities.

Approximately ten years ago, a persuasive insurance agent convinced me that it was necessary to purchase long term care insurance for myself, as well as my aging parents. As any individual who has reviewed a newspaper within the past month can determine, many of the insurance companies in America are in deep financial crisis. It appears that there is much more trouble on the horizon for the beleaguered insurance industry. Recently, benefits for some 164,000 long term care policyholders at Conseco Senior Health Insurance Company may be in danger as they are moved to an independent trust. For more information on this, please see my blog article dated October 13, 2008.

Since 1979, I have exclusively devoted my legal practice to handling catastrophic injury and insurance claims cases. In the process, I have developed a fairly intimate knowledge of the insurance industry as I have worked with many experts including but not limited to actuaries, economists, lobbyists, product developers and insurance industry executives. As a financial investor, I have carefully studied trends and balance sheets of insurance companies. I have even been asked to participate in the start up of a few insurance companies. The field of long term care insurance is a fairly young industry and has been largely in the premium collection mode (to date) from the baby boomers who are now aging or have parents who are entering the “golden years" period of life. The financial weakness of the markets is starting to reveal its effect on even the major insurance industry players as they face declining sales and an aging population. Claims are being denied or delayed and premiums being increased in a more than harsh fashion in what this writer perceives as an attempt to negate or cancel policies for non-payment.

Continue reading "LONG TERM CARE INSURANCE - A CRISIS ON THE HORIZON" »

As a Pennsylvania insurance claims attorney, with a 30 year history of representing catastrophically injured plaintiffs and disputes against insurance carriers solely on a contingent fee basis (we don’t get paid until we win), obviously the financial concerns of the insurance companies and their ability to pay claims is on the front burner in our law firm. In the past few weeks, AIG has been front and center in the headlines. This was followed by an incident with Conseco which was written about in my blog of October 13, 2008.

On October 1, 2008, Senate Majority Leader Harry Reid emerged from a luncheon on Capitol Hill and after speaking briefly to reporters about the financial crisis, mentioned that another insurance company was in danger of following AIG into failure. He mentioned “one of the individuals in the caucus today talked about a major insurance company, with a name that everyone knows, that’s on the verge of going bankrupt." The Senator stopped short of identifying the insurance company. However, the stock market acting in a nervous fashion revealed that shares of Prudential, Hartford Financial Services and MetLife decreased in value on the following days and have been struggling to recover. The rumor mill continues to circulate rumors and facts, non-facts and supposed facts about various individual companies, solvency of insurance companies, and general doom and gloom predictions. Shares of stock in insurance companies fluctuated wildly on the New York Stock Exchange. Prudential Financial warned last week that it would miss third quarter forecasts due to a series of hefty charges on negative results of investments. MetLife recently raised an additional $2 billion dollars in capital by selling 75 million shares at a discount, while Hartford Insurance Company received a $2.5 billion capital injection from German financial services company, Allianz. To make matters worse, many insureds can no longer afford rising rates.

Continue reading "SPECULATING ABOUT THE FINANCIAL HEALTH OF INSURANCE COMPANIES OTHER THAN AIG IN PENNSYLVANIA AND HOW IT AFFECTS CLAIMANTS" »

Approximately three weeks ago, I was contacted by clients who allegedly sustained catastrophic injuries. When I initially went to meet the clients, he and his wife provided me with convincingly and tearful recollections of a catastrophic accident in which they were allegedly passengers in a commercial transportation vehicle operated by another commercial vendor that was allegedly struck broadside, rolled over, and ejected the passengers, the result being multiple internal injuries, broken bones, scarring and extensive hospitalization. The initial meeting was quite emotional as the alleged clients were tearful, with other family members attempting to calm them down. The next day I went to my office and met with our staff and investigators and over the process of the next 24 hours learned that these clients were, in fact, imposters attempting to secure financial benefits for themselves by attempting to defraud our office, financial institutions, and potentially an insurance carrier. As we continued to investigate the matter, we also learned that these individuals had contacted other law firms in the same manner.

At the Philadelphia personal injury law firm of Reiff & Bily, we are committed to representing honest clients and cautiously practice law with the motto that today’s best client can be tomorrow’s worst enemy. The dangers posed to lawyers and law firms representing dishonest clients are clear. Often, we read news reports or allegations whereupon law firms are cited for aiding and abetting the dishonest clients’ fraud or misconduct therefore harming other innocent third parties. Not surprisingly, the Insurance Information Institute has estimated that insurance fraud accounts for 10% of property/casualty insurance industry’s incurred loss and loss adjustment expenses of about $30 billion dollars a year. Common frauds include padding or inflating actual claims, misrepresenting facts on insurance applications, submitting claims for injuries or damages that never occurred, and staging accidents.

The National Insurance Crime Bureau has identified ten cities with the highest numbers of staged auto accidents. One of the many types of staged accidents involves a vehicle that is positioned in front of an unsuspecting motorist with a sudden application of brakes causing a rear-end crash.

Philadelphia, Pennsylvania is the number 5 city in the United States with the highest rate of automobile insurance fraud. Just as many alleged clients attempt to commit fraud, unfortunately, so too is the case with many lawyers or healthcare providers. In any profession, there is occasionally a member who is dishonest. Although not all professions or industries protect victims of their dishonest members, the legal profession has generally offered financial protection to members of the public whose money has been stolen by their lawyer or whose lawyer has committed a fraud.

Continue reading "THE DISHONEST CLIENT - A LAWYER’S BIGGEST NIGHTMARE" »

PHILADELPHIA INSURANCE CLAIMS LAWYER, JEFFREY REIFF, SPEAKS OUT

Over the past few weeks, many Americans learned about the AIG insurance crisis and the lawyers and staff at the Pennsylvania insurance claims law firm of Reiff & Bily received many phone calls from insurance agents, clients and other concerned Pennsylvania citizens. It appears that there is more trouble on the horizon for the beleaguered insurance industry and potentially a number of Pennsylvania citizens may be affected. According to a recent article in Investment News, the benefits of some 164,000 long term care policyholders at Conseco Senior Health Insurance Company may be in danger as they are moved to an independent trust. Conseco, an Indiana-based insurance company, without notice to policyholders decided to move 144,000 long term care policies in a trust that may have devastating consequences for senior care citizens. Earlier this year, the Pennsylvania Insurance Department found that Conseco had violated insurance claims handling practices and fined the company $32.3 million dollars. Acting Pennsylvania Insurance Commissioner, Joel Ario, defined the bulk of the fines as “restitution to consumers who were harmed". Conseco reported a second quarter loss of $487.1 million dollars or $2.64 at diluted share. Conseco also disclosed recently that it held $103 million in securities with American International Group and Lehman Brothers Holdings, both in New York and Washington Mutual in Seattle. (Investment News article)

Bensalem, Pennsylvania-based Conseco Senior is a subsidiary of Conseco Inc. of Carmel, Indiana and according to industry critics is a victim of its own underwriting, signing on more policyholders than it could afford, leading to the creation of the trust. According to the Investment News article written by Darla Mercado, Frank Darras, managing partner of Shernoff Bidart Darras & Echeverria LLP of Claremont, California, stated “This product is oversold, underpriced and poorly performing because they underwrote everybody. These policyholders will either lapse on their payments or the unhealthy people will be so ill that there won’t be enough premiums to keep the trust going." A spike in premium rates could force healthy policyholders to terminate their LTC insurance with Conseco Senior leaving the unhealthy with coverage that is so costly that the premiums approach the cost of the claim for each contract, according to Philip J. Bieluch an Avon, Connecticut insurance consultant at Insurance Strategies Consulting LLC.

Continue reading "YET ANOTHER TROUBLED INSURANCE CARRIER IS PLANNING TO MOVE ITS POLICIES INTO AN INDEPENDENT TRUST - HOW THIS WILL AFFECT PENNSYLVANIA POLICYHOLDERS" »

On September 15, 2008, the beleaguered insurance company, American International Insurance Group, one of the nation’s and world’s largest insurers is struggling for survival. I received an email and call from an agent at one of the nation’s largest insurance brokers telling me that many clients are “in a panic" and asking me for my “take" on this situation. According to sources, AIG is getting help from the Insurance Commissioners of New Jersey, New York and Pennsylvania, as well as the Federal Government, in raising cash while swapping its subsidiaries liquid assets for those that are difficult to convert into cash by the parent company. As an experienced insurance claims attorney for almost 30 years, let me share my thoughts and attempt to calm your fears. (www.reiffandbily.com).

If you have a policy with AIG Insurance Company, “they are solvent and have the ability to pay claims", said Sandy Praeger, President of the National Association of Insurance Commissioners in a press release on September 16, 2008. “Our job is to ensure they continue to have the ability to pay". The New York State and Pennsylvania Insurance Departments are working with AIG to review transactions involving turning illiquid assets into liquid ones. Praeger stated “State insurance regulators will only approve this type of action if there are assured that it is part of a total resolution of liquidity at the parent company and fairly compensates its insurance company subsidies". AIG’s New York and Pennsylvania companies have approximately $120 billion dollars in total assets, about half of which is Class 1 bonds. The regulators must issue that any assets being exchanged or at least of equal quality or the financial strength of the insurers will be negatively affected. The Pennsylvania Insurance Commission is closely moderating the fate of AIG and its impact on the citizens in the Commonwealth of Pennsylvania. According to an Associated Press story on September 17, 2008, the United States Government will infuse taxpayer funds into the company, granting the U.S. Government an 80% stake in the giant insurer and the right to remove senior management. According to sources, the AIG affiliated automobile insurance companies remain on solid footing. The auto insurance unit is well capitalized. Roger Schmelzer, President of the National Conference of Insurance Guarantee Funds in Indianapolis states “that the holding company is at issue right now". The holding company could go bankrupt and for policyholders it would just be business as usual. We emphasize that AIG insured’s should not panic. The Commonwealth of Pennsylvania has a Guarantee Association in place to protect policyholders in the event of an insurance company failure. Insurance industry analysts and government officials advise that there is little for policyholders to worry about. There are safeguards in place, similar to FDIC insurance that backs up bank deposits. AIG has 11 insurance units in Pennsylvania regulated carefully by the state.

Continue reading "FINANCIAL CRISIS AT AIG HAS LARGE AND CONFUSING IMPACT ON PENNSYLVANIA AND NEW JERSEY AUTOMOBILE OWNERS INSURED WITH AIG - PHILADELPHIA PERSONAL INJURY AND INSURANCE CLAIMS LAWYER JEFFREY REIFF ADVISES HIS CLIENTS NOT TO PANIC - SAFEGUARDS IN PLACE." »

On September 15, 2008, many insurance companies had their assets battered on Wall Street. AIG, one the nation’s and world’s largest insurance companies, closed at $4.76, reaching a low of $3.50 from its yearly high at $70.13. Many of the Wall Street pundits were calling for the failure of AIG and other insurance companies who sought a lifeline for their survival. I myself was an AIG policyholder and switched to another insurance company earlier this summer as my gut recognized a financial crisis on the horizon. Today, we carefully analyzed all of our files where AIG was our opponent and fielded calls from several clients concerned about their insurance policies or their case’s financial fate where AIG was on the other side. At the time of this writing, I am not quite sure how AIG will ultimately fare in the financial markets. However, consumers should note that each state has a guarantee association in place to protect policyholders in the event of an insurance company failure.

Typically, if you have a claim filed with an insurance company that fails, the State Guarantee Association takes over the claim. If they have a claim and the insurance company is insolvent, the Guarantee Fund accepts the claim the way an insurance company would and they would do everything an insurance company would do said Roger Schmelzer, Chief Executive of the National Conference of Insurance Guarantee Funds, Inc. in Indianapolis. The Guarantee Fund steps into the shoes of the insurance company for claims paying perspective. The Pennsylvania Insurance Guarantee Association only protects Pennsylvania residents and property owners. Residents of other states or Pennsylvania residents owning property out of state are protected by other states Guarantee Associations. While the Guarantee Association payments are limited by statutes, which vary by state, most claims for policy benefits will be paid in full. Claims or policy benefits not paid by the Guarantee Association become claims against the liquidation estate. Most licensed insurance companies are required to belong to their state guarantee association that cover the lines of business that the companies write.

Continue reading "PHILADELPHIA PERSONAL INJURY ATTORNEY’S THOUGHTS ON WHAT DO I DO IF MY INSURANCE COMPANY OR THE INSURANCE COMPANY OF THE DEFENDANT FAILS" »

Driving is a privilege, not a right. Too many drivers do not take the proper responsibility to handle their motor vehicle in a safe manner. It is a sad fact that far too often a driver is intoxicated and causes an accident that results in serious injury or death to the other party. The Philadelphia auto accident attorneys at the law firm of Reiff & Bily have been researching and successfully handling drunk driver cases since 1979.

The Pennsylvania Department of Transportation (PennDot) reports that in 2005, drunk driving was responsible for 12,590 crashes, 313 of them being fatal. One alarming concern was that 22% of driver deaths between the ages of 16 to 20 (under the legal age of 21) were drunk drivers. Of the age group 21-35, 50% of driver deaths were drunk drivers. In total, 580 people died in alcohol-related crashes. On average, each day there was 36 alcohol-related traffic crashes with 1.6 people killed and 29 injured. Most alcohol-related crashes occurred between midnight and 4 AM on the weekends.

A Pennsylvania uninsured motorist accident is common, in general, but especially so for drunk drivers. Often, drunk drivers do not have insurance or not enough insurance coverage for damages. Often drunk driving could be avoided with help from others. It is always a good idea to have a designated driver and never drive after drinking. Some bars and restaurants have a breath alcohol content (BAC) machine, which will tell you if you are over the legal limit. The key to stop drunk driving is prevention; prevent someone who has had too much to drink from getting behind that wheel.

Continue reading "Dram Shops and Drunk Drivers – Death From A Bottle" »

With An Uninsured or Underinsured Defendant?

Every state has a law that requires motorists to have some type of automobile insurance. This is known as the state minimum automobile insurance requirement. Even with strict minimum insurance laws, many drivers still do not have any insurance coverage or are underinsured. When an uninsured or underinsured motorist is involved in an accident, the lack of coverage can cause hardship for any person who suffers an injury as a result of the accident. It is up to you to have proper insurance coverage in the event that the motorist who caused your injuries is uninsured or insufficiently insured with enough coverage to properly compensate you for injuries sustained. The Pennsylvania auto accident lawyers at the Philadelphia law firm of Reiff & Bily have been researching and handling uninsured and underinsured motorist cases since 1979.

The Insurance Research Council (IRC) reports that 14% of all drivers were uninsured . Pennsylvania had a reported 9% of uninsured motorists, which is much higher now especially in the city of Philadelphia. The reason why so many drivers do not have proper insurance is economical. As economic conditions continue to deteriorate, it is likely that there will be a growing epidemic of uninsured and underinsured motorists on the roadways. Many drivers cannot afford even the minimum amount of coverage required by state law. It also costs money for the state to enforce the state minimum coverage law. Some states are starting to take action to prevent uninsured drivers on the road. In California, a new bill enacts a provision that would require drivers to register their insurance coverage or else have their license plates removed. Removing the plates will still allow a limit of how many days one could drive without a plate, but after that the vehicle will be impounded if driven without a plate. While this system may have some loopholes, it’s a step in the right direction for drivers to maintain minimum insurance coverage.

Continue reading "What If I Get Involved In An Auto Accident" »

Deny Claims and Refuse Insurance to Those Who Need It The Most;
DENY DELAY and DEFEND

A recent study by the American Association for Justice (formerly The Association of Trial Lawyers of America) revealed the 10 worst insurance companies in America. To identify the worst companies for consumers, researchers at the American Association for Justice undertook a comprehensive investigation of thousands of court documents, SEC and FBI records, state insurance department investigations and complaints, news accounts from across the country and the testimony and depositions of former insurance agents and adjusters.

The 10 worst companies according to this study were:

1. Allstate
2. Unum
3. AIG
4. State Farm
5. Conseco
6. Wellpoint
7. Farmers
8. UnitedHealth
9. Torchmark
10. Liberty Mutual

Many insurance companies have discovered that they can make more money by simply paying out less. As a senior executive at the National Association of Insurance Commissioners, the group representing those who were supposed to oversee the insurance industry it was said that “the bottom line was that insurance companies make money when they don’t pay claims".

One example was Ethel Adams, a 60 year old woman left in a coma and seriously injured after a multi-vehicle crash in Washington state. Her insurance company, Farmers, decided that the other driver had acted intentionally and denied her claim contending that an intentional act is not an accident. Another example is Debra Potter, who for years was an agent for Unum selling Unum’s disability policy until she herself became disabled and had to stop working. All along, Ms. Potter thought she was helping other people protect their future but when her own time of need came, she was told her multiple sclerosis was “self reported" and her claim was denied by Unum, the very company whose policies she sold.

In cases like these and countless others, the name of the game is DENY, DELAY, DEFEND. Do anything, in fact, to avoid paying claims. For companies like Allstate, there are corporate training manuals explaining how to avoid payments, portable refrigerators awarded to adjusters who deny the most claims and pizza parties to shred documents.

Continue reading "HOW INSURANCE COMPANIES RAISE PREMIUMS " »

All owners of motor vehicles in the Pennsylvania are required by law to purchase and maintain automobile insurance, however, not everyone can afford complete coverage. By picking an insurance coverage with limited tort rights, you can save some money, however, you lose the right to sue for pain and suffering if you are injured by another person's negligence, no matter how seriously you are injured. The Pennsylvania auto accident lawyers at the Philadelphia law firm of Reiff & Bily have been researching and handling thousands of automobile accidents cases since 1979 and all too often meet with clients who were sold a false promise by their insurance agent only to find out that the policy they purchased was not full coverage and they could not collect for their injuries sustained even though they were caused by somebody else’s fault or negligence.

Be careful when your insurance salesman tells you that you are purchasing full coverage. Do not confuse this with full tort. Insurance agents are told by many insurance companies to “push" limited tort coverage to their clients and often receive higher commissions as a result. Know all of your rights and ask proper questions to make sure that you are fully covered by your policy when the need to collect arises. If you are uncertain please call the Pennsylvania vehicle accident law firm of Reiff & Bily for a FREE, NO OBLIGATION insurance policy check-up. Chance favors the prepared mind!

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