How Do Insurance Companies Such As USAA Treat Their Own Insureds in Under-Insured Motorist Claims?
Our Office Lally Law Group (San Andreas, California) along with the Law Office of Markus A. Agbulos (Stockton, California) recently had the pleasure of representing a Jenny, a Nurse Practitioner and her husband Tom, who also worked in the medical field. This is what is referred to as an Under-Insured Motorist Claim. What is an Under-Insured Claim? Example – This was a claim against Jenny’s and Tom’s own insurance company USAA. The case involved a head on car collision at a speed of about fifty miles per hour which totaled Jenny’s vehicle. Liability was not an issue. It was clear that it was the other person’s fault. The fault of the other person was never disputed.
The fifty mile per hour collision caused Jenny to have migraines (which it was clear that she never had before). The migraines in turn caused Jenny’s to have a stroke.
Jenny’s claim was for her physical injuries to her neck and back as well as the migraines and the stroke as well as the stoke’s consequences. Jenny’s medical bills were approximately $60,000.00 to $90,000.00. Jenny’s and Tom’s lost wages were approximately $90,000.00 to date and it was our opinion that Jenny as a result of the collision would also lose in addition to the $90,000.00 about one half of her income for the rest of her working carrier as a Nurse Practitioner.
Tom’s claim was for Loss of Consortium; Loss of Companionship, Emotional support, Affection, Services, e.g., household chores, Love Society and Comfort.
The lives of Jenny and Tom as they had been had forever been changed, not only by the collision but also by what they had to endure as a result of making a claim against their own insurance company, USAA.
The person that hit Jenny only had a $15,000.00 policy. The minimum required policy in California. Our office on behalf of Jenny and Tom had collected the $15,000.00 on June 1, 2011 from the insurance company of the person that hit Jenny on October 11, 2010. Jenny and Tom had a $300,000.00 liability policy with their own insurance company, USAA. Our office made a demand for the difference of $285,000.00 from USAA and have been in litigation since May17, 2013 when the demand for the policy limit of $285,000.00 was made against USAA.
After one year and three months of litigation USAA advised our office on August 25, 2014 that USAA would resolve the case for the policy limits of $285,000.00. The original claim against USAA was submitted on May17,2013. When USAA made the decision to pay the policy limits of $285,000.00 on August 25, 2014, USAA had the same medical records as were submitted to USAA on May17, 2013 along with a letter from Jenny’s treating neurologist stating that the collision and migraines following the collision were a substantial factor causing the stroke. The letter from the treating neurologist stating that the collision and migraines following the collision were a substantial factor causing the stroke met and established the proof needed for legal causation. Despite Jenny’s treating neurologist coming to this conclusion, USAA hired their own neurologist who wrote a report stating that the migraines and stroke were not caused by the collision. On August 25, 2014 USAA rejected their own neurologist’s opinions and accepted Jenny’s treating neurologist’s opinions, the exact same treating neurologist’s opinions which were submitted to USAA back on May17, 2013, one year and three months earlier.
On August 25, 2014 upon learning that USAA would now after one year and three months of litigation pay the $285,000.00 to their own insureds, USAA then requested a release of liability releasing USAA from acting in bad faith towards their own insureds Jenny and Tom.
This is a prime example of why all drivers in California should carry well over and above the minimum automobile policy liability limits of $15,000.00 required by the California Department of Motor Vehicles. In such a circumstance once the policy of the third party driver that hit Jenny had been exhausted Jenny and Tom could now make a claim against their own insurance company, USAA for the difference of $285,000.00 since Jenny had a $300,000.00 policy limit with USAA. USAA then had a duty of good faith and fair practices in examining what had occurred, the injuries suffered by Jenny and Tom and in fairly resolving the claim of Jenny and Tom. The question is did USAA meet this requirement of good faith and fair practices when it took USAA one year and three months (August 25, 2014) after the original claim had been submitted to USAA on May17, 2013 to pay the $285,000.00 when USAA had essentially the same information from Jenny’s treating neurologist which they were provided on May17, 2013?
It is our opinion that USAA did not meet this standard of a duty of good faith and fair practices which it owed towards their own insureds, Jenny and Tom. It is important to understand that USAA earned interest on the $285,000.00 that they refused to pay for one year three months.
The other question is what would have occurred to Jenny and Tom if they had never retained the services of a consumer attorney? We believe the answer to that question is self-evident.
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CONTACT ATTORNEY J. ROBERT LALLY
Telephone: 209-257-4480 / 888-360-1488