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Saturday, August 23, 2014
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Published: Saturday, 8/28/2010

There are two sides to insurance issue

Dear Dale: I was sued by a man who brought a phony insurance claim against me after a traffic accident. During the case, we learned that he had exaggerated or duplicated claims to other insurance companies. I believe our high insurance premiums are the result of insurance companies paying nuisance claims. What can be done to stop these insurance thieves from making a living by prosecuting phony claims?

While what happened to you is repugnant, I don't adopt your view that we pay high premiums as a result of what you called nuisance claims, or that they represent a significant number of claims.

Statistically, Ohio ranks as 11th lowest in average auto insurance expenditures, according to the Ohio Insurance Institute based on 2007 data. But playing the statistics game doesn't really address your premise that false claims drive up premium rates. You may feel rates are high nationwide, and Ohio's ranking is irrelevant to your larger point.

I readily agree that it is awful that you were dragged through the hassle of a lawsuit that was based on groundless claims. That's a stressful and annoying situation, to say the least. But as a guy who represents car accident victims, it's my experience that the insurance companies don't simply hand out money to get rid of claims — at least they don't pay money of any consequence.

The insurance adjusters I deal with are smart folks who have the experience to sniff out false claims. To pay any significant settlement, they require documentation by way of medical bills and medical records. They look at the police reports and the damage to the vehicle to evaluate how much — if anything — they're willing to pay to resolve a claim prior to a lawsuit.

In my experience, they're more than willing to force someone to file a lawsuit if they think the claim has no merit. You asked what can be done to stop “insurance thieves” from prosecuting phony claims. The answer is just what the insurance companies generally do: force the supposedly injured person to prove his or her claims during litigation.

The flip side of the story is that certain insurance companies — and everyone in my line of work knows who they are — treat every person who makes an injury claim as if he or she is a scoundrel out to make a quick buck. In my opinion, these companies have far more to do with forcing cases to suit and clogging up the court's docket than the so-called nuisance claims.

Just as you felt victimized by the bogus charges brought against you, people with legitimate injuries feel victimized by insurance companies that treat them as if they've been caught shoplifting. The insurance companies have paid enormous sums of money to stack the legislature and judiciary with people they think will back their big-business agenda at the expense of the little guy. And trust me, almost of all of us are little guys compared to these massive corporate interests.

So, I guess we're talking about two sides of a coin. People with phony claims certainly add costs to the system simply because it takes time to ferret out bad claims. But some insurance companies, in my view, over-balance the scales by cynically treating every accident victim who doesn't have five broken bones as if he or she were a pickpocket at a church social.

I guess it's all a matter of perspective.

Dale Emch practices law at the Dale Emch Law Office, LLC, in Toledo. In his column, he will discuss general legal principles and answer readers' questions. Neither Mr. Emch nor The Blade present or intend his column to be taken as legal advice. Readers seeking legal advice should consult with an attorney. Readers may send their questions to 615 Adams St. Toledo, OH 43604 or dale@daleemch.com. His Web site is www.daleemch.com.



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