logo

Wednesday, April 2, 2008

Right and Wrong

[Welcome Insurance Forums and CNN readers!]

This is a difficult subject.

On one hand, corporations & carriers are bound by contract (and sometimes law) to carry out some actions that many consider cruel or heartless.

On the other hand, we have seen situations where these same "villains" are willing to "bend the rules" in order to do what is morally right.

This is one of those situations.

Eight years ago, Debbie Shank was stocking shelves for the retail giant and signed up for Wal-Mart's health and benefits plan.

After a tractor-trailer slammed into her minivan, the 52-year-old mother of three lost much of her short-term memory and was confined to a wheelchair. She now lives in a nursing home.


Wal-Mart has certainly been on the receiving end of criticism over the years for a number of practices that, some believe, are only to pad their profits. Their health care benefit package is one that has been visited and revisited many times.

Wal-Mart's health care plan lets the retail giant recoup the cost of its expenses if an employee collects damages in a lawsuit. And Wal-Mart set out to do just that after Shank and her husband, Jim, won $1 million after suing the trucking company involved in the wreck. After legal fees, the couple received $417,000.

A carriers right to subrogation is in almost every policy, including health, auto, homeowners and more. Essentially a subrogation clause reimburses a carrier for losses paid that they were not technically liable for.

In this case, they paid medical expenses that were directly the liability of the at fault party (the truck driver in this case). When courts found fault and awarded damages Wal-Mart was perfectly within their right to recoup a portion of the claim dollars paid on behalf of Mrs. Shanks.

Wal-Mart sued the Shanks to recoup $470,000 it paid for her medical care. However, a court ruled that the company could only recoup about $275,000 -- the amount that was left in a trust fund for her care.

One would argue this was a heartless move by Wal-Mart.

But what happens if Wal-Mart fails to exercise their rights to recovery? This could set a precedence for future cases where they did pursue their legal rights.

In other words, to use terms floated around by the press, it would not be FAIR for Wal-Mart to pursue one action while failing to do so in another.

In fairness to Wal-Mart, they reversed their decision to pursue the claim against the Shanks and indicated they would modify their plan to allow "more discretion" in the future.

Wal-Mart did the right thing. They were right in initially pursuing their legal right to collect under subrogation. They did the right thing in allowing the Shanks to keep their award.

The sad thing is, no one wins in this.

No one.

Right and Wrong

[Welcome Insurance Forums and CNN readers!]

This is a difficult subject.

On one hand, corporations & carriers are bound by contract (and sometimes law) to carry out some actions that many consider cruel or heartless.

On the other hand, we have seen situations where these same "villains" are willing to "bend the rules" in order to do what is morally right.

This is one of those situations.

Eight years ago, Debbie Shank was stocking shelves for the retail giant and signed up for Wal-Mart's health and benefits plan.

After a tractor-trailer slammed into her minivan, the 52-year-old mother of three lost much of her short-term memory and was confined to a wheelchair. She now lives in a nursing home.


Wal-Mart has certainly been on the receiving end of criticism over the years for a number of practices that, some believe, are only to pad their profits. Their health care benefit package is one that has been visited and revisited many times.

Wal-Mart's health care plan lets the retail giant recoup the cost of its expenses if an employee collects damages in a lawsuit. And Wal-Mart set out to do just that after Shank and her husband, Jim, won $1 million after suing the trucking company involved in the wreck. After legal fees, the couple received $417,000.

A carriers right to subrogation is in almost every policy, including health, auto, homeowners and more. Essentially a subrogation clause reimburses a carrier for losses paid that they were not technically liable for.

In this case, they paid medical expenses that were directly the liability of the at fault party (the truck driver in this case). When courts found fault and awarded damages Wal-Mart was perfectly within their right to recoup a portion of the claim dollars paid on behalf of Mrs. Shanks.

Wal-Mart sued the Shanks to recoup $470,000 it paid for her medical care. However, a court ruled that the company could only recoup about $275,000 -- the amount that was left in a trust fund for her care.

One would argue this was a heartless move by Wal-Mart.

But what happens if Wal-Mart fails to exercise their rights to recovery? This could set a precedence for future cases where they did pursue their legal rights.

In other words, to use terms floated around by the press, it would not be FAIR for Wal-Mart to pursue one action while failing to do so in another.

In fairness to Wal-Mart, they reversed their decision to pursue the claim against the Shanks and indicated they would modify their plan to allow "more discretion" in the future.

Wal-Mart did the right thing. They were right in initially pursuing their legal right to collect under subrogation. They did the right thing in allowing the Shanks to keep their award.

The sad thing is, no one wins in this.

No one.

The Paint on my Fender Isn't Going To Match the Rest of the Car

Face it. Paint fades over time. Your car sits out in he sun and gets weather-beaten by rain, snow, etc. After a few years, the paint looks OK, but you can tell that it isn't like it was when the car was brand new.

Then.... you have a little fender bender and your left front fender is crunched. Damage isn't all that bad, but you need a new headlight and some paint when it's all done.

Doesn't matter how good the body shop is at matching the color. Actually most of it is completely computer driven and there's specific formulas for a given year and make of the car. The body shop can match the paint spot-on PERFECT. That's NOT your problem though.


The new paint is new and the rest of the paint is not. While it will match perfectly to the color it won't look the same and you want to paint the rest of the car. You think the insurance company should pay for that.

THEY WON'T. (usually)

Matching paint is not their concern. It's been round and round in the courts and it's just not a case you're going win. There could be an exception if you're dealing with the insurance company of the AT-FAULT driver who hit your car. I'll talk abou that next.

Sadly the case is that the insurance company is NOT obgligated to match the paint on the rest of the car. You might get an adjoining door painted or a little "blending" of some kind, but if you want the paint matched by painting the whole car, you'll have to pay for the DIFFERENCE yourself.
Take heart though! This is an OPPORTUNITY!
You might be able to strike some kind of deal with the body shop to paint the whole car. Remember most of the cost of painting is to set up the job -- Masking; mixing the paint, booth time, drying time, etc. That's all the same if they paint a fender or the whole car.

Make a deal with the body shop OUTSIDE of the insurance deal to paint the rest of the car. You'll get a better price and you can ethically let the insurance pay for all that set up on THEIR nickle.

If you were hit by someone else and are dealing with THEIR insurance company, you might be able to get some consideration for the non-matching paint. NOT MUCH, mind you, but something. This won't work if the accident was your fault because your car is being repaired under the collision portion of your policy and there's no provision for a liability-type payment (which this is) in that portion of the policy and the adjuster (even if they want to) CAN'T pay for that for you.

Before you go after this, be sure you get into the head of the adjuster and know WHAT THEY NEED to write you that check by reading (at least the Purple Section of:
They're NOT offering me enough for my vehicle.

You'll need to document the reduced value of your car because of the non-matching paint. It may only be worth a few hundred dollars, but it might be worth your time. Talk to some used car lots or people who sell cars a lot and you'll get some ideas. You'll need to get something in writing so you might want to be willing to type something up on their stationery and return to get their signature. Ask them what to say and you'll be on your way.

Remember the claim settlement gig is a process. Take your time and help the adjuster document their file and you'll get a better settlement.

GOOD LUCK!

dv

It's a Good Life !






Dennis Volz Insurance Agency
10783 Jamacha Bl, Suite 1, Spring Valley, CA 91978
OFFICE: (619) 670-1000 - FAX: (619) 670-1121

eMail:Dennis@DennisVolzInsurance.com

Websites: Company Site: DennisVolzInsurance.com

Client Convenience Site: 6701000.com

My 'Other Blogs'
Working by Referral
Musings from California



Options When You Have Damage from a Prior Accident

A client called me yesterday with an interesting dilemma. Said that recently, when his car was parked on the street, it was hit by a Fire Truck on a call. Kind of unusual as Fire Truck Drivers are usually pretty good at what they do.

Nevertheless, he was concerned because on the same side of the car there was some damage from a prior accident and wanted to see if he could get that fixed at the same time. He also wanted to make sure the paint matched the rest of the car. So here's the advice I offered to Steve.

The insurance company is only going to pay for the damage that was a direct result of the accident caused by the Fire Truck. Nothing more, nothing less.

Your best bet is to make a deal with the body shop OUTSIDE of the parameters of the insurance company settlement. Here's why.

Anytime you repair a car there are some fixed expenses that are there regardless of the size of the job. The car has floor time, rack time, parts to order, paint booth time, drying time, set up the paint sprayer time, set up the sander time, on and on and on. The body shop will appropriately include most of that in the estimate for the insurance portion of the repair. Then the body shop might to ahead and fix your "other fender" for less because they have to go through all that set up stuff anyway.

Talk to your estimator at the shop see if you can't make a bettter deal. I bet you can.

GOOD LUCK!

dv

It's a Good Life !






Dennis Volz Insurance Agency
10783 Jamacha Bl, Suite 1, Spring Valley, CA 91978
OFFICE: (619) 670-1000 - FAX: (619) 670-1121

eMail:Dennis@DennisVolzInsurance.com

Websites: Company Site: DennisVolzInsurance.com

Client Convenience Site: 6701000.com

My 'Other Blogs'
Working by Referral
Musings from California

"Strip-ChIP" Update

Several months ago, we reported on a Texas effort to levy a $5 fee on "adult entertainment venue" clients. The proceeds from this seemingly modest tax was purported to be used to help fund health care for the uninsured (among other things).

FoIB Joe Kristan has good news for champions of free speech (and/or lapdances):

"A Texas court has ruled a $5 admittance tax to strip clubs to be a violation of constitional free speech rights."

Hoo-Ah!

"Strip-ChIP" Update

Several months ago, we reported on a Texas effort to levy a $5 fee on "adult entertainment venue" clients. The proceeds from this seemingly modest tax was purported to be used to help fund health care for the uninsured (among other things).

FoIB Joe Kristan has good news for champions of free speech (and/or lapdances):

"A Texas court has ruled a $5 admittance tax to strip clubs to be a violation of constitional free speech rights."

Hoo-Ah!

Share

Twitter Delicious Facebook Digg Stumbleupon Favorites More