back to Jes Beard's home page
 

Do You Really Need An Attorney?
Why Not Settle Directly With the Insurance Company?
 by Attorney Jes Beard
return to home page

If you had the choice between all of $5.00 or two thirds of $15.00, which would you chose? 

That's about the difference that attorneys make in handling personal injury cases -- on average an attorney will get a claim to settle for roughly three times as much as the insurance company would agree to pay an injured person without an attorney.  This means most personal injury attorneys are not "costing" their clients anything -- they are making their clients money. 

The Allstate Letter
Allstate has taken to sending letters to those injured by drivers Allstate insures and asking in the letter the following question: "Do you need a lawyer?"  The letter suggests that you don't, because Allstate, of course, deals fairly with injured people and lawyers only muck up the works.  Think a moment.  Why in the world would Allstate care whether YOU have a lawyer if it doesn't cost them anything?  And if lawyers do in fact merely muck up the works and slow things down, Allstate gets to hold onto the money it would othersise pay out to settle the claim, keeping it invested longer, making more money for Allstate from the investment of that money.... meaning if attorneys merely delay things and "muck up the works," it's to the benefit of Allstate.  So why IS Allstate trying to talk you out of getting an attorney? 

According to a nationwide study performed by the Insurance Research Council in 1994, reviewing nearly 62,000 insurance claims paid by 61 major auto insurers in 1992, there was a major difference between the claim results with attorneys and without attorneys.  The study looked at the average settlement amounts, losses, and net recoveries; it also broke claims down based on the type of injury claimed (strains/sprains, concussions, fractures, emotional, etc.).  The name of the 126 page study released in September of 1994 is Auto Injuries: Claiming Behavior and Its Impact on Insurance Costs.  (It's available from the Insurance Research Council for $25.) 

The study's authors concluded that the presence of an attorney meant bigger settlements or judgments in every type of claim.  This is why Allstate and claims adjusters with other insurance companies will try to talk you into settling your claim without one. 

Here are some settlement examples from the study:
                                Avg. with Attorney    Avg. w/o Attorney
             strains/sprains         $ 9,400                  $2,100
                    fractures         $27,000                  $7,600
    serious cut & bruises         $24,300                  $3,600 
    average for all claims         $19,500                  $4,000 

What You Would Need To Know
People often want to settle claims themselves in order to avoid losing a third of the settlement to an attorney in attorney's fees and to avoid the other expenses in preparing a case for trial.  Unless they have an extremely small claim they generally would be best advised to use an attorney instead of trying in a ten minute phone call to learn all that they need to know about negotiation, the rules of evidence to make certain they don't say anything to a claims adjuster that could hurt them if the case goes to trial, the rules of civil procedure and the appropriate statute of limitations to make certain you get your case properly filed so it can go to court if you can't settle it quickly, the tendencies of the insurance company or the particular adjuster, how to preserve evidence to prepare for trial if the case is not settled, what evidence you are likely to need at trial, how to deal with your own insurance company to deal with subrogation claims as discussed below, how courts have been interpreting federal law under ERISA regarding subrogation claims, the law of negligence and comparative fault, how the local judges have been ruling on the issues likely to come up in such a case, and how local juries in the county where the case would be heard have been deciding the issues of liability and determining damages in recent personal injury cases. 

In negotiating with a claims adjuster, most people are simply in over their head. 

I once tried to prepare a client to represent himself on a DUI case where there were only about four real issues, and I prepared him for at least six hours on three different dates so he could handle it himself (for tactical reasons unique to his case  it would have been better for him to have tried the case himself without an attorney if he was able to do so).  Now, while DUI law is both complex and technical, he was not going to need to grasp all of DUI law, only a few narrow issues I prepared him to handle it at length, both coaching him in my office and giving him written material.  Two days before trial he called my office in a panic and said he felt like his head was going to explode -- there was simply too much there for him to learn and to keep straight.  I reassured him and represented him in court at trial. 

In the case of negotiating a claim yourself, you will not have an attorney well versed in the case who you can fall back on like my DUI client had.... because if the attorney is going to be that well versed in the case he's going to want to be paid... which is what you're trying to avoid if you are not using an attorney. 

Deciding What to Demand
Despite this, or anything else I might say, I know many people are still going to want to settle their claim themselves, or will at least want to have some idea before things get very far as to what their case is "worth," in effect wanting to know what they are likely to "get."  And those still wanting to represent themselves will continue asking for help in determining what a reasonable settlement might be.  While this is next to impossible to do without a far more careful review of a case than is likely to happen over the phone, I do in the following links try to explain the Settlement Factors in personal injury cases and also to explain how I reach the figures I do regarding the value of a case. 

There are many factors coming into play in determining the value of a case if taken all the way to trial.  One important factor seldom addressed is how sympathetic you appear and how honest you come across.  Attorneys seldom mention this to clients because mentioning it can mean the lawyer has to tell his client the client either sounds like a liar, or appears bitter at the world or comes across as greedy or is unlike-able... and that even though those should not be factors, the reality of life is that they are very important to juries and play a major role in determining the size of the jury award... or even whether the jury will award anything at all. 

Because of the number of considerations to look at, and the time it takes to weigh some of them few attorneys would consider taking the time to do it without being compensated, at least for their time. 

Damn -- there that compensation thing again. 

Attorney's Fees
But won't settling your case without an attorney avoid a lot of money in attorney's fees? 

This rationale is like a farmer trying to save money by not buying seed corn or fertilizer but just counting on a crop to come up from the ground.  Something will grow... but not much.  Fertilizer and seed are expensive... but the farmer gets a positive return on the investment. 

Dealing With Claims Adjusters
Well, you'd be dealing with a claims adjuster whose job it is to settle claims as quickly and as cheaply as possible.  I have known of claims adjusters contacting people in the hospital, pressuring for a settlement agreement, within 24 hours after the victim person suffered serious head injuries. 

And even when you are calm and thinking clearly, you are dealing with someone who is a professional at this, at getting you to settle for as little as possible, at conning you into thinking they are giving you a great deal, or that you have no case, or that you will do worse with an attorney than without one — after all, your injury is only worth a certain amount, right, and if you get an attorney, the insurance company is not going to pay any more, but you'll end up giving the attorney a third of it. 

Personal injury attorney Ben Glass of Virginia describes it as entering a "war zone" the day you were injured, explaining that "insurance companies have declared war on injured people and their attorneys.  Some of them write letters to claimants to discourage them from seeking legal representation. They have waged the war in the media and their propaganda has had a tremendous effect on juries and their verdicts."

Because of the success the insurance companies have had in dealing with public opinion, they often refuse to offer reasonable settlements until you show you are ready, willing and able to go to trial, and even then they are frequently more concerned about the costs that will mean in paying their own attorneys than they are afraid of what a jury might do at trial. 

Making clear you will press your case unless there is an adequate settlement offer starts with getting an attorney.  Until you do that claims adjusters look at you as easy pickin's. 

Often insurance companies never even intend to negotiate in good faith, but simply use pre-suit negotiation only to find out as much as possible about you, your case and your doctor so their attorney has issues to attack once you do get an attorney and the case goes to trial. 

Problem With Talking To Claims Adjusters At All
Insurance companies seldom admit their insured was fully at fault in accidents, even when it might appear obvious to everyone else.  In rear-end accidents, insurance companies will sometimes insist it was because the driver who was hit stopped too suddenly and without any warning, or because of an unexpected brake failure someone else is responsible for.  And in intersection accidents many claims adjusters will insist you were at least 20% at fault pretty much simply because you were there.  When the claims adjuster does this, he's trying to get you to reduce the settlement amount by the same percentage. 

Bad as it might be to have to deal with a claims adjuster taking unreasonable positions, by even talking with the claims adjuster about whether or how much you were at fault can be one of your most serious mistakes in trying to represent yourself, and it is one of the reasons I even encourage other attorneys not to represent themselves in dealing with claims adjusters. 

As soon as you admit to a claims adjuster that you were partly at fault, you've seriously hurt your case.  This is true even if you only agree that it is conceivable in such an accident that you could have been at fault, or say you were partly at fault just to get the adjuster to drop the issue so he will finally offer a settlement figure like he's been promising for the last three months he'll do if you would just be "honest" with him and admit you were partly to blame has promised but refused to do for the last three months. 

Anything you say to the claims adjuster can be used against you in court... and you will be surprised what claims adjusters will sometimes later swear you told them... even though the words never even crossed your lips.  The best way to make it hard for them to lie about what you might have said in any conversation with a claims adjuster is to refuse to talk with the adjuster.  (Letters you write to an adjuster can also be used against you in court the same way.) 

When an attorney speaks with the claims adjuster, nothing the attorney tells the claims adjuster can be used against you in court to indicate you ever admitted any responsibility for the accident. 

Subrogation
Often the most important issue in an accident case is one of what sources of funds are available to pay for injuries and whether any is entitled to what amounts to reimbursement from the settlement or judgment award in your case.  If your own insurance company, or another insurance company, pays your medical bills and you later settle a claim for damages against anyone responsible for your injuries (or if you settle with the responsible party's insurance companies) the insurance company who first paid your bills generally has what is called a right of subrogation. 

This right of subrogation involves complicated legal areas that must be understood in order to deal with your own insurance company to try to reduce or minimize or even eliminate the subrogation claim.  (While you might think the subrogation issue don't matter, let me quickly through out some numbers to illustrate it.  You are in an accident requiring ongoing medical care and surgery with bills totaling $15,000.  You have insurance that covers 85% of that, paying $12,750.  During the same time you have some other medical problems that have your insurance company pay an additional $6,000 for medical care entirely unrelated to your accident.  You and the insurance company for the person responsible for your injuries settle your claim for $20,000.  Your insurance company asks for $19,750 for that, the full amount paid by the insurance company for medical care between the date of the accident and the date  of settlement.  Or the insurance company asks for that much now and makes sure you are aware that if you have any further bills related to the accident, your insurance company will wan the last $250 of your settlement to reimburse the insurance company for those new payments.  On top of all of this, you are still responsible for your one third attorney's fee from the $20,000 settlement or judgment... meaning you could actually end up owing money as a result of the settlement you accepted.) 

An attorney familiar with subrogation issues can handle this for you in the best way possible, often getting your insurance company to seriously compromise its claim, and sometimes getting the insurance company to waive it's claim entirely. 

Uninsured Motorist
If you were injured in an auto accident, you may also have to deal with uninsured motorist issues.  When the responsible driver was uninsured or underinsured, you will need information on any umbrella liability coverage on the responsible party and also information on all sources of underinsured motorist benefits available to you beyond policy limits, and also regarding any assets the responsible party might have other than insurance to compensate you for your injuries.  The timing of settlements and notice provisions of insurance policies can also be traps for the unwary handling their own cases. 

In short, there's nothing to lose and everything to gain from talking with a personal injury attorney about your case.  Nearly all personal injury attorneys routinely talk with prospective clients without charging anything for the office visit.  If the injury is serious enough see a doctor more than a couple of times, you almost certainly want to talk with an attorney. 
 

Even Nolo Press, which is notoriously anti-lawyer and encourages people to represent themselves for nearly everything, concedes that often you would be well advised to have an attorney.  Reprinted here with permission, below is an excerpt from a Nolo Press article addressing the matter. 



When You Might Need a Lawyer
by Joseph Matthews Copyright © Nolo Press


Sometimes, the skills of an experienced personal injury lawyer -- or at least the threat to an insurance company that such a lawyer may present -- are worth the money you must pay that lawyer to represent you. You may need a lawyer because of complex legal rules involved in your claim, or because your injuries are quite serious and so the potential amount of your compensation might vary greatly, or simply because an insurance company refuses to settle the matter with you in good faith. 

There are no hard and fast rules about whether or not you need to hire a lawyer. Much of the decision has to do with how you feel things are going as you attempt to settle your claim on your own. At some point, you may feel overwhelmed -- too much work, some obscure legal rule the insurance company throws at you. Or you may be stonewalled by an insurance adjuster who blusters that the company does not have to honor your claim at all or who offers you only a piddling amount to settle it. In these situations, you may at least want to consult an attorney for advice, and perhaps have him or her take over handling the claim. 

A few types of injuries and accidents almost certainly require that you consult a lawyer. 

Long-Term or Permanently Disabling Injuries

Some accidents result in injuries that significantly affect your physical capabilities or appearance for a long time -- over six months -- or even permanently. Figuring out how much such a serious injury is worth sometimes can be a difficult business and may require some assistance from an experienced lawyer to get the most out of the claim. 

 Nolo Press: www.nolo.com



return to Jes Beard's home page at http://www.jesbeard.com/

Click here to e-mail questions, suggestions or corrections regarding this page.

                                              Disclosure on Non-Representation Link
                                              Disclosures on Certification of Specialization Link

              Copyright © 1998 Jes Beard