The Allstate Motherlode
I admit I have not had time to read through all of this yet. After all, it is 150,000 pages. But, here are Allstate's Colossus documents and information from McKinsey. More comments to come after I have summarized it all.
I admit I have not had time to read through all of this yet. After all, it is 150,000 pages. But, here are Allstate's Colossus documents and information from McKinsey. More comments to come after I have summarized it all.
I am asked often about whether an attorney should have a select group of doctors to refer cases to or accept cases from. (By the way, if you are an attorney and you want to market your practice differently than everyone else, check out this website from Virginia Attorney Ben Glass. You will stop worrying about getting referrals from doctors.)
I would limit this or avoid it. In the greater Sacramento four county area we have 3 million people or so. We have thousands of chiropractors. Why can’t I do business with most of them? (There are some who I shouldn’t do business with, but those are different reasons.) Sure, I have one or two who are really good who I love to work with. Good notes, good reports, fair bills. Amazingly, the one I am thinking about right now? Never asked her to reduce a bill. Well, I did just ask her to knock 52 cents off a bill, but that was only because it made my math easier. She is great and I think the world of her, but there is a downside…………
Insurance companies now track data like no one’s business. They might put the NSA to shame with the amount of data they collect. Typical scenario: Claimant is struck by a car. A claim is set up with name, date of birth, address. Heck, some claimants, before they get an attorney, will give up a SS#. Now, insurance company can track any prior claims. We all know this happens. But………….
Claimant treats with you. You give your bill to the attorney. At the top of your bill, you list your EIN or some other identifying number. Now, they have a number to plug in for you. Of course, before I can get paid, I have to give up my EIN thanks to the IRS. Now they can track me. So…………..
Next time I send in a letter of representation, they put me into the system and they know which docs I work with. If they see a pattern of me continually representing Dr. X’s patients, they refer the file to SIU. There may be nothing wrong and everything may be on the up and up, but the case is now substantially harder to settle.
That is why I constantly encourage attorneys (and doctors) to have a group of people to refer to. Sure, if someone is involved in an MVA near my favorite doctor and they have no place else to go, I will give out her name. But, in the course of a year, we may only have 6 or 8 cases together. Not a ton. But, it is the best relationship I have. I know that she will be fair, reasonable and give me documentation to settle the case. I also know that she is 100% supportive if I tell her I need to file, serve or even try the case. Complete trust in my ability to practice law. At the same time, she knows she is going to get paid. I will pay her in full before I take a fee. She knows I know what I am doing and will get the client the best possible settlement. It’s a win-win and has nothing to do with volume.
Avoid referrals with one or two or a small group of doctors. The bigger your pool, the easier it is to avoid the SIU trap.
A major insurer is introducing a new policy on MIST cases. Apparently, this insurer has decided to make our lives more difficult and more work. How, this time, you ask?
This insurer refuses to settle any MIST case without getting the bills directly from the health insurer. Why? Because then they are placing the name of the health insurer on the check. In California, at least, the health insurer does not have a lien, but only a right of reimbursement. So, why do they do this?
It creates one more issue for the attorney to deal with. By creating new issues, they are causing the attorney to work more. More work for the same amount of money makes a case less attractive. And that, my friends, is why they are doing it. They want to force these cases away from us.
Remember, they do not need the bills from the health insurer. You just need to provide something showing the reasonable charges. There are outside vendors who will do this for under $100. There is no need to wait and create more work, especially since some health care providers are taking six months to provide the bills (another reason for the insurance company to insist on those bills - it makes our cases take longer).
Don't be fooled by this. If they refuse to settle, take an aggressive approach with the insurer and their insured.
Surprise! I know, this must have caught everyone off guard. You can cause damage in a 3mph collision. How much damage? Over $4,500 on a Lexus IS and over $5,200 on an Infiniti G35. A Volkswagen Passat had over $4,500 in damage, as did the Pontiac G6 (did anyone ever buy a G6?), and the Nissan Maxima.
The interesting part is that this study came from the Insurance Institute for Highway Safety, an auto insurance industry sponsored group. Their study, reported in the LA Times, shows that cars are sustaining more than just bumper damage in 3 mph collisions. Grills, hoods and fenders are also sustaining damage.
You can now use this study to cross-examine defense "experts." These experts opine about the force of impact and speed of the vehicles based solely on the amount of damage. Well, if an Infiniti sustaines $5,200 in a 6 mph collision, how fast was the collision if there is $2,500 in damage? Slower? Faster? You don't know because there are many more factors that come in to play.
Two other points to keep in mind: Most cars do not have steel reinforced bumpers like they did 10 years ago. And with more cars, the bumper is being designed into the body of the vehicle so there is no bumper.
In your next MIST case, make sure you ask the defense expert about this report. My guess: he has never heard of it!
A new trend is developing: repairing bumpers. Okay, so repairing bumpers is not a new trend. But the insurance industry is pushing training for adjusters on how to repair any bumper, be it a Bentley or a Volvo, undamaged or crumpled.
I recently had a client with bumper damage. The adjuster came out and wanted to repair the bumper - even though the paint was off of the bumper. The car is a year old. They can't match the paint, but the adjuster would only give a couple of hours for repairs.
Clearly, the bumper needed to be replaced and painted to match. But, the adjuster put down for repairs because it keeps the case is a minimum impact. My client will be getting his own estimates now and those will be to replace the bumper.
Make sure you are checking those estimates on MIST cases. A replacement can add $300 or more to an estimate thus making it no longer a minimum impact.
I had someone ask me if the studies about accidents, such as by Croft and Freeman, are useful to cite in demand letters or reports from treating doctors. My response: no. Here is more of my response:
The adjusters are familiar with those studies, but they don’t really have an effect on the case. Adjusters have been trained that these studies are nonsense. The Croft and Freeman studies are good, but they are not convincing to the adjuster. I think that by including them you may be tipping off a new adjuster to the fact that it is a MIST case. (Believe it or not, some new adjusters don't know they are supposed to report MIST cases to a supervisor and they handle the claim like any other claim.) And, experienced adjusters are just not going to care. Its sad, but scientific literature doesn’t mean much these days.
Don't waste your time, energy or money adding this to your demand. It is not going to change the amount of the offer.
Its being sent overseas. Yes, the insurance companies are sending your client's information overseas. Health insurers have been doing this for years. But now the auto insurance companies are doing it. Here is when:
1. They are sending medical records to doctors to review radiological reports and other records to provide input on reasonable and necessity of treatment.
2. They are sending medical records to be input in to the databases, ie Colossus and similar programs.
3. They are sending medical bills over to be re-coded.
The insurance companies are trying to cut costs. One way is to decrease the costs of medical reviews and data entry. Since the costs of these services are less overseas, it benefits the insurers.
At this point, sit tight. Don't worry about it. Wait and see what the insurers do and if there are any breaches of privacy. Then, you can formulate a game plan.
