PI suit and insurance assigned attorney

[NJInjury]

What is the name of your state? NJ

I realize an insurance appointed attorney is primarily going to represent the insurance companies interest. I'm having a hard time getting information about my case and what their strategy is.

Would getting my own attorney to work with the insurance assigned attorney better represent my interests? Is it common to do this? Thanks for any advice.

Some background...I'm the defendant in a PI claim from a family member. Before people jump on my case about fraud and everything else, rest assured the claim is valid...polytrauma accident with multiple vertebrae fractures in the neck, and L1-L5 region, displaced pelvic fracture, broken wrist, broken foot...have had 5 surgeries already including plates and pins, future surguries may be necessarry to fuse arhritic condition present in foot fracture as well as other areas.

Any advice regarding if I should get my own attorney is appreciated.

 

[alnorth]

I realize an insurance appointed attorney is primarily going to represent the insurance companies interest.

You realized incorrectly. Usually, your interests and the insurance company's interest coincide when you are defending in a PI suit, but if they ever conflicted for whatever reason, the attorney represents you, not the insurance company. The insurance company is only paying the bill, because you paid the premium for a defense in this situation. If you believe the insurance company hired someone who is seemingly not as skilled or motivated as you'd like, thats another issue.

No, people do not normally hire another lawyer in addition to the defense that their policy calls for, unless they have plenty of money to pay for an excellent defense above and beyond what the insurance company is obligated to provide. (They only need to give you a reasonably good defense, not the best lawyers in the state) If you have a question about the specific details of the case and the strategy, ask the attorney.

 

[tranquility]

How much insurance do you have? If the damages are below the amount of insurance, the insurance company's interests closely match your own. Only if the damages are more will there be a problem. If you have a minimum policy, they will toss out the full amount and walk away. You will know as they won't supply you with an attorney in defense and you would need to get your own attorney. If you have a good policy amount, I'd let the insurance company attorney work for you until you get some notification the amount of damages exceed the policy amount--then you should consider your options.

 

[alnorth]

How much insurance do you have? If the damages are below the amount of insurance, the insurance company's interests closely match your own. Only if the damages are more will there be a problem. If you have a minimum policy, they will toss out the full amount and walk away. You will know as they won't supply you with an attorney in defense and you would need to get your own attorney. If you have a good policy amount, I'd let the insurance company attorney work for you until you get some notification the amount of damages exceed the policy amount--then you should consider your options.

The insurance company still has a duty to defend even if they are sueing for more than the policy limits. They can not just offer the policy and walk away without paying for a lawyer to defend you in court if necessary.

Once there is a judgement, then you are generally on your own if you want to appeal anything.

 

[NJInjury]

Thanks for the info.

 

[mlk1978]

The insurance company still has a duty to defend even if they are sueing for more than the policy limits. They can not just offer the policy and walk away without paying for a lawyer to defend you in court if necessary.

Once there is a judgement, then you are generally on your own if you want to appeal anything.

ALNorth is correct. The litigation charges are over and above the policy limit. Definately ask questions to your attorney if you do not feel they are competant enough. You can hire your own attorney and the insurance company may pay, but you need to get prior approval first. There are guidlines to these sorts of things. Yes, insurance company attorneys do look out for the company themselves but they also look out for you!!! Keep in mind that if you have a limit of 50,000 per person and the judge or jury awards 100,000, the judge may also order that the insurance company pay the full $100,000 eventhough your limit is much lower than that. Its happened before. Anyway, the attorney is not there to make you look like an idiot. If you have issues direct it to them (insurance attorney's dont bite).

 

[alnorth]

Keep in mind that if you have a limit of 50,000 per person and the judge or jury awards 100,000, the judge may also order that the insurance company pay the full $100,000 eventhough your limit is much lower than that.

It happens, but only if the insurance company does something wrong, usually a couple ways. First, depending on the state, if you ask the insurance company to make a settlement offer of the policy limit to avoid a trial, and the insurance company refuses, then they could be assuming full liability if the judgement comes in higher. (If the insurance company offers the policy to settle and the victim refuses and you lose big in court, your pretty much screwed). Second, if the insurance company is guilty of acting in bad faith, they could be liable for the full amount. (e.g. the insurance company decides based on the details of the accident, that its not covered so they dont defend you, you lose big in court, then later prove in a lawsuit against the insurance company that they were wrong. The arguement would then be that their bad faith refusal to offer a settlement and defend led to the high judgement, so they are liable.)

However, the judge is not going to just arbitrarily order the insurance company to pay above the policy limits just for the heck of it, the insurance company has to do something wrong.

 

[NJInjury]

What bothers me, is that I met with him, told him everything about the accident. Did the interrogatory thing. I told him about the injuries to the plaintiff....which I mentioned briefly in an earlier post. He indicated there would probably be a policy payout.

Then, I find out from the family member that my attorney isn't happy with the interrogatory answers which were given by them, and that the medical records need to be submitted. All medical records are being handled by the insurance (PIP), and my attorney already subpeoned them and had them, he wouldn't share them with the plaintiff's attorney. Since the plaintiff's attorney didn't submit the PIP file, my attorney filed for a motion to dismiss and it was granted. Then there was a reinstatement process and the plaintiff's attorney basically had to request the same PIP file and send it to my attorney. Now my attorney has two copies of the exact same file. Why does he need that? The medical file is around 600 pages so far and growing.

I tried to contact my attorney to find out why he filed a motion to dismiss and no response. Contrary to what I'm being told here, it doesn't seem he's working with me. At least his actions say something different.

Any advice? Should I speak with someone from the insurance company? Or, just give it some time.

 

[alnorth]

I may not have fully understood your situation in my first response. Is this basically a "friendly lawsuit"? By this, I mean you were at fault, the defendant is family so you want them to "win" and get paid by your insurance, but not necessarily win a judgement over your policy limit. To do that, they have to sue you (nothing personal), in order to get to the policy. So, essentially you want to "lose", but only for less than or equal to the policy limit. Is that basically whats going on?

Assuming thats the case, you have an interesting situation, and your goals may be conflicting with what your attorney is permitted to do. Normally in a PI case, the defendant only wants the judgement to be at or under the policy limit, while the insurance company wants the judgement to be as close to zero as possible. Whether the plaintiff loses and gets zip, or they win for under the policy limit makes no difference to the normal defendant (not you). The attorney defends with this goal in mind as well, even if it means writing a stern letter to your own insurance company (who is paying the attorney's fee, but not being represented by that attorney) demanding they authorize a settlement offer for the policy limit if there's a high risk of a huge judgement at trial. However, if the case against you is not that strong and there is a clear way for you and the lawyer to either win the lawsuit or settle for less than the limit, you cant just ignore that.

Your situation, assuming I am correct in the first paragraph, likely does conflict with what is written in your policy. You MUST cooperate in your own defense, which could include prevailing over the plaintiff, or forcing them to accept a settlement lower than the policy limit. You need to be careful here. If you refuse to cooperate in your own defense and try to help the plaintiff, then depending on the state and whats written in your policy, the insurance company could be relieved of not only the duty to defend, but also the duty to indemnify (pay the claim).

Assuming again that what I said in the first paragraph is true, you may be one of those rare people who should at least buy an hour or two of another independant lawyer's time to discuss this.

 

[NJInjury]

AlNorth,

Thanks for the throrough response and suggestions. Your scenario of what is going on is correct - "friendly lawsuit" - the injuries sustained are a valid claim, it just so happens that I am the defendant and family. Even if it wasn't family, and somone sustained these injuries I would fully expect them to file a justified suit against me and be ok with it. The lawsuit has already been filed against me and the demand is well in excess of policy limits ($3M vs $300K policy limit).

I am fully cooperating in my defense. My "goal" is to get this settled and be able to move on. Liability is clear, I passed someone (dotted line) and hit an oncoming vehicle (passenger side/passenger side) causing me to flip/roll multiple times. My insurance is not accepting full liability (I don't know how they can't), and they haven't told me why not.

It seemed clear to both of us (my attorney and I) when we met, that this will most likely be settled at policy limits. I know it is his job to win in my defense and lower any judgement as much as possible. That's ok, but to go ahead and get the case dismissed? Seems a little weird to me. Settling for less than policy limits would be considered. I haven't said anything like "policy limits must be paid". I have maintained my conduct as defendant and not let the "family" issue play a role in how I deal with my defense. No offers have been made...maybe the insurance is just waiting as long as possible before they need to make a payment. Do they do that.

I will look into speaking with an independant attorney about my case.

Everyone, thanks for sharing. Anything else? Just post.