4/27/2010

An elderly couple, both 90 years old, was exiting the insured location.  As he and his lovely wife walked down the sidewalk alongside the store, an employee opened a door from the side of the building, knocked the man down to the ground causing him to suffer a hip fracture. The service door had no windows for the employee to check for traffic and while it may seem like an accident, the case was one of simple negligence, a high duty of care owed to customers.  Although the medical bills were approximately $85,000 and a very good settlement was reached, this is a good example of a claim that could have easily been over half a million dollars – and one which may not have happened at all had there been a minor modification to the service door.  

Lesson:  Every employer should be certain to examine ALL parts of their operation for premises exposure and eliminate the likelihood of injuries like this one BEFORE it happens to you.

3/22/2010

The claimants were from Illinois on vacation. It was a rear end accident so fault was not at issue. One of the passengers was diagnosed with odontoid process fracture...neck fracture at the C-2 level. The claimant had to be placed in a halo for 13 weeks. She healed well and made a full recovery. Residual pain at the pin sites that is ongoing even to this date.

The settlement process took over 2 years and no attorney was ever retained. Comments from the claimant to the adjuster were “I know you will be fair to me.”  Usually we don’t make opening offers but this case was not the norm so an evaluation was made and offer given. Without much hesitation, the settlement was agreed to and life goes on. 

Lesson:  Choosing a good TPA and further a good adjuster that can explain a person’s rights and educate them throughout a claim, can help avoid costly litigation and allow for all parties to win!