Did Progressive do something bad by being adverse to it's insured?

[jtgain]

http://abcnews.go.com/US/wireStory/p...6#.UC4_Mt1lRtA

Here's a summary of the story. Young woman killed by drunk driver. The drunk only has $25k worth of insurance, obviously not enough. Young woman has $100k of underinsured coverage and makes a claim. Progressive goes to court and seemingly helps the drunk try to prove that the young woman was partially at fault. Outrage ensues.

A couple of things. One: What's not mentioned in the article is that Maryland is a state that adheres to the old contributory negligence doctrine. If it was proven that the woman was only 1% at fault, she would be denied all recovery. Surely if the insurance company had anything to base that on, they would be doing wrong by their shareholders and other policy holders not to pursue that strategy.

Two: The attorney in the article talks about bad faith. I was under the impression that bad faith in insurance law only applied when your insurance company either refuses or does a half assed job of protecting YOU from exposure to personal liability on a claim. This didn't happen here. It's basically a disagreement between the woman and Progressive, so why shouldn't they be able to assert their rights?

At first blush I was outraged at Progressive's conduct, but as sad as this story is, it seems reasonable if they actually thought this woman might have been 1% at fault. Thoughts?

[Mosier]

She paid premiums for a policy that insures her against underinsured drivers. That was the whole point of the policy. When she was hit and killed by an underinsured driver, she (or rather, her surviving beneficiaries) should have gotten what she paid for.

Is BMW "doing wrong by their shareholders" by actually giving you a car when you give them 40,000 bucks? Of course not! They're simply giving you the product you paid for!

Except Progressive went a step further than simply denying coverage (and not providing the service paid for). They went as far as to call witnesses on behalf of her killer, and provide him legal advice! Then, after it was all over, they denied having provided that legal council! Scummy, scummy, scummy. I can't think of any other industry besides insurance in which it's a reasonable business decision to not give someone what they paid for.

[Evil Captor]

Originally Posted by jtgain

http://abcnews.go.com/US/wireStory/p...6#.UC4_Mt1lRtA

Here's a summary of the story. Young woman killed by drunk driver. The drunk only has $25k worth of insurance, obviously not enough. Young woman has $100k of underinsured coverage and makes a claim. Progressive goes to court and seemingly helps the drunk try to prove that the young woman was partially at fault. Outrage ensues.

A couple of things. One: What's not mentioned in the article is that Maryland is a state that adheres to the old contributory negligence doctrine. If it was proven that the woman was only 1% at fault, she would be denied all recovery. Surely if the insurance company had anything to base that on, they would be doing wrong by their shareholders and other policy holders not to pursue that strategy.

Two: The attorney in the article talks about bad faith. I was under the impression that bad faith in insurance law only applied when your insurance company either refuses or does a half assed job of protecting YOU from exposure to personal liability on a claim. This didn't happen here. It's basically a disagreement between the woman and Progressive, so why shouldn't they be able to assert their rights?

At first blush I was outraged at Progressive's conduct, but as sad as this story is, it seems reasonable if they actually thought this woman might have been 1% at fault. Thoughts?

What is legal is not always ethical. Progressive has been extremely unethical in its treatment of this woman's family. So there is a badly written law that gets insurance companies off the hook sometimes for damages. It should be no surprise now to learn that government officials are crooks who serve whoever gives them money, not the people they "represent." Progressive is a bunch of fucking scumbags for trying to weasel out on their obligation.

[jtgain]

Originally Posted by Mosier

She paid premiums for a policy that insures her against underinsured drivers. That was the whole point of the policy. When she was hit and killed by an underinsured driver, she (or rather, her surviving beneficiaries) should have gotten what she paid for.

Is BMW "doing wrong by their shareholders" by actually giving you a car when you give them 40,000 bucks? Of course not! They're simply giving you the product you paid for!

Except Progressive went a step further than simply denying coverage (and not providing the service paid for). They went as far as to call witnesses on behalf of her killer, and provide him legal advice! Then, after it was all over, they denied having provided that legal council! Scummy, scummy, scummy. I can't think of any other industry besides insurance in which it's a reasonable business decision to not give someone what they paid for.

Right, but again, under Maryland law, if she is 1% at fault, neither the drunk driver or her insurance company owes her a thing. She pays premiums to recover from underinsured motorists who were 100% at fault in the accident. If she's slightly at fault, a payout from Progressive is not what she "paid for." Doesn't Progressive have the right to a trial to see if she was 1% at fault?

Or because she paid premiums, then they just have to pay, period. What if the evidence showed that she was 50% at fault? 90%? When does it flip to where the insurance company can say, "We don't know all of the facts here, so we will let a jury decide."

[Evil Captor]

Originally Posted by jtgain

Right, but again, under Maryland law, if she is 1% at fault, neither the drunk driver or her insurance company owes her a thing. She pays premiums to recover from underinsured motorists who were 100% at fault in the accident. If she's slightly at fault, a payout from Progressive is not what she "paid for." Doesn't Progressive have the right to a trial to see if she was 1% at fault?

Or because she paid premiums, then they just have to pay, period. What if the evidence showed that she was 50% at fault? 90%? When does it flip to where the insurance company can say, "We don't know all of the facts here, so we will let a jury decide."

Somewhere way, way, way past one percent. Cmon, jtgain, that law reeks of some insurance company lobbyist saying to a state legislator, "Hey, bud, write it at one percent, I'll see that you get some nice donations to your campaign next year." Be honest here, you know it's true.

[jtgain]

Originally Posted by Evil Captor

Somewhere way, way, way past one percent. Cmon, jtgain, that law reeks of some insurance company lobbyist saying to a state legislator, "Hey, bud, write it at one percent, I'll see that you get some nice donations to your campaign next year." Be honest here, you know it's true.

Well, the contributory negligence doctrine pre-dates auto insurance. It predates the automobile. As recently as 1960 all states had it. Today only four (plus DC) still have it: Maryland, Virginia, D.C., Alabama, North Carolina.

I could believe that Virginia, Alabama, and NC bowed to insurance companies, but blue areas like Maryland and D.C.?

But in any event, that's the law, and if you are an attorney advising Progressive, do you pay out the untold millions in claims where insureds are 1% to X% (whatever you think is reasonable) because of some higher calling? What happens when State Farm follows the law? Progressive loses its shirt and goes out of business.

I agree that the contributory negligence doctrine is painfully harsh and too one-sided. But if you are operating within that framework, wouldn't a lawyer be open to a malpractice suit from telling Progressive to do anything besides what they did?

[Acsenray]

Originally Posted by jtgain

Well, the contributory negligence doctrine pre-dates auto insurance. It predates the automobile.

This is what I was going to point out.

[The Great Sun Jester]

Trivia: Maryland, Alabama, North Carolina, Virginia, South Dakota* and Washington DC are the only places you have to deal with this "1% liability bars recovery" dragon.

* This doctrine is not a secret, closely guarded by slimy green trolls who giggle malevolently and wring their hands in the shadowy corners of insurance office buildings, it is the law of the land in these places. Presumably if enough residents don't like it, they can change the laws that govern them.

* Liability insurance, also written in plain English on the policy you get in exchange for your hard-earned frogskins, pays for damages an insured would be legally obligated to pay. Un(der) Insured Motorist coverage indemnifies an insured for damages they would be legally entitled to in the event someone else causes them damage and has insufficient insurance to compensate them. Premiums for those coverages are calculated based on the risk of having to make a payment, and that risk is greatly affected by the state's negligence rules.

With those two points in mind, she got exactly what she paid for. It's great to demonize drunk drivers and all if that makes you happy, but in this case alcohol is a red-herring. Even if it's a fact one of the involved drivers was near comatose from alcohol, there's nothing to say the sober driver didn't cause, or fail to take reasonable measures to avoid, the accident.

Progressive did nothing wrong. They examined the facts of the loss and determined their insured was partially liable. In accordance with state laws, the other driver owed nothing and her claim was denied.

That said, based on what must surely be unbiased, nonsensationalistic, and complete reporting of the abc News article, I can't say I as a claim representative would have stuck to my guns through litigation on this one. With two witnesses gving conflicting testimony about a light, it's a good bet I'll find the one without brain damage to be the more credible.




*South Dakota is actually a bit vague, having the unique "slight in comparison" standard that amounts to the same standard in practice.

eta: totally ninja'd by jtgain, nice job.

[Tom Tildrum]

Based on the article, I might question Progressive's evaluation of the facts, if not the law. The article says that the only basis for determination that the insured was partly at fault was a statement from a passenger in her car, who suffered brain damage in the accident. It's hard to see how Progressive thought that that testimony would convince a jury to find against a sympathetic insured.

[bordelond]

Tangentially, but ultimately pertinent to cases such as this one:

How can a drunk driver run a red light and not conclusively be 100% at fault? I am having trouble imagining a hypothetical in which the woman could even be 1% at fault.

[bordelond]

Originally Posted by Tom Tildrum

Based on the article, I might question Progressive's evaluation of the facts, if not the law. The article says that the only basis for determination that the insured was partly at fault was a statement from a passenger in her car, who suffered brain damage in the accident. It's hard to see how Progressive thought that that testimony would convince a jury to find against a sympathetic insured.

What the heck could that passenger have possibly said that overrode "the drunk driver that ran a red light slammed into us"?

[runner pat]

Originally Posted by bordelond

Tangentially, but ultimately pertinent to cases such as this one:

How can a drunk driver run a red light and not conclusively be 100% at fault? I am having trouble imagining a hypothetical in which the woman could even be 1% at fault.

Taillight out, tire tread near wear limit, smudge on windshieild. Remember , you're dealing with insurance companies and lawyers. Anything goes.

[doorhinge]

An insurance agent once explained to me that under the "no fault" insurance rules, you're already considered partially at fault for simply starting your vehicle and leaving your parking spot. If you hadn't been driving, you wouldn't have been in a position to have been involved in an accident.

As far as Progressive's support for "the other driver", that's just insane. When I pay an insurance company for vehicle coverage and legal representation if the situation warrants, I expect them to represent ME and no one else.

The other driver didn't have insurance which also means they didn't have an insurance company lawyer to represent them. The other driver has the option of hiring their own lawyer but that should NOT include Progressive's lawyers. That should be a conflict of interest issue.

If current law allows Progressive lawyers to legally assist "the other guy" against Progressive's own paying client then that law needs to be changed, post haste.

Whatever the outcome of this particular issue, I see no reason to purchase Progressive Insurance when they turn on their own clients.

[Marley23]

Part of what offends people about this story is that not only has Progressive not paid the rest of the woman's policy, they've actually assisted in the defense of the other driver. So they'll pay for that, but they won't pay the insurance policy their late client purchased even though the other driver's own insurance company agrees he was at fault in the accident. Progressive's basis for doing so seems very flimsy. Does Progressive really think Fisher was at fault? Maybe they do. Or maybe they thought as a broader matter of policy that in cases where there is any kind of dispute, it's a good investment to spend some money on the driver's defense because they might not have to pay the rest of the policy (or not as much of it), so they'd save money overall. It does pretty well confirm the worst things people say about insurance companies.

[Marley23]

By the way as far as I know, the driver who killed Kaitlynn Fisher was not drunk. The original Matt Fisher blog post didn't say the driver was drunk and neither does the story jtgain linked to. They just say the guy blew a red light and crashed into Kaitlynn Fisher's car.

[bordelond]

Originally Posted by runner pat

Taillight out, tire tread near wear limit, smudge on windsheild. Remember , you're dealing with insurance companies and lawyers. Anything goes.

Rhetorically (not aimed at runner pat):

None of that has any exacerbating influence in an accident where someone runs a red light and T-bones someone else. I would hope any arbitrator or judge would summarily dismiss those kinds of arguments.

[Evil Captor]

Originally Posted by jtgain

Well, the contributory negligence doctrine pre-dates auto insurance. It predates the automobile. As recently as 1960 all states had it. Today only four (plus DC) still have it: Maryland, Virginia, D.C., Alabama, North Carolina.

I could believe that Virginia, Alabama, and NC bowed to insurance companies, but blue areas like Maryland and D.C.?

But in any event, that's the law, and if you are an attorney advising Progressive, do you pay out the untold millions in claims where insureds are 1% to X% (whatever you think is reasonable) because of some higher calling? What happens when State Farm follows the law? Progressive loses its shirt and goes out of business.

I agree that the contributory negligence doctrine is painfully harsh and too one-sided. But if you are operating within that framework, wouldn't a lawyer be open to a malpractice suit from telling Progressive to do anything besides what they did?

you make it sound simpler than it is. The debate on this board is just part of a HUGE shitstorm of public outrage over Progressive's actions here. That HAS to be costing Progressive millions in business. I mean, Flo is looking real ugly to me right now, y'know? So there has to be some balance on that issue. Of course, the lawyer may not have been able to predict the shitstorm. How do you think Progressive shareholders are feeling about this?

[jtgain]

A couple of misconceptions posted here, one by me. Marley23 is correct. The article doesn't say that the other driver was drunk, but I'm sure I heard it somewhere. Until I have a cite, though, we will assume he wasn't.

First, the other driver did have auto insurance, however, his policy maxed out at $25k. That was not enough to compensate the victim's family, so they filed a claim with Progressive to get more under her underinsured motorist coverage.

The other auto insurance company fought paying the $25k because they felt that the victim was contributory negligent. Progressive sat in at the defense table and joined in their theory.

It went all the way to trial and Progressive and the other insurance company LOST. The jury found the other driver 100% at fault and so other insurance company ponies up $25k, plus Progressive pays the rest, up to $100k.

However, today they settled with the victim's family for an unspecified amount ABOVE the policy limits to head off a bad faith claim.

My problem with this is where to draw the line. Doesn't an insurance company have the freedom to protect its interests in court if there is evidence to suggest contributory negligence? Further, my understanding of bad faith against an insurance company was when they failed to defend you in good faith against allegations that could open you to personal liability. THAT is what you pay premiums for: So that if you are found negligent in a lawsuit, your home, cars, and other property aren't seized to pay a judgment.

This case is the opposite. The victim's family was suing the other driver. The insurance company, AFAIK, doesn't owe you a duty to sue on your behalf. They owe you a good faith investigation of the facts before not paying you, and there was enough of a close call in this case for the judge not to grant summary judgment, but to let it go to the jury. In that case, I can't see how/why an insurance company shouldn't be allowed to assert its rights in court.

[jtgain]

Missed the edit window: Also, for a person to be negligent, that negligence had to have "proximately caused" the accident. Just by being born, driving on a public road, or having bald tires (in an accident where your vehicle is stationary) is not enough for negligence. She either had to do or not do something that a reasonably prudent person in her situation would have done to avoid the accident.

For example, maybe her headlights were turned off at night. That would get you at least partially at fault because the other driver may not have seen the car.

[Boyo Jim]

Progressive didn't do anything that most other insurance companies do, which is jerk their custimers around trying to eliminate or minimize their payout. I have seen stories naming just about every company there is. The exeptions used to be Allstate and State Farm, or they were as far as public perception went, having very good reps for excellent customer service. But in the last 10-20 years, they've joined the pack. It's no longer enough just to make a profit -- they have to squeeze every penny of profit out at the expense of virtually everything else.

[jtgain]

For those who disagree with Progressive, let's make a hypothetical. Say the best legal experts at Progressive investigated the facts and believed, after studying past verdicts, that a jury would find the victim here 5% at fault. Should they still pay? Should they try to protect their interests by being adverse to their own insured?

[MOIDALIZE]

Originally Posted by jtgain

In that case, I can't see how/why an insurance company shouldn't be allowed to assert its rights in court.

That's not the issue. Progressive has a PR problem, not a legal problem. I dispute the notion that the existence of a pure contributory negligence regime is well-known and obvious to the average resident of those jurisdictions. I think if it was truly well-known, then Progressive would find it much more difficult to sell underinsured motorist policies in places like Maryland.

My gut feeling is that there's something rather galling about an insurance company that you paid and that you're a customer of taking sides against you. It'd be one thing if they had just let the lawsuit conclude, then used the evidence obtained to argue against paying out on the policy. But to assist the defense during the trial? When the woman bought her policy, do you think she had any idea that she would be paying for extra legal assistance for the person who would later cause her death?

[Boyo Jim]

Originally Posted by jtgain

For those who disagree with Progressive, let's make a hypothetical. Say the best legal experts at Progressive investigated the facts and believed, after studying past verdicts, that a jury would find the victim here 5% at fault. Should they still pay? Should they try to protect their interests by being adverse to their own insured?

Should a great white shark not eat a tasty small child because it's cute?

[Marley23]

I'm halfway tempted to put it this way: if Progressive isn't going to honor a policy their client paid for, shouldn't they just return all the payments the client made (with interest) instead of actually spending money on someone else's legal fees while they refuse to pay? Of course that still wouldn't resolve the fact that their late client paid them to cover her instead of taking her business elsewhere.

[Gagundathar]

Should we be paying for a product that looks like 'Flo' and is, in fact, a Great White Shark?

As was pointed out, this is a case that will be settled in the court of public opinion.
Progressive didn't break any laws.

And when, precisely, did we started expecting insurance companies to be ethical, anyway?
Last I checked, this is America in the 21st century.

Profit trumps ethics almost every time.

[jtgain]

Originally Posted by Marley23

I'm halfway tempted to put it this way: if Progressive isn't going to honor a policy their client paid for, shouldn't they just return all the payments the client made (with interest) instead of actually spending money on someone else's legal fees while they refuse to pay? Of course that still wouldn't resolve the fact that their late client paid them to cover her instead of taking her business elsewhere.

Others (and I) have said this already: Underinsured motorist insurance is not "if something bad happens to me, you pay" it is "If something bad happens to me through someone else's 100% fault, and their insurance can't pay, you pay" (at least in Maryland).

So, say again why the insurance company can't investigate, and take a position in court that it wasn't someone else 100% fault and refuse to pay? That is the "policy their client paid for." Now that a jury has spoken, they will pay.

You or I are allowed to dispute our obligations and let a jury decide. Can an insurance company not protect its own interests in court?

I believe that if people don't like this, they shouldn't blame Progressive, but blame the Maryland Legislature.

[The Great Sun Jester]

Originally Posted by runner pat

Taillight out, tire tread near wear limit, smudge on windshieild. Remember , you're dealing with insurance companies and lawyers. Anything goes.

Eh, those are niggling little details that I personally wouldn't pay much mind to in making a liability call. But here's one for you.

Large intersection, both roads have 2 lanes in each direction plus a left turn lane. (draw this one).

V1 is travelling southbound in the far right lane at the posted speed limit of 40mph, V2 is travelling westbound in the far left lane, "like a bat out of hell" according to a witness, and enters the intersection with a green light. V1 runs a red light and V2's left headlight strikes the left rear corner of V1's bumper.

In practice, I'm putting at least 75% on V1 for violating the light. However, the impact points on both cars demonstrate V1 was almost able to get out of V2's way. Assuming all drivers have a duty be drive with vigilance, was there anything V2 could have done to avoid the collision? A witness would be a huge help here. If the witness says V2 was on her brakes hard and almost avoided the collision, that's one thing. On the other hand, if V2 driver says V1 came "from out of nowhere" then I'm going to entertain the possibility she might have some liability for improper lookout. Maybe as much as 25% but probably less depending on how credible I think both drivers are. Unfortunately in a handful of places in the US, I don't even have to sell 25%, just 1% before I have to tell V2 she has no claimagainst V1.

[The Great Sun Jester]

Originally Posted by Gagundathar

Profit trumps ethics almost every time.

This is very offensive to those of us in the industry so...Cite? Not one or two examples, but something showing, as you say, this occurring almost every time.

[denquixote]

I was not present when the young lady bought her insurance policy but I can envision a situation where the salesperson explained the underinsured/uninsured coverage the same way it was explained to me whenever I bought a policy. You would be crazy not to buy this coverage with all of those people driving around out there with no insurance. If you get into an accident with one of them and you do not have that coverage you cannot recover. I would be willing to bet my life savings against yours that the words contributory negligence were never spoken.

Also, from what I have read, the defendant's insurer, Nationwide did pay before The only reason for the trial was because Maryland does not allow a policy holder to sue his insurance company, so the heirs were forced to sue the other driver to establish his negligence. Progressive was not a defendant and yet it acted as if the defendant was its client even though that position was adverse to the interest of its actual client, the victim. Progressive called witnesses, conferred with the defendant, cross examined witnesses and gave opening and closing statements, all as an interested party.

If the witness called by Progressive had been believable it's highly unlikely the jury would have found for the Fishers. This might be a basis for someone to question Progressive's good faith belief that contributory negligence existed in the case.

[Eliahna]

Originally Posted by jtgain

A couple of misconceptions posted here, one by me. Marley23 is correct. The article doesn't say that the other driver was drunk, but I'm sure I heard it somewhere. Until I have a cite, though, we will assume he wasn't.

First, the other driver did have auto insurance, however, his policy maxed out at $25k. That was not enough to compensate the victim's family, so they filed a claim with Progressive to get more under her underinsured motorist coverage.

The other auto insurance company fought paying the $25k because they felt that the victim was contributory negligent. Progressive sat in at the defense table and joined in their theory.

It went all the way to trial and Progressive and the other insurance company LOST. The jury found the other driver 100% at fault and so other insurance company ponies up $25k, plus Progressive pays the rest, up to $100k.

However, today they settled with the victim's family for an unspecified amount ABOVE the policy limits to head off a bad faith claim.

My problem with this is where to draw the line. Doesn't an insurance company have the freedom to protect its interests in court if there is evidence to suggest contributory negligence? Further, my understanding of bad faith against an insurance company was when they failed to defend you in good faith against allegations that could open you to personal liability. THAT is what you pay premiums for: So that if you are found negligent in a lawsuit, your home, cars, and other property aren't seized to pay a judgment.

This case is the opposite. The victim's family was suing the other driver. The insurance company, AFAIK, doesn't owe you a duty to sue on your behalf. They owe you a good faith investigation of the facts before not paying you, and there was enough of a close call in this case for the judge not to grant summary judgment, but to let it go to the jury. In that case, I can't see how/why an insurance company shouldn't be allowed to assert its rights in court.

That's not how I understood the facts of the case. The motorist at fault was under-insured, but his insurer accepted he was at fault and paid up the $25,000. Fisher's family made a claim with Progressive under the policy she had with them in case of an accident with an under-insured driver. Progressive denied their claim, leaving them with no choice but to file suit against the other motorist so they could get a judgement against him to leverage their claim with Progressive. Progressive provided legal assistance to the other driver.

There were two witnesses. Progressive ignored the testimony of the bystander who said the other driver ran a red light and accepted the testimony of Fisher's passenger who suffered brain damage and memory loss as a result of the accident.

[denquixote]

Originally Posted by jtgain

Others (and I) have said this already: Underinsured motorist insurance is not "if something bad happens to me, you pay" it is "If something bad happens to me through someone else's 100% fault, and their insurance can't pay, you pay" (at least in Maryland).

So, say again why the insurance company can't investigate, and take a position in court that it wasn't someone else 100% fault and refuse to pay? That is the "policy their client paid for." Now that a jury has spoken, they will pay.

You or I are allowed to dispute our obligations and let a jury decide. Can an insurance company not protect its own interests in court?

I believe that if people don't like this, they shouldn't blame Progressive, but blame the Maryland Legislature.

Well here is the problem. First, I would like to see Progressive's copy of the deceased's policy where it says that in Maryland recovery will be denied if the policy holder is at fault IN ANY WAY. Further, if that language is present I would expect to see the deceased's initials next to it to show that she was fully aware of the nature of the product she was buying.

Second, the fact that Progressive is denying the claim until liability is proven in court against the actual driver does not give progressive the right to defend that driver. That duty fell on his own insurer, Nationwide. There is no way such a conflict of interest can be tolerated.

You are right the Maryland legislature is at fault, but of course they are undoubtedly lobbied night and day by insurance companies.

[Damuri Ajashi]

Frankly, I am surprised that Progressive would try to pull this sort of shit. It is an advertisement telling all their policyholders to switch to GEICO or Allstate.

[just_some_guy5]

Originally Posted by Eliahna

That's not how I understood the facts of the case. The motorist at fault was under-insured, but his insurer accepted he was at fault and paid up the $25,000.

Any idea why his insurer accepted that he was at fault? I almost wonder if his insurer figured $25k wasn't worth going to court over, regardless of how "at fault" he was.

[FasterThanMeerkats]

Originally Posted by jtgain

For those who disagree with Progressive, let's make a hypothetical. Say the best legal experts at Progressive investigated the facts and believed, after studying past verdicts, that a jury would find the victim here 5% at fault. Should they still pay? Should they try to protect their interests by being adverse to their own insured?

They can absolutely choose that course and their attorney should advise that it is a possible choice, but the company must weigh the potential cost of tarnishing their reputation and brand.

Just because they can litigate to save some money doesn't automatically mean it's the best decision for the shareholders. A proper analysis needs to be done by management before choosing.

[Eliahna]

Originally Posted by just_some_guy5

Any idea why his insurer accepted that he was at fault? I almost wonder if his insurer figured $25k wasn't worth going to court over, regardless of how "at fault" he was.

Progressive stated "Under Maryland law, in order to receive the benefits of an underinsured driver claim, the other driver must be at fault. Sometimes this can be proven without the need for a trial, but in Ms. Fisher’s case, there were credible conflicting eyewitness accounts as to who was at fault."

I guess Nationwide accepted the testimony of the bystander, and disregarded the brain damaged passenger. Progressive apparently thought both witnesses were equally credible.

[Bricker]

Originally Posted by jtgain

Others (and I) have said this already: Underinsured motorist insurance is not "if something bad happens to me, you pay" it is "If something bad happens to me through someone else's 100% fault, and their insurance can't pay, you pay" (at least in Maryland).

So, say again why the insurance company can't investigate, and take a position in court that it wasn't someone else 100% fault and refuse to pay? That is the "policy their client paid for." Now that a jury has spoken, they will pay.

You or I are allowed to dispute our obligations and let a jury decide. Can an insurance company not protect its own interests in court?

I believe that if people don't like this, they shouldn't blame Progressive, but blame the Maryland Legislature.

But by your same reasoning -- Progressive lost. They had to pay. Now their former insured believes she has a case against Progressive for bad faith. Shouldn't SHE have the right to go to court to attempt to prove that bad faith?

Why, in other words, can Progressive's actions be analyzed in that way, but not the injured party who believes she was the victim of bad faith?

[The Great Sun Jester]

Originally Posted by denquixote

Well here is the problem. First, I would like to see Progressive's copy of the deceased's policy where it says that in Maryland recovery will be denied if the policy holder is at fault IN ANY WAY. Further, if that language is present I would expect to see the deceased's initials next to it to show that she was fully aware of the nature of the product she was buying.

Example:

Originally Posted by insuring agreement from UM/UIM coverage (not a Progressive policy, admittedly)

We will pay compensatory damages for
bodily injury an insured is legally entitled
to collect from the owner or driver of an
uninsured motor vehicle or an underinsured
motor vehicle.

In Maryland, if a party is 1% at fault, they are NOT legally entitled to collect anything. Signature on a contract is generally considered as evidence the contract has been read. "Nobody reads those things" is a flimsy defense against looking out for yourself. Maybe everyone should read the policy they're paying for rather than just assuming it will perform according to their whim.

Originally Posted by denquixote

Second, the fact that Progressive is denying the claim until liability is proven in court against the actual driver does not give progressive the right to defend that driver.

Originally Posted by example verbiage

1. a. The insured and we must agree to the
answers to the following two questions:
(1) Is the insured legally entitled to
collect compensatory damages
from the owner or driver of the uninsured
motor vehicle or underinsured
motor vehicle?
(2) If the answer to 1.a.(1) above is
yes, then what is the amount of the
compensatory damages that the insured
is legally entitled to collect
from the owner or driver of the uninsured
motor vehicle or underinsured
motor vehicle?
b. If there is no agreement on the answer
to either question in 1.a. above, then
the insured shall file a lawsuit, in a
state or federal court that has jurisdiction,
against:
(1) us;
(2) the owner and driver of the uninsured
motor vehicle or underinsured
motor vehicle unless we
have consented to a settlement offer
proposed by or on behalf of
such owner or driver; and
(3) any other party or parties who may
be legally liable for the insured’s
damages.

Are you suggesting that, should Progressive be sued because their insured disagrees with their 1% or whatever liability assessment, that they should not defend themselves? Defending against such a suit necessarily involves defending the other driver to some extent because the point to be proven is that the other driver was not wholly at fault.

Originally Posted by denquixote

they are undoubtedly lobbied night and day by insurance companies.

Aaaaaand...cite? Anything at all showing insurer's persistent and concerted involvement in suppressing attempts to overturn laws that preexisted cars & insurance. Why would an insurance company even care? The law is what it is and affects risk in a specific way. If it changes, then the risk changes and premiums are recalculated accordingly. My bet is that reworking the law into something more modern will result in higher insurance, and people are going to vote with their wallets and against their own interests.

[joebuck20]

Originally Posted by Damuri Ajashi

Frankly, I am surprised that Progressive would try to pull this sort of shit. It is an advertisement telling all their policyholders to switch to GEICO or Allstate.

Flo-bot must be broken.

[Acsenray]

Originally Posted by denquixote

Well here is the problem. First, I would like to see Progressive's copy of the deceased's policy where it says that in Maryland recovery will be denied if the policy holder is at fault IN ANY WAY. Further, if that language is present I would expect to see the deceased's initials next to it to show that she was fully aware of the nature of the product she was buying.

Since when is this a standard for contract law? Generally, a contract chooses an applicable law and that's it. Progressive isn't trying to enforce something special here. In any liability situation, Maryland applies the old contributory liability rule.

You are right the Maryland legislature is at fault, but of course they are undoubtedly lobbied night and day by insurance companies.

I'm not sure what you mean by this. Maryland (and four other jurisdictions) have not changed what was once the universally accepted contributory liability standard. Does this necessarily say anything about the legislature or lobbyists? If insurance company lobbyists are so strong, then why have 46 states changed this rule?

[El_Kabong]

Originally Posted by Gagundathar

Progressive didn't break any laws.

Absolutely not.

And when, precisely, did we started expecting insurance companies to be ethical, anyway?

Also a valid point. Based on what I've read in this thread, seems like one would have to be fool to pay for underinsured motorist coverage in a state that allows for contributory negligence.

So, yes, Progressive was perfectly within their rights, is just preserving shareholder value, blah blah blah. I hope that comforts them when I cancel the auto policies I've carried with them for some ten years, for being a bunch of chiseling bastards.

[Bosstone]

Originally Posted by El_Kabong

I hope that comforts them when I cancel the auto policies I've carried with them for some ten years, for being a bunch of chiseling bastards.

Word. I'm going to be in the market for a new car soon, and based on what I've seen of this affair I'll be setting up insurance with a different company despite all the 'perks' Progressive's given me over the years.

[joebuck20]

Originally Posted by Bosstone

Word. I'm going to be in the market for a new car soon, and based on what I've seen of this affair I'll be setting up insurance with a different company despite all the 'perks' Progressive's given me over the years.

Was one of those "perks" Flo feeding you grapes on a couch?

[jtgain]

Originally Posted by Bricker

But by your same reasoning -- Progressive lost. They had to pay. Now their former insured believes she has a case against Progressive for bad faith. Shouldn't SHE have the right to go to court to attempt to prove that bad faith?

Why, in other words, can Progressive's actions be analyzed in that way, but not the injured party who believes she was the victim of bad faith?

If she can make the case that Progressive acted in bad faith, then more power to her. The problem I have is with the public and posters here upset with the fact that the insurance company didn't pay out right away, even with evidence of contributory negligence. IOW, a lot of people think that it was per se bad faith for not paying out. I don't believe that is at all accurate.

One question I have: So the other driver's insurance paid $25k immediately. Now they are suing him? His attorney didn't get a release for paying $25k? That seems...odd..

[Marley23]

Originally Posted by jtgain

The problem I have is with the public and posters here upset with the fact that the insurance company didn't pay out right away, even with evidence of contributory negligence.

The evidence seems to be the testimony of the passenger who suffered brain damage in the accident. That's an extremely shaky basis for refusing to pay.

One question I have: So the other driver's insurance paid $25k immediately. Now they are suing him? His attorney didn't get a release for paying $25k? That seems...odd..

If I understand what you are asking, this was discussed upthread: under Maryland law, the Fishers could not sue Progressive for failing to pay the claim. They had to sue the other driver and get a ruling that he was at fault in order to get Progressive to pay up.

[The Great Sun Jester]

Originally Posted by jtgain

That seems...odd..

Now THAT'S grounds for a bad faith suit. No release:no money, babe.

[Cheesesteak]

Originally Posted by Inigo Montoya

Example:In Maryland, if a party is 1% at fault, they are NOT legally entitled to collect anything. Signature on a contract is generally considered as evidence the contract has been read. "Nobody reads those things" is a flimsy defense against looking out for yourself. Maybe everyone should read the policy they're paying for rather than just assuming it will perform according to their whim.

If Nationwide agreed to pay the original $25k, can we still say that Fisher was not legally entitled to collect anything?

[The Great Sun Jester]

Originally Posted by Cheesesteak

If Nationwide agreed to pay the original $25k, can we still say that Fisher was not legally entitled to collect anything?

Fair question.

1) Many (most? all?) releases include language to the effect of "liability is not admitted, you're taking $x in exchange for surrendering your right to pursue our insured for damages." Payment is an admission of nothing at all apart from one party's willingness to pay and another's willingness to accept the payment under the terms specefied. Nationwide may think the chances of their insured receiving a verdict in excess of his policy limits was too big a risk to expose their insured to, and so paid the $25k even though there was a chance the other driver might have some liability.

2) Nationwide may have actually believed their insured was 100% at fault. Progressive has the right to disagree. We have the civil court system and various mediation organizations in place to resolve disagreements. People interpret information differently.

[Rachellelogram]

I don't really see why everyone is saying that Progressive should have seen this PR nightmare coming. Insurance companies deal with a huge number of attorney-repped clients every day, and a significant number of trials every year. Who could have predicted that social media would blow up this particular case? Insurance companies deny hundreds or thousands of claims every day. How many of those have become famous in recent memory? None that I can think of, that's for sure.

Progressive is my carrier, and I won't be canceling my policy. But then, I work for an insurance company, so none of this shocked me. Additionally, I can't agree that the outrage over this is commensurate to the "offense" they committed. Any insurance company would have done the same thing in their place. Do you really think Progressive is so bad? They're all the same. It sucks, but I have a car so I can't just not pay into it.

Personally, I think the way auto insurers' primary customers are their shareholders, rather than their customers, is borderline-unethical and fucking reprehensible. My company's CEO is at least half-reptilian, ok (and I don't work for Progressive). But there isn't an auto insurance company out there that doesn't do this! It's six of one, or half a dozen of the other. Don't people see that?

[Bosstone]

Originally Posted by Rachellelogram

Don't people see that?

Perhaps. But the optimist in me says that if these practices become known to the public, and the public states quite clearly, whether through dropping their Progressive insurance or by speaking out, that such practices are reprehensible, we might start seeing a shift in insurance practices.

One can hope, anyway. I see no evidence that the auto insurance industry is not run by sentient but soulless AIs who hate human life.

[denquixote]

Originally Posted by just_some_guy5

Any idea why his insurer accepted that he was at fault? I almost wonder if his insurer figured $25k wasn't worth going to court over, regardless of how "at fault" he was.

Did not exactly work for him though did it? Nationwide was still responsible for defending him at trial.