One of the impacts of having a Republican Governor has been the appointment of more conservative, insurance company friendly Arbitrators. I do think most of them look at cases objectively, but it’s just a fact that some are much more favorable to insurance companies than others. In addition, due to some high profile cases, I believe that some Arbitrators feel worried that their decisions might end up in the newspaper.
As a result there’s been a definite shift in strategy by insurance companies. They will deny many cases that years ago they would have accepted. From their standpoint, if they go to trial and the Arbitrator is conservative, maybe they win. Maybe they negotiate a settlement for less than the case was worth. All of these things save/make them money.
There was a recent case that some insurance company was ballsy enough to take to trial and even appeal after they lost. A union electrician was carrying three 40 inch long structures that weighed 20-25 pounds each. While doing so he stepped in a gravel depression that and felt a pop in his knee. He was eventually diagnosed with a meniscus tear and had surgery.
Sounds like a no brainer, slam dunk case, right? Well the insurance company fought it saying that the depression he stepped in was only two inches deep, not 6-8 inches as the worker testified. As a result they tried to argue that he wasn’t at an increased risk of injury.
The good news is that the Arbitrator rejected this ridiculous argument and the appeal was denied too. Clearly the carrying of materials increased his risk of injury. The bad news is that this poor worker who did nothing wrong had to have his payments delayed and his life screwed with because an insurance company had nothing to lose by messing around with him.
The bottom line is that no matter how clear cut your case seems or how cooperative the insurance company may seem, they are always looking to screw you over if they can. You have to be prepared for this and more than ever and if your attorney doesn’t have a track record of going to trial, you will likely not get a good result. Cases are still winnable, but you really need a fighter in your corner.
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