Preparing for Your First Meeting With Your Personal Injury Lawyer

Preparing for Your First Meeting With Your Personal Injury Lawyer

In a previous article, I discussed the qualities you should look for in a personal injury attorney (trial experience, previous work with personal injury cases, a successful track record, etc). Once you have found the right lawyer, you will meet with him or her.

At the initial meeting, you should provide your attorney with as much evidence and information regarding your case as you can. Properly documenting police reports, medical reports, damage reports, photos, and/or eye-witness accounts allows for a stronger case.  Make sure to bring all correspondence from any insurance company.  Make sure to bring a copy of the “declarations page” for any insurance policy that you may have had in force. (The “declarations page” shows what types of coverage you had purchased and the amounts of coverage.)

The more documents that you can give your lawyer at the beginning of your case, the faster your lawyer can get your case moving.  Ultimately, this will yield a faster, and perhaps larger, settlement.

 

 

Slips on Snow or Ice

Slips on Snow or Ice

We typically receive several calls each winter regarding falls on ice or snow.  These slips and falls can be serious.  I once encountered a case in which a business patron actually had his leg amputated, resulting from complications of a fall on ice.

However, most people misunderstand what obligations property owners have regarding snow and ice. Contrary to popular belief, property owners and business owners generally have no duty to clear snow and ice.  (They often mistakenly believe that they do, and accordingly clear the ice and snow.)

In Ohio, snow and ice are considered general hazards of living in the northern parts of the United States.  Everyone is supposed to take care to avoid slipping on snow or ice.  In most cases, if a business owner fails to shovel the snow or put salt on ice, and you fall, you have no case against the business owner (or homeowner, or whomever).  Shoveling snow or removing ice is, legally speaking, merely a courtesy extended to the walking public.

There is one major exception, however.  If a property owner creates an unnatural accumulation of snow or icethen the owner can be liable.  For example, a property owner has a gutter that is facing in a direction that causes water to flow over a walking surface.  The water freezes and causes a slip hazard.  The owner can be liable in that situation.

More complicated are the “snow pile” cases.  Store owners with large parking lots plow the snow into large piles.  The snow starts to melt, creating new ice.  Courts have gone both ways on these cases.  Ultimately, whether the ice unnaturally accumulated will be the deciding factor.

If you think that you may have a case arising from a slip on ice, please call us at 740-374-5346.

 

Life Insurance Claim Denials caused by Portability and Conversion Mistakes

Life Insurance Claim Denials caused by Portability and Conversion Mistakes

During the last four years, I have had several cases in which children and widows of deceased employees were denied the life insurance benefits that had been purchased through their employer’s benefit plan.  In each case, the employer, in conjunction with the life insurer, botched the “conversion” process.

Employers often will sponsor “group” term life insurance plans for their employees.  The employees are usually given a small policy for which the employee pays no premium.  In many cases, the employees can also purchase additional “voluntary” term life insurance for much higher policies.  The greater the premium, the more the total insurance.

What is little understood is that when the employee quits or retires, the coverage will cease.  There is usually a 30 or 31 day period in which the employee must file a new application to “convert” the group policy to an “individual” policy.  This is often called “portability” of the policy.  The beauty of this choice is that the employee who elects to “convert” need not pass a physical or be otherwise insurable.  The employee can be very sick, in fact.  By law, the insurer must accept the employee.  (They may charge a king’s ransom for premiums.)

The key is: the employee must properly make the election and fill out the correct applications with the insurer.  Otherwise, the coverage ends. Life insurers usually are not keen on writing these types of policies, so they will not go out of their way make sure they are converted.

I have been seeing employers who: (1) fail to inform their employee of these conversion rights, or (2) misinform the employees about these conversion rights.

Every case is different. The first question is:  what does the plan state?  What does the summary plan description state? What did the retirement benefits counseling documents state?  The written documents will play a big role in any eventual lawsuit. The second question is: what did the employer tell the employee?

I have seen unusual life insurance policies that state “We will contact you within 30 days to discuss conversion.”  Then, the insurer does not contact the retiree.  That is a problem.  The insurer broke the promise.

I have also seen large employers give their employees written documents stating that there is active coverage when there is not.  This is a misrepresentation of true state of affairs, and it may cause the employer to be liable for the value of the policy.

There is even a reported case in which the employer remained silent about the employee’s conversion benefits and was held liable for those benefits.  The retiree was very ill and his girlfriend  (and beneficiary of the life insurance policy) called to ask about continuing “his benefits.”  The company explained how to continue his health insurance under COBRA, but said nothing about his life insurance benefits.   The Court of Appeals held the employer responsible for paying the life insurance benefits.

Most of these conversion disputes are governed by ERISA (Employee Retirement Income Security Act)—at least with private employers.  Under ERISA, aggrieved beneficiaries may have a claim for breach of fiduciary duty in these situations.  ERISA prescribes duties for any employer, agent, insurer, or other persons who advise employees and their families regarding benefits—“fiduciaries” under the statute.  The fiduciary can be liable to misrepresenting important details to participants.  And, as I mentioned earlier, sometimes they can be liable for not providing enough information.

If you are being denied life insurance proceeds because the insurer claims that your loved one failed convert or “port” the group life policy, please give us a call at 740-374-5346.

 

Ethan Vessels

Fields, Dehmlow & Vessels, LLC