Allegations in Complaint:
That on February 11, 2009, Plaintiff was injured in a hit-and-run automobile collision and required medical treatment. Plaintiff promptly notified her insurance carrier, Progressive Insurance Company, of the collision. On February 11, 2009, Progressive Insurance Company took Plaintiff’s recorded statement. Progressive Insurance Company investigated the collision and determined that Plaintiff would be entitled to uninsured motorist benefits under her insurance policy.
On or about March 10, 2009, Progressive Insurance Company transferred the handling of the claim from Progressive’s adjuster Brandon Whitener to Progressive’s Adjuster Kjell A. Griebesland. Progressive Insurance Company demanded a second recorded statement from Plaintiff. On or about March 17, 2009, Progressive Insurance Company took a second recorded statement of Plaintiff.
On September 3, 2009, Plaintiff provided copies of her medical records to Progressive Insurance Company and made a claim for the uninsured motorist benefits to which she was entitled. On or about September 12, 2009, Progressive Insurance Company evaluated Plaintiff’s claim at $6,005.00. Progressive Insurance Company represented that it had determined that all of Plaintiff’s medical treatment was reasonable and necessary except for $122.00 of treatment from a chiropractor. Thus, Progressive Insurance Company determined that Plaintiff was only entitled to $930.84 in general damages for pain, suffering, inconvenience, etc. Progressive Insurance Company indicated that if Plaintiff did not agree with the evaluation amount her insurance policy required her to request arbitration.
On September 12, 2009, Plaintiff requested the undisputed, uninsured motorist benefits for the medical specials per Progressive Insurance Company’s evaluation. Plaintiff also requested a written explanation as to how Progressive Insurance Company evaluated this particular claim and determined that Plaintiff only suffered $930.84 in general damages, i.e., pain, suffering, loss of enjoyment of life, etc. Plaintiff also requested an explanation as to how Progressive Insurance Company determined that only $6,005.00 in uninsured motorist benefits were due.
Progressive Insurance Company’s insurance policy forces its insureds to demand arbitration if Progressive Insurance Company and its insured person cannot agree on the amount of damages sustained. On September 12, 2009, Plaintiff demanded arbitration.
On or about September 16, 2009, Progressive Insurance Company transferred the claim to Progressive’s adjuster Katie Wakeham. Progressive Insurance Company failed to provide an explanation for its evaluation and indicated that it would “be contacting you periodically to address the status of the claim.” Progressive Insurance Company failed to pay the undisputed, medical specials.
On September 21, 2009, Plaintiff again requested the undisputed benefits in the amount of the undisputed medical specials. Plaintiff again requested an explanation as to how Progressive Insurance Company determined that Plaintiff was only entitled to $930.84 in general damages.
On September 21, 2009, despite its prior evaluation, Progressive Insurance Company represented that “the amount of the medical bills incurred by your client is subject to debate of what is reasonable and necessary.” Progressive Insurance Company refused to pay the undisputed, medical specials because “there is not any explicit provision in the contract language under the uninsured motorist bodily injury coverage, which provides for the immediate payment of medical bills.” Progressive Insurance Company further represented that “the prior adjuster, Kjell Greibesland, relied on his independent professional judgment when he made an offer to settle [Plaintiff’s] uninsured motorist bodily injury claim.” Progressive Insurance Company failed to provide an explanation as to how it evaluated Plaintiff’s general damages at $930.84
Laux v. Nationwide Insurance Company / Allied Insurance
Oct 23, 2008
$106k and $163k
At the beginning of a long awaited family trip to Idaho in September of 2006, a Nationwide insured and her mother were the victims of a high-speed, hit-and-run collision. Thus, the reason they were forced to file an uninsured motorist claim with their insurance company, Nationwide Insurance Company of America / Allied Insurance Company. Despite Nationwide Insurance Company's representation, Nationwide clearly was not "On Their Side." Based upon their experience, it was their opinion that the advertising slogan of "Nationwide on Your Side" may be an effective marketing campaign with no substance when a valid claim is attempted to be resolved by those who pay premiums to Nationwide Insurance Company.
Just a few miles from the Phoenix, Arizona (Sky Harbor) airport, a vehicle traveling approximately 90-95 miles per hour smashed into the back of their vehicle, and fled the scene of the collision. As a direct and proximate result of this collision, their vehicle suffered over $10,000.00 in property damage and both were injured.
Because this family trip had been planned for several months and was extremely important for their entire family, they attempted to continue on with the family trip as planned. Shortly after arriving in Idaho, because the pain became so severe, they sought treatment at an Idaho Urgent Care facility. At that time, Nationwide's insured's main problem was noted as neck and low back pain. Her mother suffered from pain in her neck, back, and right shoulder. The Urgent Care doctor prescribed anti-inflammatory and pain medication for both and instructed them to follow up with their primary care physician when they returned home to Arizona. Both followed up with their primary care physician at the Mayo Clinic and Hospital. Her injured mother suffered from severe low back pain for over two years and tried multiple rehabilitative efforts including therapy, modalities, manual techniques, exercise instruction, and PSIS / iliolumbar ligament / SI joint injections. These injections only helped for about four days. To this day, she continues to suffer from severe low back pain which at times radiates down her right side. She incurred approximately $6,000 in medical expenses because of treatment related to this incident.
Prior to this collision, she was an extremely healthy, active, and independent 82-year old mother, grandmother, and great-grandmother. Sadly, she not only lost her health and activity, but her independence. She regularly volunteered at a local elementary school and assisted one of the first grade teachers. This volunteer work was incredibly important to not only her, but also to all the children. Following the collision, She tried to assist with her first-grade class but was unable to do so because of the severe back pain.
Nationwide's insured suffered from cervical pain, pain in the mid to low thoracic area, and increasing pain and instability to her left knee. She had extensive treatment including prescription medication, physical therapy, and two surgeries on her left knee. She incurred approximately $38,000.00 in medical expenses because of the treatment related to this incident.
Nationwide Insurance Company assigned adjuster Courtney Martin to handle the uninsured motorist claim. Nationwide refused to consider the injuries to Nationwide's insured's knee as part of the claim. Nationwide also refused to explain the factual or legal basis for its position and during the claim, Ms. Martin misrepresented conversations she had with Nationwide's insureds.
On November 28, 2007, Nationwide offered $8,190.00 and $6,194.00 respectively to settle the personal injury claims.
Glass v. Progressive Insurance Company
May 15, 2008
On October 1, 2007, Mrs. Glass's high-end vehicle was stolen from her home. Mrs. Glass immediately contacted the police department and notified her insurance company, Progressive Insurance Company, about the theft. Progressive Insurance accepted the claim and requested pay off figures from Mrs. Glass's Credit Union three days following the theft. Then, without any explanation whatsoever to Mrs. Glass, Progressive Insurance Company turned Mrs. Glass's claim over to their special investigation unit and forwarded Mrs. Glass a Reservation of Rights letter. The letter provided no explanation other than that Progressive was investigating the incident.
Progressive Insurance Company did not respond to Mrs. Glass's requests to Progressive Insurance Company for an explanation as to why the claim had been transferred to the special investigation unit. Mrs. Glass inquiry as to whether or not Progressive had simply turned this claim over to the special investigations unit to delay payment of this high-end loss also did not receive a response. Likewise, Progressive Insurance Company did not respond to Mrs. Glass's request for prompt payment of the claim.
Progressive's special investigator, Ted Cimino, contacted Mrs. Glass's neighbors and showed up at Mrs. Glass's home unannounced. Mr. Cimino described this behavior as "typical special investigations unit cold call tactics." Progressive's investigator even went so far as to attempt to question Mrs. Glass's business partner at his home. Again, Mr. Cimino showed up unannounced. Progressive required Mrs. Glass to turn over private phone and financial records, including cell phone records, bank records, and income tax returns. Progressive subjected Mrs. Glass to an examination under oath. This is a process in which Progressive Insurance Company's attorney questions the insured in front of a court reporter and in the presence of the special investigation unit investigator. Progressive refused to allow Mrs. Glass to have anyone, other than her attorney, present. Progressive also refused to allow the examination under oath to be video recorded. These tactics, and more, were extremely upsetting, embarassing and humiliating for Mrs. Glass. Mrs. Glass felt compelled to obtain the assistance of an attorney because her insurance carrier, Progressive Insurance Company, was not treating her fairly and indeed was treating her as a criminal.
On May 15, 2008, this matter resolved for $120,261.29 without the necessity of filing a lawsuit.
Ritthaler v. IDS Property & Casualty
Jan 01, 2007
IDS Property Casualty Insurance Company, Amex Assurance Company, and Ameriprise Auto & Home Insurance Company are subsidiaries of Ameriprise Financial, Inc. For at least eighteen months (June 2006), IDS Property Casualty Insurance Company, Amex Assurance Company, and Ameriprise Auto & Home Insurance Company have been selling automobile insurance, including Medpay (medical payment) benefits coverage, through an arrangement with Costco. These insurance companies recently extended this contract with Costco in the latter part of 2007.
As of June of 2006, advertisements, including mailings, directed at Costco members inform them that Costco members can "save up to 20%" on their auto insurance premiums" and/or that "Costco members report saving up to $400 on their auto insurance when they switch." Such ads direct Costco members (and others) to a toll free 1-888 number or to Costco's website.
During the sell of automobile insurance these insurers ask for a copy of the potential policyholder's declaration page, they then represent that the potential policyholder could save on their insurance premiums without cutting their coverage with their current automobile insurance carrier.
Problem is that they are selling a type of "killer bee" insurance with respect to the medical payment insurance benefits. These insurance companies represent that the potential policyholder will have medical payment benefits if they switch. However, when an insured actually makes an insurance claim which includes medical payment benefits, these insurance companies argue that the medical payment insurance benefits are only "excess" benefits.
The insurers make the following representation regarding medical payment benefits to all potential insurance buyers, "this covers reasonable expenses for your medical and funeral expenses because of injuries caused in an auto accident." As of June 2006, these insurance companies do not provide an option for a potential insurance policyholder to choose medical payment benefits which are "excess" only, at a reduced cost, as opposed to primary coverage. These insurance companies do not allow an insured who has insurance to skip this coverage for a reduced premium. In fact, in Arizona, as of June 2006, these insurance companies make this "killer bee" insurance mandatory. It is automatically included in all Arizona policies as of June 2006. It is listed as "included" in the premium for liability coverage, BUT THERE IS A CHARGE FOR IT (these insurance companies just don't disclose it to the potential insurance policyholders).
After a policyholder makes a claim for medical payment benefits, these insurers, for the first time, disclose their position that policyholders only have medical payment benefits as "excess." This argument is made despite the fact that the declaration page clearly shows that the policy benefits are not excess (sometime in 2007, IDS Property Casualty Insurance Company, Amex Assurance Company, and Ameriprise Auto & Home Insurance Company changed their declaration pages to show "excess" coverage only after Ms. Ritthaler had filed her lawsuit alleging insurance bad faith and violations of Arizona's consumer fraud and insurance unfair practices and deceptions statutes.) It is IDS Property Casualty Insurance Company's, Amex Assurance Company's, and Ameriprise Auto & Home Insurance Company's position that every single policy sold in Arizona is only "excess" medical payment benefits.
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See www.azinjurycenter.com for remaining details as space is limited.
Rodriguez v. Progressive Insurance Company
Jan 01, 2007
Allegations contained in the Complaint:
That Plaintiffs are, and at all times relevant hereto were, residents of Maricopa County, State of Arizona.
Defendant The Progressive Corporation ("Defendant Progressive") is the management company for Defendant Progressive Classic Insurance Company ("Defendant Progressive Classic).
Defendant Progressive is a holding company that has insurance and non-insurance subsidiaries.
Defendant Progressive does not have any revenue producing operations of its own.
Defendant Progressive creates and dictates the national claim policies, processes and practices utilized by Defendant Progressive Classic on the policies sold by Defendant Progressive Classic.
Progressive Agency Holdings, Inc., a subsidiary of Defendant Progressive, owns all outstanding capital stock in Defendant Progressive Classic.
Defendant Progressive Classic shares common officers with Progressive Casualty, Gregory Trapp (Chairman of Progressive Classic and Progressive Casualty, and President of Progressive Classic), Terence W. Fibbi (Treasurer of Progressive Classic and Progressive Casualty), and Dane E. Shrallow (Secretary of Progressive Classic and Progressive Casualty).
Defendant Progressive Classic and Progressive Casualty share common directors.
Management of Progressive Casualty is headed by Peter B. Lewis and Glen M. Renwick.
Peter B. Lewis is the Chairman of the Board of Defendant Progressive and Glen M. Renwick is its President and CEO.
Defendant Progressive's annual reports set out retirement plans to which the company contributes post-employment benefits, and describes its incentive compensation plans for its "employees" including "a cash gainsharing program" for certain employees.
The Gainsharing program is a nationwide program administered by the Executive Committee of the Board of Directors of Defendant Progressive.
The Gainsharing program is based, at least in part, on Defendants' profits and growth.
Defendant Progressive Classic is, in effect, a sales agent for Defendant Progressive.
Defendant Progressive Classic sells insurance under the name and logo of "PROGRESSIVE."
Defendant Progressive and Defendant Progressive Classic share the same principal office and principal phone numbers.
All premiums written by Defendant Progressive Classic are assigned to a holding company, Progressive Agency Holdings, Inc., a subsidiary of Defendant Progressive.
Defendant Progressive Classic is an insurer authorized to transact insurance business and transacting business within the State of Arizona. Defendant Progressive Classic is a subsidiary of Defendant Progressive.
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Defendants have policies in place to encourage "loss payment reduction."
Defendants' claims departments have a goal of making and/or increasing profits for Defendants.
Defendants have internal incentives and measures driving claims decisions.
Defendants have nationwide bonus/reward programs known as the "Gain Sharing Program," "Casualty Cup," "Inventory Reduction Sales," and "Prog Buck Program."
Defendants' bonus programs, including the Gain Sharing Program, are tied, at least in part, to Defendants' employees' performance reviews.
Defendants' employees' performance reviews are based in part on Defendants' business units' results.
Defendants' employees' performance reviews are based in part on median bodily injury benefit payments towards claims.
Defendants' Gain Sharing Program is based upon business performance measures including profitability related to loss payouts.
Defendants do not disclose the Gain Sharing Program to potential policyholders.
Defendants have "institutionalize[d] the 'lowest ultimate cost' approach to file handling."
Defendants' performance evaluations for claims personnel are based, in part, on claims payments.
Defendants require employees to sign an oath pledging to "avoid being in a position where your financial or other interest conflict with th