How Does the Insurance Company Decide How Much My Case is Worth?

Injury Assessment Software for Injury Cases

computer imageAll major insurance companies now use computer software programs to assist adjusters in placing a “value” on injury claims. These specially-designed programs purportedly allow adjusters to “standardize” claim information so that claims evaluations are efficient and consistent. The problem is, the programs were written for the insurance companies, using their input as to what was fair compensation. So the whole program is flawed in favor of the insurance company.

Some insurance companies have developed their own adjustment software programs, while others have opted for the commercially marketed software programs. The leading adjustment software programs that are commercially available are Colossus, Claims Outcome Advisor, and Claims IQ. These programs systematically assess claim information and assign a reduced value to each injury claim. The program assesses all your past medical conditions and treatments and your current and future medical treatments and then arbitrarily places a “value” on your claim.

Some programs also assess the skill and experience of the personal injury attorney, and whether he or she is capable of getting a substantial verdict against the company. Claims adjusters are instructed not to deviate from the computer assessment of the injury claim. What they personally may think about the value of the injury claim is completely taken out of the picture; it’s not important or relevant. This is why the adjuster’s “low-ball” offer of settlement doesn’t bother them; their personal opinion doesn’t matter.

Example of a Computer Assessment for a Personal Injury Claim

Let’s consider how a claims adjuster would use computer assessment software to assess the value of a serious injury claim. Suppose the serious injury being evaluated is a crush injury to the foot. Because no surgery would adequately repair the damaged ligaments in the foot, the surgeon is reluctant to try surgery unless the injury victim reports that they can’t walk at all. So, the medical bills are just a few thousand dollars for initial treatments. But the injury victim can’t work on his or her feet without pain, and can’t participate in many other activities previously enjoyed.

The claims adjuster will enter information about the claim on the computer program, and the assessment program will indicate a highest possible value on the claim. The problem is, the assessed value may be as low as only 25% of the full value of the claim. Nonetheless, the adjuster will not offer even this grossly inadequate amount as a settlement offer—they are prohibited from doing so without special company authorization.

How Does the Insurance Adjuster Use this Computer Generated Assessment of my Injury Claim?

click here for free report buttonThe adjuster is only permitted to negotiate a settlement significantly below the computer assessment. The adjuster will attempt to withhold payment of at least 50% of the full value of claim to the injury victim.  In the assessment of this injury claim, the computer assessment may be as low as $10,000. The claims adjuster then will offer only $5,000 in settlement, which is half of the computer assessment value. The computer assessment completely ignores the possibility of future surgery costs, which may be as much as $30,000, because the surgeon is hesitant to say exactly when a future surgery would be needed.

Although it is clear that there is a permanent injury—a torn ligament—and all other previous treatments have failed to correct the symptoms, there is a “minimal” value placed on the injury claim.

The claims adjuster can’t even consider any lost wages because the person can still walk, albeit, in a lot of pain—thus, no reason not to work! The claims adjuster remains convinced that her low-ball offer is fair because she has a computer program assessment to support her position.

Even if the adjuster felt compelled to offer more money in settlement, she’s not allowed to offer more without authorization from management. Because computer assessment software is written for the benefit of insurance companies, there is a built-in bias against your claim, and it should be no surprise that the claims adjuster’s assessment of the value of your injury claim is grossly inadequate to compensate you for all your injuries.

So What Can I Do to Receive Maximum Compensation for my Injuries and Losses?

free e-book buttonWhat is the value of an attorney in negotiating with an insurance company? If you go it alone, you may wind up settling for much less than your claim is actually worth. Many times, insurance companies offer settlements for cents on the dollar. But they will tell you a settlement is in your best interests. They may try to get to you say things that hurt your case. Many people who are struggling with injuries find this an intimidating and confusing process. If you enlist our firm to represent you, we will handle all negotiations on your behalf.

We have handled numerous insurance claims involving car accidents, truck accidents, premises liability and other personal injury accidents. In the past, our lawyers have represented insurance companies, and therefore we know how they value claims and what arguments they will respond to. We are adept at reaching favorable results through negotiation and settlement. If we do not achieve favorable results by those means, we are always prepared to meet the insurance companies in court.

Contact a Morgantown Insurance Dispute Attorney

Contact us to learn how we can help you recover full and fair money damages for your injuries and financial losses. From our offices in Morgantown, we represent clients in car accident and motor vehicle injury cases throughout West Virginia.  Call Today:  304-594-1800 or 304-216-6695 after business hours for a free evaluation of your insurance claim.  You don’t have to do this alone.

righting_the_wrong_3dSource:  Righting the Wrong:  West Virginia Serious Injury Guide by Jeff Robinette, Word Association Publishers, 2012.

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Mountainfest 2013 Motorcycle Fatality

Mountainfest Morgantown WV Motorcycle EventBiker Killed In MountainFest Accident

An estimated 60,000 motorcycle riders attended this year’s MountainFest sponsored by Triple S Harley Davidson of Morgantown, WV.  My observation was it was a well regulated, safety focused event, but some circumstances such as rain showers all day and evening Saturday, July 27th were beyond the event host’s control.

Sadly, a motorcyclist attending MountainFest in Morgantown WV was killed Saturday in a highway accident.

The biker was part of a line of motorcycles leaving MountainFest along Chaplin Hill Road. Rain-slickened roads after a rain storm caused the driver to lose control of his bike and drive into oncoming traffic where the motorcycle collided with a Dodge Neon. Police say the man was killed instantly.Mountainfest 2013

The driver of the Dodge Neon was transported to Ruby Memorial Hospital with minor injuries, according to police. A passenger in the car did not sustain any injuries, and no charges are expected to be filed.

Rain was the probable cause of twelve other crashes that day, so EMS crews stayed busy.  Local and State police were on top of the event and stopped several instances of reckless driving.Motorcycle with flames

Morgantown WV Motorcycle Crash Attorneys

Motorcyclists have rights on our West Virginia roads and highways. After an accident, many car and truck drivers will say that they didn’t see the motorcycle. Isn’t that another way of admitting they were negligent?

Jeff Robinette of the Robinette Legal Group, PLLC is ready to stand up and fight for your rights to pursue full and fair money damages after a motorcycle injury or wrongful death. If you or a family member has been involved in a motorcycle accident, don’t let the insurance company tell you it was the motorcyclist’s fault. It’s a common tactic. Insurance defense lawyers know that juries are often prejudiced against bikers.

Free Consultation · No Attorneys Fees Unless You Win · Statewide Motorcycle Practice

Yes, you can try to file a motorcycle accident claim yourself, but there are some important things you will come to realize over time. The insurance company isn’t interested in protecting your rights. Even if they admit liability on the part of their policyholder, they will minimize the value of your injuries and your financial losses. That’s why having an experienced trial  attorney from our firm is so important. We have years of experience handling motorcycle accident cases, as both defense lawyers and on behalf of injury victims.

We know what motorcycle accident cases settle for and we know what juries are likely to award if the case goes to court. We don’t back down in our pursuit of fair compensation for you.

We have trial experience in the most complex types of motorcycle accident injury and wrongful death cases, including:

From our offices in Morgantown, we are prepared to represent motorcycle accident injury victims throughout West Virginia.  Contact us for a free consultation about your bike wreck injury claim today.

Call 24 hours a day:  304-216-6695 or during office hours:  304-594-1800.

Source:  The Dominion Post, July 28, 2013:  http://www.dominionpost.com

Consol Found to be at Fault for Slurry Impoundment Collapse

The West Virginia Office of Miners’ Health Safety and Training has cited Consolidation Coal Co. for the coal slurry impoundment collapse that killed one in November.

The haulage road on the coarse refuse dump area was not safe to drive on, according to the agency’s July 10 report on the incident.

“This is a violation of a Health and Safety statute of serious nature involving a fatality,” the report reads.

Coal mine slurry pondIn the November 30 incident at the Robinson Run mine in Harrison County, experienced miner Markel J. Koon, age 58, was running a bulldozer on the haulage road about noon when the dump site cracked and failed, sweeping the dozer, with Koon, into the impoundment.

The report details evidence that the location was not safe.

Consolidation Coal engineer Paul Stuart Carter had received numerous email messages from supervisor Michael Friedline over the previous week about high readings on a piezometer on the upstream slope, according to the report. A piezometer measures water pressure and is used to monitor stability of a dam.

Carter arrived at the mine at about 11:30 a.m. on Nov. 30, and the two walked the slope and noticed bubbling — more, in Friedline’s observation, than even that morning.  Carter said, “we need to get off the fill.” Friedline instructed Koon by radio to leave the fill, and Koon had begun moving the dozer when a large crack began to develop. Large sections immediately broke off, sliding into the thick slurry and carrying Friedline, Carter, their pickup trucks, and the bulldozer and Koon with it.

Friedline and Carter were quickly rescued. The recovery of Koon’s body on Dec. 14 concluded an extensive recovery operation.

The section that failed, according to the report, was more than 600 feet long, 50 feet wide and 24 feet high. The depth of slurry where the dozer came to rest was 27 feet.

In addition to citing the company, Miners Health Safety and Training recommended the company train employees on hazards of working near water, and that life jackets should be worn by all employees working near water.

It is not clear whether that would have helped Koon.

Further recommendations may be issued when all of the information has been reviewed, the report said.

For Full Story of Markel Koon Recovery Efforts:  https://wvaccidentlawyer.org/2012/12/01/consol-miner-missing/

Legal Insight — Work-related Wrongful Death Claims

West Virginia workers have had a long-standing tradition of persevering and working hard in spite of dangerous and exhausting conditions.  In most cases, the family of a worker who is killed on the job will be able to receive some benefits from a Worker’s Compensation claim.  In West Virginia, if employer is found to have intentionally placed their employee in harm’s way, resulting in serious injury or death, that family may qualify to file a claim against the employer’s insurance company.

Workers’ compensation laws say that you cannot hold your employer accountable for damages above the amount of benefits paid by the workers’ comp insurance unless you can prove the employer acted with “deliberate intent,” as provided in W. Va. Code 23-4-2.

In many workplace injury and wrongful death cases, however, there may also be a third party who can be held liable for negligence. The third party can include the manufacturer of a piece of defective industrial equipment, the property owner or a subcontractor working on the same job site.

If you or your loved one has died due to negligence or willful violation of safety regulations in the workplace, it is important to act quickly to protect your claim.  Mr. Robinette has handled hundreds of cases involving serious injury and wrongful death and can provide the insight you need right now.  Call Jeff Robinette today for a free evaluation of your case at 304-594-1800 or after hours, 304-216-6695 or visit our website for more information.

Submitted by the Robinette Legal Group, PLLC, West Virginia Workplace Injury/Wrongful Death Lawyers.  Free books — Call us today: 304-216-6695 or 304-594-1800 for your free copy of Righting the Wrong: WV Serious Injury Guide; Collision Care:  WV Auto Injury Guide; or Beside Still Waters:  WV Fatal Injury Guide for Families.

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Source: The State Journal, July 10, 2013, Pam Kasey http://www.statejournal.com/story/22809250/supervisor-had-concerns-before-consol-slurry-impoundment-fell-in#.Ud6WooeXXPI.twitter

Tired Truckers Protest New Regulations

FedEx Truck Crash on I-79New Rules for Truckers

In an effort to increase safety on our roadways and reduce driver fatigue, a leading factor in large truck crashes, the Department of Transportation has updated its mandates for breaks and rest periods for long haul truckers.

Tired drivers are far more likely to cause accidents than those who are well rested and driving in compliance with federal trucking guidelines. Tired drivers may also enter a dangerous state known as “highway hypnosis” in which dozens of miles may pass that they do not even remember. Whether a driver falls asleep at the wheel or is inattentive due to lack of sleep, the resulting accidents can lead to catastrophic injuries and wrongful death.

New Schedule Guidelines for Truckers

Starting Monday, drivers will have to stick to a schedule that requires taking a 30-minute break in the first eight hours of driving, cut the maximum workweek to 70 hours from 82, and “restart” those 70 hours with a 34-hour break once a week.

The rules are part of a program to make U.S. highways safer by reducing the number of truck accidents and fatalities. The program also includes a safety rating system that shippers can review when they chose a new carrier, with the goal of prodding the trucking industry to further improve the safety of its drivers and equipment.

Recent Examples of Driving Fatigue in West Virginia

Driver fatigue is a dangerous condition on highways throughout West Virginia. Federal laws regulate how many miles a truck driver can travel per day, per week and on consecutive days. All too often, however, truck drivers push these limits to increase profits or because they are pressured by their employers. In either case, the lives of innocent motorists, passengers and pedestrians are put at risk.

  • This year in Doddridge County three people were injured when an ambulance driver had fallen asleep while driving.  The driver said he was traveling toward Parkersburg when the vehicle ran off the roadway and ended up in the guard rail and a ravine, according to West Virginia State Police.
  • Last July, Richard Detamore was killed when he and coworker Jacob Rowan Forrest were ejected from their vehicle. Now Ashley Detamore is suing her husband’s employer, Nabors Well Services for negligence and wrongful death.  She said the Nabors company knew her husband and Forrest, both truckers for Nabors, had worked more than 30 hours in a 48-hour span.
  • In October, 2012 near Morgantown, WV a FedEx truck was traveling north in the southbound lanes shortly before 1 a.m. when the driver tried to make a U-turn to correct his direction.  The FedEx driver caused a truck accident when he struck a tractor-trailer which then crossed the median into the northbound lanes and crashed through a guardrail on the east edge of the road.

What does the Trucking Industry Think About New Rules?

But the trucking industry—which has sued to have the rules reversed—is warning that they will mean more highway traffic and high shipping costs for consumers. Truckers are saying, “If I get any more breaks out here I won’t be able to make a living.”

What the complainers are missing is that trucking is dangerous when drivers are too tired to be on full alert at all times.   Slugging out the last hundred miles every day is what the new laws are designed to address.   The truckers should actually “rest” during the rest stops instead of playing arcade games, going gambling or watching movies.   That is not rest.

The new rules are predicted to prevent 1,400 crashes and 560 injuries, and saving 19 lives each year.  The DOT says the new rules will also produce a broader economic benefit. The department’s analysis found that in 2009 alone, large truck and bus accidents cost some $20 billion in medical and insurance costs, infrastructure damage, lost wages and productivity. The analysis also estimated $470 million in benefits from reduced driver mortality.

 Jeff Robinette, West Virginia Truck Accident Attorney

Jeff Robinette is a National Board Certified Trial Attorney who has focused his practice on motor vehicle accidents.  Our office is in Morgantown, but we represent clients in car accident and motor vehicle injury cases in Monongalia County, Taylor County, Doddridge County, Marion County, and Preston County, West Virginia.

Free Books for WV Accident Victims

Call us today: 304-216-6695 or 304-594-1800 for your free copy of Righting the Wrong: WV Serious Injury Guide; Collision Care: WV Auto Injury Guide; or Beside Still Waters: WV Fatal Injury Guide for Families. We are glad to answer your questions.

righting_the_wrong_3dBeside_Still_Waters_-_Covers_3DCollision Care

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Gas Well Fire in Doddridge County WV Legal Insight

On Sunday July 7th, 2013,  Antero officials reported five workers were injured in a gas well pad explosion at about 4:00 a.m. at a Doddridge County, WV gas drilling site off Brushy Fork Road near New Milton, WV.  The five men were taken to the West Penn Burn Center and are being treated for various degrees of burns.  Regular operations have been shut down at the Antero Resources well site after the two explosions on Sunday morning.  Most of the injured are in severe critical condition and some have required surgery.

The men who suffered burn injuries were working for contracting companies — three men from Nabors Completion and Production Service, one from C and R Downhole Drilling LLC, and a worker who is employed by Willowbend Investments Incorporated.  The identities of the men and their conditions have not been released.  Antero operates 15 drilling sites in seven counties in West Virginia.  This is the second explosion at an Antero site within a year in West Virginia.  Two deaths resulted from this tragic incident.Gas Well Fire Doddridge County WV

Right now investigators believe a pump which the employees were working on may have ignited gas vapors which caused an explosion, causing two tanks to rupture and causing damage to other tanks.  The diesel engine pump, which had malfunctioned, was being used to push data logging equipment down into the horizontal wellbore, which had been drilled and hydraulically fractured, by pumping fluid behind it.  The well had been drilled recently, and the crew was in the final stages of completing the well.  Workers were inserting a narrow production tube into the metal casing around the drilled hole when methane gas somehow ignited.  Investigators have not ruled out the possibility that fumes that had volatilized and accumulated inside the tanks and exploded.

The fluid that was contained in two tanks next to the pump was “produced water” which is a fluid that comes back up from wells which may contain explosive volatile organic compounds.  DEP spokeswoman said Monday the blast ruptured two tanks containing flow back water that Antero had been reusing, but the secondary containment system captured the fluid as designed and none left the site. There was no contamination to any nearby streams, she said, and the nearest home is about a half-mile away so it was unaffected.

Legal Insight You Need for Your Gas Well Injury Claim


West Virginia workers have had a long-standing tradition of persevering and working hard in spite of dangerous and exhausting conditions.  As the oil and gas drilling industry grows, an increasing number of workers are experiencing accidents resulting in serious permanent injuries and wrongful death.

In most cases, a worker who is injured on the job will be able to receive some benefits from a Worker’s Compensation claim.  In West Virginia, if employer is found to have intentionally placed their employee in harm’s way, resulting in serious injury or death, that employee may qualify to file a claim against the employer’s insurance company.

Many injured workers think that their financial damages for medical bills and lost earnings are limited to West Virginia workers’ compensation benefits.

Workers’ compensation laws say that you cannot hold your employer accountable for damages above the amount of benefits paid by the workers’ comp insurance unless you can prove the employer acted with “deliberate intent,” as provided in W. Va. Code 23-4-2.

In many workplace injury and wrongful death cases, however, there may also be a third party who can be held liable for negligence. The third party can include the manufacturer of a piece of defective industrial equipment, the property owner or a subcontractor working on the same job site.

If you or your loved one has been injured due to negligence or willful violation of safety regulations in the workplace, it is important to act quickly to protect your claim.  Mr. Robinette has handled hundreds of cases involving serious injury and wrongful death and can provide the insight you need right now.  Call Jeff Robinette today for a free evaluation of your case at 304-594-1800 or after hours, 304-216-6695 or visit our website for more information.

We are glad to provide free books and information for WV accident victims: Collision Care: West Virginia Auto Collision Guide, and Righting the Wrong, West Virginia Serious Injury Guide:  304-594-1800.

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For More Information:  WBOY news, July 8th, 2013:  http://www.wboy.com/story/22776291/gas-well-workers-injured-in-explosion#.Udq5ObZMY_0.twitter

West Virginia State Journal, July 8th, 2013:  http://www.statejournal.com/story/22782306/basic-details-still-coming-in-on-sunday-antero-wellpad-explosion