The following post discusses GEICO Insurance claim settlement practices, where our office obtained a $420,000 arbitration outcome on an offer of $39,700.
Oregon personal injury lawyer Aaron DeShaw was representing a 71 year old doctor who had sustained a mild traumatic brain injury in a crash with an underinsured motorist in 2012. Despite being seat belted, the force of the collision pushed his vehicle forward approximately 60 feet, blew out his back window and sent his head into the A pillar of his car, leaving a large visible bruise on his head. His chiropractor diagnosed a concussion the following day, and despite not wanting to go to the ER immediately, he ended up going approximately one week later due to increasing cognitive symptoms, headaches and crying without reason.
The traumatic brain injury was deemed “mild” despite significant personal impact, because under the medical definition he did not meet the loss of consciousness criteria for moderate traumatic brain injury despite a very hard head strike inside the car.
In the period following the collision, the doctor continued to have cognitive and behavioral changes, resulting in him having to close a health food company he had started (but which was not yet profitable), and doubling the hours he worked in his practice to accommodate the problems from his injury.
The doctor had obtained a SPECT scan at the Amen Clinic in Washington, which was read as abnormal due to traumatic brain injury. A CT scan showed abnormality in a deep area of the brain. One 1.5T (standard resolution) MRI was read as negative, but a higher quality 3T (higher resolution) MRI was read as having 15 white matter changes within the brain. GEICO’s defense doctors claimed that SPECT scan was not reliable (despite evidence to the contrary) and that the photograph of the massive bruise on his head, the positive CT findings and the positive MRI findings should all be ignored.
Medical bills in the case were just under $60,000. Treating doctors confirmed that all of the treatment was reasonable and necessary for the cognitive, behavioral, and physical injuries sustained in the crash, which also included injuries to the spine, knee, and arms.
Our client wanted to settle with GEICO for a fair amount, but GEICO Insurance refused to ever make a fair settlement offer. GEICO Insurance is owned by Warren Buffett (through his company Berkshire Hathaway), one of the wealthiest people in the world. Berkshire Hathaway is cited by some as the most profitable company in the United States (well in excess of Apple, Microsoft, Walmart, Amazon, J.P. Morgan, Alphabet / Google and others.) They profit in part by charging for insurance premiums and then by denying or underpaying GEICO's insurance claims.
GEICO Refused to Accept the Opinion of Its Own Expert
In an attempted litigation tactic, GEICO Insurance hired an economist on this case that had previously been hired by DeShaw on other cases. The economist came up with a past financial loss of over $50,000, with some projected future loss that was limited due to the doctor already being past the normal age of retirement.
The doctor wanted to settle the claim against GEICO, but needed to be fairly compensated for his financial and personal losses. GEICO never gave him the opportunity by making a fair offer. Despite GEICO’s own economist telling the GEICO insurance adjustor that the wage loss alone was worth over $50,000 on top of the $59,000 in medical bills, GEICO offered a total of $39,700, apparently evaluating the doctor’s personal losses at worth less than $0. This is a typical result from GEICO, a company which frequently provides little or no offer on serious injury cases because there is no financial penalty for improperly denying or delaying insurance payments in Oregon. Faced with the opportunity to stop this type of insurance practice, the Oregon legislature has repeatedly refused to implement “bad faith” legislation in Oregon leaving Oregonians subjected to the worst insurance abuses in the country. Oregon is one of two states with no bad faith legislation (along with New York.)
GEICO Fires its Own Expert
Not surprisingly, when GEICO didn’t like the result of the economic report of that expert, they hired another economist who said that the doctor had no economic loss. When DeShaw attempted to subpoena GEICO’s first economics expert, they refused, hiring an attorney in an attempt not to have to testify against GEICO. The arbitrators in the case, three experienced Portland area lawyers, required the economist to testify and answer the questions about the financial loss.
Exposing Deceptive IME Doctors
It is difficult for some people to believe that some doctors are paid by insurance companies to do exams that will result in the doctor saying that the person wasn’t injured, simply to deny their own policyholder’s personal injury claims. But, this happens every day in the personal injury protet ("PIP") context, in workers compensation claims, and even in the litigation of these claims by an insurance company's own policyholder. It is an Oregon personal injury lawyer’s job to demonstrate for arbitrators or jurors that these doctors have a financial interest in continuing to discredit injured people, in order to continue making money from insurance companies. The clinics that perform these examinations provide little or no care to sick or injured people. Most of these “IME” clinics are not owned by doctors or hospitals. Most of these companies are not real medical clinics, and they are not owned by doctors. In fact, some of them are owned by insurance software and service companies who are already making millions of dollars from insurance companies. They are merely a front for doctors who perform examinations for insurance companies, and some doctors make hundreds of thousands to millions of dollars per year doing insurance company examinations.
In his trademark method of cross examination, Oregon Personal Injury Attorney Aaron DeShaw took on defense doctors Dr. Lynne Bell (insurance neurologist), and Dr. Donna Wicher (psychologist) in this case. Unlike many lawyers, who are hesitant to take on a witness on the topic of their own expertise, DeShaw’s cross examination method delves deep into medicine and psychology testing practices to expose the false basis for the insurance doctor’s opinions. Both Dr. Lynn Bell and Dr. Donna Witcher are well known doctors who testify for insurance companies, and are hired by insurers regularly to testify against DeShaw’s clients. Despite the car being thrown forward 60 feet, a photograph clearly showing a large bruise on the doctor’s forehead, positive SPECT scans, positive CT scan and positive MRI scan, both doctors claimed that there was minimal injury to the doctor, that he should have been fully healed within approximately 12 weeks, and that he had a psychological condition that would explain what he falsely believed were ongoing symptoms related to the brain injury. These are all common defenses that an Oregon personal injury lawyer must know how to handle if they are striving to be the best Oregon brain injury lawyer. They went further to say that the symptoms may be caused by the simple fact that he had been diagnosed with a brain injury - that the diagnosis itself caused him to believe he had problems that he didn’t really have. DeShaw took these issues on, head on, disproving them with a combination of medical treatises, medical research articles, the DSM-IV and DMS-V books, and through testimony of lay witnesses who knew the client before and after the crash. For injured people looking for an Oregon personal injury attorney who gets in the trenches and takes on the insurance doctors head on, Aaron DeShaw takes an approach based upon medical research.
DeShaw is a nationally known brain injury lawyer, and his deep knowledge of this topic became important in winning this case. Cross examination on the neuropsychological scores showed that the client had been in the 95th to 98th percentile of the population in terms of his intelligence before the crash, but that after the crash many of his scores were far lower than expected. The cross examination also showed that the defense neuropsychologist isn’t actually a neuropsychologist, that she hadn’t done the testing herself, that she had failed to disclose the use of a test technician in her report, that she had failed to correctly score the testing, and that she had failed to compare the client to the demographic groups that would best demonstrate whether he had brain damage.
One of the most shocking moments of the arbitration was when insurance defense neurologist Dr. Lynne Bell suggested that the injured doctor, who had been doing orthopedic and neurological tests for over 40 years, would attempt to fake one of those tests with her by waiving his arms around in an exaggerated way in order to make himself look injured when he wasn’t. The client’s response in his redirect testimony was that such an attempt would be idiotic, and that he didn’t exaggerate anything during his testing. But this demonstrates that some insurance doctors will mislead even when the patient has been doing the same testing longer than they have, and when the negative testimony will hurt another doctor.
Our law firm keeps entire physical notebooks and digital research files on insurance doctors, including Dr. Lynne Bell, Dr. Donna Wicher, and many others, for our use when we represent injured people. In some cases we have thousands of pages of research on these insurance witnesses and know the weaknesses in their education, training, and testimony. This massive amount of research, compiled over decades, helps brain injury survivors seeking the best representation for their traumatic brain injury or other catastrophic injury.
GEICO’s Request
GEICO asked the arbitrators to compensate the doctor (their own policyholder) for a few weeks of medical care, and $15,000 for his past and future non-economic damages (pain, change in quality of life, humiliation, and mental suffering.)
GEICO Loses
After all the testimony over two days, the three arbitrators decided that appropriate compensation for this 71 year old physician is $420,281.84; $59,642.84 in past medical costs, $10,639.00 in lost wages, and $350,000 in non-economic damages (change in quality of life, physical pain, humiliation, mental suffering, etc.) DeShaw expects that age did play some part in the limitation on the amount of non-economic damages, as that amount is often based upon the number of years that the person will suffer with permanent injuries.
GEICO’s Insurance Bad Faith
For those people who are being made little or no offer from GEICO after an injury, it is clear that GEICO is making unreasonable offers in Oregon because there are no legal penalties for doing so, leading to greater profits for the company. (GEICO has made $337 Million in profits in the last three months alone.)
This case is one that would be a clear “insurance bad faith” case in most states due to GEICO’s failure to offer a fair value for the claim prior to the client instituting litigation, but not in Oregon because we have no laws that penalize improper insurer conduct. While clever advertising methods like using a likable gecko with an British accent, and other unique advertising schemes make potential jurors favorable to the company in a jury trial, the reality is that GEICO Insurance Company is systematically underpaying claims even to their own policyholder. These savings have helped make GEICO’s owner, Warren Buffet, one of the richest people in the world. This is but one more example of how injured people with a claim against GEICO will not get what is reasonable for their injuries without hiring an Oregon personal injury lawyer and taking the claim to trial or arbitration.