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Are You Really
Insured?
Don’t be So Sure…
You think you’re covered in a
catastrophic event… after all, you’ve paid your premiums faithfully
for years and never before had a claim. And then one day… the day you
need the benefits of your insurance, you find that all you paid for was
the battle of your life. And when you’ve been in your own business,
the battle is even more intense.
It was a beautiful, but hot Sunday. My
husband and I were excited… we were on our way to buy a new stereo.
Ric pulled slowly out of the shopping mall while I was gulping down some
ice water we’d brought along. We were the second car out of a green
light when, from around my large plastic glass, I caught a glimpse of
white. The next thing I remember was holding my head and telling the
first paramedic on the scene that ‘my head exploded.’ Little did we
know that we were just beginning what would be years of recovery.
We were hit broadside from the driver’s
side. As a passenger, the shoulder harness did not contain my upper body
from the direction we were hit. First came the stretch of my life…. my
upper body was thrown at 45 miles per hour to it’s fullest extent.
Then it stopped… and so did my brain… that’s a 45mph impact inside
my skull. Then (I don’t remember any of this by the way, but the laws
of physics are pretty clear when you think about them.) my body was
thrown violently back against the passenger door… smashing my shoulder
and possibly hitting my head again on the window. This went on for a
couple lesser "volleys" of my head… kind of like a tennis
ball thrown in a small room. It comes back violently at first and
gradually slows until it finally stops.
My husband, thankfully, was stopped first
by the driver’s door and window and didn’t receive as much of a
whiplash, but his brain too went from 45 to zero in almost an instant.
We both suffered a traumatic brain injury (TBI). Thankfully he was able
to continue working, or we would have been bankrupt long before now. And
we still may have to yet.
I spent most of the first year sleeping
and going to doctors… or I should say getting lost and hoping to find
my doctors. The second year has gotten better… the pain is less, but
not gone. I’ve also learned many of my limitations that resulted from
the brain injury, so I can stay out of situations that make me feel like
a total idiot at least.
It’s now two plus years post accident.
We’ve paid thousands of dollars worth of doctor’s bills, have
another $20,000 or so to go, I haven’t worked since the accident, and
can never go back to my previous business because of the brain injury.
And oh yea, this is where the fun starts.
My insurance agent, when talking with him
about another matter said to me the other day… "now aren’t you
glad I talked you into a bigger policy." He had, in good faith,
encouraged us to get a 250/500 policy – that’s $250,000 coverage per
person or a max of $500,000 per incident. I agreed… but that was
before we got the "offer" from the insurance company… for
$30,000 for Ric, and a whopin’ $125,000 for me. It doesn’t matter
that we weren’t at fault.
You see, this major insurance company has
recently adopted the usage of a new program called "Colossus".
It calculates a settlement amount based on history of others with
similar injuries, they state it and there’s NO negotiation.
It doesn’t take into consideration that
as an infant I had half the muscles removed from my neck and what’s
left received such a trauma I still can’t work for more than 4-5 hours
a day without severe pain. That injury also prevents me from driving or
even spending much time in a car since the lateral movements from the
car increase the pain 10 fold.
To add insult to injury (literally) these
guys are doing their best to prove that my business wasn’t making any
money at all, and therefore I had virtually no income that I could
claim. If you ever thought getting a loan from a banker was rough, try
getting a settlement you’re entitled to from an insurance adjuster!!!
Number one, a banker knows that tax
deductions (like depreciation) are just that … they’re the first
thing they add back in to see what your real income is. Not so with
these insurance adjusters. And, they can’t imagine why I didn’t
unplug all my phones, drop all my advertising, and basically just
"quit" my business, so the expenses I’ve incurred keeping a
business presence for two years when I couldn’t make any money, aren’t
being considered as valid either. And, as you know if you have your own
business, starting up again from zero can take two to three years to be
generating that same income I had before the accident IF I could
continue to do the same work.
Some of the low-cost business generating
options like networking, speaking, etc. aren’t an option. Getting to
them causes me to be in too much pain, and if I happened to get business
from them it’d be quite likely that the "pain episode"
getting the business would prohibit me from "doing the
business."
The adjusters are doing their best to
invalidate my business and a lifetime of hard work to develop a highly
regarded nationwide reputation. They’re unwilling to consider the
facts or the unique circumstances of my medical condition. They’ve got
their formula and by golly they’re going to stick with it…
regardless of the fact that we, the policy-holders, thought we were
buying the right amount of insurance from a well-reputed company that we’d
be financially OK in a catastrophic event. But, the fact that we bought
a policy with limits WE knew we’d need in such an event,
doesn’t mean anything.
A note from our attorney a couple of days
ago summarized it nicely, "they know you need the money more than
they do." The insurance companies take advantage of their policy
holders when they are most in need of what they bought. I could see them
arguing, digging deeply and fighting if the claimant had a history of
fraud, taking advantage of public programs, etc. But all we’ve done
was to be in the wrong place at the wrong time and are now being forced
to fight them instead of trying to find a new way to make a living.
If it was just this circumstance, I might
think that we’re in an unusual situation. But, at various doctors
offices and physical therapists over the last couple of years, I’ve
met many people who been in accidents. Without exception, their
insurance companies were making it extremely difficult to even get the
medical attention they needed, let alone a means to support themselves
or pay for their "down" time or losses. These are all people
who are in one of the most vulnerable times of their lives. They’re
injured. They’re broke. They’re in pain. And they’re getting
screwed simply because they don’t have the energy to fight a good
battle because of their situation.
The offer the insurance company made to
us would amount to about $50,000 for two of us after we pay off the rest
of what is about $50,000 in medical bills. I’m 50 years old, and now
have to figure out what I’m going to do when I grow up… and pay the
price of finding a new way to make a living when I LOVED what I was
doing before in my business.
Please understand, this isn’t about
greed. We’ll survive whether we get a dime from them or not, but it
won’t be easy. What it’s really about is that fact that I’m
outraged at the lack of fairness and the false sense of security one
gets when they buy insurance. And it’s also about letting other
business owners know how much of an additional battle they have just
because they’re in their own business. If you had a job, the issue of
income is non-existent.
As a business owner, you’re used to
planning and calculating risks. And, because insurance is a regulated
industry, it’s easy to be lulled into thinking you’ll get the value
of what you’re paying for when and if you need it.
And please, don’t think that "it’ll
never happen to you." According to the National Transportation
Safety Board, over 2 million people a year are injured in auto accidents
nationwide. If you drive (or ride in a vehicle) for 30 years that means
you have a 23.3% probability of being injured in an auto accident.
And, it’s about knowing what you’re
buying… or not. I thought we were covered, but our coverage seems to
be a unilateral decision made by someone who doesn’t have a clue
about, nor do they care, whether we can ever go back to our normal
lives. I’d trade a million dollar settlement in one minute to not be
in constant pain and to be able to just continue with my pre-accident
life… most people in my situation would.
Now you tell me… do I have insurance or
don’t I.
Want
more of the details on where the problems lie... click
here.
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