Posts in: June

9Jun 2020

When evaluating a personal injury claim, insurance adjusters routinely look at your medical records. One of the first things they look for are “gaps in treatment.” In the insurance industry, a “gap in treatment” is a term that means that your medical records show a gap or break in seeking medical attention for injuries that were caused by an accident or incident. A gap in treatment can mean you did not seek medical attention immediately after the accident. It could also mean that you did seek medical attention immediately after the collision, but at some point after you began your medical treatment, there was a significant period of time wherein you did not seek/receive medical treatment.

The insurance industry uses “gaps in treatment” to discount your medical treatment. To an insurance adjuster, a gap in treatment means you did not need medical care or that you weren’t in pain. In the real world, though, we all know that there are many different reasons why someone would not seek immediate medical attention or allow a significant amount of time to pass between doctor visits. Some people don’t have the medical insurance or money to pay for treatment. Others may not be able to take off of work for doctor visits or may have recently relocated to a new city where they have more limited treatment options.

A gap in medical treatment has never been a valid reason to discount someone’s medical treatment, but the events of the past three months have further discredited that point of view. The COVID-19 pandemic began shutting down a multitude of business worldwide in early March, including many healthcare facilities. As of the date of this article, many healthcare facilities continue to be either closed or operating at a reduced capacity. Sadly, some have been shut down altogether.

As a result, if you needed medical treatment in the past three months, it is highly probable that your medical provider was not able to see you for treatment for a period of time. In fact, given the priority that was given to COVID-19 patients and the burden that those patients placed on many facilities across the world, even those who were in need of emergency medical care were at times not able to receive treatment in some areas. Furthermore, some people undoubtedly decided that even though they were in pain and had access to a healthcare provider, seeking treatment was not a good idea because of the increased risk of exposing themselves to COVID-19, and certainly no one would fault them for that decision.

So, in light of the recent dynamics of COVID-19, how can the insurance industry continue to use “gaps in treatment” as a basis for discounting, and in some cases, denying claims? The prudent insurance carriers will not continue to do so, because they realize that the world has changed, including how people are forced to deal with their injuries and receive treatment. The imprudent insurance carriers, though, will continue to robotically chant “gaps in treatment” in evaluating their claims, but when those claims become lawsuits, they will soon find a jury made up of six or twelve human beings who have all been through the events of COVD-19 and who will judge those insurance companies harshly for continuing to make the same old “gaps in treatment” argument.

Are you having issues with contacting a medical provider or seeking treatment following a motor vehicle crash? Give our office a call today and make a free appointment to speak with one of our Car Crash Specialist.

9Jun 2020
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Farmers Insurance Wasting Time and Money

Update: As of November 17, 2021, after Farmers lost their frivolous and meritless motion for sanctions, earlier in the year, Attorney Polito was taken off the case, and an offer was presented for $15,000.00 over the $30,000.00 Farmers Policy Limits.

In the world of “Personal Injury,” you are told what to do by the insurance adjusters. If you don’t listen, they tell you “go do what you have to do.” We heard that line about 25,000 times from insurance adjusters, and each time we went to do what we had to, setting a record for the Most Motor Vehicle Trials in Harris County, and maybe in the nation, in 2019 for a firm our size.

Now, all they say is “Congratulations.” Yeah, right. Now they say “Stop doing what you are doing,” “Don’t go to trial,” “take our policy limits,” “here’s over our limits.” The Hadi Law Firm settled over 12 cases in 2019 alone, 2 by Verdict, in excess of an Insurance Carriers Policy Limits. A case called STOWERS allows us to do that. Still, you need to work for it, which sometimes means going to trial and getting a verdict. We have successfully “Stowerized and Settled in excess of limits” against over 15 Insurance Carriers.

We recently received an offer at mediation, on June 4, 2020, for the maximum limits of $30,000.00, afforded our client under the at-fault tortfeasors coverages. Farmers Insurance refused to respond and settle after numerous demands to settle. Farmers even refused after watching their Insured run over our client. Watch the Video here. Speeding in a School Parking Lot! Their Defense Counsel, Hipolito “Polo” Gonzalez, even taunted the limits at one point but ultimately refused to offer it. When push came to shove, Farmers filed a Motion with the courts COMPELLING MEDIATION. In their motion, they discussed how our client’s case was bad, and that:

“9. The undersigned defense counsel believes that this case is ripe for mediation, and that a local mediator will better be able to reach the Plaintiff’s lawyer from Houston as to how a jury in McClennon [sic] County, Texas would respond to his arguments and demands given the actual proof in this case.”

Instead of properly evaluating a case in the beginning, Farmers instructed their Defense counsel to draft a Motion to Compel that suggests the Jury Pool in McLennan County [Waco, Texas area] would somehow be less willing to award our client money. Their so called “Local Mediator,” couldn’t put out the torch, even after he said:

“All this Texas Torch mumbo Jumbo goes right over my head and I don’t give a FIT. Are you going to demand less than limits or no, if NOT, THIS MEDIATION IS OVER!”

We said no. They Offered their Limits. We still said no.

Instead of evaluating this case and resolving it in 2016, Farmers pushed their options and selected bias and intimidation, forcing our office to spend money on mediation when they had already decided to offer the limits. Their games will turn into flames. They saw that nothing will stop The Texas Torch and tendered their limits, but by that time, it was a little too late. Subscribe to our YouTube Channel for updates and videos on Personal Injury Law and How To Attack in Texas.