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How insurance companies use the money you pay to them against You

I saw a YouTube Clip of a prominent American Trial Lawyer not long ago. It was very “us against them” in tone, but the messaging rang true.

For years, and in some cases, for decades, hard working people pay their hard earned after tax dollars to car insurers for premium payments. In Ontario, it’s illegal to drive a car without car insurance. So, paying your car premiums is the law; so you have to pay these premiums if you want to drive legaly.

More often than not, these payments are made to the same insurance company for years because studies show that people don’t often change insurance companies. That means you’re dealing with the same insurance company year, after year.

And year after year, nothing out of the ordinary will happen. You will pay your insurance premiums, and receive the occasional letter from your car insurer enclosing updated policy information and slips. But that’s pretty much it. You won’t ask a lot from your car insurer. And, in return, they won’t ask a lot from you aside from demanding the payment of premiums.

Car accidents and catastrophic events are the exception. They aren’t the rule. You can go your whole life without ever being involved in a serious car accident. And, let’s hope that’s the case because nobody wants to be involved in a car accident.

But, in the rare circumstance that you’ve been hurt or injured in a car accident; you would expect that the insurer who you have been dealing with for years to be there at your side in order to pay you the compensation which you deserve.

At the end of the day, you were in the wrong place, at the wrong time and have done nothing wrong. All that you are seeking is that you are compensated fairly for your losses, along with your pain and suffering.

But this is not how things work in personal injury cases. Instead of helping you out, the insurance company will use their immense resources to fight your claim every step of the way. They will pay experts, investigators and their lawyers thousands and thousands of dollars (if not more), to make sure that you aren’t compensated a single dime.

Where does the money to fight your claim so vigorously come from?

That’s another good question.

Insurance companies have many ways of making money. Some ways are directly tied to the insurance industry. Other ways aren’t. But, their bread and butter remains from running successful insurance businesses. In it’s most basic form, insurers make money by collecting premiums, and, in exchange, provide insurance policies to their customers. The more premiums which they collect, and the fewer claims which they have to pay out on those premiums, the more money they can make. Once insurance premiums are collected, what the insurance company does with those premiums is their business. It’s not unheard of for insurers to invest those collected premium money so that they can make more money.linkedin-2-300x300

That premium money which you pay also goes to fuel the day to day operations and business expenses of a large insurance company.  Part of those daily operations is paying for lawyers, investigators and medical experts to defend plaintiff claims brought against an insurer (like the claim of an innocent accident victim in a car accident case). So, in essence, your very own premium dollars are being used against you to fight your own claim.

There are no limits as to how much money and/or resources an insurer can use to fight a claim. That means that should it choose to do so, an insurer can spend $500,000 on legal fees, experts, and surveillance on a case with an objective valued exposure of just $5,000.

While this might not seem like an economical approach for one individual case, the insurer may not be looking at the one case. They might take the approach of sending a message to the personal injury lawyer, or a community, or the public,. or to other lawyers that they will take a purposed approach regardless of the value of the claim (big or small). The insurer is playing the long game and looking at the entire playing field as oppose to taking each case on a case by case basis. There are consequences to such an approach which personal injury lawyers have seen play out in the Courts. On cases where insuers have take a scorched earth approach to defending the case; meaning that they are playing hardball leaving the Plaintiff with no other option but to go to trial; insurers have been hit with giant cost awards against them. The Court has spoken loud and clear that there are consequences to taking a hard line approach. Those consequences are only economical in nature (nobody goes to jail, nor is the insurer’s license for operating in the province taken away).

What’s even more hard to understand is that the name of the insurance company which has taken that hard line and unreasonable approach in the case is often never known to the public because the name of the insurer is not listed in the case. Instead of the insurance company, it’s the name of the insured Defendant driver who is listed in the publicly released decision. This gives the appearance that the individual defendant driver who is listed as the defendant on the Statement of Claim was being unreasonable; when all along, it was a large multi national insurance company calling the shots and strategizing behind the scenes to take a scorched earth approach to defending the case. If more people knew which insurers took such an approach, and which didn’t, it may influence consumer behaviour. People shopping around for insurance would be more likely to go with insurers which are viewed as more reasonable in dealing with; rather than insures which take the opposite view. The way that our legal system works in Ontario is such that the named insurer has anonymity when fighting most personal injury cases (not long term disability cases where the long term disability insurer is named directly as a Defendant in the case). That anonymity provides insurers with a barrier of protection for their reputation where they have behaved badly or unreasonably in many personal injury cases. If an insurer plays hard ball, they won’t loose any goodwill in the community because their identity remains a secret, and unpublicized in the public court record.

 

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