October 21st, 2015

The Kool-Aid Drinking Lawyer

Helene Blank

Even though Helene Blank has tried cases for both defendants and plaintiffs, and has been doing so since 1979 in roughly 130+ trials, and lectures widely, she is still stunned by what she sees.

She last appeared here in a good rant about bad faith and insurance companies.

She guest blogs today on lawyers that have surrendered their objectivity, and with it their ability to actually assist their clients…

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Kool-Aid drinkers to a plaintiff’s lawyer are defendants’ lawyers who, no matter how stark the evidence that the plaintiff is seriously injured, refuses to believe it and does everything they can to make sure your client isn’t properly compensated for their injuries. The insurance company must be protected from really hurt people at all costs.

I always thought the true Kool-Aid drinker was really a mythological beast not any more real than Bigfoot, Yeti or a werewolf. That was until last week.

I ran into a defense lawyer I hadn’t seen since we tried a damages only case of a client of mine who was irreparably and horribly injured from the accident caused by her client. This poor, sad soul developed what is known as RSD or CRPS – which stands for Reflex Sympathetic Dystrophy or Complex Regional Pain Syndrome — the people who have the true misfortune of getting this call it CRAPS — ’cause that’s what your life becomes, crap.

This syndrome happens to an unlucky person after an injury, their brain just goes haywire – and the affected limb is in constant unending pain. You become hypersensitive. You can’t be touched, you can barely wear clothes, you can’t use the limb, and it atrophies or wastes away.

This poor soul had even worse misfortune when the CRPS jumped from his left arm to his right leg — a not unknown phenomenon for these poor people.

His life as he knew it was ruined. He couldn’t sleep in a bed, be touched by another human, not his wife, not his children. He had a pain pump inserted into his spine in the hopes of gaining some relief.

He routinely begged his doctor to cut off his arm. If only it were that simple and such a barbaric act would cure him. Too bad, but it wouldn’t.

He was unable to really walk and he couldn’t use the affect arm to do much of anything.

The defense had him examined twice by a wonderfully credentialed doctor from one of the best hospitals in the world – the Hospital for Special Surgery. After each exam, this doctor reported that it was his opinion that my client did indeed suffer from RSD/CRPS.

But they never produced that doctor for the trial.

Instead, they hired for trial what plaintiffs’ lawyers in gentle circles call “a witness for hire” to testify that my client did not suffer from this. A witness who spends her career traveling the country testifying against injured victims who suffer from this. This doctor never once examined my client and completely discounted the defense’s medical exams. But okay –I know that’s what defense lawyers do. It’s their job to try and get the best possible settlement for their client.

I understand that, really I do. I was once one of them. But my encounter with this adversary last week so saddened me that it’s hard to get out of my mind.

After we exchanged niceties, she actually said to me: your client, he’s out somewhere partying with all that money he got and he has finally taken that bandage off his arm. A “bandage” that he wore constantly to protect himself from human touch which he found excruciating.

I was shocked. Truly, absolutely shocked. This seemingly intelligent woman, who had all the truth in front of her during the trial, really drank the Kool-Aid. She just simply refused to believe that this poor man was so badly hurt.

I answered that she must be kidding. Did she really truly believe he was a fraud?

She actually said yes, and said she regretted not doing surveillance on my client. I told her that so did I, if for no other reason than I could have used the footage against her client because all she would have seen was what she saw in court. A beaten, hurt human being whose life was destroyed.

Her bizarre response to that was this made her feel better. It all made me feel so sad for this lawyer whose humanity was somehow lost along her way. It made me realize why I stopped being a defense lawyer a long time ago. I never was going to lose my humanity for any insurance company.

October 14th, 2015

About That Aunt Suing An 8-year-old…. (Updated x4)

Face of random kid that looks to be about 8

It shot around the Internet yesterday, like so many other viral stories do, and all I could do was roll my eyes. It was the story of an exuberant 8-year-old boy in Connecticut leaping into the arms of his aunt upon seeing her, and her resulting injury, a broken arm.

The story was one that any adult could imagine. The woman testified:

All of a sudden he was there in the air, I had to catch him, and we tumbled onto the ground…I remember him shouting, ‘Auntie Jen I love you,’ and there he was flying at me.”

People were aghast. One only needs to read the comments of any article on the subject. How could you sue a beloved relative? And how could you sue a child?

But suing relatives (or close friends) happens all the time, particularly in auto collisions. Who, after all, are you most likely to be with at the time of a collision? A close friend or relative. Unless you drive a taxi, you don’t often have strangers in your car.

And it’s the same with your home, in that the most likely visitors inside are family and friends.

When I first saw the aunt-nephew story, my first thought was that homeowner’s insurance would cover the incident if there was liability, and that this was similar to suing a relative over a car crash. I tweeted as such:

This is, in fact, one of the reasons we have insurance. To cover us in case we slip up and someone is injured due to our negligence.

Certainly insurance companies would prefer that folks don’t sue. It would be a great business model, wouldn’t it, to keep collecting all those premiums and never pay anything out?

In a story later in the day yesterday, the jury came back with a defense verdict — one juror said the jury simply didn’t think the boy was negligent when measured against the reasonable conduct of a child his age. OK, I can live with that.

At some point we all grow up and become increasingly responsible, and that line of responsibility won’t only be gray for a child’s conduct, but ever-shifting depending on what happened. (see, for example, a 4-year-old sued in NY along with parent for negligent supervision.)

Would I have taken such a case? No. Because the jury did what I expect a jury would do. But eviscerate her on the Internet for it? No. She took the advice of counsel. Bad judgment call perhaps, though the attorneys defend the decision to move forward (see update).

And the injured woman was interviewed and confirmed my thoughts: Suit was brought against the homeowners policy to cover the medical bills, but you don’t sue the insurance companies, you have to sue the individuals. From CNN, who interviewed the Aunt:

“This was meant to be a simple homeowners insurance case”

Also at the CNN story, the woman testified that she remains close with the family and recently took the boy (now 12) shopping for a Halloween costume.

As with so many other things on the Internet, many people will howl and yell first due to the way a headline is written, without bothering to think that the actual conduct isn’t particularly egregious. The case may have been a loser, but it was not worthy of spilling all the resulting venom.

Update: On her attorneys’ website is this message about the case and the desire to get the medical bills paid:

“From the start, this was a case was about one thing: getting medical bills paid by homeowner’s insurance. Our client was never looking for money from her nephew or his family. It was about the insurance industry and being forced to sue to get medical bills paid. She suffered a horrific injury. She had two surgeries and is potentially facing a third. Prior to the trial, the insurance company offered her one dollar. Unfortunately, due to Connecticut law, the homeowner’s insurance company could not be identified as the defendant.”

“Our client was very reluctant to pursue this case, but in the end she had no choice but to sue the minor defendant directly to get her bills paid. She didn’t want to do this anymore than anyone else would.” But her hand was forced by the insurance company. We are disappointed in the outcome, but we understand the verdict. Our client is being attacked on social media. Our client has been through enough.”

Updated x2: These are examples of what Twitter has to offer. Remember, this is suit is essentially about whether homeowner’s insurance will pay the medicals. The first from Joshua Carrasquillo of Lowell Massachusetts:
And the second from Brady Ricci of Vail, CO and Los Angeles:

And this is from Jack Marshall, who says he actually teaches ethics and has a blog called Ethics Alarms (coded “no follow“):

What’s going on is that Aunt Jennifer is pure hellspawn, a mysteriously animated pile of human excrement that embodies the worst of humanity.

This is what happens when people elect to post stuff on the web based on an initial news report that was, shall we say, very selective on what it chose to report.

Update x3: This site is getting quite a bit of traffic, most likely from many who never knew it existed. So let me answer a question some of you may have: Yes, I know what it’s like to be on the receiving end of lawsuits, and they weren’t nearly as benign as this run-of-the-mill kind: On Suing and Being Sued

Update x4: Why did this little suit get national attention? Because of the way the original author wrote it — designed for clickbait, not accuracy. See: The Media Hit Job on the Evil Aunt

February 11th, 2015

Allstate Adjuster Likely Wants Her Snark Back

Don’t those nice Allstate hands look so friendly?

A snarky email from an Allstate adjuster may cost the company $900,000. Here’s the story.

By most anyone’s definition, 66-year-old Carol Haberman’s experience while walking her dog can be a horrible, life-altering one. Newspaper deliveryman James Burke backed out of a driveway at night while making a 3-point turn and ran her over. Realizing something happened, he pulled forward, likely running her over again.

The result? A complex left hip fracture requiring a total hip replacement, a lumbar compression fracture and compartment syndrome requiring a fasciotomy of the left leg.

What happened in litigation, however, was astounding. You may hear me rant about insurance companies and adjusters sometimes, and now you’ll see another reason why. The difference here is that the adjuster actually put her Kool-Aid inspired thoughts into writing.

There were two fundamental issues to deal with: How to apportion fault as between a driver and pedestrian. And how severe the injuries were. This would include, of course, the extent to which she had prior injuries that may have been affected.

But any way you sliced it, this was a significant matter to be deftly handled. Practically speaking, both plaintiff and defendant would want to limit their exposure with a jury. This is the type of common sense risk management of which settlements are made.

This is also one of the primary reasons that picking stupid personal fights with the other side is detrimental to a client. Because one day you might need to talk turkey over coffee with that other side about how to best serve your client with a negotiated deal.

And so it came to pass that, with a $1.25M insurance policy on the line, the parties in Haberman v. Burke thought that they had reached a settlement of sorts. This would have been what we call a high-low agreement that limits the financial exposure of both sides, with the high being $1.1M and the low being $100K.

The problem? Plaintiff’s counsel, Paul Edelstein, believed that this established the high and low of damages, and that only the issue of liability would be tried. Given the costs of hauling experts into court, this is an arrangement that can make sense for both sides.

But no. Allstate insurance adjuster Andrea Sewsankar thought that both liability and damages would still be tried. And she wanted that despite the fact that her “expert” was the discredited orthopedist Robert Israel.

OK. An understandable miscommunication occurred. But one would logically then assume that an effort would be made to hash out a solution, especially since the defendant had a problem with its expert. Whether agreement would have been ultimately reached, who knows, but certainly the efforts would be continued. Right?

Dear Reader, would I be writing this if that effort were made?

No. Instead, Allstate’s Ms. Sewsankar shot off a deliciously snarky email after Edelstein said that the two of them were not on the same page as to the details of the high-low. This was the set-up to the nastiness, via emails that I have obtained that were being used to confirm the deal:

Sewsankar: As we discussed, win or lose, your client is guaranteed a payout of $100,000 in exchange for a cap at 1.1 million. No appeal & your client will be responsible for all liens including and not limited to Medicare.

Edelstein: Correct. But also no damages trial. We will do hold harmless and deal with any medicare lien

Sewsanker: Oh no, damages trial also.

Edelstein: Oh man. Sorry. We weren’t on the same page. I cant do that. Only high low if we do away with damages trial

So far, not a problem, right? Just two sides trying to confirm in writing the nature of a deal, and then realizing that they had an unresolved issue.

And then, Boom! The testy little missive that will likely cost Allstate a bucket full of money before it’s all over, and which cracks open the Kool-Aid drinking mindset of some insurance adjusters, and which will be extremely important after this week’s verdict:

Sewsankar: No problem, I thought you had recognized the awesome skills of my defense counsel & wanted to garner a six figure payout for your client, so I took the opportunity to solidly protect my insured with this cap. Luckily, no payout will be warranted when Ed scores a defendant verdict on liability.

Thanks a million.

Don’t you love the hubris? I’m not sure which part of the email is the best: Is it boasting of the “awesome skills” of her counsel? The “no payout will be warranted?”

I’m betting it’s the “thanks a million” part that really must be hurting Allstate now. Because the liability verdict found 65% in favor of the plaintiff, meaning that Allstate would have been on the hook for only 65% of $1.1M high-low, or $715K.

But instead the case then proceeded to a damages trial with this result this week in very conservative Suffolk County:

past pain/suffering: $500K

future pain/suffering: $750K

future medical expenses: $400K

future home health aid/ assisted living facility costs: $800K

Add that up, and it comes to $2.45M, and 65% of that is $1.6M. And the insurance policy was only $1.25M.

So, when Ms. Sewsankar wrote “thanks a million” she was off by a bit. (I emailed her for comment yesterday morning but she has not responded.)

Her hubristic and intemperate email will, no doubt, be part of plaintiff’s efforts to collect the excess against Allstate in an action for bad faith. Her snark may cost Allstate about $900K. Either that, or it may bankrupt its insured.

You can almost feel the love from Allstate’s “good hands” logo. Almost.

April 8th, 2014

New York Central Mutual Slammed in Bad Faith (And What it means for you)

Helene Blank

Her name is Helene Blank and she last appeared on this page ripping into the City’s Corporation Counsel for his incredible hypocrisy in calling our courts inefficient.

She isn’t just a top trial lawyer here in New York, and a frequent lecturer to others. No, she is also something else. She’s pissed. Again.

And she’s got a damn good reason…so without further ado, Helene Blank as guest blogger…

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It’s a tale of corporate greed, in all its ugly manifestations, which starts with grave human suffering. And thanks to a federal court decision last week, we share it today in all that ugliness.

We turn the clock back to November 11, 2000, in the Town of Ulysses, New York, when Peggy Horton, a married mother of three and licensed registered practical nurse, was struck by Ralph Wade when he failed to yield at a stop sign.

No one disputes that Wade caused the collision (not an accident). What he did was unfortunate. But what his insurance companies did next to the two of them for almost a decade – and what they almost got away with and could get away with today — is inconceivable. Yet it continues to happen all the time.

Horton underwent six separate surgeries to correct the damage done to her back — starting with a fusion of two spinal levels and progressing to the insertion of hardware due to instability, incisional hernias, hardware removal and additional fusion.

She never returned to work as a nurse. She suffered from depression and post traumatic stress. Even the doctors hired by the insurance company agreed, finding that she suffered from what is known as failed back syndrome and that she would have nothing but a life of pain to look forward to.

Eleven months after the collision, Horton sued Wade.

Wade was insured by New York Central Mutual for $500,000.00. In addition, he had an umbrella policy with his homeowners insurance, Quincy Mutual, for another million. This is where the ugliness comes in.

Despite the fact that both insurers were immediately notified of this lawsuit, the primary insurer (New York Central Mutual) withheld the existence of the excess million for years. Horton, unaware of the extra million, had agreed to accept the 500K in settlement, perhaps recognizing that a personal judgment against Wade would be useless, under the well-known legal theory that you can’t get blood from a stone.

For her massive injuries and inability to work, New York Central offered the piddling sum of $75K.

The irony is that if it hadn’t been for its greed in refusing to offer the primary $500K when it had multiple opportunities, New York Central would have gotten away with hiding the existence of the excess policy. Instead, because of its greed, New York Central not only has to pay its primary policy of $500K, but also has to pay the excess million excess held by Qunicy (plus interest).

The long, sad and shocking story only came to light when the excess/umbrella carrier brought a law suit in bad faith, against New York Central Mutual in the Northern District of New York. The suit was based on New York Central’s apparent failure to cheat this plaintiff in a timely fashion and settle quickly before the excess was revealed, resulting in it being on the hook for the late-revealed excess million. See: Qunicy Mututal v.New York Central Mutual

Quincy Mutual showed that, at multiple times, the plaintiff had agreed to accept the $500K in final settlement of her action because at that time, despite being legally entitled to the knowledge of all available insurance — that knowledge was withheld from her lawyers. New York Central fouled up yet again, apparently, as after the excess million was finally revealed, she still gave them a short time to meet the 500K demand.

But this isn’t about the good faith of a plaintiff keeping the settlement door open. It’s about the greed of the insurance company. Perhaps the insurance carrier thought that, if the litigation was delayed long enough and Horton suffered more due to her inability to work, it could strike a better deal.

U.S. Magistrate Judge David Peebles found New York Central had acted in “gross disregard” of the excess carrier’s interest when it stuck to its $75K settlement offer and lost opportunities to settle with Horton.

The real outrage for all consumers is that you could not open up a settlement, which is induced by the insurance company, if you learned later that there was in fact more coverage.

Wade — the negligent driver that started it all — was put to the expense and worry for years that his personal assets might be in jeopardy because all the experts agreed that Horton’s losses well exceeded his available coverage. He was forced to hire private counsel to protect him because his insurance companies were not keeping their part of the contracts that he had bought and paid for.

Both the plaintiff and the defendant lost here. But the insurance companies did not. They kept their money for years longer than they ever should have been allowed to, dragging the parties through the court system for almost a decade before they resolved this matter.

New York Central Mutual continued to use the money without a care towards their statutory obligation to negotiate in good faith to protect their insured.

So it’s time that victims like Peggy Horton get the right from Albany to open up a settlement if you learn after you accept what you were mislead into believing was all the available insurance when in fact it wasn’t.

This unbridled corporate greed has to end. Insurance companies should not be allowed to cause additional harm to injured victims, to their insureds, and needlessly keep un-winnable litigation going for years and years without any recourse by the people they harm.

We all lose when this happens – our courts’ limited resources are clogged up with cases that should be resolved, victims who can’t work, who need the money to live are kept waiting forever and dragged through the system for no reason, and the people who paid their hard earned money to protect themselves with insurance are entitled to have the contract they paid for honored.

October 21st, 2013

Dear Judge Smith — You gotta be kidding me.

Hon. Robert S. Smith

Judge Robert S. Smith sits on New York’s highest court, our Court of Appeals. Last week he wrote a dissenting opinion in a case dealing with auto collisions and insurance fraud, Ramkumar v. Grand Style Transportation. This is my open letter to the judge in response to that dissent:

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Honorable Sir:

Let me start by stating that I write this letter with great trepidation. If you take offense at either the content or the tone, you have enormous power as 1/7 of our top court to repay my clients, or other injury victims, in ways that can be quite unfriendly.

But your dissenting opinion last week in Ramkumar v. Grand Style Transportation made me angry and forces me to pound on this keyboard, given your assumptions that the no-fault system is riddled with fraud by claimants. My concern is that if you feel this way, then other jurists might also, and claimants do not appear before our courts with the scales of justice in equilibrium.

For those that missed the case — this is, after all, an open letter and I hope to educate by doing it this way — this was a simple matter of a plaintiff testifying that he stopped getting treatment after sustaining injuries in an auto collision, because he “was cut off” by the insurance. Those of us on the plaintiffs’ side of the “v” refer to this as standard operating procedure. Insurance companies are in the business of generating profits and satisfying shareholders, and cutting off claimants — oft times with sham exams that last just two to three minutes– bolsters those profits. This is not news to those of us that represent such people.

At issue in Ramkumar was the simple matter of determining what level of proof was needed by the plaintiff to oppose a motion to dismiss his case that was based on defendant’s assertion that the plaintiff lacked a “serious injury” in the ridiculously vague way the Legislature has defined it. The majority said his statement that he wasn’t getting treatment because he was cut off was enough to raise a triable issue of fact. But you dissented.

In arguing for more proof, you went on to allege that there is rampant fraud in the No-Fault arena. But — and this is what raised my anger — 100% of your comments address this from the plaintiffs side of being responsible for fraud. And where is the data coming from for these reports? Insurance companies with a vested interest?

Let me suggest to you, Judge Smith, that there is indeed rampant fraud. Systemic fraud. Nauseating fraud that affects many thousands of cases per year. To prove this, I submit this bill of particulars–

A New York Times exposé on sham medical exams by the insurance industry regarding Workers’ Compensation exams, where one doctor that did those exams said:

“If you did a truly pure report you’d be out on your ears and the insurers wouldn’t pay for it. You have to give them what they want, or you’re in Florida. That’s the game, baby”;
Dr. Robert Israel, an orthopedist doing 1,500 defense medical exams per year, is hit with three year sanction for his conduct in doing defense medical exams;
Dr. Michael Katz, an orthopedist who once testified to doing 750-1,000 defense medical exams per year, busted for lying on the stand about the length of his exam, testifying it was likely 10-20 minutes. A secret recording documented it at merely one minute 56 seconds;
An analysis of exams by orthopedists Edward Toriello (1,500 – 2,000 per year), Lisa Nason and neurologist Jean-Robert Desrouleaux (1,000 – 1,500 per year) all show disturbingly short exams done for insurance companies, averaging less than five minutes per exam, and many times lasting only two to three minutes.
Dr. Joseph Tuvia, another frequent flier for the insurance industry (radiology, reviewing 1,000 films a year for litigation), magically has at least five different signatures on his reports that are allegedly signed under oath.
Dr. Harvey Goldberg is instructed by the insurance company that hired him to do an exam of the plaintiff to leave out of his report things that would be beneficial to the plaintiff. His original report, it seems, had a favorable causality finding for the plaintiff and he was asked to remove it from his report;
An orthopedist that I cross-examined last month, who testified that in describing range of motion losses, he used a different standard of “normal” in another case. Why? Because this “conforms to what this carrier says is normal.”

Now you will notice, your honor, that if you click those links, you will see that all of those stories and investigations, except for the Times piece, were done by me. Think about that for a moment: I’m a solo practitioner, with a full time practice, that blogs a few hours a week. If I can find that much evidence of tainted and quickie defense medical exams, how much do you think a real investigation would find? Does the phrase “scratching the surface” seem like a fair one?

We are talking about the potential for an unprecedented level of insurance fraud being perpetrated by the insurance industry.

And after claims are fraudulently denied in No-Fault, what is done with the data? It’s used in a self-fullfilling report to claim insurance fraud? I’m sure you remember the old saying about analysis: garbage in, garbage out.

I don’t blame you, of course, for having skepticism about claims. This what the insurance industry peddles to the world. What troubles me greatly, however, is that your skepticism appears to be one-sided and therefore imbalances the judicial scales before the evidence is even weighed.

You made this comment in your dissent:

If plaintiffs and their witnesses are willing to say under oath whatever they have to say to get past summary judgment, they will succeed in doing so….”

And what of the insurance company doctors — those comically referred to as “independent” as they earn six figure sums (or more) from such exams? Why should a judiciary dismiss cases based on such reports instead of, as Justice Scalia once famously wrote, testing their credibility “in the crucible of cross-examination“?

You seem to trust these insurance doctors very much, as you wrote:

If there is indeed a reasonable explanation for plaintiff’s cessation of physical therapy, he should have had no trouble in offering much better proof of it. He could have submitted an affidavit in opposition to summary judgment, identifying his no-fault carrier, attaching a copy of the written communication, or describing the oral one, in which the carrier cut him off, and saying what, if any, reason the carrier gave.

That any judge would accept an insurance doctor’s opinion on the real reason so many injured people are cut off from benefits reveals to me a judge that is, I’m sorry to say, deeply out of touch with what is actually going on. I see an industry orchestrating what are, little doubt, many thousands of sham exams every year. Those of us in the trenches of practice see a world appearing vastly different to what you’ve described in your view from Eagle Street.

This is not a new issue to you. Back in 2009, in Bazakos v.Lewis, you wrote the majority decision on a case dealing with these so-called “independent” medical exams, (deciding that if one sues a doctor for injuries incurred during the exam, it was subject to the 2 1/2 year medical malpractice statute of limitations).

Your boss, Chief Judge Lippman, made this observation about what is ” known euphemistically as an ‘independent’ medical examination”:

These exams, far from being independent in any ordinary sense of the word, are paid for and frequently controlled in their scope and conduct by legal adversaries of the examinee.

Just to be clear, there are countless cases of No-Fault carriers cutting off benefits claiming no injury, or that treatment wouldn’t benefit the victim, only to have these individuals go in for surgery on knees, shoulders, neck, backs and other body parts. Identical problems are rife in these medical-legal exams of all kinds.

Your faith in the so-called IME seems deeply misplaced given the substantial evidence of insurance company fraud and exploitation, which seems clearly in need of investigation by the Attorney General or Department of Financial Services.

My questions for you judge are these: How would you feel if a 3-minute orthopedic exam would be the basis upon which courts and juries would weigh your claim if you’d been injured? And if you feed your family with physical labor instead of with the pen, and those injuries therefore had a more dramatic effect, how would you feel about that 3-minute exam? And given the substantial evidence of problems, how does a judge simply accept as true the proclamations of an insurance industry that profits from it?

Respectfully yours,

Eric Turkewitz