Beware the Insurance Company Three D’s: Delay, Deny, Defend

Delay, Deny, Defend Puts Profits Over People

PaperworkEndless forms, arbitrary rules and a sea of fine print discourage claims.

If you’ve ever had to file an insurance claim, you know the frustration that seems baked right into the maze of endless forms and confusing small print. Companies that once lived up to their promise to “be on your side” when disaster strikes dramatically shifted business practices in the 1990s to meet Wall Street demands for short-term profits. The result is chronicled in the book Delay, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It by distinguished Rutgers law professor Jay Feinman. Not surprisingly, insurance companies are recording astronomical profits. Here’s how it works:

Trick #1: Deny, Deny, Deny Claims 
Insurance companies will outright deny that an accident occurred or that the policyholder was seriously injured. Some companies even offer gifts and bonuses to employees who deny claims and keep payments to a minimum. Arbitrary rules will crop up, often referencing provisions that do not exist or that contradict a previous statement. The hope is that denial after denial will defeat and deflate claimants, making them feel they have no choice but to throw in the towel.

Trick #2: Delay Paying as Long as Possible … Even Until Death
You’ve jumped through all the hoops and the insurance company has agreed to pay the claim, so you can rest easy, right? Think again. Delaying payment is another common tactic to boost profits. Insurance companies have been known to send out incorrect forms and then blame claimants for the error, or set very short time limits on when a claim can be made after an accident, injury or illness. In cases involving elderly or gravely ill claimants, some insurance companies have even delayed payments in hopes that the customer dies before they have to pay.

Trick #3: Defend in Court
Following a denied claim or a delayed payment, insurance companies know they can further delay writing a check by defending their questionable tactics in court. Billions of dollars in profits and thousands of high-priced lawyers on the payroll means they are always ready for a trial. Insurance companies know that many of their customers may be afraid or unwilling to hire a lawyer, and they use that fear to convince claimants that a court battle would only end in an insurance company victory.

Courtroom
Forcing a claimant to sue for benefits owed is one way insurance companies fail their customers.

Getting Paid What You Deserve

What can a David do against these insurance company Goliaths? Here are some tips on what to do before, during and after making a claim to an insurance company:

  • Pick a reputable company: It pays to do a little homework before you sign on the dotted line. Start with this list of best/worst insurers ranked on claim denials and bad-faith practices.
  • Read your policy carefully: You should know exactly what is covered and what you need for an appeal in case your claim is denied.
  • Double- and triple- check forms: An incorrectly filled-out form can be used by an insurance company to deny or delay claims. Past forms can even be used as a way to retroactively deny coverage. Be thorough and honest on every piece of paper you fill out.
  • Do not cash the check right away: Insurance companies will send checks with very low offers, or pay premium refunds if they rescind your coverage. Cashing these checks can be legally interpreted as accepting their offers.
  • Get everything in writing: If you need to fight your insurance company, you must be able to produce every bill, form and piece of correspondence.
  • Reach out for help: An experienced plaintiff’s lawyer can guide you through your claims process and provide the firepower necessary to challenge the insurance company in court if necessary.

Adult Supervision Is the Number One Way to Prevent Playground Injuries

CPSC Playground Safety Poster

According to the Centers for Disease Control (CDC), at least 200,000 children age 14 or younger are treated in emergency rooms each year for playground-related injuries. More than 10 percent of these are traumatic brain injuries (TBIs), and the rate of TBIs is rising.
Because public playgrounds are numerous and easily accessible, most kids spend their time on these rather than private playgrounds. Thus, the largest percentage of playground injuries take place on public facilities. Monkey bars and climbing equipment are responsible for the highest number of injuries.
But despite the risks, we know kids love playgrounds and benefit from the exercise and social interaction. The good news: Adults can play a key role in keeping kids safe on their favorite playgrounds with these tips and resources:
boy on swing

Keep Your Kids Safe With These Tips

Areas underneath the equipment, known as fall surfaces, should be made of soft material such as wood chips, mulch, sand or rubber.

Inspect equipment for any piece (especially metal) that may be hot from the sun.
Watch for hazards or protrusions like bolts, hooks, stumps or rocks that could trip or cut children.

Look for neglected maintenance, such as rusty or broken equipment.

Make sure kids wear safe clothing. No loose scarves or hoodies with drawstrings, as these can become a strangulation hazard if entangled with equipment. Shoes should be comfortable for play and protect feet, like sneakers. Tie long hair back as well.

Make sure there are strong and sturdy guardrails to prevent falls.

Your children should be using age-appropriate equipment. Read all playground signs for warnings and instructions.

Most importantly, the best way to prevent injuries is parental supervision. Talk to your kids about appropriate playground behavior before you visit the playground and watch them while you’re there.

More Resources for Safe Playgrounds
To ensure your local playground is safe, the National Recreations and Parks Association has a network of Certified Playground Safety Inspectors (CPSI). The CPSI certification program provides comprehensive and up-to-date training on playground safety issues, including hazard identification, equipment specifications, surfacing requirements and risk management methods. To find your local CPSI, click here.
A thorough playground safety checklist and ranking tool, created by the National Program for Playground Safety, can be found here. If you see safety hazards or poorly maintained equipment, reach out to the owner as soon as possible. In most cases, this will be a school or park district.
Keeping our kids safe while out on the playground is an issue we can all get behind, and one that benefits the community as a whole. So let’s all get out there and have some fun!

More Cars, More Walkers and Bikes, More Distractions = Higher Traffic Deaths

More Cars, More Walkers and Bikes, More Distractions = Higher Traffic Deaths
PedestrianUse marked crosswalks: Eighty-two percent of pedestrian deaths occur outside the crosswalk.
According to the Governors Highway Safety Association (GHSA), almost 6,000 pedestrians were killed in 2016 in traffic accidents. In 2015, more than 800 bicyclists lost their lives in motor vehicle-involved crashes. Pedestrian deaths shot up 10 percent between 2014 and 2015, bicyclist deaths by 13 percent – both more than any other category of traffic-related fatalities, according to National Highway Traffic Safety Administration (NHTSA).
The cause of this deadly trend has been greatly debated, with different groups pointing to a stronger economy and hence more cars on the road, more people walking to work or for recreation, and distraction due to the skyrocketing use of smartphone technology. Meanwhile, most efforts to prevent distraction are focused on motor vehicle drivers and passengers rather than pedestrians and bicyclists.

Teens Account for 25 Percent Increase in Pedestrian Deaths Over Past Five Years
Financial AbuseBicycle fatalities have risen sharply for adults (especially men) 20 years or older since 1975. Click for large graph.
Even if a person is not behind a wheel, they can be at risk if walking while talking on a cell phone or listening to music through headphones. Among kids, teens account for 50 percent of all pedestrian deaths in the United States, and unintentional pedestrian traffic injuries are the fifth leading cause of fatalities for ages 5 to 19. Older teens have accounted for a staggering 25 percent increase in pedestrian injuries in the past five years. Over half of all adults have been involved in a distracted walking encounter.

Tips To Stay Safe
Walking or bicycling are healthy for both people and the environment. Perhaps that is why we’ve seen a 60 percent increase in commuter biking during the past decade. But while bicycle deaths among children have thankfully decreased by 88 percent since 1975, deaths among bicyclists age 20 and older have more than tripled. Here are a few safety tips to keep in mind that will increase your chances of arriving safely at your destination, whether on foot or by pedal!
Look left, right and left again before crossing the street
Make eye contact with drivers of oncoming vehicles to make sure they see you
Be aware of drivers even when you’re in a crosswalk; vehicles have blind spots
Don’t wear headphones while walking or biking
Never use a cell phone or other electronic device while walking or biking
If your view is blocked, move to a place where you can see oncoming traffic
Never rely on a car to stop
Only cross at designated crosswalks (82 percent of pedestrian fatalities occur outside crosswalks)
Wear bright and/or reflective clothing, especially at night
Always wear a helmet while biking
Walk in groups, if possible
Follow all traffic laws and road signs, and signal to turn