Who Has to Pay For Your Personal Injury Claim?

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After an accident, minutes matter. Your words and actions matter even more. You need help, and you need it now.

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This is David vs Goliath, brought to you by Dolman Law Group Accident Injury Lawyers, a boutique firm with a reputation for going head to head with the insurance company giants and putting people over profits.

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Thanks for joining us. This is an episode from our back catalog, so the episode numbers and firm name may have changed, but this is quality information, so instead of scrapping them, we decided it was more important to make sure you still had access. Enjoy the episode and listen to new episodes of David vs Goliath at dolmanlaw.com.

Matt Dolman:

Welcome to Dolman Law Group Podcast. I'm Matthew Dolman from the Dolman Law Group. I'm here with Stanley Gipe, likes to be known as Stan-

Stan Gipe:

That's what I go by.

Matt Dolman:

do not think about [crosstalk: 00:01:24

Stan Gipe:

And I know we talked about this a little bit before the show began as we were getting ready. There's a lot of different things out there that happen to people that they really don't realize result in a claim, okay? One of the things we see most often with what we're dealing with is issues regarding domestic violence, or issues regarding physical altercations between people.

Stan Gipe:

Anytime that results in an injury, it's just like getting hit by a car, getting hit by a person, the person who hits you and causes you damage owes you for every bit of damage that they've caused. But what happens is most people when they're involved in a situation like that are more concerned and focused on the criminal aspect of it. The, "Hey, I've been beaten, this is a crime. There's a domestic violence issue," something like that. But, a lot of times people end up with residual injuries. And sometimes these injuries are significant, the medical bills are significant, etc, and they don't realize that they've actually got a claim against that person who hit them.

Matt Dolman:

How collectable are these claims?

Stan Gipe:

It depends on who hits you. That's really what it's going to boil down to. A lot of times these claims are going to be covered under homeowner's insurance. And even if there's not homeowner's insurance, most of the time people have some personal assets to go after if they're involved in a situation like this and you can get them to part with the assets in this scenario.

Matt Dolman:

Let's take the listeners through a couple of different angles here. With homeowner's insurance, when does homeowner's insurance apply? I know that if it's an intentional tort, if you meant to do the wrong, for those who don't know what tort is, if you meant to do the civil wrong, if you're meant to hurt somebody, there's an exclusion, correct?

Stan Gipe:

There is an exclusion, but the intent required is sometimes different than what we would necessarily think of. A lot of times what you've got is a criminal issue that's going at the same time. I've had a case that involved an intentional act that was a car in a parking lot that apparently intended to run over my client, okay?

Stan Gipe:

When you look at the video, it appears that they intended to hit my client. They ran up on the sidewalk. My client had had a previous dispute with this defendant, but when we got into the criminal scenario, because there were criminal charges associated with this, the defendant was saying they didn't intend to do this. There were some of the elements of intent that were missing. They were claiming-

Matt Dolman:

Which creates a very interesting interplay between civil and criminal.

Stan Gipe:

Exactly. Because what you're going to have there is when an insurance company goes to try to deny and say this is an intentional act and we don't cover it, you've now got the defendant on your side saying, "No, this isn't an intentional act." No, because they're doing that, not only because they want the coverage, but because they've got a pending criminal issue. If they say it's intentional, they're guilty. A lot of times what you find are what seem to be intentional acts result in temporary insanity, temporary loss of ability to control yourself because of some pending anger. Think of a temporary insanity situation where you walk in and catch someone, a cheating spouse.

Matt Dolman:

Of course.

Stan Gipe:

Okay? Just about everybody's going to act violent in that scenario.

Matt Dolman:

Yeah, there'll be a fit of rage, of course.

Stan Gipe:

There'll be a fit of rage and often a physical confrontation, but it's harder in a criminal context to say that this is someone who is thinking clear, this is someone who intended to cause harm, as opposed to someone who simply lost their mind. Now that particular fact pattern, we probably wouldn't take the cheating spouse or someone that got beat up in that scenario, but that's the type of stuff that happens. You get the temporary loss of ability to control yourself, and when that happens you negate the intent aspect of the crime or the denial of insurance coverage.

Matt Dolman:

Fair enough.

Stan Gipe:

A lot of times what you find is these things, acts of violence, things like that, there actually is coverage underlying it.

Matt Dolman:

I know before the show you discussed also with the interplay the incentive that the individual who is wrong has now. If the civil case has been satisfied, they might not have the emotional drive now in terms of the criminal case, which actually helps out ... both parties help each other, so to speak.

Stan Gipe:

Exactly. Whenever you're dealing with any sort of criminal prosecution, one of the main components that a prosecutor's going to look at is how's the defendant, okay? Is the defendant okay with the deal we're looking to strike with this person, especially if it's a victim of a violent crime? What we find and what you typically find, it's common sense, it doesn't take ... you don't have to be a deep thinker to figure it out. If I've been beat up by someone and I'm facing $20,000 in unpaid medical bills, I've got a collector coming after me. I'm having trouble paying my rent. I've been unable to work and things like that, I'm going to have much more anger and much less willingness to work with a prosecutor. If those medical bills have been paid, I'm not struggling to pay my rent, my lost wages have been compensated, I'm still going to be angry-

Matt Dolman:

But you've gotten your pound of flesh, so to speak.

Stan Gipe:

Yeah, but you're not going to be as dead set against a reasonable outcome with a prosecutor. In that aspect, the defendant also has a reason to try to keep the injured person happy because they've got a criminal proceeding going at the same time. We would never trade, and it's illegal to trade, say, "Hey, I'll agree not to bring criminal charges if you settle this in a civil action." That's not what's going on. What we've got are just the natural tendencies and reactions of people when things are satisfied versus being unsatisfied.

Matt Dolman:

Sure. Any other weird type of cases and angles out there that we're not seeing?

Stan Gipe:

There's all kinds of, tons of, weird issues and cases out there. And a lot of times they pop up in unusual fact patterns. I had a case not too long ago ... And people don't realize, when you think, "Hey, I've got to get hit by a car," Okay, well, you'd be surprised, there's people that get injuries trying to avoid getting hit by a car.

Matt Dolman:

Sure.

Stan Gipe:

I had a case not too long ago where my lady's standing on the side of the road. She's just standing there minding her own business. Cars spin out of control, start coming towards her. It actually stopped before it got to her, but she thought she was going to get hit, so she dove out of the way, injured her knee and ultimately had to have a knee surgery. The initial response we got from the insurance company, as insurance companies do, was a denial, "Hey, this car never hit her."

Matt Dolman:

Never seen that before.

Stan Gipe:

"That was unreasonable," and these kind of things. In situations like that, you don't actually have to be hit by the car, the car doesn't have to make contact with you for you to have a claim against a driver. It's an act of negligence that caused your injury. We could sit here for days and talk about just different weird fact patterns that come up that people don't always think about, but what you got to look at is if you sustained an injury, if you sustained an injury due to a violent act or a near violent act, those are worth looking into if you've got the type of injury that you feel like warrants making a claim.

Matt Dolman:

When you get a typical caller, calls you up, or somebody, via email, sends you an email about a case that has some potential, they were struck by another individual, what's the first thing you look at? Do you look at whether his insurance company's applicable? If it's not applicable and if insurance is not available, when would you take on these type of cases?

Stan Gipe:

Well, you've got a double-sided sword there in that, yet typically, if insurance isn't available, first thing we're going to do is talk to the person and get a grip for the fact pattern because as you know, we deal with some technical issues, but at the end of the day, if we don't agree, if we don't settle something, we're going in front of a jury, okay? A jury can be six people, right? They're not insurance companies. They're not computers. And they make their decisions based on how they feel. If there's some unsavory aspects of the claim, we want to ferret that out in the very beginning.

Stan Gipe:

"Hey, this person was smoking crack, and then they got beat up getting thrown out of a house." That's not going to play well in front of a jury, so we try to look for those issues, those landmines that are going to be negative for the claim to see if we can ferret it out and make sure we're not investing a bunch of time into a case that's not going to have any traction. Second thing is we look for some insurance coverage, okay? Insurance coverage is a typical way we're going to get paid. That doesn't always work. Sometimes we have to go after personal assets, but the general rule of thumb is that people with enough personal assets to pursue or to go after usually have insurance coverage out there.

Stan Gipe:

It's not always the case. And I've got one right now with a guy with an AC company that grew organically and just by chance ended up being woefully under-insured. But, most of the time, what you find is that people with money go out and purchase insurance policies so they don't lose their money. I think we may get into that in a little bit too, is there's different types of insurance and people don't always realize when they're buying insurance really what they're protecting.

Matt Dolman:

Yeah, and it's hold full coverage by the broker when really they're getting a bare bones policy. Only what is required by law.

Stan Gipe:

I had this happen two days ago in an accident. It was a friend of mine, had just bought S550 used. He paid cash for it. Went in, said he wanted full coverage, but the cheapest full coverage he could get.

Matt Dolman:

Which really to the broker means I'm going to give you everything that's applicable in the law, and that's about it.

Stan Gipe:

Exactly.

Matt Dolman:

You get comp, collision?

Stan Gipe:

, he had: 1020

Matt Dolman:

Awful.

Stan Gipe:

That's it.

Matt Dolman:

And woefully under insured.

Stan Gipe:

And, of course, on Valentine's day, he gets hit by the drunk lady who's just gotten her nails done.

Matt Dolman:

It's an awful scenario.

Stan Gipe:

Yeah. He gets smashed. He comes to me and goes, "Oh, I'm good. I got full coverage." I'm like, "Oh boy," because I know right away when someone comes in and says have got full coverage-

Matt Dolman:

I always assume they got the bare bones minimum.

Stan Gipe:

Yes. Because that's a matter of, "Hey, I went in, told them I wanted full coverage. They gave me the cheapest thing that could comply with those terms." And what you got is there's several different components of your coverage like you know. Bodily injury, that's what most people think of when they think I've got coverage. And bodily injury really doesn't protect anything but your assets.

Matt Dolman:

Correct.

Stan Gipe:

Okay. When you buy bodily injury, you're trying to protect your stuff against someone you may hit who's then going to sue you and say, "I'm coming to take your stuff unless you pay me." Your level of bodily injury typically moves hand in hand with the assets you have to protect. If you've got millions of dollars in assets, you need to have millions of dollars in bodily injury coverage because you never know when an accident may happen. You paralyze someone in a crosswalk or, God forbid, hit a kid on a bike where you cause significant injuries, you're liable for that. If you don't have adequate coverage on your bodily injury-

Matt Dolman:

And that's where umbrella policies come in. We can go into detail about that.

Stan Gipe:

Exactly. An umbrella. And I'll tell you with what I do, I get as much coverage as they will sell me to protect everything. And what you find is those next layers of coverage, as you go up, your million dollar umbrella, $2 million and 3 million of coverage, those are extremely cheap compared to that first 10,000, 25 or 50,000 in coverage.

Matt Dolman:

It's true. Yeah.

Stan Gipe:

Yeah, it is because most accidents, every accident involves that first level of coverage. Very-

Matt Dolman:

It's the actuaries mathematicians that are going to figure out what are the rates and what's the rate of incidents, what's the likelihood of that ever occurring. It's rare, so infrequent, that they can afford to give it to you for such a low amount of money.

Stan Gipe:

Exactly. Exactly. Every accident you get in is going to involve that first level of coverage, that first 10,000, because dollar one, okay? Very few times do you see those accidents that involve a million or two million in damages.

Matt Dolman:

Very rare.

Stan Gipe:

But, the one thing that a lot of people miss, and what my friend did not have on his policy and should have had, is uninsured motorist or underinsured motorist.

Matt Dolman:

Take me through uninsured and underinsured motorist. When does it apply? Why is this so important? And we both know as personal injury attorneys in this area, how rare it is, most drivers do not have it. I believe the recent statistic actually is 25% of Floridians do not have any type of bodily injury coverage.

Stan Gipe:

Yeah. Shocking to me because personal ... okay, bodily injury, we have to get it pursuant to law. You don't have to have any uninsured motors, but uninsured motorist is so important, okay? What it does, it protects you, okay? It's like buying coverage for everyone who's going to hit you. Remember when I said that, "Hey, you hit someone and get paralyzed in the crosswalk"?

Matt Dolman:

Correct.

Stan Gipe:

Well, if you're the guy in the crosswalk that gets hit and gets paralyzed, it's your uninsured motorist that's going to pay for your damages. That's what you're doing, you're buying to protect your family, to protect you if something happens to you, okay? Hey, if you got $3 million in uninsured motorist, you got a way to get paid if that happens. You got someone to cover your wage loss. Your family's not going, "oh my God, what just happened?" And catastrophic injuries are rare, but you ensure for the rare event. That's why you do it. And uninsured motors coverage is cheap, okay? It's really cheap in comparison to the bodily injury coverage. It's extremely important. And I can't tell you how many people come in and go, "Wow. I didn't realize that," when you tell them, "Hey, there's, there's no bodily injury coverage on the person that hit you and you don't have uninsured motorist."

Matt Dolman:

That's the worst conversation have. And you just mentioned the layers of coverage and how it gets cheaper, and these are rare. You ever see these just terrible egregious injuries, you do see the uninsured motorist coming into play often in our practice. And underinsured claims where the tort fees or the person who's actually wrong in the accident only has 10 or $25,000 in coverage. You have to claim the ultimate value of the claim exceeds probably 50,000 or 100,000, now we're tapping into what's called underinsured motorist coverage, which is part of your uninsured motorist coverage.

Stan Gipe:

Yeah. In Florida, they typically go hand in hand. Under and uninsured run as the same type of coverage. Some other states will have a little bit different distinctions, but I'll tell you if nothing else speaks to the importance of uninsured motorist, it's this one fact, okay?

Matt Dolman:

Shoot.

Stan Gipe:

If you're buying an insurance policy, right, and you don't want uninsured motorist, you actually have to sign a special form saying, "They've offered me uninsured motorist. I realize how important this is to buy. And I realize I'm doing something dumb by not buying it." And I'm paraphrasing. It doesn't have the wording-

Matt Dolman:

Of course, and you're rejecting it.

Stan Gipe:

It's called a selection rejection form. The Florida legislature has already said, "Look, uninsured motors is so important, every policy has to have it unless you get the consumer, the person buying the policy, to sign a document saying they realize it's dumb not to have it. And they agree not to have it."

Matt Dolman:

But, sadly, most unsophisticated consumers, and when I use the word unsophisticated, I'm not talking about education level or knowledge, I'm talking about knowledge about the insurance industry. They're just throwing this paper in front of them, by the broker, and they're just told to sign here because it affects their loss ratio. Brokers, the more claims that are put against them, it affects their loss ratio with the insurance carrier and that affects their job and their ability to pay their family, so they have every incentive in the world not to give that coverage.

Stan Gipe:

Well, you're right. And when you talk about the unsophisticated consumer, you're right. We're all unsophisticated consumers when it comes to insurance coverage, until you get in depth with it, because I can promise you, until I was an attorney, I never read that book that came with my policy. I never read the actual policy. I knew what I was buying. "Hey, I got this much coverage." I never looked to see what had actually covered. I never looked to see what was in there for exclusions. And you typically don't until you need coverage.

Stan Gipe:

So, what happens is even as attorneys, when we go to buy products or insurance products in unfamiliar areas, hey, you're buying some business insurance and you don't do business litigation, things like that, we're all unsophisticated consumers, because you don't really learn until you go through the problem. You don't really learn how to deal with an insurance company until you face a denial, then you see the issue come out, you see how it plays out. We're all unsophisticated consumers when it comes to buying insurance. And that's why the legislature put that out there saying, "Look, we know they're not going to read this whole book, but they need to sign this one document with bold print saying this is important coverage to buy."

Matt Dolman:

And I wish more brokers were honest about it.

Stan Gipe:

I wish they were, too. I wish more clients would have it. And I can promise you, most people after they come in and realize, "Hey, you mean for $20 extra on my policy, I could have had this coverage," and I say, "Yes."

Matt Dolman:

That's one of the big secrets out there, and we're going to talk about it in the next podcast, the non-joinder statute, that you know so very well as a civil lawyer, what you can and can't discuss in front of a jury in the state of Florida, which is the infinite wisdom of our legislature. Tune into our next podcast. I was lucky enough today to have Stan Gipe with us. He was by far the best guest we've ever had, the most knowledgeable, the most informative, so thank you for joining us today.

Stan Gipe:

Hey, I appreciate it. Anytime. I enjoy talking about this stuff. As you can probably tell, I go ad nauseam if you give me a chance.

Matt Dolman:

Oh, I know. The consumers out there, they don't necessarily have to pick Dolman Law Group. Tell them about your firm, where you located, how they hold of you, Stan. There's enough business out there for everybody.

Stan Gipe:

We're the law office of Papa & Gipe. I'm right around the corner here on Gulf to Bay Boulevard.

Matt Dolman:

You can't miss.

Stan Gipe:

In Clearwater. Anyone who drives from the airport to the beach passes our firm. You see us out there-

Matt Dolman:

Right past Clearwater High School on the right hand side, you'll see it.

Stan Gipe:

Exactly. We do all aspects of insurance claims and injury claims. We get into some of the more exotic and less seen type of claims out there. If there's anything out there that you just think, "Hey, this happened. I want to see if there's something I can do," run the fact pattern past us. Generally, if you've got a sense that someone wronged you and they're responsible for an injury, we can find a theory of liability depending on what happened. If you feel like something's happened, even if it's a little awkward or unusual, give us a call and we love to dig into it.

Matt Dolman:

Yeah. That's all we see is awkward and unusual claims all day long, so. Really appreciate it. Thanks for joining us again, Stan, another episode of Dolman Law Group podcast. Thanks for joining us.

Stan Gipe:

Thanks for having me.

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