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Elaine and Jack Mahler Receive Recieve WSTLA Special Client Recognition Award

By William S. Bailey

The insurance industry has perpetuated a myth that injured people who bring claims do so eagerly with motives of financial leverage. Nothing could be further from the truth. The typical plaintiff comes forward most reluctantly, in pain, driven by fear over who will pay for their medical bills and lost wages, as well as concern about what their future holds. Beyond this, there is an almost total invasion of privacy by insurance companies and their attorneys in the claims process, getting near complete access to a plaintiff's confidential medical records.

Elaine Mahler was a most reluctant plaintiff who had never brought a claim of any kind prior to the forceful side impact collision of January 4, 1993 , which left her with persistent headaches, neck, back and hip pain. Similarly, her husband Jack had never brought a claim either. The Mahlers had their automobile insurance with State Farm for nearly 20 years and always thought in the back of their mind that if they ever needed the help of their company, State Farm could be counted on to be a “Good neighbor.”

In fact, State Farm moved very aggressively to cut off all PIP medical benefits for Elaine Mahler (sending her to the “usual suspect,” Dr. Charles Brooks, who declared her need for treatment at an end despite her continued pain), along with antagonistic calls from its adjusters and ominously worded form letters sent to their home. To make matters worse, Elaine Mahler's health maintenance organization refused to authorize medical care because it was “covered by other insurance” (purportedly her State Farm PIP). Hence, she was caught in an insurance crossfire and ended up paying for her treatment herself.

When her third-party lawsuit was finally settled almost 2 1/2 years after the accident, Elaine and Jack Mahler wanted nothing more than to get on with the quiet enjoyment of their lives. The prospect of closure was a great comfort.

However, in keeping with its business practices at the time, State Farm refused to honor the explicit language in the insurance contract promising to pay its fair share of legal expenses in recovering PIP from the third party carrier. Once this scenario became apparent, their attorney explained to them that this was an abuse of power by State Farm which had been repeated over and over again. State Farm had gotten away with it, cynically counting on capitulation because the amount involved ”just wasn't worth it.”