This is Amazingly Disgusting

Ethal Adams was driving along minding her own business when a pickup truck (travelling in the opposite direction) was forced into her lane by another driver. Adams was in a coma for nine days, had a collapsed lung, 17 broken bones and now can only stand with the aid of walker. Amazingly here insurance company, Farmer’s Insurance, has denied her claim saying the incident was not an accident.

But a Farmers’ affiliate, Truck Insurance Exchange, argues that Adams’ state of mind is irrelevant. Even though it was Adams’ insurance policy, the uninsured-motorist portion is designed to cover Testa’s liability. Therefore it’s Testa’s state of mind that matters, and Testa meant to cause the wreck, so it’s not an accident.

Explains a letter from Farmers’ Seattle-based attorney, Ronald Dinning: “The common meaning of ‘accident’ does not depend on the perspective of the injured insured, but instead essentially depends on the intent of the person causing the injury or damage.”

He cited a 1990 Pierce County case in which a woman purposely crashed into a car driven by her ex-husband. The state Supreme Court ruled then that insurance didn’t have to cover the ex-husband’s injuries in part because the outcome wasn’t “unexpected or unforeseen” — that is, it wasn’t an accident.

“It’s also not unexpected or unforeseen that if you are ramming a car from behind with the intent of pushing it into oncoming traffic, you’re going to hit some people,” Dinning said in an interview. “That’s what Testa did. Liability insurance is only for accidents, and this wasn’t an accident.”

My problem is that while the initial part of the crash (Michael Testa’s attempt to force his girlfriend off the road) was not an accident, the secondary and tertiary accidents involving others including Ethel Adams likely were accidents. In fact, it is because of things like this that I buy insurance. I want insurance incase some guy goes bonkers and in trying to do something dumb involves me in the process. From all the data provided by the article there appears to be nothing indicating that Testa wanted to do anything at all to Ethel Adams. Farmer’s Insurance and all of its senior officers are despicable humans for not immediately correcting this kind of thing.

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Steve Verdon
About Steve Verdon
Steve has a B.A. in Economics from the University of California, Los Angeles and attended graduate school at The George Washington University, leaving school shortly before staring work on his dissertation when his first child was born. He works in the energy industry and prior to that worked at the Bureau of Labor Statistics in the Division of Price Index and Number Research. He joined the staff at OTB in November 2004.

Comments

  1. CromBolti says:

    Give me a break. When you buy a policy, the insurance companies tell you what is covered. They also tell you that they have authority to determine what constitutes an “accident” or not. You don’t seem to realize that Farmer’s Insurance is not a chairity agency–they are a business. Every cent spent comes at the expense of the company’s shareholders. If this Adams lady has a problem she can take them (or the guy who caused the crash) to court.

    She should have been taking the bus or driving a couple of hundred miles north in Canada where the socialist government takes care of stuff like medical bills–of course, had she been run off the road in Canada, it would have taken a month before she could get in to see a doctor and she probably would have bled to death in the waiting room.

    This culture of vicitmization typified by Adams’ cries is absurd. Her stupidity is on display in the final sentence of the story: “The insurance companies say they’re here to protect people. But then when you need them most, they do something like this.”

    If you really think that insurance companies are “here to protect people,” you are must be taking some kind of drugs. Insurance companies, as private companies, depend on their very survival to maximize profits–not protect people. It doesn’t take a rocket scientist to know that they have no incentive to pay out claims. Hopefully this Adams lady learned her lesson.

  2. Steve Verdon says:

    You don’t seem to realize that Farmer’s Insurance is not a chairity agency…

    You are an idiot.

  3. Russ McMahon says:

    “The state of Washington has paid her medical bills so far through workers’ compensation — more than $500,000, according to her attorney, Karen Koehler.” – The Seattle Times Oct. 14, 2005

    She must have been at work. Personal auto policies don’t pay for injuries sustained on the job. Plus, you don’t get to double-dip insurance; that, as we know, is built into every insurance policy.

    I believe folks just don’t feel the need to consider all the facts when the opportunity arises to bash an insurance company. In fact, I’m only going on what I read in that column; I’m sure there is more to the story, but has been conveniently left out.

  4. DaveD says:

    Crombolti, I must agree with Steve on this one. You may not have any sympathy for Ms. Adams plight and, OK, in your mind you are offended that she considers herself an innocent victim (and I pretty much think that she is), but I think if you put Testa on the stand and ask him point blank if he had every intention of specifically injuring Ms. Adams he would say no. At least if he was sane he would say that because if he HAD every intention of harming Ms. Adams, then think of the additonal charges he could be brought up on. This case doesn’t even come close to representing the worst of the culture of victimhood. It’s not clear to me what “lesson” you think Ms. Adams was supposed to have “learned”.

  5. Anderson says:

    I have to wonder about insurance that covers me, or not, based on other people’s states of mind.

    The state supreme court could work around this if they cared to; maybe this will be the case that does it.

    (One problem that comes to mind is collusion, but even then, the insured’s state of mind would be collusive and could thus be determinative.)

  6. McGehee says:

    This culture of vicitmization typified by Adams’ cries is absurd.

    Well, no. Adams is a victim. No culture about it.

  7. CromBolti says:

    You are an idiot.

    Crombolti, I must agree with Steve on this one.

    Listen, I come at this from the perspective of someone who has worked in the insurance industry for the last two decades. People forget that we are BUSINESSES. We operate in a VERY competitive marketplace that requires us to cut costs and eliminate waste. It also requires that policies are interpreted correctly and in a standardized fashion.

    Why should Farmers be liable for paying something that falls out of the person’s policy? They write auto policies–not medical polices anyway. I am sure they are covering the car. Washington is an add-on state meaning that she has the opportunity to pursue her dispute through the torts system. That should make Steve Verdon and his liberal buddy John Edwards happy since there is no limit on tort claims in WA. I can see a big-time “pain and suffering” argument coming down the pike!

  8. Kent says:

    I’m sympathetic with Adam’s plight. Yes, she is an innocent victim. And people of good will should be willing to help her with her medical bills and disability. However, this was clearly not an accident. If you have the bad luck to be standing next to the target of an assassination attempt, and you end up taking a bullet, you aren’t the victim of an accident.

    Is there a way to relieve Adam’s plight while honoring the limitations written into her insurance contract? CromBolt has given one suggestion: Sue the socks off the malicious driver.

    The guy’s nuts and can’t pay a penny? Then maybe Adams should sue all the people who knew he was crazy but didn’t act to keep him from behind a driver’s wheel.

    Oh, they don’t have any money, either? This is one of the thorniest issues in tort law: People can, and often do, inflict damage on others that is far beyond their means to make good. So lawyers go for the deep pockets. In this case, an insurance company that did not contract to cover acts of malice by others, but will (very likely) be compelled to cover the loss anyway.

    Maybe insurance ought to cover such things. You can certainly buy homeowner’s or renter’s insurance that covers burglary. Why not violent crime insurance? Great idea — But that’s not the policy Ethel Adams purchased.

    Instead of fulminating at an insurance company for the “outrage” of insisting on sticking to the terms of its contract, why not direct your anger and concern towards (a) seeing that the Michael Testas of this world are locked away where they can’t do this kind of harm, and (b) organizing a charity drive on behalf of Ethel Adams? You post a PayPal link, and I’ll kick in some dollars.

  9. Lanny says:

    Farmer’s Insurance and all of its senior officers are despicable humans for not immediately correcting this kind of thing.

    You might as well throw Bush in there too since Dana Mead, Jim Schiro, and a bunch of other senior officers of Zurich Financial [the corporate holders of Farmers] are big-time Republican donors. Bush has been silent on the issue even though he has profited from the people responsible for this absurd decision.

  10. Anderson says:

    Lanny, you’re being satirical, right?

  11. Lanny says:

    Lanny, you’re being satirical, right?

    If Steve is saying that these guys are “despicable humans,” and they are all big Republican/Bush donors, then why not expect him to use the bully pulpit of the presidency to get these guys to change the decision?

    Hell, he uses his State of the Union speeches for non-issues like amending the constitution to prohibit gay marriage or encouraging millionaires to stop using steroids, why couldn’t he do something in this case?

    It would actually be smart politically since it could divert attention away from some of his recent questionable actions. I bet if the Iraqi constitiution gets rejected tomorrow, Rove will have her in the Rose Garden by Monday morning! Sure he may piss off a couple of his corporate donors but he ain’t running for office again anyway, so what’s the risk?

  12. Herb says:

    Most everyone knows that insurance companies will do everything possible including lying, cheating and almost stealing to get out of paying a claim. I compare insurance companies to gamblers. Some will take their losses and quietly go from the table, some will cheat to win, some will stack the cards against the other players, and a lot of them will pull almost pull a gun and shoot you if they lose. Like most people, they don,t like to lose, but the insurance companies will pull every trick in the books to keep from paying up if they do lose.
    The best way to do business with an insurance company is to have everything typed in language that one can understand (not the lawyer talk small print) and have them sign the document with witnesses. In other words, “Don’t Trust them”.
    I have changed insurance companies many times when the raised my rates after they had to pay claims for their losses they had from such things as hurricanes and tornados.
    Insurance companies are no better than a bunch of “Old time crooked riverboat gamblers”
    If you play their game, count on getting it put to you.

  13. sk says:

    If you have the bad luck to be standing next to the target of an assassination attempt, and you end up taking a bullet, you aren’t the victim of an accident.

    How are you not a victim of an accident? Did you _mean_ to get hit with an assassin’s bullet? It was an accident to you.

  14. Boycott Farmers Insurance!
    Farmers Insurance Sucks!

    http://www.farmersinsurancegroupsucks.com/

  15. Kent says:

    How are you not a victim of an accident? Did you mean to get hit with an assassin’s bullet? It was an accident to you.

    No, it was incredibly bad luck. This is not the same thing as an accident.

    If the bullet kills you, your death certificate will list the circumstances of death as homicide, not mischance. And the assassin can be charged with first-degree murder, not involuntary manslaughter. (Though it will probably be plea-bargained to voluntary manslaughter.)

  16. ron says:

    This is a situation like many others where a company has the law on its side. When a company gets bad publicity (price gouging, loop holes to get out of expected obligations, etc.), some people remember. I remember the gas stations that gouged on 9-11, and never traded with them again. I do not know the facts of this one, just what I read on the link, but this is PR disaster in the making, and Farmers better get ahead of it.

  17. Chris Black says:

    As I understand it, Farmers are part of the Zurich Group. Zurich Municipal are a big player in the market in the UK for councils and local authorities insurance, including the council where I serve. (I’d better admit to all you conservative folks that I’m a Liberal Democrat , but quite a reasonable chap , really).

    I’ve asked one of our council officers to see if the same dodgy exclusions would apply to any of our staff in such a dreadful situation. I would also like to see if there’s any international leverage that could be applied from the UK – maybe we could get a lot of councils asking questions.

    However it would be hard from the UK to keep a check on what’s going on with this case.

    You’ve done a public service in publicising this, could you keep us informed of any developments?

  18. Bill Quick says:

    If you have the bad luck to be standing next to the target of an assassination attempt, and you end up taking a bullet, you arent the victim of an accident.

    This is the sort of thinking common to insurance adjusters and mass tort lawyers that has helped to keep their reputations right up there with serial rape-murderes and diseased child molesters in the public mind.

  19. Eliza G says:

    “She must have been at work. Personal auto policies don’t pay for injuries sustained on the job. Plus, you don’t get to double-dip insurance; that, as we know, is built into every insurance policy.” FYI – she had a commercial policy with a 2 million dollar limit – she is not trying to double dip, she is working with L&I and the Washington Insurance Commission to get what she is entitled to, not MORE than she is entitled to. Wow you guys are cynical, but who can blame you? Today’s development is the mass email canned response from Farmers that states they have “never denied her claim” while the WA Insurance Commissioner’s Office has a five-page denial from Farmers.

  20. katrina says:

    To Crombolti,

    You are an idiot. Saying personal insurance policies don’t cover her while she is on the job. She was driving a company car with 2 million dollars _UNINSURED motorist coverage, which her employer paid to cover their workers for exactly this reason.

    You hope she learned her lesson? What lesson is this? That she shouldn’t have been doing her delivery job that day?

    She had the coverage for the uninsured motorist. There is absolutely no intent to harm her and her insurance should cover.

    Plus the guy is bipolar and mentally insane. How can he make a rational decision?

    I think if you or someone you loved was almost killed by a crazy person on the road and broke 17 bones in your body, that you’re view would really change.

    But my view of you….you’re probably a sado-masochistic ……off!!

    Maybe if Ethel Adams had 20 bones in her body broke, or died,,,, she would have “learned her lesson”.

    Stupid people make me mad.

  21. katrina says:

    ..oh, and by the way…saying that everyone knows what’s in the insurance policy they buy…..her employers that bought the policy DID NOT know that their employees would not be covered in this situation. It’s NOT in the policy idiot. It’s legislature that no one has even heard of until this kind of thing happens.

  22. katrina says:

    Give me a break. When you buy a policy, the insurance companies tell you what is covered. They also tell you that they have authority to determine what constitutes an “accident” or not.

    The insurance company never told the employer any of this….and every time I buy an insurance policy,,,,I’m never informed of slimey loopholes that they won’t cover.

    To this jerk….

    How would you feel if a person bumped a car into your lane and killed your whole family and you had 500,000 in medical bills and they said,,,,”sorry, this was an intentional act…you’re going bankrupt and have to pay all of these medical bills?”

    I think you would change your mind.

    And what kind of lesson does ethel adams have to learn? I think it stands out clear as day….
    DON’T GET UNINSURED MOTORIST COVERAGE…BECAUSE WE WON’T COVER!!!

  23. katrina says:

    ..and everyone keeps saying “sue the driver”…HE WAS UNINSURED!!! THAT’S WHERE HER “UNINSURED MOTORIST COVERAGE” SHOULD STEP IN!!!!!!!!!!

  24. Kathryn says:

    Farmers thought it could turn down Ethel’s claim and she would go away. Instead the public found out and is outraged. Farmers is sending out spin trying to fix the PR nightmare, but because it isn’t telling the truth the mess is getting worse. Today on talk radio the Washington insurance commissioner said Farmer’s conduct was “unconscionable and against public policy” and demanded immediate action. Farmers can’t hide from that.

  25. David says:

    The Washington State insurance commissioner flat out told Farmer’s “you WILL pay this claim – you have no legal standing to deny it.” Farmer’s has until noon tomorrow (10/20) to respond

  26. Heather says:

    As of today, Farmers a) claims that they never actually denied the claim, b) they are only waiting for the King County Sheriff to supply the police report for same, and c) they will “of course” pursue a speedy settling of Ms. Adams’ claim against them once they have completed their own investigation.

    But they do seem to be spinning just a wee liddle bit: Ms. Adams is in possession of a June 22nd letter from them that “denies” (their word) that scum Testa’s actions and consequences of same were an accident. This is tantamount to refusing her claim.

    Also: from what I understand, the Farmers policy is Ms. Adams’ own policy, not her employers’. While her initial care and lost wages, etc., are covered by Labor & Industries (workman’s comp) insurance, that coverage is limited in duration and doesn’t deal with the full scope of her damages. Testa is gonna be in prison a good long while, so it’s not realistic to suggest that she sue him. Meanwhile, she had Uninsured Motorist insurance. What the hell is UMI for, if not for this kind of accident?

    Ms. Adams is not attempting to get rich by “double dipping.” She hasn’t asked Farmers to pay her for pain and suffering, she isn’t asking them to do anything more than that which they promised to do when they wrote the contract with her and TOOK HER MONEY. She isn’t a leech on the goddamn shareholders, she is one of millions of people who’ve paid into Farmers Insurance and its affiliates, and she of all people ever caught by circumstances *deserves* to have her claim covered.

    Farmers is just trying to weasel its way out of its obligations because it doesn’t want the bottom line hit that hard. Yay for the WA State Insurance Commissioner and all the media for not letting them get away with cheating this lady.