What Do You Do if Your Oregon Auto Insurer Improperly Denies or Delays Your Claim?

In the realm of insurance, the relationship between policyholders and insurance companies is founded on trust. Policyholders expect their insurers to act in good faith, promptly handling claims and providing the coverage promised in their policies. However, what happens when this trust is violated? In Oregon insurance bad faith can leave individuals grappling with denied claims, delayed payments, and unfair treatment.

One area where this often comes to the forefront is when an insurer unlawfully denies or cuts off personal injury protection (PIP) benefits. This usually occurs when there is a “file review” or an “insurance medical exam” by a medical provider that is hired by the insurer and concludes future medical treatment is not necessary or related to the crash. Bad faith conduct also arises when the insurer does not process bills in time or the insurer makes your medical providers jump through unnecessary hoops. This may result in teh providers passing the bills on to you.

What is Insurance Bad Faith?

Insurance bad faith occurs when an insurance company fails to uphold its contractual obligations to its policyholders. This can manifest in various forms, including unjustified claim denials, unreasonable delays in claim processing, inadequate investigations, and deceptive practices. When an insurer acts in bad faith, it undermines the fundamental purpose of insurance, which is to provide financial protection and peace of mind to policyholders in times of need. In Oregon bad faith is written into the law in the Unfair Claims Settlement Practices Act found in ORS 746.230. The recent court decision in Moody v. Federal Insurance Company, has provided persons insured by an Oregon policy a legal remedy to obtain financial compensation when an insurer violates Oregon’s Unfair Claims Settlement Practices Act.

Understanding Personal Injury Protection (PIP) Benefits

Personal Injury Protection (PIP) is a type of coverage that is mandated in some states, including Oregon, as part of auto insurance policies. PIP benefits are designed to provide prompt payment for medical expenses and lost wages resulting from injuries sustained in a car accident, regardless of who was at fault. In Oregon, drivers are required to carry a minimum of $15,000.00 of PIP coverage that pays crash related medical expenses as part of their auto insurance policies.

The Tools Insurance Companies Use to Wrongfully Deny PIP Benefits:

While PIP coverage is intended to provide swift and efficient compensation for accident-related injuries, navigating the claims process can sometimes be fraught with challenges. Insurance companies may engage in tactics aimed at minimizing their financial exposure, including:

1. Unjustified Claim Denials: Insurers may wrongfully deny valid PIP claims, citing vague policy language or alleging that the injuries are not covered under the policy.

2. Delaying Claim Processing: Delays in processing PIP claims can exacerbate financial strain for injured individuals who rely on timely reimbursement for medical expenses and lost wages.

3. Undervaluing Claims: Insurance companies may offer settlements that do not adequately compensate injured parties for their medical costs, lost income, and pain and suffering.

4. Inadequate Investigations: Insurers have a duty to conduct thorough and fair investigations into PIP claims. However, they may cut corners or overlook crucial evidence to justify denying or undervaluing claims.

Protecting Your Rights

If you believe that your insurer is acting in bad faith regarding your PIP claim, it is essential to take proactive steps to protect your rights:

1. Document Everything: Keep detailed records of all communication with your insurance company, including emails, letters, and phone calls. Document your medical expenses, treatments, and any correspondence related to your claim.

2. Know Your Policy: Familiarize yourself with the terms and conditions of your insurance policy, including the extent of your PIP coverage and any limitations or exclusions that may apply.

3. Seek Legal Guidance: If you encounter difficulties with your PIP claim, consider consulting with an experienced personal injury attorney, such as Jeremiah Ross, who can advocate on your behalf. Ross Law can review your case, negotiate with the insurance company, and, if necessary, pursue legal action to enforce your rights.

Conclusion

Insurance bad faith can have devastating consequences for individuals seeking compensation for injuries sustained in car accidents. Understanding your rights under Oregon's PIP coverage and recognizing the signs of insurer misconduct are crucial steps in safeguarding your interests. By staying informed, documenting your expenses, and seeking legal guidance when needed, you can assert your rights and pursue fair treatment from your insurance company. Remember, you deserve prompt and equitable compensation for your injuries, and insurance bad faith should never stand in the way of justice.

Please remember this blog post is for informational purposes only and is not considered to be legal advice. Please contact an Oregon Personal Injury lawyer such as Jeremiah Ross at 503.224.1658 to discuss your insurance denial. Please remember the law is constanty changing, and this blog post is not updated regularly.

The Difference Between Civil and Criminal Sex Abuse Cases in Oregon

Sexual abuse cases are sensitive and complex legal matters that often involve both civil claims and criminal charges. In the state of Oregon, as in many jurisdictions, it's crucial to distinguish between the two legal processes to comprehend the nuances and implications for the parties involved. For many sexual assault survivors, these nuances are often misunderstood. Many times the sexual abuse victim may think the District Attorney or Victim Witness is “their lawyer” and is acting to ensure their civil claim is protected. That is not the case. Every sexual assault victim should understand the following if they desire to pursue a civil claim against the wrongdoers:

1. Purpose and Parties Involved:

   • Civil Claim: Civil claims in Oregon for sex abuse typically involve a victim seeking financial compensation from the alleged perpetrator. The purpose is to try and make up for the harm caused to the victim through financial compensation. Civil claims not only involve the actual perpetrator but can also involve a person or entity that foreseeably caused the sexual assault to happen. There are countless situations where a corporation or the government may be responsible for a sexual assault. Some examples are: 1) Oregon DHS houses a child with a foster parent who did not perform a background check and the foster parent sexually abuses the child. 2) School Administrators ignore complaints a teacher is acting inappropriately around children, and the teacher later abuses a child, 3) A security guard or law enforcement officer sexually assaults a person while on duty,

   • Criminal Charges: Criminal charges, on the other hand, are initiated by the state of Oregon against the alleged offender. The primary goal is to punish the perpetrator for violating criminal laws and to protect society. They are limited to the actual perpetrator.

2. Burden of Proof:

   • Civil Claim: The burden of proof in civil cases is lower than in criminal cases. In a civil claim, the plaintiff must establish the defendant's liability by a preponderance of the evidence, meaning that it is more likely than not that the alleged misconduct occurred. This is much lower than criminal court.

   • Criminal Charges: Criminal charges require a higher burden of proof. The prosecutor must prove the defendant's guilt beyond a reasonable doubt, a significantly more demanding standard to secure a conviction.

3. Legal Consequences:

   • Civil Claim: If the plaintiff prevails in a civil claim, the court may award monetary damages to compensate the victim for physical, emotional, and financial harm suffered due to the sex abuse. The court can also award punitive damages to punish the wrongdoers for the harm that they caused.

   • Criminal Charges: A conviction in a criminal case can lead to various legal consequences, including imprisonment, fines, probation, and mandatory registration as a sex offender.

4. Initiation of Legal Proceedings:

   • Civil Claim: Civil claims are usually initiated by the victim or their legal representative filing a lawsuit against the alleged perpetrator. The victim is often seeking justice and financial compensation for the harm suffered.

   • Criminal Charges: Criminal charges are initiated by the state or federal government through a prosecutor who represents the public's interest. The victim may or may not be directly involved in the decision to press charges. This is a big distinction because the victim may have a civil lawyer and the District Attorney working on their cases at the same time.

5. Statute of Limitations:

   • Civil Claim: Civil claims for sex abuse in Oregon have a specific statute of limitations that dictates the timeframe within which a lawsuit must be filed. This timeframe can vary based on factors such as the age of the victim and the nature of the abuse.

   • Criminal Charges: The statute of limitations for criminal charges in sex abuse cases may differ, and it is essential to consider the specific details of the alleged offense.

Understanding the difference between civil claims and criminal charges in Oregon sex abuse cases is crucial for all parties involved. While a civil claim focuses on compensating the victim, criminal charges aim to punish the offender and protect society. Navigating these legal processes requires a nuanced understanding of the distinct standards of proof, purposes, and consequences associated with each legal avenue. That is why it is highly recommended that any sexual assault survivor consults with a lawyer with experience in Oregon Sex Abuse Cases such as Jeremiah Ross at Ross Law LLC. Please call 503.224.1658.

3 Tips for Dealing with Insurance Companies After an Oregon Car Crash

Navigating the aftermath of a car crash can be a daunting task, especially when dealing with insurance companies. Insurance Companies in Oregon are focused on minimizing the amount of money you get, which can leave you feeling overwhelmed and at a disadvantage. However, with the right approach, you can enhance your negotiation skills and secure a fair settlement. Here are three tips to help you effectively negotiate with insurance companies after a car crash.

Document Everything

The importance of thorough documentation cannot be overstated when negotiating with insurance companies. From the moment the accident occurs, start collecting and preserving evidence. This includes gathering information at the scene, such as exchanging contact details with the other party involved, taking pictures of the vehicles and the accident scene, and noting the names and badge numbers of responding law enforcement officers.

Additionally, keep a detailed record of all medical treatments, expenses, and any related receipts. This documentation serves as tangible evidence of the extent of your injuries and the financial losses incurred. Insurance companies often rely on these records when assessing the validity and severity of your claim. By presenting a well-documented case, you strengthen your negotiating position and provide a clear picture of the impact the accident has had on your life.

Also, document when you speak with an insurance company and who you speak with. If you are using the insurance company’s app then screen shot the correspondence to preserve the communication. Preserve all email correspondence with the insurer. This information is invaluable so you don’t feel overwhelmed with trying to remember what you have previously discussed or sent in. It is fairly common for insurers to deny receiving documents or correspondence.

Understand Your Policy and Rights

One common mistake individuals make when negotiating with insurance companies is not fully understanding their insurance policy and legal rights. Take the time to carefully review your policy to know the coverage limits, deductibles, and any exclusions that may apply to your situation. Knowledge is power, and being well-informed allows you to speak confidently during negotiations.

Moreover, familiarize yourself with the laws and regulations governing insurance claims in your jurisdiction. Each state may have different rules regarding fault determination, deadlines for filing claims, and limitations on damages. Armed with this knowledge, you can assert your rights effectively and challenge any unjust denials or lowball offers from the insurance company.

Consider Seeking Professional Assistance

Insurance negotiations can be complex, and the tactics used by insurance adjusters may catch you off guard. Insurers that can make the process more stressful and overwhelming know that you are likely to take a low settlement offer to avoid future stress and frustration. In such cases, enlisting the help of a skilled attorney such as Ross Law LLC experienced in car crash cases can make a significant difference. Personal injury attorneys, such as Jeremiah Ross, specialize in negotiating with insurance companies and can advocate on your behalf to ensure you receive a fair settlement.

Attorneys possess the legal expertise to interpret policy language, assess the true value of your claim, and navigate the complexities of the negotiation process. They can also handle communication with the insurance company, alleviating the stress and burden on you. While legal representation may involve fees, the potential increase in your settlement often outweighs the costs, making it a valuable investment in securing a just outcome. If you have questions regarding your personal injury case call Ross Law at 503.224.1658.

Conclusion

Negotiating with insurance companies after a car crash requires a strategic and well-informed approach. By documenting everything, understanding your policy and rights, and considering professional assistance, you can enhance your chances of reaching a fair settlement. Remember, the key to successful negotiation is being well-prepared and assertive in advocating for your rights and compensation.

Please remember this blog post is for informational purposes only. Please consult with an attorney regarding your Oregon personal injury case to ensure all of your rights and obligations are understood.

Can you sue the Delivery Company or Driver's Employer for Trespassing Into your Home?

In the digital age, on-line delivery and shopping have become an integral part of our daily lives, revolutionizing the way we shop and conduct business. However, as these powerful entities expand the scope of their services, controversies and legal disputes are bound to arise. One such area gaining attention is the potential for suing an online retailer or their delivery drivers for negligence and trespass.

These lawsuits typically arise when a delivery service driver is found in a person’s home or in a private area on their property. This is becoming more and more common as consumers are using these services more. For example, in October a delivery driver entered a home without permission and was stealing cash. These incidents can arise in several ways. The driver may just snoop around, the driver may take your personal property, or the driver may damage your property.

The issue then becomes who is responsible and whether there is any way to be compensated for the violation of your property rights and the fear from the invasion of your home and property.

In Oregon, civil remedies for trespass provide legal recourse for those whose property rights have been violated. Trespass occurs when someone unlawfully enters or remains on another person's property. The state's laws allow property owners to seek civil remedies, including injunctive relief, which can prevent the trespasser from continuing their actions. Additionally, property owners may pursue damages to compensate for any harm caused. Oregon's legal framework emphasizes the importance of protecting property rights, providing individuals with the means to address trespass and seek restitution through civil remedies.

Negligence may also be alleged. Negligence is a legal concept that arises when a party fails to exercise reasonable care, resulting in harm or damage to another party. One theory to recover from the online retailer or their delivery service partner is to allege a negligence tort. Usually in Oregon negligence arises from unreasonable conduct by the wrongdoer that results in foreseeable harm that causes injury. There are nuances in ensuring an online retailer or its delivery services such as the “course and scope of employment” issue, the “physical impact rule,” and “special relationships” that should be addressed.

There are also challenges in proving the case. To recover you are likely going to need to have saved the Order information and delivery information and any communications with the retailer or delivery service mentioning or referring to the incident. You are also going to need to have evidence to corroborate that the driver trespassed such as video camera footage, witnesses that are not related or do not know you, or a police report showing some corroborating evidence.

While negligence and trespass claims against On-line retailers and delivery service partner (DSPs) are theoretically possible, pursuing legal action against a tech giant presents significant challenges. Some user agreements often include arbitration clauses, diverting disputes away from the traditional court system. This can limit the options available to those seeking legal recourse.

Furthermore, some online retailers’ position as a platform connecting buyers and sellers can complicate matters. The company often contends that it is not directly responsible for the actions of third-party sellers or for the security of user data, which can create legal hurdles for plaintiffs.

Suing an online retailer for negligence and trespass requires a careful examination of the legal landscape and a thorough understanding of the specific circumstances surrounding the claim. If you or someone you know would like to pursue a claim against an online retailer for trespass in Oregon contact Ross Law PDX at 503.224.1658 to discuss your options.

Please remember this post is for informational purposes only. There are various factual or legal issues that may prevent you from pursuing a claim against an online retailer or their delivery service provider. Please also remember this is a simplified explanation of Oregon Law and there are many nuances that may make your situation different.

What You Need to Know if You were Injured by a DUII Driver during the Holidays

‘Tis the season for holiday parties. This also means this is the season where more drunk drivers are on the road crashing into others. Many of these crashes cause catastrophic injuries or deaths. When that occurs it is likely that the injured person’s family will want to hold all negligent persons responsible for causing the injuries or death. Most people think that simply the impaired driver is solely responsible for causing the crash. However, that may not be the case if the DUII driver is leaving a residence or bar where they were over-served alcohol. In Oregon you can sue a social host that over-serves a visibly intoxicated person who causes a car crash. This means the drunk driver may not be the only person or entity responsible for the injured person’s harms and losses.

This is important because homeowner’s and their insurance can be held responsible for compensating a person that was injured as a result of the homeowner serving alcohol to a person that is visibly intoxicated. (See ORS 471.565). Oregon courts have ruled that a person who receives guests in a social setting, in which the host serves or directs the serving of booze or beer to guests can be held accountable if the overly intoxicated person later injures another in a DUII crash. Don’t believe me? Check out the Court’s opinion in Deckard v. Bunch, 358 Or 754 (2016).

Social Host liability is important because home owner’s and renter’s insurance policies may cover DUII crash injuries and provide tens of thousands, or hundreds of thousands of dollars, in additional insurance coverage. This money can be used to pay medical bills, physical therapy, vocational rehabilitation, and to compensate the injured person or their family for their harms and losses. More importantly, social host liability will hopefully act as a deterrent to over-serving intoxicated people who may get behind the wheel.

Social Host cases can be complicated and there are time limitations to send the social host a notice after the injury. Additionally, there are other theories an attorney can use to attempt to obtain maximum recovery for a person’s wrongful death, injury, or loss. Please contact Portland Personal Injury Attorney, Jeremiah Ross, at 503.224.1658 for a free personal injury consultation. Please remember this post is for informational purposes only and you should rely on the current statute and case law when considering a dram shop claim. These laws constantly change and the theories of liability are not as clear as they were in the past. Please consult with an attorney if you believe you have a dram shop claim, social host claim, or have been injured by a DUII Driver.

Tagged: DUII, Personal Injury, Dram Shop, social host liability, impaired driver, drunk driver, negligence, reckless driver, wrongful death, injuy

Suing the State of Oregon DHS for Foster Child Abuse

In recent years, concerns have emerged regarding the well-being of foster children under the care of the State of Oregon Department of Human Services (DHS). Allegations of abuse and neglect have raised serious questions about the effectiveness of the state's foster care system, prompting some families to consider legal action. Some of those families have come to Ross Law which has successfully litigated cases against the State of Oregon for their failures to Oregon’s foster children. Suing the DHS for foster child abuse is a complex process, but it is a necessary process to ensure the protection of vulnerable children.

Understanding the Legal Landscape:

Taking legal action against a government agency like the DHS involves navigating a complex legal landscape. While the government is typically protected by sovereign immunity, there are exceptions that may allow individuals to sue for damages in cases of abuse or negligence. One such exception is when the government agency fails to uphold its duty to protect the rights and safety of foster children. Another legal issue that commonly arises is the Tort Claim Notice which may be necessary depending on the legal status of the custody of the child when the harm arose. Additionally, there are different legal claims ranging from negligence under Oregon’s Tort Claims Act, Strict Liability for Foster Children abusing others, and Civil Rights violation for the State’s violations of the child’s civil rights.

Building a Case:

To successfully sue the State of Oregon DHS, it's crucial to gather compelling evidence of abuse or neglect. This may involve obtaining medical records, testimonies from witnesses, DHS CPS Records (investigative reports and findings), police reports, and any documentation of any reported incidents. Engaging the services of an experienced attorney with expertise in child welfare cases is essential for building a strong case against the government agency.

Challenges and Considerations:

Suing a government entity comes with its own set of challenges, including legal hurdles and potential backlash. The process can be lengthy and emotionally draining, requiring a resilient commitment to the pursuit of justice. It's essential to weigh the potential benefits against the inherent difficulties, considering the impact on the affected children and their families.

Advocating for Change:

While legal action is a route for seeking justice for individual cases, it's also an opportunity to bring attention to systemic issues within the foster care system. Ross Law and others can leverage the legal process to push for policy changes, increased transparency, and improved oversight to prevent future cases of abuse and ensure the well-being of all Oregon’s foster children.

Conclusion:

Suing the State of Oregon DHS for foster child abuse is a challenging but potentially impactful endeavor. It requires dedication, a strong legal strategy, and a commitment to improving the overall welfare of vulnerable children. By holding the state accountable, individuals can contribute to a broader conversation about the need for reform within the foster care system, ultimately working towards a safer and more protective environment for all foster children.

Need Help?

If you or someone you know has been abused while in the custody of the State of Oregon please call Ross Law at 503.224.1658 to discuss your case. Attorney Jeremiah Ross has represented foster children and victims of Oregon’s DHS’s failures throughout the State of Oregon.