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Notify Your Insurance Company Immediately When Injured

by on July 28, 2011 » Add the first comment.

Insurance companies market themselves as trustworthy and friendly.  They claim to be “the good hands people?”  Or:  “Like a good neighbor, we’re there for you?”  Thus, it’s easy to get lulled into believing you’ll be treated fairly when you’re injured.  In reality, insurance companies are for-profit companies searching for ways to avoid paying claims.

For example, in October 2004, an Atlanta water extraction company employee fell 30 feet off a ladder.  Hoover v. Maxum Indemnity Co., A11A0284; A11A0285, 11 FCDR 2106 (7/8/11).  He sustained life-threatening and catastrophic brain-stem injuries.  At the hospital, the employee’s father asked for the water extraction company’s insurance information and was told by a supervisor that the insurance company would be notified.  [Allegedly the father called the insurance company, but this couldn't be proven.]

The employee initially filed a workers’ compensation claim, which was denied because the water extraction company didn’t qualify under Georgia’s Workers’ Compensation Act.  Thus, the employee brought a tort claim directly against the employer.  The trial court issued a $16 million dollar award in favor of the employee.  There was no doubt that the employee fell off a ladder while at work and that the fall was the direct cause of the devastating injuries he sustained; nevertheless, the employer’s insurance carrier refused to pay the judgment.  The insurance company argued that its obligation to provide coverage was extinguished because it hadn’t been timely notified of the employee’s injury.

The Georgia Court of Appeals agreed, finding that the insurance company didn’t have to pay the $16 million judgment.  The purpose of notification clauses in insurance contracts are to allow insurance companies the opportunity to investigate claims while the matter is still fresh.  In this instance, no investigation was required.  Regardless, the Georgia Court of Appeals strictly construed the insurance contract, relieving the insurance company of any liability.

The lesson is to notify all potential insurance companies in writing (preferably by certified mail) as soon as possible after any injury.

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