Insurance Company Secret #2 - Setoffs

In the second installment of Insurance Company Secrets, today we examine setoffs and their application in a jury trial stemming from a car accident. If you or a loved one are injured in a car accident, your attorney most likely will attempt to resolve your claim through a demand package to the insurance company before filing a lawsuit against the the at-fault party and/or your uninsured motorist carrier if you have such coverage. Most personal injury lawsuits arise when you and your attorney are unable to agree on an appropriate settlement amount with the insurance company prior to filing suit. In those cases where an agreement on a settlement amount cannot be reached, a lawsuit is often filed. Many suits are settled during the litigation process but some cases do not resolve and require a jury trial where a jury of your peers will decide your case. It is in these cases that Insurance Company Secret #2 is applicable.

During the closing argument of your case, your lawyer will be requesting from the jury a sum of money to compensate you for the personal injuries you sustained in your car accident. The defense attorney also has the opportunity to make a closing statement to the jury. After closing arguments, the jury will retire to deliberate and once a verdict is decided upon by the jury, the jury will return to the courtroom where the verdict will be read. The verdict can range from a defense verdict (zero dollars awarded to the injured person) to a very large verdict in favor of the injured person. Here is where Insurance Company Secret #2 comes into play. After the jury has reached its verdict, your attorney and the defense attorney will return to see the judge a few weeks after the trial. It is at this hearing before the judge that setoffs will be subtracted from the jury verdict. Depending on the case, set-offs can include subtractions from the verdict for PIP benefis paid or payable, medical payments coverage and any bodily injury settlement.

Here are two examples to consider: First, is a standard third party case against the party who caused the accident. John Doe v. Suzie Q. Suzie Q is insured by State Farm hypothetically. John Doe has his automobile insurance with GEICO and has standard PIP coverage in the amount of $10,000.00 which is exhausted. Let's assume that the case is tried and the jury awards John Doe $23,000.00. At the hearing following the trial, Suzie Q's attorney (an attorney paid for by State Farm or a State Farm salaried employee) will ask the judge to set off the $10,000.00 in PIP benefits available to John Doe under his GEICO policy against the $23,000.00 jury verdict. The net effect of this is that the $23,000.00 verdict gets reduced down to $13,000.00 after the trial and the jury will never know this. If you were to ask to most jurors sitting in these types of cases, they would tell you that had they known that the judge was going to subtract money from the amount of their award, they would have awarded more money to offset this post-trial subtraction.

Here is another example: Let us assume for this hypothetical that John Doe has $10,000.00 in standard PIP coverage and $50,000.00 in uninsured motorist coverage (UM). Suzie Q has $25,000.00 in bodily injury coverage with State Farm. State Farm agreed to pay its $25,000.00 in bodily injury limits to avoid a trial; however, GEICO refused to make an adequate offer under its UM policy so a trial ensued, John Doe v. GEICO. A jury renders a verdict in favor of John Doe in the amount of $45,000.00. Post trial, GEICO, through its attorney will ask the judge to subtract not only the $10,000.00 in PIP coverage but also the $25,000.00 in bodily injury coverage available under State Farm's policy. Thus, the $45,000.00 jury verdict will be reduced to $10,000.00 with a whopping $35,000.00 being subtracted off the jury's verdict. Again, like in hypothetical #1, the jury never knows that this post-trial subtraction will take place. Additional subtractions can take place if a plaintiff has medical payment coverage.

Insurance companies use these set-offs (subtractions after a jury renders its verdict) to continually make low-ball offers to claimants with legitimate injuries. Some defense attorneys will even suggest to a jury things like "give Mr. Doe a few thousand dollars if you think he deserves it" in an attempt to sound conciliatory even though these types of tactics are designed to cut a claimant's legs clean off once the post-trial set-offs are applied. It is important to have a full understanding of how Florida insurance companies take full advantage of Florida law coupled with their economic clout to put the screws to claimants who present personal injury claims against them. For these reasons, it is critical that you have an attorney on your side to represent your interestsin your personal injury claim and to battle the insurance companies and their army of attorneys.