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Real life auto insurance horror story (again)

March 15, 2011 by Steven M. Gursten

Michigan No-Fault insurance lawyer exposes atrocious claims adjusters and the tactics they use on innocent car accident victims

Want to see how far too many real-life auto accident victims are treated by claims adjusters?

Below is a recent deposition (recorded testimony under oath) of Soncia Salter. Ms. Salter is employed with the Department of Management and Budget, and the Risk Management Division of Wayne County. The No-Fault insurance lawyers who took the deposition were Deborah Tonelli and Kevin Seiferheld from my office.

Our insurance lawyers see innocent people being abused like this all the time, but that’s because this is what we do. For those who read this deposition, it’s important to remember that there is a real person being affected. This type of gross negligence by insurance company claims adjusters can cause enormous devastation to innocent people’s lives.

In fairness, not every claims adjuster is this terrible, but this is a good example of how many claims are being handled by insurance companies every day. This case involves Wayne County — because it was a Wayne County vehicle involved in the underlying auto accident. Under Michigan’s No-Fault insurance law, Wayne County became responsible for paying No-Fault benefits.

What if this was you?

Before you read this deposition, imagine for just a moment that this person is you. You are seriously injured in a car accident that is not your fault. Now you can’t work because of your injuries. You need medical care and treatment.

And then, your insurance company just stops paying. No explanation. No letter. No warning. Everything just stops.

You become desperate. Your claims adjuster ignores you. Phone calls go unreturned. You hire a No-Fault insurance lawyer to help you. The insurance lawyer calls the claims adjuster, and the claims adjuster actually tells the lawyer the check is “in the mail” (sadly, I’m not making this up). Of course, the check never arrives. The claims adjuster thereafter refuses to return any phone calls and messages that are left for her from the insurance lawyer you hired. Your lawyer files a lawsuit.

Deposition between No-Fault insurance lawyer and a claims adjuster

The questioning below involves why Ms. Salter (the insurance adjuster), never sent a letter to the Mr. Wells, (the accident victim), explaining why all of his No-Fault benefits suddenly stopped. This is real testimony taken from Ms. Salter. The testimony has not been altered.

No-Fault lawyer:
Did you send a letter to Mr. Wells, advising him that you were no longer going to pay No-Fault benefits to him?

Insurance adjuster: I do not recall.

No-Fault lawyer: Well, take a look and see if you have a letter advising him that you’re not going to pay benefits to him anymore.

Insurance adjuster: I do not see a letter to that effect.

No-Fault lawyer:
Why isn’t there a letter in your file letting Mr. Wells know that you have stopped paying his No-Fault benefits?

Insurance adjuster: There isn’t one. I can’t answer that question.

No-Fault lawyer: Do you typically send one to people to let them know that you are going to stop paying benefits?

Insurance adjuster: Typically, yes.

No-Fault lawyer: And what’s the explanation as to why there is no letter in this file?

Insurance adjuster: I don’t have a letter in the file, period.

No-Fault lawyer: How is Mr. Wells supposed to know that you are no longer paying his benefits?

Insurance adjuster: I don’t — I don’t know.

No-Fault lawyer: Did you stop paying Mr. Wells’ No-Fault benefits at any point in time?

Insurance adjuster: Yes.

No-Fault lawyer: When?

Insurance adjuster: Once I was provided information that advised that Mr. Wells was able to return to work.

No-Fault lawyer: And as we sit here, there is nothing in your file that indicates that Mr. Wells was advised of the discontinuance of his benefits. Right?

Insurance adjuster: There is nothing that I saw, as far as a letter.

No-Fault lawyer: And you know that you did based on what?

Insurance adjuster: I don’t recall.

No-Fault lawyer: So there is no note in your file by you that says: I, Ms. Salter, have determined that we should no longer pay No-Fault benefits to Mr. Wells, and this is the date that I have made this decision?

Insurance adjuster: I don’t find a note in my file, no.

No-Fault lawyer: Do you keep any kind of log, as a claims person, as to what you’re doing on a file?

Insurance adjuster: A claim log such as what?

No-Fault lawyer: Typically at insurance companies, the adjusters have a computer, and they log in phone calls from their insured. They log in receipt of bills. They log in receipt of medical records, decisions that they’re making on the file to pay or not pay bills. You keep no log whatsoever about what you have done on this file. Am I correct?

Insurance adjuster: That is not a process here, no. That is correct.


No-Fault lawyer: So why didn’t you pay him wage loss from March until December?

Insurance adjuster: I was advised not to.

No-Fault lawyer: By whom?

Insurance adjuster: Counsel.

No-Fault lawyer: Counsel advised you not to pay him wage loss benefits?

Insurance adjuster: That we didn’t — that is correct. That is correct.


No-Fault lawyer: And, Ms. Salter, did you agree that that was a good decision? And I don’t mean that you had a conversation, but did you, in your mind, think that that was appropriate to deny benefits for the previous nine months?

Insurance adjuster: I was to follow the decision.

No-Fault lawyer: That wasn’t my question. Did you as a claims handler think that that was appropriate to retroactively deny somebody benefits?

Insurance adjuster: It seemed questionable.

Here’s a PDF of the the entire deposition of Soncia Salter.

As I said, this was taken from the very recent deposition testimony of Soncia Salter, a Wayne County No-Fault claims adjuster. On Thursday, I will further blog about this despicable, yet very common insurance claims adjuster abuse and the need for a law that prevents insurance adjusters from being able to cut off No-Fault benefits from innocent and injured accident victims – for no reason whatsoever.

Steve Gursten is recognized as one of the nation’s top lawyers handling serious car accident and truck accident lawsuits, and No-Fault insurance litigation. He routinely writes about insurance company abuse and the No-Fault laws in Michigan, and is available for comment.

Related information:

Cartoon: How insurance companies handle car accident cases

Out of state car accidents and Michigan’s No-Fault insurance laws

Michigan insurance claims adjuster tactics

Michigan Auto Law is the largest law firm exclusively handling car accident, truck accident and motorcycle accident cases throughout the entire state. We have offices in Farmington Hills, Detroit, Ann Arbor, Grand Rapids and Sterling Heights to better serve you. Call (248) 353-7575 for a free consultation with one of our insurance lawyers.

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3 Replies to “Real life auto insurance horror story (again)”

  1. I am an independent insurance agent here in Michigan. I have rarely seen this kind of thing in my 27 years in the business. Usually, if something is not going according to plan, the agent steps in and serves as liason between the 2 parties. And almost always we find it involves a miscommunication of some sort.

    Sometimes honest errors have occurred on the adjuster’s side, but, like I said, that usually gets handled quickly when the insured calls me.

    In this situation no Insurance company was involved. In fact, this is a self insured Municipality. Very small compared to an insurance company.

    You yourself said in the deposition: “Typically at insurance companies, the adjusters have a computer, and they log in phone calls from their insured. They log in receipt of bills. They log in receipt of medical records, decisions that they’re making on the file to pay or not pay bills.”

    In reality the quality control procedures are much more elaborate than that.

    Ms. Salter is just an employee of a small, non-typical, self-insured fund of a local government. They are so small, they lack the typical procedures and safeguards that you mentioned above.

    This is a very non-typical example in my experience. But I only deal with insurance companies of course.

  2. I appreciate your comment, but I respectfully suggest you couldn’t be more wrong on two points.

    First, the City of Detroit is not some “small” self-insured fund of local government. The City processes thousands of claims every year. More importantly, even if your comment was accurate, that doesn’t give them an exemption from the requirements of the Michigan No-Fault Act to pay benefits within 30 days upon reasonable proof. The actions, and inactions, of the City in paying timely No-Fault benefits to bus accident victims and hundreds of other people results in a violation of the law and a lot of needless but very significant harm to people who can’t get their wage loss checks or medical bills paid and find themselves soon unable to treat.

    Second, I would encourage you to list the insurance companies you do work with. From my own experience in litigating wrongful denial of insurance benefits cases with State Farm, Allstate, Geico, Titan, Farm Bureua, and many others, I can tell you that the cut-off and denial of benefits exemplified here is certainly not unusual. In fact, in a state without bad faith laws, there is not much that quality control adjusters do differently at these other insurance companies.

    Finally, the City of Detroit does have such a quality control person. In this case, it is Ms. Salter’s supervisor in the claims department.

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