I had a bad accident 3 years ago at small restaurant in L.A. A piece of ceiling collapsed on top of me while I was walking to the table knocking me out unconscious for 5 minutes. Suffered a TBI was in the hospital for nearly 1 week. I have had 2 surgeries so far, to my left eye my vision is poor now can be barely see at 20/200 near legally blind can only see the BIG E on a eye chart and neck had fusion from C2-C6. I still have 2 more pending surgeries. My attorneys are now telling me the insurance company wants to settle after nearly 2.5 years fighting the case they had to send a lawsuit for bad faith because they failed to respond to claim 2.5 yrs unreasonable denying the claim as well. I don’t understand why now are they making an offer at policy limit $1 Million (attorney fees & medical bills will take most of that) when my attorneys told me I can sue for $5 million or more if the case goes to trial but a jury decides. Are they low balling my case? I LITERALLY HAVE NOTHING! I am homeless living in my car and few family members once in awhile. I have not worked for 3 years because of the accident and I am not able to go back to the profession I did for over 20 years because the TBI side effects symptoms. I don’t think they want me to go to court. I have not signed anything in accepting the offer or settlement/ liability but I am considering a second opinion. I am willing to go to court and take my chances. My question is if the insurance is only offering policy limit $1Mil, where would the rest of settlement come from, the restaurant owners assets? I feel my attorneys are not being direct with me and want me to accept the settlement offer and I am being hesitant 😕 I do believe there must be merit in having a strong case for possibly a trial mainly negligence because they were aware of the ceiling needing repairs. This is my life and I suffered a lot 🤷🏻♀️
If I was offered a settlement in a slip and fall case at the insurance policy limit can I decline
byu/CreoleRedbonedeaux inInsurance
Posted by CreoleRedbonedeaux
17 Comments
Honest question. Do you think you would be able to collect actual funds for a settlement beyond policy limits?
Sorry, believing you’re entitled to more doesn’t mean you’re going to get more
Most likely they want you to settle as it means they can collect 40% plus all of their fees right now. If they go forward with a verdict there is a possibility they don’t get all of that money. But even if they got $5 millions, it’s as you mentioned, they collect the $1 mill from the insurance company and then need to continue spending money to try to get the $4 million from the restaurant. That takes a lot more time and effort and the firm is probably already out something like $50k with another $100k in wages. To answer your question… I’m guessing there _are_ questions as to the extent of the injury or liability. Your attorney is going to tell you what a great case you have as this is what you want to hear.
Since you are going to be paying your attorney north of $400,000… why not at least ask these question of him/her? Some questions, such as “why don’t we go for $5 million?” should get a good answer.
If the verdict rules in your favor their insurance will only pay a million. Meaning you would need to sue the restaurant for the remaining amount which who knows how long that’ll take.
Restaurants are low margin businesses. They are probably predicting terrible odds of success at collecting any meaningful amount past the policy limits.
The restaurant insurance is offering policy limits. You can decline and go to court and that could take another year? Your homeless living in a car or couch surfing. Can you live like that for another year?
If you win a higher judgement, then the insurance company will still hand over a $1 million check and it’s obligation to the restaurant owner is over. Anything above $1 million you (legal team) will have to collect from the restaurant owners. However if the restaurant owner doesn’t have much in assets then there’s not much more you can do to collect. In most states, you can put a lien on their home, but can’t force them to sell to collect your money.
OTH your attorney may have done a financial background check on the restaurant owners and feel that they can get the $5 million out of them.
All you’d do is force them into bankruptcy and be stuck with the insurance settlement less more legal fees
Policy limits are policy limits.
Has your attorney investigated whether or not the owner of the restaurant also owned the building? Is the owner of the restaurant the one also operating the restaurant?
ABC Development may own the building
X Restaurant corp may own the restaurant (lock, stock, and barrel – the name, menu, recipes, equipment)
Y may actually operate the restaurant, handle staffing, and is essentially the face of the restaurant. Sometimes the operator actually owns the menus/recipes and might create something to fit a certain concept
If they haven’t done that, they need to. There could be several layers of coverage here.
Keep in mind, fees can go to 50% if it goes to litigation and fees can change depending on the award. Then there’s the collecting part of it. You also have to consider the jury’s opinion of you. While your being homeless seems to be due to the accident, will the jury be sympathetic to that? What’s the jury’s opinion going to be on somebody that’s homeless?
So, this is a tough one, because I don’t know if your lawyer has went through the full discovery process to see if the restaurant has an Umbrella policy. This insured could very well have an umbrella policy that has more limits, and this insurance company could just not know about it, or wording the settlement in a way that would be accurate (limits of this policy) but is not fully truthful.
If this insured has no umbrella policy, then it’s true, you can get no more money than the limits of insurance from the insurance company.
The question to ask is, are there any other policies, has your lawyer done discovery to make sure there aren’t, and would the settlement wave any actions by you to collect from another policy?
Honestly, in CA, it’s strange an agent/broker would not push very hard, if not require their insured to get an umbrella policy, as failure to do so would be seen as E&O by them.
I’m sorry this happened to you for starters
Im not an expert in this field, so i have no idea of your chances of getting $5m
If you take the $1m i assume you have to pay taxes on it, but then you could invest all of it and make $40-60k annually on the interest (assuming medical was covered by your insurance)
If not and you’d have to dump it all into medical bills then idk, if you cannot go back to your career then I’d think you should get more, arguably enough that the interest would pay your previous salary + any debt accrued from this
Again, not an expert, that’s what just makes sense to me as a normal dude, realistically your lawyers probably have a better idea of if you should take it or not
Edit: just saw you’d have to pay your attorney 40%, idk, you’d have to go after the restaurant for more, consult a lawyer that could sue them maybe
Did your attorney confirm there was no excess insurance policy? Which is another insurance policy on top of the primary $1M policy.
I assume you’ve at least applied for SSD? Are you now on Medicare?
If there is only the primary $1M policy, then the only way to try and “take the lid off” of that policy would have been if your attorneys sent a time limited demand to the carrier requesting the limits, which was refused. At that point, you could go to trial and if you got a verdict above the $1M, the insurance company could be on the hook for the excess, but that is all state by state dependent on the actual logistics and feasibility.
On this size of settlement, I’d personally suggest a second consult with another attorney for an opinion, if you’re having challenges trusting yours.
Jury trials are a risk. Ultimately you’re in the drivers seat; a jury trial could result in higher award (and dependent on jurisdiction + other nuances, insurer may be on the hook regardless of limits or, you may have to chase the owner for their assets.)
I’d suggest:
1. Asking your attorney why they’re suggesting settlement, what they feel the likelihood of success at trial is. Ask them to be brutally honest with you: some plaintiffs are more likeable than others, and this makes a huge impact at jury trials, and some attorneys may hesitate to lay that out for you. (Not saying this is you or even valid, just saying this is the reality. As unsympathetic as insurance companies can be in court, sometimes juries just do their own thing and don’t particularly care for a plaintiff.)
2. If they’ve found out if there’s any additional (ie Umbrella) coverage on the restaurants part or if not, what assets the defendant has.
3. For a breakdown of what you’ll take after fees, medical bills, and so on if you accept the settlement.
Then you can make a more educated decision. Don’t rush it; take a day, think it through, ask for more opinions.
Sorry for all the troubles this accident caused you.
Honestly, if you go for more, the restaurant would likely just file for bankruptcy.
If you take the $1 million, You won’t pay any taxes on it
Buy a house for $200,000
Talk to an insurance professional about a Guaranteed lifetime income annuity With certain guarantees (30 years certain)
Learn what in annuity is before you talk to the salesman
If You give the insurance company $400,000, And get annuity contract for the rest of your life or 30 years period Certain.
The contract will pay out monthly checks to you, like a pension either your entire lifetime or 30 years to your Surviving family members after your death, Whichever is longer!!!
If you live two years, the family gets 28 years of monthly payments
If you live more than 30 years, you would’ve received monthly payments for Your entire life but when you die After the 30th anniversary, there is nothing left
The 30 year certainty is for the beneficiaries, And it’s only available if you die before the 30th anniversary
You are guaranteed to get this income check every month of your life
How are you gonna invest the other 4 hundred thousand dollars?
, I don’t know you want AAA rated insurance company.
10 years ago, I worked at New York Life
You will have a roof over your head head, A monthly income for the rest of your life, And $400,000 cash
Be very careful
$400,000 does not go as far as it used to
You don’t have to use my numbers
You can buy more or less house
You can buy more or less guaranteed lifetime income annuity
Talk to an agent
If you go above policy limits, do you really think you’re gonna get the money? The business will likely file for bankruptcy and you won’t get anything. Sorry that you were living in your car ask friends or family if they can take you in if your financial position was terriblebefore the accident, it’s even worse now. I would take the settlement before the this gets wrapped up and tied up for another couple years.
First thing your attorney should have told you is to not talk about this online while case is ongoing
I agree the restaurant might be limited on the possible lawsuit money, but seems like the property owner would be involved in this also?
You can not not work due to a injury, seems like you should be eligible for disability either through the state or Social Security?