Negotiating a Personal Injury Settlement with Fred Loya Insurance

Fred Loya Insurance was founded by a Hispanic cattle rancher, Fred Loya, in El Paso, Texas, in 1974. The insurance carrier started as a single storefront office and has expanded to more than 361 different agencies with more than 700 offices scattered across Alabama, Arizona, California, Colorado, Georgia, Illinois, Indiana, Missouri, New Mexico, Nevada, Ohio, and Texas. 

Fred Loya Insurance Policies 

Importantly, Fred Loya Insurance typically writes “non-standard insurance policies” not offered by other insurance companies. This means many of the automobile policies sold are to high-risk drivers more likely to be involved in a motor vehicle accident. For example, Fred Loya Insurance will extend coverage to drivers with a history of multiple accidents, DUI charges, or other driving violations that most other carries do not want to insure. 

Because the non-standard insurance policies are geared towards high-risk drivers, it is not uncommon for the policies to extend bare-bones coverage. In Colorado, it is rare to see a Fred Loya Insurance that extends more than $25,000.00 per person and $50,000.00 per accident. This is called a “minimum limits policy” and these policies are often stripped down with no medical payments coverage or uninsured motorist/ underinsured motorist coverage. 

When non-standard insurance policies are involved, it is also common to encounter a Named Driver Exclusion, which dictates that, for any driver specifically named as an “excluded driver,” there is no insurance coverage regardless of whether they had permission to use the vehicle or not. These exclusions are commonly used when there is a minor in the home or another high-risk driver the insured represents will not be permitted to operate the vehicle. If the “excluded driver” gets into a car accident while using the insured vehicle, insurance coverage is voidable. 

Unfortunately, in Colorado, we have seen some drivers purchase policies from Fred Loya Insurance deceptively. They may opt to pay for a policy in installments simply to acquire proof of insurance in case they are pulled over or to renew their driver’s license, then stop making payments on the policy premiums. 

Fred Loya Insurance Claims Adjusting 

Like all insurance companies, Fred Loya Insurance is in business to make money. Unfortunately, Fred Loya Insurance does not make profits by generously paying out personal injury claims. In fact, it is very common for Fred Loya Insurance Adjusters to deny a claim based upon the Named Driver Exclusion or lack of cooperation from a claimant. It is also common for Fred Loya Insurance Adjusters to extend an unreasonably low offer. 

In the 50 years Fred Loya Insurance has been operating, the carrier has been accused of unfair and oftentimes illegal practices by both customers and state agencies across the country. A cursory review of the website, Consumer Affairs, for example, reveals ratings by actual consumers and 65% of the 291 reviews rates Fred Loya Insurance at a 1 out of 5. Similar ratings can be found at Ripoff Report, a website touted to be by consumers for consumers as well as on the BBB website, where Fred Loya Insurance is rated at a 1.07/5 with 145 customer reviews. The overwhelming theme highlighted by Fred Loya Insurance policyholders is that the claims adjusters purposefully delay handling claims, are rude, aggressive, and even combative. 

Tools Employed By Fred Loya Insurance Adjusters

Even though it is not a giant insurance company like State Farm or Allstate, Fred Loya Insurance is big enough to handle its own claims with in-house adjusting staff and legal counsel. There are several tools typically employed by Fred Loya Insurance adjusters. 

First, insurance adjusters at Fred Loya Insurance typically extend quick, minimal, early offers to settle. In so doing, they will try to convince uninformed injury victims to take quick cash for far less than their full claim value. Claimants should never simply take the insurance adjuster’s word regarding claim value. Once an injured party signs a release, they cannot seek additional money for settlement. 

Another strategy commonly employed by Fred Loya Insurance is to delay. Every day a claim is delayed is another day the carrier can maintain possession of settlement funds to earn a few cents or dollars more on their investments. When considered across thousands of claims, the interest Fred Loya Insurance earns on unpaid claims adds up to a significant amount of money. 

Another common tactic employed by Fred Loya Insurance is repricing medical bills. Specifically, the insurance adjusters attack the valuation of medical bills by assigning an arbitrary criteria to recalculate medical bills and other expenses based on the location of medical treatment. 

Avoid Being Treated Unfairly by Fred Loya Insurance

It is important that personal injury victims do not fall victim to Fred Loya Insurance’s strategies outline above. 

1. Beware of Recorded Statement

Typically, one of your first calls regarding a new auto insurance accident claim will involve the insurance adjuster asking for a recorded statement. While it may be the insurance adjuster is trying to gather basic facts and details of the accident, injuries and monetary losses, a much bigger part is trying to get an injured claimant to say things on a recorded line that may damage their claim in the long run. 

Personal injury victims are not required to provide a recorded statement to the at-fault driver’s insurance company. If, however, Fred Loya Insurance is the victim’s first party insurance company, they will need to provide a recorded statement. People should keep in mind, simply because Fred Loya Insurance is the first party carrier does not mean they have their insured’s best interests in mind. 

2. Do Not Accept an Early Lowball Offer from Fred Loya Insurance

There is no way to know the full value of a personal injury claim immediately after a car accident. In fact, it is difficult to value a case within the first few months because that depends on the severity of injuries, whether those injuries heal, and nature and cost of medical treatment, lost wages, and pain and suffering. Even medical doctors make educated guesses about the course of healing and treatment. 

The insurance adjuster from Fred Loya Insurance will have a pretty good idea of the minimum value of an injury claim. Accordingly, they may extend an immediate offer of a few thousand dollars (always less than what they think the actual minimum claim value could be) to “get the claim resolved” and “make the hassle go away.” Injured parties should not listen to these early, lowball offers. Accepting an early offer will almost always be insufficient.  

If Fred Loya Insurance is offering a claimant for a bodily injury claim, there is likely more money on the table. It is also likely the insurance adjuster does not have all relevant information and documentation. Once a claimant executes a settlement release, it is going to be extremely difficult, if not impossible, to continue with a personal injury claim. This is because a settlement is final. Prior to settling a claim, claimants should consult with a personal injury lawyer in Colorado. 

3. Understand the “Eggshell Plaintiff Doctrine”

The Eggshell Plaintiff Doctrine is a judicially-created doctrine (common law) that says the at-fault party must take the injured victim as he finds him when he exacerbates a pre-existing condition. This means an at-fault party is liable for aggravating an issue that an injured party had prior to a car accident in Colorado. 

For example, an at-fault driver causes a minor fender-bender with an elderly person with brittle bones and shatters her hip. Notwithstanding her pre-existing issues of glass bones, the at-fault driver is responsible for making the condition worse. It does not matter the fender-bender would not have caused this type of injury to most people. Another example is when a man with an asymptomatic (i.e., no symptoms) herniated disc in his lower back becomes symptomatic. It does not matter that the careless driver did not cause the herniated disc. All that matters is that the careless driver aggravated a preexisting injury, for which he is responsible under the Eggshell Skull Plaintiff doctrine.

Fred Loya Insurance will use a pre-existing injury or condition to argue their insured did not cause the injuries. The insurance adjusters will claim there is no causal relationship to sort out a prior injury versus a potentially new or aggravated one. This is simply not how claims should be handled. It can be, however, complex to prove an aggravation of a pre-existing injury. Hence the importance of consulting with a personal injury lawyer in Denver, Colorado. 

4. Know the Factors Affecting Case Value

Insurance adjusters from Fred Loya Insurance often selectively ignore items that increase the value of cases if not mentioned. It is important to keep in mind the facts that can affect the value of a case, including the following: 

• Facts Surrounding the Accident: A crucial fact involves the property damage of the vehicles because the more significant the property damage, the higher the likelihood of serious injuries. Another important fact is the location of the accident. Fred Loya Insurance pays attention to the county where the accident happened because some counties, such as Boulder County and Denver County, offer a more plaintiff-friendly venue. 

• Severity of Injuries: Fred Loya Insurance pays more money when the injuries are more severe. Soft tissue injuries, such as whiplash, are going to be valued lower than cases involving a broken bone or brain injury. It is helpful to keep in mind, simply because a person suffered a soft tissue injury, does not mean their injuries are not serious. The value of cases involving soft tissue injuries will come down to proper and consistent medical treatment. 

• Medical Expenses for Future Care: Many injuries are so severe that they will require long-term care. All residual complaints or permanent physical injuries are important because they will likely require future medical treatment. Injured parties should make clear to the insurance adjuster that they know they are entitled to compensation for future expenses. Remember, the claim only settles once. A claimant does not get to return to the process years later after 75 visits to a chiropractor and surgery. 

• Lost Wages: Claimants are entitled to compensation to reimburse them for lost earnings. If an injured party has suffered lost wages as a result of the injuries sustained in a car accident, they should seek such compensation. If a claimant uses benefits, such as paid time off or sick leave, they are entitled to compensation for those. People who are self-employed or work on a contract are entitled to compensation for their lost wages too. 

• Aggravating Factors: In a personal injury case based on negligence, the claimant merely needs to prove the at-fault party failed to meet the reasonable person standard and, as a result, caused demonstrable damages, harms, and losses. In cases where the at-fault party acted with gross negligence or recklessness, both of which are elevated levels of culpability above regular negligence, they may be liable for punitive damages, which can be awarded in addition to compensatory damages (medical bills, lost wages, pain and suffering), and are intended to punish the at-fault driver for their conduct. An example of this is an accident caused by a drunk driver. 

5. Do Not Let Fred Loya Insurance Reduce Medical Bills

The insurance adjuster may ask a claimant to produce copies of medical bills early on so that they can “fairly compensate you” for those bills.  However, it is also common that the adjuster will later inform a claimant the bills were “submitted for review” by a billing expert who found that the amounts charged were unreasonable. As discussed above, the insurance adjuster knows the total medical charges is a significant element in determining a claim value. It is unacceptable and unreasonable for Fred Loya Insurance to extend a bodily injury offer using the argument that the bills that were $20,000.00 were “repriced” to $7,000.00 by an expert. 

Negotiating Tips for Personal Injury Claims 

Personal injury victims should know the figure they want to settle before beginning negotiations. With each round of offers and counteroffers, it may be a good idea to match the movement of the insurance adjuster as they move from the previous offer. That said, it is also important not to bid against oneself by lowering an offer in response to the insurance adjuster not increasing the offer. Typically, Fred Loya Insurance will begin with a low-ball offer, especially if the claim involves soft tissue injuries. 

Typically, Fred Loya Insurance will move from the initial offer anywhere between 3-5 times throughout negotiations. If the parties reach a point where the offers cease to increase, claimants should consider providing additional information and documentation in an effort to aid the insurance adjuster in increasing the reserves. It would also be helpful to review each line of damages with the insurance adjuster, including each line item of the medical bills. It is important to make sure the bill Fred Loya Insurance has is equal to the bill the claimant has. As highlighted above, keep in mind, Fred Loya Insurance will likely attempt to discount the medical bills based on an arbitrary calculation relating to geography, as well as what the insurance adjusters will label “usually and customary.” 

Ultimately, claimants should keep in mind the insurance adjusters are simply doing their jobs within the confines of the policies and procedures dictated by Fred Loya Insurance. There is no point to be disrespectful or aggressive, or use foul language. All of this will be recorded in the claims file and, frankly, it will not help in the resolution of the claim. Personal injury victims should be kind and use facts to support the value placed on the claim. 

If the case does not seem to be moving in the right direction, another option is to speak with the insurance adjuster’s supervisor. Fred Loya Insurance operates under an organizational hierarchy, just like most large corporations, with lower-level employees, middle management, and upper management. The insurance adjusters that handle the vast majority of claims at Fred Loya Insurance, especially at the team level, do not have a significant amount of settlement authority. They are required to strictly adhere to the policies and procedures dictated by Fred Loya Insurance. It is possible to make further headway by circumventing the process by discussing the claim directly with the assigned insurance adjuster’s supervisor. It is possible Fred Loya Insurance will consider taking a second look at the evidence to see if the insurance adjuster missed something. 

Of course, a claimant may get pushback from the assigned insurance adjuster. They may indicate their supervisor is unable to add any value to the claim. Personal injury victims should not take this statement at face value. They should continue to push until they speak with the supervisor directly. Also, as highlighted herein, if a claimant has additional information or documentation that may increase the value of the case, provide it immediately. 

Consult with our Car Accident Lawyers Today 

While it is encouraging to see claimants attempt to settle their bodily injury claim directly with Fred Loya Insurance, the car accident lawyers at Bowman Law have seen far too often how doing so creates issues. We have taken cases where clients have attempted to settle their cases directly with Fred Loya Insurance and have had to spend countless hours fixing problems that were unnecessarily created. We have also rejected potential clients where the issues became too unsurmountable to overcome. The point is, claimants attempting to handle a claim themselves may actually make things worse. When the damage is done, there is not much our personal injury lawyers can do to get these cases back on track. 

This is why our car accident lawyers try to educate members of the community on injury claims ahead of time, but also highlight the importance of consulting with our attorneys early in their cases. 

A consultation is always free and may mean the difference between a case that had significant value versus a case that will only receive a nuisance offer. It is very rarely the case that a claimant will make more money by not hiring an attorney. In fact, a study by the Insurance Research Council revealed that attorney-represented claimants received 2-3 times more in settlements than those without a lawyer. Even when considering the contingency fee, claimants end up with far more money in their pocket when retaining qualified personal injury lawyers. 

Get Started With Our Colorado Law Firm Today

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