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Your Case
Representative Cases:
Insurance company refuses to pay for brain injury treatment ; jury awards over $1 Million.
A local woman was sitting in the driver's seat of her family Toyota Sequoia, stopped for a red light at an intersection near the University of Oregon campus. She was rear-ended by a Cadillac driven by an underinsured motorist. It was a modest speed impact, but she immediately started to have headaches.
The headaches continued, and worsened. She developed problems with her memory. She experienced a loss of energy, became more fatigued, and eventually had regular exhaustion. She developed problems with weakness, dizziness, and loss of balance. She began to experience abnormal sensations in the skin, including numbness, tingling, prickling, and burning or cutting pain.
What she did not know was that she was one out of about a million people who have two conditions that make them extremely vulnerable in a rear-end collision. The first condition is called a Chiari I malformation, in which part of a person's brain is pushed down through the hole at the base of the skull where the spinal cord goes. The second condition is Ehler-Danlos syndrome. With that syndrome, a person has loose ligaments and other connective tissues that allow excessive movement.
Her conditions were eventually diagnosed, and she was treated at The Chiari Institute in New York, the nation's leading medical center for this condition. Treatment included major brain surgery. Her medical bills to date exceed $200,000.
The insurance company for the negligent Cadillac driver settled, and then we asked our client's own insurance company to pay the balance of her losses. Her family had paid for a $1,000,000 underinsured motorist insurance policy. The insurance company refused to pay anything for her losses, and refused to submit the matter to arbitration, instead forcing her into a jury trial. At trial, the insurance company asked the jury to give no benefits under the insurance policy. Instead, the jury returned a verdict in her favor, in the amount of $1,020,000
Health insurer refuses to pay for surgery; confidential settlement
An Oregon woman had several potentially life-threatening health problems associated with morbid obesity. After years of unsuccessfully trying diets and various weight loss programs, her physicians recommended a surgical procedure to cause her to lose weight. They did so because of the health risks she faced and because no other treatment had been or was likely to be successful in curing those problems.
The woman had health insurance which provided that "medically necessary services are covered when ordered, provided, or pre-authorized by a primary care physician." The health insurance policy had no exception for treatment, including surgical treatment, for morbid obesity. The proper pre-authorization paperwork was submitted by her physicians but the insurance company denied coverage for the surgery, saying that the surgery was not medically necessary because she did not have a sufficient number of health risks. She appealed the insurance company's decision through its administrative channels with the help of an attorney who specializes in representing people who seek insurance coverage for gastric bypass surgery. When this was unsuccessful, she asked us to bring a legal claim.
We brought an action for breach of contract, bad faith, and negligence. After litigation, including extensive document discovery and depositions, the insurance company asked for a mediation. The case was settled through mediation for a confidential amount.
Auto insurer refuses to pay for pedestrian's head injury; confidential settlement
A motorist, after passing a flashing amber light and a yellow warning sign indicating a pedestrian crossing ahead, ran down a college student who was crossing in the marked crosswalk. The force of the impact sent the young woman cartwheeling on the pavement, fracturing her skull. The young woman suffered head injuries resulting in the total, permanent loss of the ability to smell, impaired taste, and other losses.
We successfully prosecuted a case against the negligent driver, and collected his $100,000 policy limits from his insurance company. However, the woman's losses were significantly greater than this amount. Her family had purchased a substantial amount of underinsured motorist coverage, and we asked their insurance company to cover the additional losses. The insurance company refused.
We then prosecuted a case against the family's insurance company for the underinsured motorist benefits promised under their auto insurance policy. During the litigation, the insurance company asked for a judicial settlement conference, and the case settled.
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