Do a lawyer have to file a lawsuit if claim was denied?

by Shawn58 » Sat Oct 11, 2008 10:12 am

I have a lawyer that is try to work with an adjuster. But the adjuster is sticking with her denial. This specific company is known for being hard. Her reason for denial is because i stated that i did know about the defect and her insured didnt know either. I guess she is trying to say is the person didnt know about it so why would the owner. Something like stairs in a business are one of the place a owner is suppose to check isnt it? Especially if the owner know it used by many people. Also the owner is in this area alot. That is her reason for denying the claim. What about constructive notice cant my lawyer show that? I dont see any reason a lawsuit have to filed. When this should be worked out. Why is the adjuster doing this?

Total Comments: 6

Posted: Sat Oct 11, 2008 10:31 am Post Subject:

Sorry but you need to explain this a little better from the beginning, then I'm sure we will be able to assist...i'm 'assuming' you fell on some stairs? start at the beginning and go slow explain what EXACTLY happened...and what the denial is...

Posted: Sat Oct 11, 2008 10:47 am Post Subject:

If the adjuster is stating that her client wasn't aware of the defect that has caused injuries/damages to you then I think she is right in her way of denying the claim. The person can't be held responsible that wasn't caused by his negligence. If it had happened that you have informed the landlord about the damaged property and he hadn't paid any attention to it, then you might stand a chance against him. However, we seriously need more details to offer better replies.

Posted: Sat Oct 11, 2008 12:21 pm Post Subject:

The stair where rotten and piece was gone and i stepped and fell. How is the owner not aware of rotten steps. I guess the owner told the adjuster he didnt know. Isnt a owner suppose to inspect areas such as entrance stair?

Posted: Sat Oct 11, 2008 05:52 pm Post Subject:

First... was the denial sent in writing? If not, it's not been denied yet. While details would need to be known, sometimes and adjuster will argue a defense, such as no constructive notice, and make it sound like they have no liability ("denial") and what they are really doing is posturing. It's the same that your attorney will do.

Why you were there is a big factor. If this was a business open to the public then it's tough to get away constructive notice. For, as you mentioned, the business owner would owe a greater degree of care and should have been inspecting the area for defects.

Regardless, constructive notice will be used as a defense by the insurance company in order to limit the amount they may need to pay.

Why is the adjuster doing this? To be frank, because it's part of their job. I'm not saying denying claims they owe is part of their job but they do need to look at both sides of the issue and make a determination. I, as an adjuster, almost always see two sides to every issue (if you don't, I don't think your doing a good job as an adjuster). However, I also need to provide my insured a good defense and also need to pay only what is owed. When you go into McDonald's, they give you correct change and don't just give you extra, right?

Posted: Sat Oct 11, 2008 06:17 pm Post Subject:

And I'm sure the adjusters insured (the property owner) told them they knew nothing about this...to say otherwise would be foolish at best...that not only is negligent but gross negligence...no body admits to that!

Please post exactly what the written denial says if there is one....also why were you in the building? what type of building is it? how many times had you been there? do you live there? how many times prior had you been on these stairs? see there are a ton of questions and answers that need to be address to see if in fact the owner of the building was negligent...are the stairs inside a dwelling?

Posted: Sat Oct 11, 2008 07:06 pm Post Subject:

Looks like this post needs alot more detail before anyone can give any standing advise. Lets hope the poster stops back in.

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