We sent Progressive Insurance a demand letter in a case where the client had some pretty serious injuries, including 50 staples in her head to close a scalp laceration. Progressive faxed us a letter stating it cannot conclude its investigation until we obtain different bills from the medical providers that are on certain health claim forms, because Progressive wants the individual CPT codes for every visit. CPT codes are numbers assigned to every task or service a doctor may provide to a patient.
Are CPT codes necessary for Progressive Insurance to determine whether medical care rendered was fair, reasonable, necessary, and causally related to the car accident? I think the best way to frame the question is to ask whether a jury can render a verdict without CPT codes. The answer, of course, in that I have never in my life heard testimony that included CPT codes at trial.
There are a few insurance companies I trust well enough that I’m willing to jump through a few dumb hoops to help them deal with whatever internal challenges the adjuster might have to making a fair settlement offer. Progressive Insurance has taught me time and time again that if you take the time to jump through their hoops, you are just delaying the inevitable lawsuit that I am sure to file.
Progressive continues to cement its reputation as an insurance company that will not make a fair settlement offer until a lawsuit is filed. I think this business model works for Progressive because it writes generally small insurance policies. You rarely see a Progressive Insurance policy in Maryland for over $100,000 and it is often the Maryland minimum coverage of $30,000 per person/$60,000 per accident. So, in many of our Progressive cases, the underinsured motorist carrier is prepared to make an offer but can’t until Progressive tenders its policy.
These small insurance policies embolden Progressive, so they know they can always pony up the policy at the last minute and avoid any real pain. As big of a tough guy as Progressive is in discussing settlement before suit is filed, it is about one-tenth as brave as State Farm in taking a case to verdict.