Posted March 6, 2023
The Case of the Disappearing Pothole

On a warm August night in 2020, a married couple, Josh and Traci*, were out on a date night. They decided to go to a local bar and grill near their home that had recently changed owners. They ate dinner, and Josh claimed to have consumed three bottles of domestic beer. As they walked out to their truck, Josh fell and landed face first in the parking lot, causing severe injury to his nose and mouth.

In March 2021, ICC received notice of suit from Josh and Traci. The suit alleged that the condition of the parking lot was dangerous due to potholes, uneven pavement, and an overall eroded condition, which caused Josh to trip and fall. His injury resulted in permanent facial scars, and the suit included a loss of consortium claim from Traci. Josh incurred medical bills exceeding $60,000, which were paid by his medical insurance. The suit requested a trial by jury to award appropriate compensation to Josh and Traci.

This is not an uncommon claim for ICC or any insurance carrier to receive. The injuries were relatively minor, and this was likely a claim that most carriers could settle for an amount less than the medical expenses.

As with all third-party liability cases, ICC chose to investigate first. We discovered from an onsite investigation that the parking lot was not as described. It was very well-maintained with no visible potholes or uneven surfaces. When presented with photos of the parking lot in its current condition during discovery, Josh claimed that it had been patched after he fell. We then produced our own Loss Control inspection photographs from late 2019, showing the parking lot to be in similar condition, refuting the claim that the lot had been subsequently repaired.

The owner of the establishment recalled the incident and remembered viewing it on her video surveillance recording. She said that Josh had been “fooling around” and acted like he was going to jump on Traci’s back when he fell.

Immediately upon receiving notice of the suit, we requested the insured retrieve any video recordings from the incident. Although she viewed the incident on video and had been contacted by an attorney representing the couple, the insured thought that because the video showed no wrongdoing on her part, that was the end of it. She told the attorney what was on the video and had not heard anything more. Because the injury occurred seven months earlier, the insured did not think she still had the recording.

Fortunately, a couple weeks later, the insured found the recording and was able to provide it to ICC. The footage was as the owner had described and did not show Josh tripping over a pothole. We then shared the video with the personal injury attorney representing Josh and Traci. That, along with the medical report, which indicated that Josh had a high BAC (well above what would be caused by three beers), quickly lead to a settlement of a couple thousand dollars.

In this case, ICC’s cost to investigate the claim and defend the suit was about four times the amount actually paid to Josh and Traci. However, most of our expenditures were to outside counsel to defend our insured, rather than to help fund a personal injury attorney and a questionable claim.

This was a relatively simple claim that illustrates ICC’s commitment to Loss Control documentation, thorough claim investigation, and the tremendous value of having the video recording show what really happened.

These factors lead to a much different outcome than what may have been achieved by another insurance carrier. Make sure your business is covered by the food and beverage insurance experts. Find an ICC agent in your area and get a quote today.