How many people receive structured settlements and why?

Advertisements offering people cash for structured settlement payments are remarkably widespread. I'm sure this service has a ridiculously huge profit margin and many detractors, but those are beside the point.

Is this a really, really tiny amount of people being advertised to, or is this kind of settlement more common than we might guess and even rising? What kind of lawsuits result in these kinds of settlements?

Your observations are correct. Advertisements offering people cash for structured settlement payments are at high saturation levels. While there may seem to be huge profit margins because of the mismatch between future value and discounted present value, buyers spend sick money on TV advertising, SEO and PPC advertising. The structured settlement cost per click is one of the most expensive around.  

At this point there are over 50 companies who are purchasers or brokers of purchasers of all sizes shapes and financing,  all competing for the same pot.

Now what we are talking about above is the secondary market.. The primary market is where structured settlements are actually created.   

A claim not in suit, or a law suit may settle if parties to the claim or  suit come to an agreement.  The agreement is negotiated, generally with parties each represented by counsel. You cannot be awarded a structured settlement as it is  a"settlement".

A settlement can be composed of cash, future periodic payments or both.   Structured settlements are placed as the result of the advice and work of structured settlement brokers and/or settlement planners.  These are individuals or are licensed professionals possessing an insurance license in their home state and state of solicitation who are appointed by the structured annuity issuing life insurance company.   Structures can also be funded with US treasury obligations. At its peak the primary market was producing about $6B a year in premium. which translates in multiples more in future benefits funded by stable insurance companies, some of whom have been around since before the Civil War.

As interest rates rise structures will become more popular.  Certain types of cases  [ where payments represent damages on account of personal physical injury or physical sickness or workers comp] there are significant tax benefits. Payments in such cases are exempt from taxation under IRC 104.  So here we are speaking of medical malpractice,  auto. aircraft and trucking accidents, dog bites, defective products that cause physical injury or physical sickness.  Care must be taken in documentation. It's not simply the mater of buying an annuity.

Other types of cases involving taxable damages are also conducive to structured settlements. In those cases however, tax deferral is the aim. 

Marketplace initial interest confusion for consuers and investors may result when secondary market players or the SEO's they hire use terms like "structured settlement broker" in a manner that implies licensure where there is none or terms like"annuity" when they are actually  selling structured settlement payment rights to investors.

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