Monthly Archives: August 2009

Personal Injury 101 For Clients – Part III

1. What will the insurance company for the person, persons or company who caused my injury do about my claim?

After the insurance company has been notified about the claim, a file is established on you and your case. An insurance clams adjuster is assigned to your file by a claims manager or claims supervisor. The supervisor may assign different adjusters to your case as it progresses.

The insurance claims adjuster responsible for your file will maintain contact with your lawyer. The adjuster will also perform an independent investigation of your claim to ascertain the following:

a. Who is at fault in your case.

b. Whether or not you bear any fault for your own injuries. This is also referred to as comparative negligence or contributory negligence.

c. Potential witnesses in the case.

d. The location of the scene of the accident.

e. The contents of police reports, Department of Motor Vehicle reports, and any other investigative reports that have been filed in the case.

After the initial investigation, the claims adjuster will request medical reports and any other reports dealing with your injuries. The adjuster will also review documents about your time lost from work. Most importantly, the insurance claims adjuster will want to receive accurate records of your medical bills, prescription bills, hospital bills, therapy bills, and any other actual expenses incurred as a result of your injury. That is why it is very important for you to maintain an accurate account of your medical bills, lost wages, and other expenses which result from your injury.

2. How does the insurance company put a value on my case?

This question is quite complicated. First, the claims supervisor or claims manager will provide that a certain amount be “set aside” as a potential value of your case. This figure is usually called “reserves.” Such reserves are the outside value that the company has established on your claim. The reserves may change as the case progresses. In serious cases, such reserves may equal what are called policy limits. Policy limits are the outside limit amounts of liability established in the insurance policy of the person or persons who caused your injury.

During the preparation stages of your case, the insurance company will keep track of your medical bills, lost wages, any permanency regarding your injury, and other factors. The company will also take into consideration the quality of evidence against their insured, the quality of your witnesses and their witnesses, extent of liability on your part, and other important considerations such as previous injuries.

If you had a previous injury in the same area of your body, the insurance carrier will want to see medical records pertaining to that injury. During the course of your claim, your attorney will be notified by the insurance company about the important factors that are being considered in your particular case.

3. Should I communicate with or contact the insurance company for the person who caused my injuries?

Absolutely not! Under no circumstances should you contact the insurance company once you have retained an attorney. If you contact the other person’s insurance company, for any reason, you could ruin your entire case with one question or one statement.

Secondly, because you are now represented by a lawyer, the insurance company, in most states, is absolutely prohibited from having any personal contact with you for any reason.

4. Can I contact my own insurance company?

If you have health insurance, medical payments insurance, automobile uninsurance or underinsurance coverage, there may be occasions when it is appropriate for you to contact your own company. However, you should always ask your lawyer whether or not such contact is appropriate. Never contact an insurance company without first obtaining approval from your attorney.

5. Will the insurance company for the person who caused my injuries dispute my claim?

If liability and responsibility are well-established in your case — that is, if fault clearly rests with the insurance company’s insured (the person or persons who caused your injury), they will try very hard to settle your claim. Insurance companies usually dispute the following types of claims:

a. Claim in which the fault rests with someone other than their insured. This could mean you or someone else involved in the incident who may have caused your injuries rather than the person who is insured by the insurance company.

b. Claims in which the insurance company and its representatives do not believe that you are injured, or that you were injured as badly as you claim. For this reason, documentation of medical bills, lost wages, and other expenses are extremely important to establish credibility and the existence of your injury.

c. Cases in which you or your witnesses have lied, exaggerated, or fabricated the nature and extent of your injury or how the incident occurred.

6. What can I do to convince the insurance company that my claim is valid?

As stated above, the most important thing you can do is to recover as quickly as possible from your injury. Insurance company personnel tend to believe those people who actively try to recover from their injuries. That is why you must cooperate with your doctor, physical therapist and other personnel who are trying to help you improve from your injury.

Secondly, insurance companies believe those people who can document their injuries through medical bills, credible medical reports and accurate lost wage information that is neither exaggerated nor subject to dispute and interpretation.

Thirdly, insurance companies usually settle cases easier with those clients who have been in active contact and cooperation with their attorney.

In summary, it is important for you to try to get better, keep an accurate record of your expenses, and cooperate with your lawyer and his or her staff.


Personal Injury 101 For Clients – Part II

1. How will my lawyer handle my case?

After initial meetings with you, your lawyer will investigate your claim. This usually requires a review of some or all of the following:

a. Witness statements.

b. Police reports.

c. A possible visit to the scene of the incident.

d. A review of appropriate statutory law (laws enacted by your legislature).

e. A review of appropriate case law (laws made by judges who interpret statutory law).

f. A review of all medical reports.

g. A review of all medical bills.

h. The possible hiring of an investigator to investigate the details of the incident.

Your lawyer will also contact the insurance company for the person, persons, or company who caused your injuries. After the initial investigation and contact with the insurance company, your lawyer will maintain contact with you to make sure of the following:

a. That you are following the advice of your physicians and other medical practitioners.

b. That you are doing your best to improve from your injury.

c. That you are providing your lawyer with copies of all medical bills and other expenses related to the incident.

d. That you are providing records of loss of income from your job.

e. That you are keeping track of potential witnesses in your case.

Medical records will be obtained through the use of authorization forms as discussed below. Your lawyer will review those medical reports as they come in from your doctor and will keep abreast of the applicable law relating to your case.

2. How can I help my lawyer with my case?

The most important thing for you to do is to provide documentation of your medical bills, expenses and loss of income from your employment. The following is a list of things that will also help your lawyer with your claim.

a. Return all phone calls promptly to your lawyer.

b. Read all correspondence from your lawyer.

c. Keep all appointments with medical facilities.

d. Maintain a file and record of medical bills, lost wages, and other expenses associated with the injury.

e. Keep a list of witnesses who may testify about your injuries or about the incident.

f. Take photographs as instructed by your attorney and maintain copies and negatives of such pictures.

g. Notify your attorney immediately of any change of address, telephone numbers, marital status, change of employment or drastic change in your physical condition.

h. Answer all questions posed by your attorney truthfully and candidly.

i. Sign all forms requested by your attorney.

3. Why do I have to sign so many forms?

Doctors, hospitals, employers, and other establishments will not release personal information about you without signed written authorizations. It is against the law, in most instances, to release information about a person, to anyone, including your lawyer, without formal documentation. Therefore, your lawyer will ask you to sign such authorization forms which will allow him or her to retrieve important information about you.

4. How will my lawyer be paid and what is a contingent fee agreement?

In almost all personal injury cases, your attorney will be paid by keeping a percentage or portion of the final settlement or court award resulting from your injury. The percentage will be discussed with you and will be the subject of what is called a contingent fee agreement. The law requires, for your protection and that of your lawyer, a written contract which specifies the fee he or she will charge so there will be no misunderstanding about how much your case will cost. Most contingent fee agreements provide that you do not have to pay your lawyer for his or her services unless, and until, the case is settled or is resolved by a court verdict in your favor. The agreement will provide that your lawyer will work diligently on your case in exchange for the percentage or portion outlined in the agreement. As discussed below, however, you will be responsible for actual out-of-pocket costs, in addition to the attorneys’ fees, even if the case is not settled or won.

5. What other costs will there be in addition to the attorneys’ fees?

The fee for your attorney is based upon his or her work, time, effort and expertise. The lawyer’s fee also encompasses certain office overhead such as secretarial time, rent, files, and other built-in costs. However, there are also additional out-of-pocket expenses which are incurred specifically as a result of your case. Some of these expenses include the following:

a. Fees that doctors and hospitals charge for medical reports. Such reports may cost anywhere from a few dollars for simple copies to $100 or more for reports that have to be written or prepared specifically by your doctor.

b. Photocopy charges. Insurance companies require significant numbers of copies of medical bills, medical reports, police reports, witness statements, and lost income information. Your law firm has to pay for these photocopies and you will usually be charged a certain amount for each page of copy.

c. Long distance telephone calls. If long distance telephone calls are required, you will probably have to reimburse your attorney for the actual cost of each call.

d. Costs of photographs. Photographs are extremely important in personal injury cases and if your attorney incurs expense in having photos obtained or enlarged, you will be responsible for such costs.

e. Reports of experts. Reports from experts other than physicians may be required in your case and, if so, you will have to pay the costs that such experts charge for their reports.

f. Litigation costs. If your case has to proceed to suit or litigation, there will be costs incurred as a result of the filing of such a lawsuit.

6. Are the attorneys’ disbursements and costs also contingent and if not, do they have to be paid in advance?

The costs and disbursements outlined above in question 5 are your responsibility even if there is no recovery in your case. In other words, although your attorney’s fee is contingent upon a settlement or successful court award, the actual out-of-pocket costs are not contingent upon successful recovery. Your attorney may require you to assist in such costs as they are incurred. Therefore, you may be requested to pay some of the out-of-pocket costs in advance of settlement as the case progresses. The reason for this is that it is not economically feasible for law firms to “finance” personal injury cases. For this reason, the law provides that out-of-pocket expenses are the responsibility of the client even if the case does not settle.