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♦ Legal Myth Busters: Myth #3 “I Don’t Have to Reimburse My Health Insurer”

♦ Legal Myth Busters: Myth #3 “I Don’t Have to Reimburse My Health Insurer”

After Receiving My Personal Injury Settlement, I Don’t Have To Reimburse My Health Insurer/Med-Pay Provider for Amounts Paid for My Accident-Related Medical Bills Wrong. The reason this myth likely arose among non-lawyers is that clients understandably believe that the high cost of monthly insurance premiums that they pay for health and auto insurance—including all those years when they never used the coverage—should be compensation enough so why should they receive anything from a client’s personal injury settlement? I definitely sympathize with my clients on this point, but the reality is that the law is not on their side. There is a reason why, however, and sometimes understanding of the law can soften the blow. What is Subrogation? Most health insurance plans and automobile med-pay coverage provisions have a section in the plan or policy entitled either Subrogation, Coordination of Benefits or Right of Reimbursement. These provisions state that while the insurer is obligated to pay medical expenses pursuant to the terms of the contract, they also state that if any of the medical expenses paid are due to an accident and their insured pursues a claim against an at-fault party for damages and obtains a recovery, then the plan has a right to be reimbursed for the amounts they paid for accident-related care. Even if your health insurer or automobile med-pay coverage insurer did not have that language in its plan or policy, subrogation is still recognized by the courts as an equitable (fairness) doctrine, as distinct from a contractual provision. This right to piggy back along with an injured party’s claim and seek reimbursement in the event a...
♦ Legal Myth Busters: Myth #2 – Traffic Tickets and Personal Injury

♦ Legal Myth Busters: Myth #2 – Traffic Tickets and Personal Injury

The Traffic Ticket Given to the Other Driver and the Police Officer’s Opinion of Who Caused the Accident Are Admissible As Evidence If My Personal Injury Case Goes To Trial Clients are always surprised and frustrated to learn that the jury is not allowed to hear that the other driver was issued a traffic ticket—often for following too close or inattentive driving in a rear-end collision, or for disregarding a traffic signal in an intersection collision.  Almost always, such evidence will be excluded by the judge at a jury trial. There are two main reasons why this is the case.  First, most drivers just pay the ticket rather than contest it, and there is a state statute that expressly allows them to enter a “no contest” plea without the traffic conviction being used against them to prove fault in a later civil action. Second, as to the opinions of the investigating police officer contained within the accident report, unless the officer happened to actually be an eyewitness to the crash, his or her opinions are viewed by the court as based only on after-the-fact hearsay provided by the involved drivers or any eyewitnesses to the accident. The judge excludes the officer’s conclusion based on hearsay, because of a belief that the jury should be allowed to draw its own conclusions about fault after hearing all of the testimony from those that actually observed the events leading up to the collision.  The court does not want the jury’s role as the finder of fact and determination of the credibility of witnesses to be unduly influenced by conclusions drawn by the...
♦ Selecting the Right Attorney For Your Personal Injury or Wrongful Death Case – Part 2

♦ Selecting the Right Attorney For Your Personal Injury or Wrongful Death Case – Part 2

In Part 1 of this blog, Selecting the Right Attorney for your Personal Injury or Wrongful Death Case the initial steps for building a list of prospective attorneys and legal firms that may be right for your need were discussed. Now that you have completed a list of possible law firms based upon your initial research, picking up the phone and contacting them is your next step. You’re initial phone conversation can provide useful insights. Does the attorney seem distracted or in a hurry just to schedule an appointment without taking any time to speak with you first? If they can’t take the time to talk with you on the phone, they are probably going to be one of those attorneys who will not have time to give attention to your case or return your phone calls later when you want the status of your case. If the attorney seems knowledgeable, caring, and willing to answer your preliminary questions, then request an initial consultation. Most firms offer an initial consultation in personal injury matters at no charge to you, so feel free to meet with more than one firm if you are unsure of the fit after the initial consultation. In that initial meeting, question the attorney about his or her background and experience in the kind of injury claim you have. Find out if the attorney specializes in that area of law. Make sure that you ask about the attorney’s trial experience, because you want to make sure you hire someone who is willing and able to take your case to trial if settlement negotiations are unsuccessful. Not all...
♦ Selecting the Right Attorney For Your Personal Injury or Wrongful Death Case – Part 1

♦ Selecting the Right Attorney For Your Personal Injury or Wrongful Death Case – Part 1

Your mail box, your TV, and your phone book are full of advertising by law firms – all claiming to be the best firm to handle your personal injury or wrongful death claim. In the “old days,” such promotion did not exist as law firms were not legally allowed to advertise their services to injury or wrongful death victims or their families. As a result, clients found their way to a good firm simply by word of mouth from other satisfied clients. In more recent times, because marketing to injury victims is now allowed, virtually all firms engage in some kind of advertising, whether they want to or not, in order to stay competitive, and make sure that prospective clients are aware of options beyond just those firms who have decided to make the most “noise.” The end result is that prospective clients can become overwhelmed and find it difficult to decide which firm is really the best fit for their particular case. This article is intended to provide some helpful steps for wading through that attorney selection process. Ask people you know and respect whether they have a law firm that they trust who has helped them with a similar situation in the past. That way, you have a first-hand reference of who to contact or who to avoid for an initial consultation. Review the websites of legal firms you believe might be a good fit. Take a look at the attorney profiles listed and the information about their education and experience level in handling the kind of claim presented. Has the firm been around a long time,...
♦ Legal Myth Busters – Myth #1: “I Fell On Someone’s Property”

♦ Legal Myth Busters – Myth #1: “I Fell On Someone’s Property”

I fell on someone’s property, therefore, the owner of the property by law is automatically responsible for all of my injuries and damages Wrong. The real answer as to whether an owner of property or their insurance company will be held accountable for injuries you sustained in a fall on the owner’s property is, it depends. It depends on whether a good argument can be made that a jury would find that the owner was negligent—that he or she failed to exercise reasonable care in inspecting or maintaining the property giving rise to an unsafe condition that was a cause of your fall—and that your own fault in failing to take steps for your own safety to avoid falling—was not greater than any fault on the part of the owner. Legal myth origins How the myth got started among non-lawyers that some “no-fault” principle applies when they fall on property owned by another is unclear. It may be that people have confused the liability of a property owner for negligence (fault on the part of the owner) with med-pay coverage that some, but not all, owners may have available under their property liability insurance policy. Med-pay coverage is a “no-fault” coverage. All you have to do is show that you were injured on the owner’s property and that required medical treatment was related to those injuries in order to be entitled to med-pay coverage. You do not have to show that the owner did anything wrong to cause your injury to access that coverage. However, med-pay coverage, if it exists at all under a property insurance policy, is usually very...