Information Booklet for West Palm Beach Car accident victims Clients 1-800-74-TRIAL
QUESTIONS AND ANSWERS ABOUT YOUR PERSONAL INJURY CASE
Introduction
The purpose of this information booklet is to enlighten you about personal injury law and to explain how your case will be handled by your attorney. Most of the questions that you may have about your case are answered in this booklet. Please read this thoroughly, more than once if necessary. The information will be very important to you. A thorough understanding of the details of your personal injury case can help promote a fair, adequate settlement.
If you have further questions after reading this booklet, write them down or note them in the booklet itself, and your attorney will discuss them with you in detail.
You the Client
1. What is the most important thing for me to do after my injury?
The most important thing for you to do, quite simply, is to recover from your injury. The law requires injured people to "mitigate their damages." In other words, the law requires you to do that which is necessary to improve your physical condi¬tion and recover from your injury.
For you this may mean some, or all, of the following steps:
a. Do not miss appointments with your doctor. Stay in touch with your doctor and be certain to maintain your appointments. If you have to cancel, notify the doctor with as much notice as possible. The words "no show" on a doctor's record sheet can be used against you at the time of settlement or trial.
b. Attend physical therapy sessions as prescribed. Your physician or hospital may prescribe therapy to facilitate recovery from your injury. Such a proce¬dure is often helpful in many types of injuries including strains, sprains and other so called "soft tissue" injuries. If physical therapy is prescribed, be sure to keep your appointments and participate actively in the process. Again, if you have to cancel an appointment, be sure to call, but try to avoid cancellation as much as possible.
c. Do what your doctor tells you to do. If your physician prescribes certain medications, therapy exercises, or limitations on activities, be sure to follow your doctor's orders. Failure to follow your doctor's advice can be used against you when it comes time to settle your case, or can be used against you in court if your claim proceeds to litigation.
d. Follow your doctor's advice with respect to work and leisure activities. If your physician advises you to rest, stay home from work, or avoid certain activities, it is important that you follow such advice. If you resist your doctor's advice and do activities that have been limited, it will not only prevent a speedy recovery, but could also affect the legal aspects of your case. Even though staying out of work may have an impact financially, it is important that you follow such advice so that your recovery will be en¬hanced. Your attorney will attempt to recover lost earnings.
2. How do I pay my medical bills?
Your lawyer will discuss the payment of your medical bills in detail with you. In summary, your medical bills may be paid by one of the following methods:
a. Your own health insurance from your employment benefits package.
b. Your own health insurance that you may have paid for personally.
c. Health insurance obtained by your spouse for your benefit or by your par¬ents if you are under age and living with such parents.
d. Medical payments insurance coverage from your own automobile policy if you were driving your automobile and were involved in an automobile collision.
e. Medical payments insurance coverage from the person you were riding with if you were a passenger in an automobile that has automobile insurance coverage.
f. Your own personal funds if you were not insured and are able to pay medical bills as they are incurred.
g. Workers' compensation insurance if your injury occurred while you were working on the job and the injury occurred as a result of your employment.
h. The liability insurance coverage for the person, persons or company who caused your injuries. Such insurance coverage will most likely be paid at the time of settlement rather than during the period that you incur such medical bills.
i. Other possible sources.
Depending on the nature of your case, your medical bills may be covered by any of the above possibilities. If there is no insurance coverage, your bills will be saved by you and your lawyer, and will be paid at a later date when and if your case settles.
3. Will the doctors, hospitals and other medical facilities wait for payment if I am unable to pay my bills as they are incurred?
In most cases where there is no immediate method to pay medical bills as they are incurred, many doctors, hospitals, and other medical facilities will wait to be paid for their services when the case is finally resolved by way of settlement or verdict in court. It is important to let medical providers know early in the process if you have no insurance or financial means to pay medical bills as they are incurred.
4. How does my lawyer make sure that the doctors and medical facilities will got paid?
Most lawyers have a policy of withholding money from the settlement or court verdict to pay doctors and medical facilities. Many doctors and medical facilities require that the patient/client sign a form (usually called a subrogation or lien form) which allows the attorney to withhold enough money to pay medical bills directly from the insurance settlement proceeds.
5. Why won't the insurance company for the person or company who caused my injuries automatically pay my medical bills as they occur?
Most insurance companies for the tortfeasor (the person, persons or company who caused your injuries) will not automatically pay medical bills as they occur. There are many reasons for this. One reason is that they do not want to spend a substantial amount of money for medical bills and then be faced with an unreason¬able or excessive demand at the time of final settlement. In other words, they do not want to expend a substantial sum of money on medical bills and then be faced with the chance of defending a lawsuit. Secondly, most insurance companies want to conclude or settle the claim with one sum of money. Therefore, most liability insur¬ance companies will wait for the letter of demand from your attorney and then try to conclude the case all at once with one payment.
6. How do I keep track of all my bills?
One of the most important things for you to do is to keep an accurate record of your medical bills. This is how you do it:
a. Ask for a medical bill each time you see a doctor or facility.
Maintain a record of your visits and make sure that you obtain a medical bill for each visit to your doctor, hospital, physical therapist or medical facility.
b. Save all prescription bills.
Be sure to save copies of your prescriptions and drugstore charges for medicine that you purchase as a result of your injury.
c. Keep a separate chart with dates, amounts of medical bills, and purchases of medication.
Maintain a separate record which has the date of the medical service or pur¬chase of medication, the amount charged, and how the bill was paid (by insurance, your own personal funds, etc.). This requirement is very important because it will be your actual record of medical bills incurred as a result of your injury.
d. Be sure that your lawyer receives a copy of each medical bill, prescription bill, or other bill related to your injury.
It is important for your lawyer to receive copies of all your medical bills as well as a copy of your medical bill summary when your case is ready for settlement. Even though your lawyer may receive copies of bills directly from the medical facilities, a double check process will assure that your claim settles for the maxi¬mum value. If your lawyer does not have a record of all your medical bills, your case may be settled for much less than its actual value.
e. Keep a record of medical bills even if they are processed through a health insurance carrier.
Even if your medical bills are paid by a health insurance company or your employer, you must still maintain copies for yourself and be sure to get copies to your lawyer.
Your Lawyer
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 statu¬tory 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 inci¬dent.
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 per¬sonal 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 contin¬gent 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 exper¬tise. 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 responsibil¬ity 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.
The Insurance Companies
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 re¬ferred 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 com¬pany 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 com¬pany once you have retained an attorney. If you contact the other person's insur¬ance 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 com¬pany, 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 appro¬priate 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 compa¬nies 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 ex¬penses 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 cooper¬ate 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.
The Person, Persons or Company Who Caused Your Injuries
1. What happens to the person, persons or company who caused my injury?
After the incident which caused your injury, the person, persons or company that you claim may be responsible for your injury was contacted by the insurance company. Either the person who caused your injury or a representative of the company who caused your u)jury gave statements and reports to the appropriate insurance claims adjuster. Such statements and reports were probably recorded and there are most likely written reports or transcripts of such statements.
After the insurance company's initial investigation, there is usually little or no contact between the tortfeasors (the person, persons, or company who caused your injury) and the insurance company. In other words, the insurance representative usually does not keep the insured advised about day to day progress in the case. An exception may be medical malpractice cases. Therefore, the person, persons or company who caused your injury is probably going on with their daily lives, hopeful that the case will simply be settled by the insurance company with little or no involvement on their part.
2. What happens to the person who caused my injury if the case does not settle?
If the case does not settle between you, your lawyer and the insurance company and proceeds to litigation (lawsuit), the insurance carrier will again contact the insured. An attorney hired by the insurance company will be assigned to defend and represent the tortfeasor, whether the tortfeasor is a person, persons or company. The insured will be required to participate in the litigation process and will be required to cooperate with the attorney assigned.
It is important to remember that if a lawsuit becomes necessary, it will be brought against the tortfeasor and not against the insurance carrier, even though the insurance carrier will probably be the one to pay the settlement or verdict.
3. What if the tortfeasor was untruthful or not accurate about how the incident happened?
Unfortunately, in many cases, the person or persons responsible for the inci¬dent may not tell the complete truth about the incident. It is human nature for many people to deny liability, fault or blame even in cases where negligence or wrong doing was obvious. Your lawyer has had many cases where the tortfeasors did not tell the truth about the incident. In some cases, the insurance carrier will believe their insured or the insured's witnesses and will deny your claim. In such cases a lawsuit becomes necessary and the case will proceed to litigation and some¬times all the way to trial.
In most cases, however, the truth eventually surfaces and the claim will get settled one way or the other. Your lawyer will investigate your claim in the hope of obtaining witnesses, evidence, facts and law that support the truth of how the incident happened.
4. Can I contact the person or persons who are responsible for my injuries?
Again, absolutely not! If you contact the person or persons responsible, you could jeopardize settlement of your case. Remember that any statement you make, even an innocent comment, could be used against you or misinterpreted. It is not appropriate for you to contact the tortfeasor even if the tortfeasor has not told the truth about how the incident occurred.
Settlement
1. When will my case settle?
It is impossible in the early stages of a personal injury claim to predict when that particular claim will actually settle. Some cases settle in a matter of months after the injury while others can take years to get to settlement or trial. Your lawyer will usually wait until you have completed recovery from your injury or have at least come close to recovery before trying to settle your case. It is impor¬tant to know the following before your case is settled:
a. What is the total of all medical bills?
b. Will any further medical treatment be necessary?
c. If further medical treatment is necessary, what is the prediction of its cost?
d. Are any of your injuries permanent?
e. If any of the injuries are permanent, how do such permanent injuries affect your earning capacity?
f. What was your total loss of income and what other employment benefits were lost because of the injury?
g. Is it likely that you will lose any further income as a result of your injury?
There are other factors that must be taken into consideration before settlement. As the case progresses, your lawyer will have some idea as to the approximate time that the case may be appropriate for settlement.
2. How much is my case worth?
This question is one of the most frequently asked questions and is also very difficult to answer in the early stages. It is virtually impossible to predict the value of a case until all of the information has been collected and you have recovered or almost recovered from your injury. There are many factors that determine the value of a case. They include:
a. The actual amount of all of your medical bills.
b. How such medical bills were incurred; that is, from diagnostic tests, treat¬ments, physical therapy, hospital stays, prescription medication, over the¬counter medication, chiropractic care and other treatment.
c. How much income and other employment benefits were lost as a result of your injury. This would include lost pay, sick leave used, vacation time used, loss of insurance benefits and other losses resulting from your injury.
d. The actual extent of your injury and how such injury affected your daily life. This would include limitations of household activities, sports and leisure activities, and social life.
e. Whether or not any aspect of your injuries are permanent. This would also include permanent disfigurement such as scars, blemishes and other disfig¬uring characteristics.
f. Whether any of your injuries required hospitalization.
g. The extent of liability on the part of the potential defendant.
h. Whether there is any evidence that you were partly at fault for your own injuries.
i. The status of the law as it relates to your case.
j. The quality of your witnesses, including those who will testify about the incident, your injuries, and your medical treatment.
k. Other factors such as pain, suffering, inconvenience and loss of consortium (how the injury affected your marital relationship).
1. which insurance company is involved in the case.
The above are just a few of the factors that must be taken into consideration in determining a settlement value. Some factors are more important than others and because insurance companies require specific documentation, it is your responsibility and that of your lawyer to provide the insurance company with as much clear information as possible to support your claim.
3. Who determines the settlement value of my case?
Your lawyer, and the firm in which your lawyer is a member, have a great deal of experience in the area of personal injury law. After evaluating all of the factors enumerated in question 2 above, your lawyer will discuss the case with you to arrive at a possible settlement range.
Once you have agreed upon a general settlement range, your attorney will present a demand to the insurance company in the hope and expectation that the insurance company will pay a settlement within the range determined.
It is important to know that you have the ultimate decision to make, but, be¬cause of your lawyer's experience in this area of law, you should seriously and carefully consider any recommendation he or she makes as to the ultimate value of your case.
4. What steps will be taken to settle my case?
After all the investigation and research has been completed, your lawyer will keep in touch with the progress of your recovery. Hopefully, your injury will not be a serious one and eventually it will be appropriate to attempt settlement. After a settlement range has been decided upon, the lawyer will send what is usually called a letter of demand to the insurance company.
The letter of demand summarizes the important factors of your claim and is a formal request to initiate settlement discussions. After the insurance carrier's claims adjuster receives the letter of demand, he or she will meet with appropriate supervisors to obtain settlement authority. Once the adjuster has his final authority figure, he will respond and negotiations between your lawyer and the insurance adjuster will take place.
Some cases can be concluded with a series of telephone conferences, office conferences, and correspondence. The period of time required to complete negotia¬tions usually depends upon a number of factors including the nature of the insur¬ance company, how busy the insurance adjuster is, and other factors.
5. Will the insurance carrier pay the demand figure in my attorney's request for settlement?
In almost every case, the final demand figure issued by your attorney in the first letter requesting settlement is substantially higher than the actual settlement range. This is a common negotiation tactic for personal injury cases.
Because of your attorney's experience in this area of law, a request for settle¬ment will usually be made in an amount that gives both parties a fair amount of room to negotiate. Therefore, do not consider the demand figure to be the actual settlement range of your case.
6. How long does it take to complete settlement after the first letter of demand?
In most cases the amount of time it takes from the first letter of demand to final settlement can be several weeks to a few months or sometimes longer. In smaller, clear cut liability cases where the injuries are fairly minimal, the process can be achieved in a month or two usually. Every case is different, however, and your lawyer will advise you about his opinion on the amount of time it will probably
take to settle your case. There are many factors which affect the response time and the adjuster's final offer. They include:
a. How many files the insurance adjuster is handling.
b.
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