IMPORTANT QUESTIONS AND ANSWERS ABOUT YOUR PERSONAL INJURY CASE

Provided By Raymon King
Attorney at Law
512-419-1616 

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 claims 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:

• Who is at fault in your case.
• Whether or not you bear any fault for your own injuries.  This is also referred to as comparative negligence or contributory negligence.
• Potential witnesses in the case.
• The location of the scene of the accident.
• 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, 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:

• Claims 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. 
• 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.
• 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.

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 important to know the following before your case is settled:

• What is the total of all medical bills?
• Will any further medical treatment be necessary?
• If further medical treatment is necessary, what is the prediction of its cost?
• Are any of your injuries permanent?
• If any of the injuries are permanent, how do such permanent injuries affect your earning capacity?
• What was your total loss of income and what other employment benefits were lost because of the injury?
• 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:

• The actual amount of all of your medical bills.
• How such medical bills were incurred; that is, from diagnostic tests, treatments, physical therapy, hospital stays, prescription medication, over-the-counter medication, chiropractic care and other treatment.
• 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.
• 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.
• Whether or not any aspect of your injuries are permanent.  This would also include permanent disfigurement such as scars, blemishes and other disfiguring characteristics.
• Whether any of your injuries required hospitalization.
• The extent of liability on the part of the potential defendant.
• Whether there is any evidence that you were partly at fault for your own injuries.
• The status of the law as it relates to your case.
• The quality of your witnesses, including those  who will testify about the incident, your injuries, and your medical treatment.
• Other factors such as pain, suffering, inconvenience and loss of consortium (how the injury affected your marital relationship).
• 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, because of your lawyers' experience in this area of law, you should seriously and carefully consider any recommendation he makes as to the ultimate value of your case.

4.  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 requisition 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 settlement will usually be made in an amount that give 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.

5.  After the insurance company and my attorney agree upon settlement, how long will it take to get my money?

After an agreement has been reached between the insurance company and you through your lawyer, it usually takes between two and six weeks to complete the settlement process.  There may be exceptions to his range, but the average time to sign all the documents, receive the check, and figure out the exact proceeds for each party usually requires at least a month.

6. What has to be done before I get the money that is due me from the settlement?     

First, the insurance company will require that you, and perhaps your spouse, sign a release.  This is a document that settles your claim.  In the release, you will read language stating that you are forever giving up your right to sue the person, persons, or company who was responsible for your injuries.  In exchange for given up your claim, you will receive a certain sum of money when the insurance company receives the release.

Second, your lawyer will have to pay any medical bills that have not been paid and may be required to reimburse any insurance company that has expended money for medical bills such as your health insurance carrier, automobile insurance carrier or some other party who paid for your medial bills resulting from your injury.

Third, your lawyer will deduct attorney's fees, actual out-of-pocket expenses, and other possible costs associated with the claim.  After all deductions have been made for medical bills, possible liens, attorney's fees, and costs, you will receive the balance in a check processed from your own attorney's office.

7.  After attorney's fees, medical bills, liens, and costs, will there be anything left for me?

In most cases there should be a fair sum of money left for you to compensate you for pain, suffering, and some loss of income.  There are many factors influencing settlements.  Such factors include the amount of your medical bills, whether those medical bills have to be paid from the settlement, whether you actually lost income from your job or used sick leave, etc.  If you have to pay all of your medical bills from your settlement or reimburse a health or medical payments carrier, this will substantially affect the final amount.

You must remember that the law allows you to be compensated for your injury--to give you compensation for lost wages, medical bills, and a reasonable amount for pain  and suffering.  The law does not provide that injured parties "get rich" from insurance claims, especially in small cases.  Your attorney will do his very best to see that you get fair compensation for your injuries.

DO'S AND DON'TS FOR ACCIDENT VICTIMS

TAKE PICTURES

It is important to visit the scene of the accident as soon after the accident as possible. Please make sure pictures are taken of everything involved in your accident. You should also take pictures of any medical treatment, such as your cast or hospital room. Remember the general rule "a picture is worth a thousand words."

KEEP A DIARY OF PAIN AND EXPENSES

Keep a day-to-day diary from the time of your accident. Write down how your injury has restricted your daily living, from the time you get up from bed and dress at the beginning of your day to the time you go back to bed at the end of the day, and include any problems experienced during your sleeping hours.

Describe, each day, the pain or restricted movement you experienced in each part of your body, from the top of your head down to all parts of your body. Also, describe the daily medications and medicinal treatments which you have taken.

REPORT ALL EVIDENCE AND SUBSEQUENT OCCURRENCES

We need to know everything that may relate to your case. Much of what you know, including records and documents, can be used as evidence in your case. Please don't assume that we are aware of that information. We may not know about it, unless you tell us.

Let us know the names, addresses and telephone numbers of all witnesses. Do not repair any damaged items as it may be necessary to take photographs of the damage and it may be advisable to use the damaged article as evidence for presentation in court.

Keep all physical objects which might serve as evidence to support your claim of injuries and damages, such as wearing apparel and shoes at the time of the accident, splints, casts, and braces.

All accidents, claims, and disabilities which you had prior to the accident should be disclosed to us since the defendant's insurance company has methods of discovering such prior accidents, claims, and disabilities and we do not want your case to be jeopardized as a result of our not being alerted to such facts. Such methods include the use of a nationwide organization which has compiled a list of most damage claims made by each person during his or her lifetime. The defendants are also entitled to obtain copies of your past medical records.

CONTINUE TO SEE A DOCTOR UNTIL YOUR CASE IS COMPLETED

You may not be able to prove your damages unless you are seeing a doctor. You must seek medical treatment until your case is over.

BE CAREFUL WHAT YOU TELL THE DOCTOR

The doctor will write down exactly what you say. If you are in pain, tell the doctor. Don't tell the doctor you are feeling better just to make him or her happy. Always relate your injury to the accident for which you are claiming money.

REPORT CHANGES IN YOUR PHYSICAL CONDITION

Please call us at least once a month so we can keep track of any changes in your physical condition. We need to know the names, addresses and telephone numbers of each doctor you visit and the nature of the medical treatments and medicines which have been prescribed to you. You must keep all of your doctor appointments. If you need to reschedule treatment, that is OK but let us make the arrangements.

TRY TO AVOID ANY SUBSEQUENT INJURY

Be careful! Any injury not related to your case may affect the case's value. A subsequent injury may result in your receiving no money.

KEEP EVIDENCE OF ALL EXPENSES

You should keep a separate itemized daily list of all your expenses and losses, to include the following: doctors, nurses, hospitals, medicines, medical braces, splints, and other paraphernalia, repairs, travel expenses, costs of hiring others to help around the house or business (including baby-sitters), etc.

Payment of expenses should be by check and you should get a written receipt (preferably two copies) and send or bring all canceled checks and receipts to this office. Two copies of any bills received should also be sent to this office. You should also keep a record of the following: days off work, loss of pay or profits, sick leave used up, travel time to and from doctors, hospital, etc. Keep all medical containers and supplies.

Until you have first received our approval, do not discuss this case with any other person (including friends, family, neighbors, doctors, police, and your own insurance company); do not fill out any forms; and do not sign any papers. The defendant's insurance company may try to take movies or photographs of your daily activities with the hope of proving that you are exaggerating your claim as to your injuries and disabilities. It may also try to tape record your conversations with others.

If anyone, other than a representative from this office, contacts or questions you with respect to your claim, tell the person to contact this office.

If anyone claims to represent this office, verify the person's representation by contacting this office before answering any questions.

DO NOT OVERLOOK OTHER SOURCES FOR PAYMENT OF EXPENSES

You may be able to have your medical and other bills paid from other sources as a result of the coverage afforded to you under your own insurance policies (homeowners, automobile, etc.), medical plans, or group benefits at your place of work, in which case you will want to initiate whatever action is necessary to obtain such payments.

REPORT ANY ADDRESS OR TELEPHONE NUMBER CHANGES

If you move or are planning to go out of town on vacation, please let us know where you can be reached and give us your new address and telephone number.

PLEASE: DO NOT DISCUSS THE CASE WITH ANYONE OUTSIDE OUR OFFICE, DO NOT FILL OUT FORMS GIVEN TO YOU FROM ANYONE ELSE, AND DO NOT SIGN ANYTHING WITHOUT HAVING OUR FIRM REVIEW IT FIRST.

IF YOU HAVE ANY QUESTIONS, PLEASE CALL US!