Explaining the Compensation Process in a Personal Injury Claim

 Posted on February 27, 2019 in Uncategorized

In the unfortunate circumstance that you are the victim of any personal injury incident, it's important for your claim (as well as your body) to immediately obtain necessary medical treatment. Hospitals will treat you regardless of whether you have been in a motor vehicle crash or other incident. Primary care physicians and specialists, however, very often refuse to see even long-time patients in these circumstances. Some good personal injury law firms know of quality physicians, therapists and other medical providers who will treat injured victims even without health insurance or up- front payment. Moreover, in the right type of case, most of the post-emergency room treatment can be arranged so that payment is only required if enough compensation from the personal injury claim is obtained (note - there are circumstances in which it is strategically beneficial to utilize health insurance throughout a claim but only in a working minority of claims).

Depending on the injuries, medical treatment can require a few weeks to months, and in more serious cases, lifetime care may be required. Either after medical treatment is completed or the claim begins to approach the statute of limitations, our focus broadens from managing our client's medical treatment to positioning the case in the optimal light to "make you whole," in order to compensate you for your medical expenses and any lingering damages you have from any disfigurement, physical impairment, pain, loss of enjoyment of life, loss of consortium and/or mental anguish. In an ideal world, the insurance company will concede liability on behalf of its insured and pay full value for the claim.

Remember, when a claim is pre-suit, the insurance company is not required to reveal its insured's policy limits. Our boutique injury law firm is fortunate to have a ton of personal injury experience - more than 125 years - and we "see the field." Because of this, we have inside sources that often allow us to learn policy information. In other cases, our vast experience helps us utilize key indicators to predict available insurance to cover responsible parties. In most cases, the claim process runs smoothly, and we obtain full value (and sometimes more than full value) for our clients.

It may be necessary, in some cases, to consider settling your case against the at-fault party for less than full value. Why would anyone do that? One reason, which is all too common, is because the responsible party is underinsured. For instance, if you are injured by a driver carrying only $30,000 in liability insurance (the state minimum), and the responsible party is not capable of paying a large payment out of his own pocket, but your medical bills are over $50,000, then the insurance money may be all that the driver has to pay your bills. You could still reject this offer, but if the insurance company is offering the full policy on behalf of a "judgment proof" or "indigent" responsible party, then settlement for the policy may well be in your best interest. To proceed forward to trial under such a scenario would increase costs significantly, thereby providing a lower recovery to the client in the end. However, excellent lawyers do not simply settle your case, take their fee and leave you in a mountain of debt to handle yourself. This is certainly not our strategy at Burress Injury Law.

If we are met with a case such as this, we first exhaust every effort available to identify whether there are other sources of compensation available to you. Almost every year, we have a case in which an at fault party chose to be underinsured but has appreciable, recoverable assets. In such cases, we routinely require the responsible party to pay over and above his own insurance policy. For example, two years ago, a woefully underinsured at fault driver was forced to sell a ski home in Taos to help pay for injuries he caused to our client, who had suffered a traumatic brain injury.

Additionally, our clients often have component parts of their own insurance policies that allow for additional compensation beyond what can be recovered from the Defendant. If you have obtained Uninsured/Underinsured Motorist Coverage, Medical Payments or Personal Injury Protection, we may be able to recover additional compensation for you. However, it is important to know that your own insurance company is normally just as stingy in providing compensation as the at-fault party's insurance company. Burress Injury Law levels the playing field for our clients so that the chances of receiving full financial recovery are maximized.

Finally, our law firm takes enormous pride in our ability to reduce our clients outstanding medical bills and health insurance subrogation claims (i.e. when your health insurance pays crash-related benefits, they often have a right to be repaid out of your settlement). For example, we recently had a 1-year old client who was backed over by his Grandfather's truck and suffered very serious injuries, including a traumatic brain injury. In that case, a self-funded ERISA Health Plan (the type of health insurance plan that maintains the strongest legal rights to reimbursement from a client's personal injury settlement/verdict proceeds) had a subrogation interest of almost $550,000.00. In that case, our team worked for months to fight the ERISA Health Plan and eventually forced it to accept $55,000.00, representing 10% of its subrogation interest. Interestingly, an excellent trial lawyer who is often our opposing counsel (i.e. he defends the largest insurance carrier in the world), was appointed by the court in this case to serve as the baby's Guardian ad Litem to ensure the settlement was fair. He was so impressed at the result we obtained that he has since forwarded several Plaintiff's lawyers in other cases to our team to seek advice on how to obtain the best possible result when dealing with the health insurance plan.
In summary, the team at Burress Injury Law take enormous pride in what we do from beginning to end to represent our clients best interest. Please call us at 214-726-0016 for a free consultation on your personal injury case.