Med Pay Coverage in NC Auto Accidents

Automobile insurance coverage is a somewhat complicated situation in North Carolina.  Most auto accident victims in North Carolina tend to focus on what the at-fault party’s insurance company will pay for the treatment of the victim’s injuries.  And the primary focus should be there.

But if victims look closer at their situation, they might have thousands of dollars of medical coverage that they’ve been paying for, in addition to the liability coverage for the bad guy!

Medical Payments coverage, or “Med Pay” as we call it in the business, is optional extra coverage you can purchase with the liability policy that you have to buy.  Many people have Med Pay coverage but – believe it or not – most people that I speak with don’t even know whether or not they have it!

This coverage no-fault coverage – meaning it doesn’t matter who is at fault – and is designed to pay for any and all medical expenses, up to the policy limits of the Medical Payments policy, incurred as a result of injuries sustained by any person riding in the car which is covered by that policy of insurance. I see policy limits vary a lot.  I see little policies at $500, and I once saw one for $1 million.  Most Med Pay policies in NC are $1000 or $2000.  Any victims in the covered vehicle can be covered by the policy; they do not have to own the car and do not have to be a named insured under the policy. Anyone who is injured while riding in the car at the time of the accident and incurs medical treatment costs can have all of their reasonable medical bills paid up to the amount of the Med Pay coverage.

The big hesitation I see from clients is a concern that using their coverage might raise their rates.  Med Pay coverage is optional “no fault” coverage, so it doesn’t matter who caused the accident.  If you were in a covered vehicle and were injured in an accident, regardless of who caused it, you have access to that vehicle’s Med Pay.  Moreover, if your treatment costs exceed that vehicle’s Med Pay limits, you may have access to another Med Pay policy of a different vehicle’s policy, depending on the circumstances.  This is a tricky topic and you’d do well in seeking legal counsel for coverage questions.

Med Pay coverage is available in addition to the coverage you’re seeking through the at-fault party’s liability coverage (assuming we’re talking about the Med Pay for the car you were in and the driver of that same car wasn’t at fault…).  Med Pay coverage is available in addition to your health insurance.

Maybe the most important thing about Med Pay is to know is whether or not you have it!  Check out your policy or talk to your insurance agent.  And remember, if you have it, use it!  You’re paying for it after all, right?  Otherwise, why would you be paying for it?

When I represent an auto accident victim I help to process the Med Pay coverage free of charge.

Remember, if you are in an automobile accident in North Carolina and want to talk to an attorney about your options, call me.  919-929-2992.

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PROTECT YO NECK!

North Carolina is a “liability” state, meaning that drivers must have liability insurance to legally operate a motor vehicle on the streets and highways of our fair state.  Liability insurance pays out, theoretically, for the losses caused by your negligent operation of a motor vehicle.  This works out, in general.

But, as with all systems, there are gaps.

The main gap in our liability system is that NC minimum liability insurance is $30,000.  That means someone could run you over and chop off both of your legs and the most you’d likely ever see from them is a whopping $30,000.

How do you protect against that kind of catastrophic loss?

First, you should have health insurance.  I know, it’s not cheap.  Believe me, I personally pay for 4 people and get no help with that.  BUT it’s worth it!  Your health insurance should cover what might be the biggest part of your loss – health care expenses – AND unless you have an unusual policy, they shouldn’t have any right to dip into your liability award.

Second, you should have as much UNINSURED/UNDERINSURED MOTORIST COVERAGE as possible.  That coverage, which you have on your auto policy, will help cover you in a situation where there is no liability insurance, or there isn’t enough to cover your losses.  Of course, it has limits, too, which is why I say you should get as much as you can. Here’s an example:

Fred runs me over and chops off my legs.  Fred has $30,000 in coverage.  I have $100,000 in UIM (underinsured) coverage.  That means I can get $30,000 from Fred’s carrier AND $70,000 from mine, for a total amount of my UIM coverage of $100,000.  If in that scenario, Fred had NO coverage, then I could use my UM (uninsured) coverage up to $100,000 from my own carrier.  What happens between Fred and my carrier afterward is another story.

Third, heaven forfend that you die in an auto accident, but it can happen.  Given that the survival rate for all of us is 0% on a long enough timeline, you should have life insurance. If Fred killed me in one of the above examples, my estate should be able to get up to my UM/UIM limits AND my life insurance would pay out to the beneficiaries, too.

It would be great if everyone had $1 million or more in coverage, but the reality is they don’t.  The moral of the story is that you should do your best to insure yourself against these sorts of losses by getting as much coverage for all eventualities as you can.   Do it.

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Why You Need Auto Insurance

https://www.jeffreyhowardlaw.com/auto-insurance-in-a-nutshell-liability-um-uim-med-pay-no-faultpip/

Insurance always sounds complicated.  Automobile insurance in NC can be especially complicated.

The little video I’ve linked above tells you, briefly, what our auto insurance policies in NC tend to cover.  It’s not exhaustive, but gives you some ideas as to what you’re buying.  I don’t really want to talk about all the types of coverage today, but I just want to get a few messages across.

The message for today is that you NEED to have adequate insurance!  Why?  I’m glad you asked!

First, it’s the law,  You are required to have liability insurance.  That’s the coverage that will pay your victims, up to the limits of your coverage, if you screw up and hurt someone or their stuff.  Get it!

Second, when you buy liability insurance in NC, you automatically get uninsured and underinsured motorist coverageThis stuff is worth every penny you’re paying for it.  In fact, I think you should go buy extra if you can.  Uninsured coverage helps cover your damages if some knucklehead hits you and didn’t have liability insurance.  Second, if some knucklehead with insurance screws up so bad that their liability coverage isn’t enough to cover all of your damages, YOUR underinsured coverage can fill in the gap up to the amount of your policy limits.  I can’t tell you how many times these two types of situations have come up in my practice.  If you’re in an automobile accident in NC you DO NOT want to be in a position where you have either no coverage for your injuries or you don’t have enough coverage for your injuries.

So, call your insurance agent now and get as much UM/UIM coverage as he or she will let you buy.  I promise you they’ll let you buy a lot.

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Treatment in Injury Claims

 

 

You’re hurt.  You want to get better.  The obvious next step is to go get treatment.  But where? With whom?  What kind?  How much?

These are easy questions for me to answer: I don’t know and am not qualified to say!  Unlike a lot of attorneys, I’m not going to tell you where to go, whom to seek out, what treatment modality is best for you, or how much you should get.  That’s just not what I’m trained to do.

What I am trained to do is to tell you how these decisions can affect the value of your claim.

Personally, I’m not as worried about where/what you’re doing with regards to treatment, but I’m more concerned that you ARE IN FACT GETTING SOME KIND OF TREATMENT.

The best way to articulate this concern is this: Injury claims are judged on many things.  One of the main factors is your pain and suffering.  Whether it’s right or wrong I can’t say, but one way to measure this is how much treatment you’re suffering through.  Your pain and suffering argument is intrinsically linked to how much treatment you’re getting.

So if you aren’t getting any treatment, that is going to drastically and negatively affect the value of your claim.

Conversely, if you are getting ALL the treatment, as the kids say these days, then that just looks like you’re running up an unnecessary bill, and you don’t want to do that.  That doesn’t help anyone.

The moral of the story is that if you’re hurt, get appropriate treatment.  Trust your health care providers to tell you what that is, and keep me posted as to what’s going on throughout your recovery.  If you do those things, you really help your chances of getting a reasonable outcome in your claim.

 

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How to Kill Your Claim

 

Trucking Accident Attorney

People are very good and coming up with new and interesting ways to make life harder for themselves.  I’m astounded by their ingenuity.

But one thing I see consistently in this field is people getting hurt, getting treatment recommendations from doctors, and then not following through with their treatment. 

Ugh…..

If I’ve said it once, I’ve said it a million times, the MOST important thing in an accident claim is your health.  That’s obvious, right?  You want to get better so you can get back to your life.  That is clearly the ultimate goal of everyone in this situation.  So WHY would you avoid treatment?

I get it.  Treatment can be expensive.  Treatment can be time-consuming.  Treatment can, in some instances, be physically demanding, even painful.  But if it’s what the health care providers are saying will get you better, and get you better faster, then WHY WOULD YOU NOT DO IT?  The expense, the time, and even the pain can all be worked around to get you at least some, if not all, of the treatment you need.

And if you can’t get the treatment you need, you should at least understand how your lack of treatment will be received.  Over here in injury claim land, no treatment is the same as no injury (see my blog post here for more on that).  I hear this all the time from adjusters: “If she was hurt that badly, then she would have been getting treated.”  If you have the same claim, with the same injuries, but one person has treatment and the other doesn’t, the one with treatment is vastly more valuable from the settlement perspective than the other.

If you can’t afford treatment, let’s talk to the providers, or find another provider, to see what can be done.  If you don’t have time for treatment, let’s get creative in ways to get you something.  If you don’t want to get treatment, that’s fine.  I can’t make you.  But if you make the choice to avoid treatment, and you don’t even try to talk to me about how you can work around your perception of problems with treatment, don’t question me when I tell you your claim value isn’t what you want it to be.

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Injury Claims and Sand Castles

 

What do Injury Claims have to do with Sand Castles?

Everything.

You see, injury claims are sand castles…

To make a sand castle, you need two things:  You need sand, and you need water.

But you need the right amount of water.  Too much water, and you have mud.  Too little water, and you have a sand hill.

To make a good injury claim, you need two things: You need an injury, and you need treatment for that injury.

But you need the right amount of treatment.  Too much treatment, and you are a money-grubbing malingerer.  Too little treatment, and you have no framework around which I can document and explain your pain and suffering.  Not to mention the obvious point that treatment should help you get better faster.

The moral of this little tale is you should make sure you get treated.  If you’re not following my advice, and you’re not following a doctor’s advice, then you should understand that your claim is simply not going to go the way you would like.

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Faster Personal Injury Claims

Trucking Accident Attorney

A common question I receive in this business is, “How long is all of this going to take?”  I have one smarty pants answer: “How long is it going to take you to get better?”  You see, the process of resolving your injury claim is innately tied to your recovery.  It is normally (there are exceptions) unwise to try to settle your claim prior to your recovery, so as long as you are still treating/getting better, we have to wait.  Another way to state that is that I can’t make your claim go any faster, generally, than your treatment and recovery process. The sooner you get better, generally, the sooner we can get your case resolved.

But that information doesn’t really normally help people who are worried about the length of the claims process.  The reality is that every case resolves in its own time.  There are A LOT of variables in this process that can affect the length of the process.  But is there anything you can do to speed it up?  Here are a few tips that can help:

  1. Communicate!  The more you stay in touch with your lawyer, the more stream-lined this process will be, and the less time it will take.  I normally try to communicate with clients via email, so look for those every two weeks, answer the questions I pose, ask any questions you have, and keep me apprised of any developments.  If you aren’t seeing emails bi-weekly, something is wrong and you should call.  If you don’t like email, then tell me (or whomever you hire) to communicate with you in your preferred fashion.  If you have concerns, raise them promptly.  The sooner you get answers from me the happier you’ll probably be.  And I’m full of answers!
  2. Do your homework!  When clients hire me, they get what I call my “client summary memo.” If they read that, they know exactly what the normal process looks like and what they should be doing.  If they don’t know that, that’s on them, not me.  First, we normally talk about all of those things in the initial meeting.  Second, they have it all in writing in their email, so they have everything they need right there.  And if they don’t know/aren’t sure about something, they can call.  See number 1 above…ask questions!  But there are things you can do early on in the process that can save us time toward the end…namely, make sure you’re keeping up with your pain journal, make sure your health insurance is doing what it’s supposed to, and approach your employer about the lost wage letter you may need so that will already be in the works.
  3. Get rid of your pre-conceived notions!  To be blunt, your opinion on how long this should take is probably ill-informed.  It’s not your fault, but the information you are working with is probably inaccurate.  Most of the time this sort of problem arises from talking to friends and family…”Uncle Bob told me he had a case just like mine but he got $1 million AND his settled in 1 and half weeks!”  Uncle Bob is probably full of $#!^ so don’t listen to him.  Who you should listen to is the professional with almost two decades of experience in this field and whom you’ve hired to handle your claim.  The reality is that there is no guaranteed time-line on which cases resolve.  Yes, there are averages, but – and I can’t say this enough – EVERY CASE IS DIFFERENT!  Knowing that there is no time-line will help you be more patient with this process.

Having said all of that, why are you so worried about how long this is taking?  Your main concern should be your recovery, so if you focus on on that instead of your settlement, things will probably seem to go by a lot more quickly.  Ryron Gracie, a jiu jitsu legend, says that the fastest way to getting a black belt is not to worry about it.  Same thing here.

Finally, I’ll leave you to consider the old adage, “Do you want it done quickly or do you want it done right?”

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Use Your Health Insurance!

The basic question is this: If I am in an auto accident, do I use my health insurance to pay for treatment?

Here’s the answer:  Use your health insurance! In NC, and virtually all other “liability” states (states that don’t have n0-fault coverage) the victim’s health care costs are their own responsibility until the end, at which point you hope to get reimbursed for all of your losses – medical expenses, lost wages, pain and suffering, etc. – from the liability carrier (or the at-fault driver personally, but that’s another story).

Auto liability insurance policies are not set up to pay your medical bills as they are incurred.  In other words, the bad guy’s liability policy DOES NOT take the place of your health insurance.  Your health insurance is the front line defense against medical costs, but the liability policy might be a safety net that helps you at the end.

But why is it so important to use health insurance if you’re going to get reimbursed at the end anyway? The biggest benefit of using health insurance is the contractual adjustment.  Your health insurance most likely doesn’t have to pay full cost for your bills.  They get some discount based on their contract with the provider, and that limits your responsibility.  This is part of what you’re paying for, so use it!

This becomes particularly important when rogue health care providers (*cough* Wake Med *cough) refuse or “forget” to bill your health insurance on the hopes that they’ll get paid their full bill by the liability carrier.  This is exploitative and shameful, though currently not illegal, per se.

But the other issue is that there is no guarantee that the liability carrier is going to pay you anything!  So it is foolish to not use your health insurance when you can.

That brings up the reasons why having an attorney to help you makes a ton of sense.  First, you might not know all of this unless you read knowledge-dropping, woke legal blogs like this one.  Second, even if you know it, you might fall prey to the facilities like Wake Med who try to rob you of your health insurance benefits.  Third, you might not know how to best play the insurance game and get all of your bills covered.  Finally, you’re hurt and likely not at your best at the moment, so why do you need more work and hassle?  Let me (or another attorney) handle it for you.

If any of this is confusing, call me and I’ll try to help.  919-929-2992

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Trip, Slip, and Fall Injuries in Grocery Stores

 

People fall in grocery stores ALL the time.  In North Carolina, injuries resulting from falls aren’t always the responsibility of the property owner.  The law is tricky!

So, when are property owners responsible for injuries related to falls on their property.  In short, victims have to show that the owner was aware of the “dangerous condition” that caused their fall, OR that by the exercise of reasonable care they should have been aware of it, AND that they failed to adequately warn the victim of the dangerous condition.

That’s a mouthful.  In layman’s terms, you have to show that what caused your fall was something they knew about, or should have if they were doing their job, that you had no reasonable way of knowing about it, and that caused your fall. Not an easy task, as you might imagine.

On top of that, North Carolina is a contributory negligence state, which means that if you’re even 1% at fault in your accident, you can’t recover from the person who’s 99% at fault.

The way this plays out in these case is like this: The better you are at proving that dangerous condition was so darn dangerous and so darn obvious, the more help you give the defendant in proving that you should have known about it, too, and should have been able to avoid it.  It’s almost a Catch-22.

These injuries can be life-altering and the cases can be complex.  If you are injured in a fall in a grocery store, or any commercial area, give me a call.  919-929-2992

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Don’t Panic – the first offer is almost never the best offer

This is a topic I discuss over and over again, so I think that makes it blog-worthy.

When I’m negotiating the settlement of a personal injury claim or a worker’s compensation claim, we have to start somewhere. When the other side starts negotiations with a lower number than you wanted to hear, what should your reaction be?

Your reaction should be to chill the #%$^ out.

Remember, it’s their first offer. Those are almost NEVER the the best or the highest offer.  It’s just a starting point. What you have to understand is that the insurance company doesn’t want to pay a cent more than they have to.  As a result, they are going to start out with a low number.  That doesn’t mean they are going to end with that same number, nor does it mean the sky is falling and everything is lost!  My job is to keep the negotiation moving up and to get them to their highest number.  If your facts are good, and you’ve done everything you were supposed to, then everything is probably going to work out the way it’s supposed to.  Conversely, if either your facts are not good, or you’ve made some missteps along the way, that’s probably why the number is what it is, which there’s nothing you can do about now.  And if they’re starting low just to be jerks, who cares?  Let me them be jerks, as long as they end at a number you can live with.  And if they don’t, that’s what litigation is for.

Negotiations are a process.  We start high, they start low, we work our way to somewhere in the middle.  If they were just going to walk out and give you everything you wanted, you wouldn’t need me.  But they aren’t, so you do.  That being the case, just chill, let me keep working, and we’ll see how we can work it out.

 

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Jeffrey Allen Howard, Attorney at Law, PLLC
1829 E. Franklin St. - Bldg 600
Chapel Hill, NC 27514

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