*AGENT/FRIEND DISCLAIMER: I have several friends who are State Farm agents and at the same time kind and wonderful people. This is not meant as a slight against the agents of State Farm, but it is an accurate report of what the claims department of State Farm is doing now. Love you guys, but this stuff is going down and people should know.

While you were asleep in 2011 the Republican-controlled General Assembly of North Carolina passed a bill that is referred to as the “billed v. paid” legislation. This changed the Rules of Evidence to allow evidence of what was necessary to pay the bill, as opposed to what was actually billed, when people were seeking recovery for health care expenses. Here’s the text of the Rule:

“Evidence offered to prove past medical expenses shall be limited to evidence of the amounts actually paid to satisfy the bills that have been satisfied, regardless of the source of payment, and evidence of the amounts actually necessary to satisfy the bills that have been incurred but not yet satisfied. This rule does not impose upon any party an affirmative duty to seek a reduction in billed charges to which the party is not contractually entitled.”

The best way to explain what this means is to go back in time before it was passed.

In the good old days, when you were attempting to recover against someone who harmed you, what they owed you was whatever was billed by your health care provider, regardless of your health insurance adjustments. That meant that if your hospital bill was $5000, your health insurance paid $3000, and the hospital wrote off the other $2000 as part of their contractual adjustment with the insurance company, the bad guy in your case owed you the full $5000 because that’s what was billed.

Now, what is allowed into evidence, and therefore all a victim is allowed to recover, is the amount that is necessary to pay the bill. So in the above example, you could only recover the $3000 on that bill, even though it was billed at $5000.

That’s right, now tortfeasors get credit for the health insurance that you pay for. Super fair, right?

That’s sarcasm, by the way. Of course it’s not fair.

We aren’t in a position to change that law now, and maybe will never be, so we have to deal with it.

What’s unfortunate is that, as insurance companies are wont to do, State Farm’s claims department is taking its own unilateral and irrational interpretation of this Rule of Evidence. State Farm claims is telling victims of their insureds that they don’t have to pay any bills that aren’t paid by health insurance.

Go back and look at the text of the Rule. There isn’t anything that even comes close to, “Thou shalt use thine health insurance.” There is no such compulsion in the rule whatsoever. But State Farm is claiming that there is.

This may seem simply like an annoyance to those of you who aren’t in a claims situation right now. But here is where it’s getting really, really ugly: Many people in auto accidents sustain soft tissue neck and back injuries that they believe to be best treated by chiropractic care. Health insurance isn’t exactly friendly about chiropractic care, and the co-pays are dreadfully expensive. As a result, what most people do is simply go to the chiropractor, not use their health insurance, and have the bill wait until the case is settled. If they are forced to use their health insurance, then they would have to be shelling out $40ish every time they are treated, which is normally 3 times a week for a few months. Who do you know that can sustain that sort of expenditure? And why should they when they are the victim and didn’t ask for this in the first place?

Why shouldn’t State Farm do this? Several reasons:

• Nowhere in this revised Rule of Evidence does it say that a victim has to use health insurance. Period.
• Your health insurance is yours. You can choose to use it or not, and the insurance company of the knucklehead who just ran you over shouldn’t be able to tell you when to use it.
• When you try to take the path of least resistance as a victim in this situation, you are victimized further because using your health insurance is going to cost you more out of pocket when you go to a chiropractor. You bear more of the burden than you should, for an injury that wasn’t your fault in the first place.

What can we do? Well, the only real solution is to file suit over and over again and beat State Farm on this issue enough to cost them money and get them to change course. The problem with that is not many people want to file suit given the uncertainty, time, and expense involved. But that’s the reality we are facing now.

So the next time you think that personal injury attorneys are the reason that law suits are filed, stop and think about how insurance claims departments can necessitate this uptick in litigation because of their opportunistic and manipulative practices.

If you have an auto accident, call me. I would like to help. 919-929-2992.

Stereotypes are all over. Here are a few:

PI attorneys are take advantage of “the system” to siphon off money for clients who aren’t hurt as badly as they say and to make profit for themselves.

Claimants exaggerate their injuries for profit, and some even do this as a part-time occupation. They file false claims with insurance carriers and cost honest premium-payers money.

Insurance companies are megalomaniacal corporations with more money than heart and play a gambling game that they refuse to lose, along with their bought and paid-for politicians.

 

Are any of these exactly correct? What’s your opinion? I’d love to hear it. Here’s mine:

There are good and bad folks in every walk of life. There are honest PI attorneys and there are scheisters. There are claimants with legitimate injuries and claims and there are scammers. But do the scheisters and the scammers represent all of us? Obviously not. But do those bad apples make the rest of us look bad and cause problems? You bet.

Insurance companies are in a for-profit business and like the rest of us do their best to manipulate circumstances to their financial advantage. Who can blame them?

I can blame them. It’s a matter of scale. Insurance companies have vast resources, and have over the years spent a ton of time in money to mold a system that favors them. So when a person has a legitimate claim, it’s vastly unfair when a multi-billion dollar company refuses a $10,000 claim. How can the little guy fight and win? And how many times do they do this to almost powerless injured people each day? Thousands?

It’s a circular problem, I know. But think about it and see if there’s anything you can do to change the system. I’d love to hear your thoughts.

Insurance companies do not want you to hire an attorney for your auto accident personal injury claims. This might seem intuitive to some, but trust me: it isn’t intuitive to others.

It’s important to think about this. Why wouldn’t an insurance company want you to hire an attorney?

The way to the answer is, oddly, by answering another question: What’s always the most important thing to insurance companies? That’s an easy one…money!

Take this into consideration:

In 1995, Allstate produced a training manual for its claim adjusters [Allstate Insurance Co., Unrepresented Segment Training Manual, 15-30, July 1995]. This document stressed the importance of convincing claimants to represent themselves and not retain an attorney. Why? Allstate explained its position with a number of telling statistics: With settlements under $15,000 injured claimants represented by an attorney averaged $7,450 in a total settlement. Those who represented themselves to Allstate averaged only $3,464.

So what does this boil down to?

Personal injury claims are an example of a zero sum game. That means that every time the insurance company saves a buck, you lose a buck. So if there’s anything you can do to turn that around – where you get a buck and they lose a buck – and put the profit on your side, shouldn’t you do it?

Hiring an attorney does just that; it puts you in a position to turn the odds in your favor and help you get the compensation you deserve on your claim.

If you have a personal injury claim, an auto accident claim, a slip and fall claim, a dog bite claim, or anything like that, call an attorney. Better yet. Call me. 919-929-2992.

This is less of an informational piece than I have routinely been providing, but more of a positional piece that is my opinion, for what that is worth.

I heard through the grapevine that a tragic accident happened here in town and the family of the victim hired a Cary lawyer.  What the what?! Why a Cary lawyer?

If you have an auto accident or slip and fall or dog bite in Chapel Hill, wouldn’t it make sense to hire a Chapel Hill Personal Injury lawyer?

This is of course not to say that out of town lawyers can’t do anything. There are tons of great attorneys out there and they can do marvelous things for their clients.  But in making the decision to hire an attorney, location might be something that is worth considering.

Yeah, I know.  For years I’ve been saying, “Location doesn’t matter!  I can handle any injury claim in NC.”  That is still true.  The converse is true as well: Other attorneys not in Chapel Hill can handle claims here, too.  That’s great.  What I’m arguing is that if you have an injury in Chapel Hill, it makes more sense to have a Chapel Hill attorney than an out of town-er.  Here are a few reasons why:

1) I would assume, though not necessarily always correctly, that if you are injured in Chapel Hill you either live, work, or are a student in Chapel Hill.  That being the case, my proximity to you makes interaction far more convenient.  My Chapel Hill clients drop stuff off all the time, and can often chat with me about their case at a moment’s notice.  Isn’t that worth something?  Conversely, while an out of town attorney could competently handle a case situated here, is it as convenient to stop in and see him?  Not necessarily.

*Before you decide to argue with me about me talking out of the other side of my mouth and asking to be hired for out of town cases, check this out:  It’s a completely separate argument!  While I may not be as close to out of town clients, I do have an overwhelming amount of accessibility to communication.  I answer my own phone, I respond to emails, I return voice mails, I have a mailbox, of course, and I even have a live chat on my website.  If you’ve worked with me before and another attorney, tell me: Who was more accessible?  I bet I win that every time.

2) If you don’t live or work here, then you would benefit from having someone who is local and can bring that familiarity of place to the handling of the case.  Being local I have many helpful connections in town and am likely far more familiar with where your accident happened than an out of town lawyer.  Case in point: I was hired to represent a student who was run over on campus.  When her parents described to me how this happened, I immediately knew the crosswalk involved because I had seen and heard of near misses there myself.  I was able to quickly get footage of the scene at a relevant time and get a favorable disposition for my client.  I’m also in the Orange County Courthouse regularly.  So why would you want an outsider?

I bet in some situations the victim or family live elsewhere, so they get an attorney closer to them, or someone whom they already know.  That’s fine. I get it; I can’t win ’em all.  But to me, if you have an incident leading to an injury in Chapel Hill, then it only makes sense to keep it local and hire a Chapel Hill attorney if you need one.  Namely me.  So do that.

919-929-2992.

There are thousands of traffic tickets handled every day in North Carolina. Most of those are handled by the defendants themselves without the benefits of an attorney’s advice. When they are handled that way – what we call pro se in this business, which is to say without an attorney or for yourself – it’s very easy to mess things up. Here are (what I think to be) the Top Traffic Ticket Errors in North Carolina:

3. Pleading to something you don’t understand: People often have no idea what is best for their driving record/insurance points if they don’t have the proper training. I often hear people say, “Just use a PJC! That’s what I did.” In many cases, that’s your third best option, meaning there are two other superior ones, and in some cases, it’s worse than just pleading guilty. Before you decide to plead guilty to something, know the consequences.
4. Paying it off: This is similar to Number 3. When you pay a ticket off you are pleading guilty to your original charge! Do you know the consequences of that? It’s almost never a good idea to do that. You should not make that decision without knowing what will happen as a result.
5. Not showing up: Missing your court date for your traffic ticket is like getting shot by an arrow and thinking that if you just ignore it, that arrow will just fall out and everything will be just fine. That is never going to happen. And the longer you wait, the more things can get nasty. To use another metaphor, things can snowball and get bigger and worse as time goes on. You can get arrested, lose your license, get worse charges and eventually, possibly, go to jail, all because you missed your court date for a simple traffic ticket. This is the worst and most avoidable error in NC Traffic Tickets.

Now you know. Really, the best thing for you to do is to call and attorney and get some proper advice.

Call me if you are reading this because you probably need help. 919-929-2992.

Step 1. Pull your driving record so you know what you’ve got working against you.   You’ll need to contact your license-issuing state’s Division of Motor Vehicles or whatever they call it where you are.

Step 2. Go to law school so you can take a few criminal and insurance law courses and see what the stuff on your driving record means and how convictions affect your insurance rates, as well as how out of state convictions may transfer.  Some evidence and trial advocacy courses would come in handy, too.

Important notes about Step 2:

a) You’ll need to continue your ticket’s court date for about three years, which may be a stretching it a tad, but you can give it a try!

b) You better pay attention; there are more practicing attorneys who do not understand the ins and outs of traffic ticket and insurance law than there are that do, so make sure you get what you paid for!

Step 3. Practice law for a little bit in the county where your ticket was written so you can understand the local policy with regards to traffic ticket plea agreements and get to know the local bar so you know with whom you’re dealing and what to expect.

Important note about Step 3: In addition to getting to know the prosecutors so you know what to expect with them, it would help to get to know the local defense bar, too, in case you need some help in the form of backup or advice.

Step 4. Appear in court and negotiate the best plea available based on your driving record, your charge, local policies, and your own skill as an advocate.

Easy, huh? And it only took you a little more than three or four years and several thousand dollars!  Way to save that attorney’s fee!  That’ll show ’em.

…or you can just do it all in one step that won’t take 3 plus years and cost you thousands of dollars and just hire an attorney who can help you avoid excessive and needless insurance rate increases.

Whatever floats your boat.

To date, this topic is the number one reason people find my website.  Crazy, huh?

It’s crazy for several reasons.  First, handling traffic tickets is only about 5% of what I do in my law practice, so it’s very much the internet tail wagging the website dog here.  I’m a small town lawyer that handles mostly injury claims; handling tickets is just something I do to help my local friends.  But that’s fine.  I like attention.

Second, I’m so surprised at how often this happens to people.  I’m not judging, I’m just surprised that given how easy it is to hire an attorney to represent you it still can happen.

Yes.  It’s that easy.  There’s just a two-step process to hiring me (and probably many other attorneys for that matter).  First, you call me at 919-929-2992 to process your attorney fee payment over the phone.  Depending on the county, the charge varies.  See this link for details.

Second, you go to this page to fill out my online representation agreement to authorize me to appear for you. Just fill it out and hit “submit” and that’s that!

“What?” you ask.  “But my ticket says there is a ‘mandatory court appearance’; doesn’t that mean I have to show up?”

NO!  That’s where they get you. What they mean when that’s on there is that you can’t just pay it off.  Someone has to show up.  You or your attorney.  So you can avoid that by hiring an attorney.  Perhaps one like me.  Perhaps me.

So there is absolutely no reason to miss your court date.  When you get a ticket, call me or another attorney and there’s a good chance we can help.

If you have already missed your court date, call me anyway!  It may be a bit more of a mess but there’s hope we can clean it up without too much hassle.  It’s really never too late.  And remember, if you don’t take care of that, your license will be revoked indefinitely until you handle it.

Call me now and see what I can do.

Disclaimer: This information offered in this post is for offered for informational purposes only, and does not constitute legal advice nor does it create an attorney/client relationship. I am admitted in the state of North Carolina only and make no attempt to opine on matters of law that are not relevant to that state. This advice is based on general principles of law that may or may not relate to your specific situation. You should not rely on this advice alone and nothing in these communications creates an attorney client relationship. Seeking direct advice from an attorney in person may be advised.

I told you so. But you had to try! I cannot tell you how many people have come to me who tried to handle their own claim but now want help. It happens A LOT, though.

There are really two types of problems that this creates: Claim damage and settlement snafus. Claim damage is messing up during the process – saying the wrong thing, giving up the wrong info – that causes the case to be worth less than it would have been otherwise. People inexperienced in this process make these mistakes without knowing it. That’s the problem of amateurism.   Settlement snafus occur when a pro se (non-attorney-having) party undervalues a claim and/or paints an adjuster in a corner as to settlement amounts. After that, getting an attorney involved to negotiate almost never does any good, as you have to at least begin litigation to get anywhere further.

So what do you do now? You can try to get an attorney to help, but sometimes the damage has been done and there won’t be much we can do to help. Not always, but sometimes.   It’s probably at least worth a call.

I like to tell accident victims this: Using a personal injury attorney is like doing karate according to Mr. Miyagi, “either you attorney hire YES, or you attorney hire NO; you attorney hire MAYBE/SOMETIME means sooner or later squish like grape.”

What does that mean? It means that in my opinion you should make your decision at the outset to either hire an attorney or not.

Hiring an attorney at the beginning can help prevent problems and make less work for you.

Trying to hire an attorney after you’ve already tried to do this on your own may just create more problems than the attorney can fix.

Think of it this way: Does it make more sense to try to build a house on your own, and then get a carpenter to fix your mistakes at the end, or to just hire a carpenter to do it right the first time?

The choice is yours. Good luck!

Jeffrey Howard

919-929-2992

www.jeffreyhowardlaw.com

 

Disclaimer: This information offered in this post is for offered for informational purposes only, and does not constitute legal advice nor does it create an attorney/client relationship. I am admitted in the state of North Carolina only and make no attempt to opine on matters of law that are not relevant to that state. This advice is based on general principles of law that may or may not relate to your specific situation. You should not rely on this advice alone and nothing in these communications creates an attorney client relationship. Seeking direct advice from an attorney in person may be advised.

The chapter above briefly addressed not signing releases and taking personal responsibility for getting your records and bills. That bears repeating, as insurance companies can tell you they are only going to get related treatment stuff, but the next thing you know they have records about when you were born. So watch it!

When you get your records and bills, ask for treatment notes and itemized bills from each and every provider. Remember that if you went to a hospital, there may be different physicians and radiology bills, so inquire as to where those requests should be sent.

Recent legislation in NC allows defendants to get credit for your health insurance. While that’s patently unfair, it’s the law passed by your insurance-industry-friendly Republican majority. This means that you can only recover what your insurance company (and you) had to pay to satisfy your bills; in other words, the defendants get a credit for the health insurance contractual adjustment. So make sure you get this documented or they may not even talk to you.

So now you’ve gotten your records and bills, what else do you need. If you incurred lost wages, you’ll want something from your employer to document what you lost and how much it was worth. Most employers will provide that, but sometimes they may give you hassle. Just make sure it states clearly the value of the lost wage claim.

You will want to send all records and bills and lost wage documents to the liability adjuster AND to your Med Pay adjuster(s) (Med Pay won’t care about lost wages, of course, but it’s easy to put everything in one cd nowadays). This will go out with a demand letter. “What’s that?”, you ask:

A demand letter states what you think your case is worth. Don’t start with what you want; start with a lot more than that to give you negotiating room.

Well, what do you want? What is your case worth? The answer is I don’t know! I use my judgment and experience, as well as that of other attorneys I know through consultation, to evaluate each case on a case by case basis, factoring in treatment time, costs, lost wages, pain and suffering, permanency, and other factors. How can you do that? It will be hard, as you won’t have anything to go by. But there’s an old saying that a case is worth what it settles for, so if you have a number you feel good about, use it as your goal.

PLEASE remember that the days of getting three times the medical bills to settle every case are over. That just doesn’t happen now. You will of course have a cousin who got a bazillion dollars for his case that was less severe than yours, but pay no attention to that. People lie. Do your best with what you’ve got and cross your fingers. If you are handling it on your own, that’s about as good as you can do.

 

 

Disclaimer: This information offered in this post is for offered for informational purposes only, and does not constitute legal advice nor does it create an attorney/client relationship. I am admitted in the state of North Carolina only and make no attempt to opine on matters of law that are not relevant to that state. This advice is based on general principles of law that may or may not relate to your specific situation. You should not rely on this advice alone and nothing in these communications creates an attorney client relationship. Seeking direct advice from an attorney in person may be advised.

The number one thing to remember here is that if you feel injured, you should seek treatment. Period. Don’t worry about what an insurance adjuster says, don’t worry about who’s going to pay for what. Your health is the most important thing and if you are injured, or even think you are injured, making sure your health needs are met should be your number one priority.

So where should you go? The answer is wherever you want. I often explain to clients that my job as an attorney isn’t to direct your medical care; after all, what qualifications would I have to do that? My job in this context, however, is to tell you what impact your health care decisions may have on your claim.

At the outset, depending on how badly you are hurt, you may not have any choice about health care. If you are taken by EMS to a hospital, that’s done. No choosing there. Just remember, if you can, to ask about all of the different entities involved in your care. You will want to know from whom to request bills and records when this is all said and done. More on that later.

Afterward, your injury will guide your care. You may seek advice from your family doctor. You may go to a chiropractor, you might get physical therapy, acupuncture, massage therapy. You may need surgery. There are many options, dependent of course on your injury.

Much of what you would need to know here is situation-specific, so it’s difficult to generalize and give good information. However, there is some amount of general info that you may find useful in determining where to seek treatment:

• The sooner you seek treatment, the better. Insurance companies use “gaps in treatment” (time between the accident and treatment, or large time period between treatment) to devalue your claim. So if you’re hurt, get treated ASAP; don’t play tough.
• If possible, it can be helpful to follow up with your primary care doc, who can then make treatment referrals for you. It will look better if someone else is saying you need the treatment, not just you choosing to get treated.
• Many victims with soft tissue injuries (sprain/strains, generally in the neck and back) choose to go to a chiropractor.
  • Positives: They are specialists in these types of injuries and are very knowledgeable, generally. They will often withhold collection on their bill pending settlement, which helps with reducing out of pocket expenses.
  • Negatives: Insurance companies often discount chiropractic bills unilaterally, making it hard to get their bills paid in full, and for whatever reason don’t respect them as much as other providers, which can make settlement more difficult.
• You can get reimbursed for massage, but it is normally best to couple it with    chiropractic or PT, and it is always best to have it prescribed, if possible, by a physician or health care provider of some type.
• If it’s different than it was before the accident, it needs checking out. Many victims walk around with traumatic brain injuries, wondering what happened to them, simply never putting the accident together with their symptoms, as they can sometimes be delayed. If it doesn’t feel right, get it checked out!

There is a phrase you should learn right now: Maximum Medical Improvement. This means the point at which you have reached a plateau in your recovery from these injuries. You should not even think about valuing your claim or documenting your medical treatment until AFTER you have reached this point. How do you know you’ve reached it? You will know, or your doc will tell you – one or the other.

Remember: It is best NOT to sign a blanket release for the insurance company to get your records and bills. Get them and provide them to the insurance company yourself! EVEN if the release says it’s only for these injuries, health care providers almost never read them, and if the insurance company asks for unrelated stuff that may hurt your claim, they may give it up!

Whatever you send may be used against you…but you have to send something…so do it.