Med Pay and Your Liability Policy

Sometimes we have to make a liability claim against our own liability policy. This happens most often in inter-family claims where, perhaps, hubby was driving, screws up, causes a wreck, and wife is injured. Well, that’s what you have liability insurance for, so there’s no need to be shy. Make the claim!

But there is a little surprise lurking in that process for people who have opted to pay extra for medical payments coverage, or “med pay” as we call it in the business.

Let’s say your overall claim was worth $6000. Cool. Let’s also say that you have $2000 in Med Pay. That means your policy will pay out your $2000 in Med Pay, and your liability policy will then cover the remaining $4000. In other words, the liability policy gets a credit for Med Pay! But you’ve paid extra for that! Is that fair?

Well, it depends on your perspective. It’s allowed, so we’re stuck with it, so fair doesn’t really matter. But from the POV of the insurance companies, the claim is “worth” $6000, so why should they pay more? From our POV, though, they should pay the $6000 because that’s what the liability policy is on the hook for, and they should pay the $2000 because you’ve paid for it.

The current rule for the credit stands as of this writing. However, it is worth noting that if the liability policy pays out its limits, then it does not get a credit for Med Pay, in which case you’d get the limits PLUS the Med Pay. So there’s that.

This stuff is wacky, and you probably don’t have time to figure it all out, which is precisely why you should call me. If you have an injury claim call me at 919-929-2992.

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Medicare Advantage Plans and your Injury Claim

By now, you probably know that if you have an injury claim that you get money from, and Medicare paid for some of your treatment, you MUST pay Medicare back. There’s a whole process for this that your attorney can help you with. If you’re not an attorney trying to handle that, heaven help you.

What you might not know is that if you have a Medicare Advantage plan you might have a similar issue.

Many of these Medicare Advantage plans have what’s called a “right of reimbursement” or “subrogation” claim.  That means that in a situation where we obtain for you payment in compensation for incurred medical expenses from an at-fault party, then your health plan may have a right to get paid back what they paid out.  Normally if this is the case, they or a company they hire, reach out to you to investigate this.  If you get a letter about this, YOU MUST NOT IGNORE IT! IF YOU HAVE AN ATTORNEY YOU MUST BRING THIS TO THEIR ATTENTION! Your attorney probably can’t effectively investigate this for you with your plan. 

If you have a Medicare Advantage plan it would be most wise for you to contact your health plan, make this inquiry – does the plan have a right of reimbursement for third party claims? – and let your attorney know the response.  Failure to do so can leave you owing them after your settlement money is gone, and can impact your coverage as well. 

This is not the type of thing you want to ignore. You can end up thousands of dollars in debt and lose your coverage. You’ve been warned.

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Personal Injury AND Worker’s Comp Claims

Oh, lort. This stuff can get really complicated…but here it goes:

Most of you are familiar with the idea of a worker’s comp claim…you get hurt at work, you have the right to certain protective benefits. Most of you are familiar with auto accident injury claims…someone runs into you and you hope to be able to recover what you lost as a result of their negligence.

But what happens if you have an auto accident claim WHILE you’re working? Can you have a worker’s comp claim AND a personal injury claim at the same time? YES! But be careful how you handle them.

I could write FOR DAYS on what you are entitled to with each of these claims and how they might intersect, but that would make for a long blog post that no one would want to read. So let’s just summarize:

What should you get from worker’s comp? Mostly just three things: Payment for your time out of work due to your injury, payment of your medical expenses, and to the extent that you have permanent impairment, payment for that. There are lots of little nuances in there, and they aren’t quite as nice as they sound, but they’re something.

What should you get from a personal injury claim? I’ve written on this previously, so check this post out. But suffice it to say you should be able to recover for whatever you can prove was proximately caused by the negligence of the other driver…normally this is full payment of your medical expenses, lost income, and something for pain and suffering. The main difference with worker’s comp is that there is NO PAIN AND SUFFERING IN WORKER’S COMP.

But here’s the big problem: The Worker’s Comp Lien. Whatever worker’s comp pays for, they’re going to want you to pay them back from whatever you get out of the related injury claim settlement (what they’ll call the third-party claim). This can result in the classic “Robbing Peter to pay Paul” metaphor, but there’s a lot that your attorney can do to help you navigate this issue. Sometimes we can help to limit the payment of the lien, and sometimes we can make it go away totally! What you DON’T want to do is handle your worker’s comp and personal injury liens claim without considering this, because you might end up just taking lots of money from one insurance company and giving it to another. And that’s not what any good-natured American wants now, is it?

Anyway, if you have a worker’s comp claim resulting from an auto accident, call me or another attorney before it gets too wacky. 919-929-2992.

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Is it expensive to hire an attorney for your ticket?

Traffic Attorney

I recently quoted my fee to a potential client for handling her ticket and she said, “That’s expensive!”

I thought that was an odd reaction. But being the self-reflective and awesome person I am, I didn’t argue with her. I just pointed out that I think it’s probably less expensive than risking the loss of her driver’s license or having her insurance rates go up for 3 years, but the choice was hers.

Maybe that wasn’t the best salesmanship in the world. While I admit that part of what I must do in my business is selling my service, I feel that there’s a line to be drawn. I’m not going to pander to you and beg for your business. I will, however, tell you what I charge for the valuable service I offer, and here I’ll tell you what you get for it:

  • If you hire me, YOU don’t have to go to court, I do that for you
  • I analyze your driving record and make a choice as to the preferred disposition of your ticket, as I can tell what impact each disposition might have on your record (prior tickets can impact this one, and vice versa!)
  • I use my knowledge and experience to get you the best deal available in order to minimize the impact this ticket will have on you
  • If your ticket isn’t handled appropriately, you could risk losing your license, or maybe having your insurance rates increase for three years! Sometimes that increase will be 100%

I can then only leave it up to you. Do you know how to do what I do? Do you want to bet on it? If you’re OK with the consequences of being wrong, then have at it! Maybe you keep your license! Maybe you don’t! If you’re not comfortable making that bet, then pay me a few bucks and let me do it right. I really don’t think you’ll regret it.

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Who is at fault in your auto accident?

Fault can be clear sometimes in automobile accidents. But sometimes, it’s really, really tricky to tell who is the responsible party.

Who had the right of way? Was anyone speeding? Were lights/blinkers in use? Should they have been? What were the conditions? There’s a ton to consider.

Can you tell from the accident report who the officer thought was at fault? Does that matter? Does the officer’s opinion control the issue? Can you read the semi-secret codes on the report? This is getting more and more complicated, which means it’s more likely you’re going to need help.

What makes that even more difficult in North Carolina is that we are a contributory negligence state. In short, that means if a person is even 1% at fault in their accident, then they can’t get anything from the person who is 99% at fault. This is crazy when you consider that in most states under those facts the 1% guy could get 99% of his damages from the other guy. That seems a lot more fair, but we have a really strong insurance lobby here, so they get to make the laws!

If you have a question about who is at fault in your auto accident in North Carolina, you’re probably in for an uphill battle. Call me for some advice and help. 919-929-2992.

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NC Auto Accident and Out of State Insurance Policies

This happens more often than you’d think: You’re driving in North Carolina, you’re involved in an auto accident, and one of you has an auto insurance policy from another state. Seems like it would be simple. But it ain’t.

North Carolina is a liability state. That means we all (should) carry liability insurance to cover our mistakes, meaning if we cause an accident our insurance should pay for the damages to the person whom we damaged. There are several other states who are very similar in that regard. Some other states have variations of no-fault coverage, often called PIP, which stands for Personal Injury Protection. In those states, your auto coverage covers your own losses when anyone causes an accident. And there are variations of those. Some have a lot of coverage, some have a little of that, then they turn into liability policies. Some have PIP and your health insurances is precluded from getting involved. It gets weird fast.

So what happens when you’re in this situation? It’s my favorite lawyer answer: It depends. Who caused the accident, and who has the out of state policy? Is it a PIP policy? Does that help or hurt? How does the PIP interact with health insurance? How does it interact with liability coverage? Will we be robbing Peter to pay Paul? Ack!

This stuff can get really complicated really quickly. That being the case, doesn’t it make sense to get an attorney to help you investigate your coverage situation and help you navigate your course? I think so. If you’re in an accident, call me at 919-929-2992.

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What does Worker’s Comp do?

I probably use this joke too much, but I often say that the “comp” in worker’s comp doesn’t stand for “compensation,” but for compromise.

In North Carolina Worker’s Comp was created as a compromise to help injured workers get the support necessary to get back to work, but to also not hold employers accountable for things they may not have caused.

Worker’s Compensation claims can be “comp” – licated too. It is a separate body of law unto itself and there’s a lot of weird stuff in there. But if you want to know what worker’s comp is supposed to do, in essence, here it is boiled down for you:

  1. They should pay you for your time out of work. Granted, it’s only 66% of your average weekly wage, but it’s something.
  2. They should pay for your treatment related to your injury. Yes, they get to choose the doctor, which can have a huge impact on the type and quality of care you get, but still, it’s something.
  3. To the extent you have permanent impairment, you should get money for that. How much? Ask an attorney.

Worker’s Comp claims are wacky. Save yourself a lot of time and heart ache. Get an attorney. Call me at 919-929-2992.

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Whose insurance matters?

In auto accident injury claims in North Carolina it’s not always intuitive which auto insurance policy is “on the risk” as we say. Whose policies matter? When do they matter? In what order? This can all be a bit overwhelming, especially in certain fact patterns. Let’s go over a relatively complex example that will help you understand how it should work out…

Let’s say Alex was driving his car and hit the car being driven and owned by Bob, who was carrying Cathy as a passenger. Cathy has her own auto policy on a vehicle that she left at her home.

Assuming there’s no question as to fault and it’s all on Alex, then the liability policy on Alex’s car is on the risk and can be looked to to pay the property damage and bodily injury claim damages for both Bob and Cathy. If Alex has Medical Payments coverage on his policy then HE can access that portion of his coverage, but Bob and Cathy can’t.

If Bob has Med Pay on his auto policy, then both he AND Cathy can access that in addition to the liability policy of Alex. IF Cathy obtains the limits of Bob’s Med Pay AND she has Med Pay on her own separate policy, she can access that.

If Alex’s liability policy pays out its limits to Bob, and Bob has adequate UIM coverage, he can access that. So can Cathy.

There’s more to this, and we could go on for a while, but this gives you an idea that you probably want to talk to an attorney if you’ve gotten into a mess like this. Call me at 919-929-2992.

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Uninsured and Underinsured Insurance In Your Accident Claim

Most of the time when you’re in an auto accident you’re usually able to seek compensation for your injuries from the at-fault party’s auto insurance company. But often it isn’t that simple, especially with more serious injuries. What if the bad guys didn’t have insurance? Or what if they didn’t have enough?

People who get stuck in these sorts of situations might feel like there’s nothing they can do to get adequately reimbursed for their losses.

This is why it’s important to have a personal injury attorney who can help you determine if there might be more insurance coverage available.  Here’s where you look for Uninsured/Underinsured Motorist Coverage…or UM/UIM.

Most of us have these types of coverages included in our policies by default.  If you have a minimum limits policy, then you probably don’t have Underinsured (UIM) coverage, though.  But assuming you have what you need – and you hopefully do –  you can seek payment from your own insurance company instead of (UNinsured), or in addition to (UNDERinsured), the insurance company of the bad guy. Uninsured Motorist coverage is for situations where the at-fault party doesn’t have auto insurance or for some reason the policy doesn’t cover him.   Underinsured Motorist coverage is for when the at-fault party doesn’t have enough coverage for the damage he caused.

This stuff can be the difference between a horribly unfair outcome and a palatable one, so please make sure you get good advice. Call me at 919-929-2992.

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Injury Settlements Take Time

“My accident happened a year ago and this case STILL isn’t settled!”

Most of my cases don’t take that long, really. But I sometimes here this exclamation of frustration from clients and it’s hard to talk them down. So I thought I’d lay the foundation for why the statement is based on a misunderstanding of this process and is therefore faulty from the start.

How long ago your accident happened is really no metric for how far along you might be in resolving your case. What? You’re surprised by that? Think about it: What’s more relevant in terms of determining a value on your case – How long your recovery took and how much treatment you had, OR how long ago it happened?

Obviously, the more important factors in determining your claim value is how long your recovery took and how much treatment you had. Your accident might have happened last week, and you’re already done with treatment. In that case, your claim is probably ripe for valuation and settlement. But your accident may have happened two years ago, and you’re still in treatment and recovery. In that case, your case is not likely ripe for settlement so it’s just not ready to be settled!

When you think of it that way, how long ago it happened is completely and totally irrelevant as to the value of your claim and the timing of the resolution thereof.

Just because your accident happened a long time ago doesn’t mean your case is ready to settle. The only relevance is to your frustration in the process taking longer than you would like. That’s totally understandable and a valid emotion. But please don’t confuse your frustration with the process with a flaw in the handling of the process. Those two things are not always the same thing.

So, if your case is taking longer than you’d like, stop to think about whether or not it’s your recovery that you’re frustrated with, or if the claims process is the problem. If you’re still in recovery, your case is probably just not ready to be resolved yet. And if you only were released from treatment a month ago, then we still need time to work through the normal process.

I know. I get it. You want it done quickly. But please understand that there is, generally speaking, an order to things, and each of those things take their own time. Let’s handle them in the proper order, and trust in me to get them done in a reasonable time. I’ll do my best for you, I promise.

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Contact Jeffrey

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

(P) 919-929-2992
(F) 919-636-4779

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