Sometimes I frustrate clients when I don’t tell them what to do. I get it. They call me wanting me to fix their problem. Heck, I want to fix it for them! But here’s the deal: I can’t make decisions for my clients.
You’ve probably heard the term “attorney and counselor at law.” That says it all. I “counsel.” My job is to give advice. It’s to tell you what your options are and what those options look like in terms of cost/benefit. With that information, what I hope is that I give you the chance to make the best decision for you under your particular circumstances. I’m not you and I can’t tell you what’s best. I can only give you as much information as I can get to put you in the best position possible to make the decision most likely to help you in your particular situation.
I can help, but I can’t and won’t dictate. That’s not me or my job.
If you have an injury claim, let me counsel you. 919-929-2992.
My personal injury clients are sometimes asked by their healthcare providers to ask me to send them what they call a “letter of protection.” In short, I can’t. But let’s talk about why.
The “letter of protection” that these providers want is a promise from me that I’ll pay their bill from the settlement. This is problematic on several levels, but let’s focus on the big one. For an attorney to promise to hold someone else’s interests over the interests of their clients is a conflict of interest, and if you have watched television in the past two decades, you know that that is a bad thing. Obviously, I cannot create such a conflict by promising a party that I’ll protect them over my client.
The good news is that these letters of protection are totally unimportant in the collections process. If the health care provider wants to treat the patient/client on a lien basis and get paid from the settlement, all they have to do is read the NC lien statute and perfect their lien! And trust me, that’s a very low bar and is very easy to accomplish. A perfected lien creates a legal obligation for me to address that bill in disbursement, and that a law is better than any letter I can write.
It is worth noting that sometimes these requests belie a somewhat nefarious end. I’ll be the first to say that health insurance sucks. But that’s the system we have and so we’re stuck with it. Of course when you use health insurance, that results in an “adjustment,” which is really just a fancy word for discount. This means that when you use health insurance the health care provider gets paid less than they would if you just paid them cash (or if they got paid from a settlement). Sometimes, though not always, a health care provider will advise a patient/client in a personal injury setting to NOT use their health insurance in an effort to make the health care provider’s bill payment higher. To that end they request the aforementioned letter of protection which in their minds solidifies their ability to get paid at the end of an injury claim. This is not often in the interests of the patient/client, as they could use their health insurance, get that discount, and not be burdened with the hassle of balances later. Of course, I’m not saying every provider who asks for such a letter is out to improve their billing, and maybe the motivation is benevolent in some instances. But sometimes it ain’t.
This, like lots of topics surrounding personal injury claims in NC, can be complicated. If you have a personal injury claim, call me at 919-929-2992.
This should probably go without saying, but if you’re going to hire an attorney, DO NOT agree to settle your claim with the insurance company beforehand.
Seriously, people do that.
I get it, sort of. You’re talking to the adjuster, they’re being really nice and persuasive, and they get you to say “yes” to a settlement offer. Sadly, that’s binding (most of the time) in NC. That means your case is settled. And while you might be able to find an attorney willing to fight it, best case scenario you’ve created a monster cluster$#@# that didn’t need to be there ON TOP OF the underlying problem of your injury claim, and worst case scenario you go through a lot of hassle, expense, and heartache and lose.
Don’t create problems for yourself. You already have enough. Don’t agree to settle your damn claim. Please.
Health insurance is supposed to be there to cover you when you need it. And, for the most part, it kind of is. But should they have the right to get paid back from your injury claim proceeds? According to some plans, they should.
North Carolina generally doesn’t allow this right of reimbursement to third party claims on the part of health plans. Sometimes this is referred to as “subrogation” but that may not be precisely the right word depending on plan language. As you can imagine, there are exceptions to every rule. One of those exceptions is if you have an employer-sponsored ERISA health plan. Those plans are set up under a Federal law that supersedes State law and allows health plans to get back what they paid out when/if an insured gets paid from a “third party” (like in an auto accident) for the incurred medical expenses.
We can talk about why these plans were designed with this right, but that’s for another post. For now, the issue is whether or not YOU have one of those plans and if you do, are we going to have to pay them back from your settlement.
IF your plan has this right you don’t want to ignore this potential right because they can take away benefits and/or might pursue you in court for the payback, so don’t play around. As such, we need to do some digging.
So what should you do now?
Call your health plan with your insurance card in hand and ask them if your particular plan has a “right of reimbursement for third party claims” or “subrogation in third party claims.” If they claim to have such a right, have them get you to the right people to set that claim up and give that information to your attorney. That should get us to the right folks so we can then discuss with them the source of their perceived right and the amount of payment, if any, to which they may be entitled.
This stuff can get complicated and it’s important to make sure you’re on the right track. Talk to someone who knows what’s up. Talk to me. 919-929-2992.
There is a really simple answer to this which no one is going to like, but I’m going to explain it after I give it and it should, hopefully, make you feel better.
Who is paying for your healthcare after an accident? You are.
Eek. That’s a hard pill to swallow, I know. You weren’t at fault, you didn’t cause the accident, you didn’t ask to get hurt, so why should you pay for it? It’s a systemic issue that does have a remedy. If it helps, you can think that you’re temporarily renting the bills until you get someone else to buy them. What the hell does that mean? Let me explain…
The best way to begin this analysis is to look at it is that nothing is certain until it’s certain. If you have a need for healthcare, it’s just that: A need for healthcare like any other, so you have to pay for it. If there is a liability claim against the person who caused the need for the care, then there might be a way to get reimbursed for it. But the take-home message is this: In North Carolina, there is no system set up to protect you from paying for your own health care needs following an accident that was caused by someone else. Your bills are yours until and unless you (or your attorney) can make someone else take responsibility for them.
The good news is that there IS a system for RECOVERING your losses, including medical expenses, from an accident that was someone else’s fault. But the hard bit to swallow is that you have to incur those losses first in order to recover for them. That means, for the most part, that you’re responsible for paying your bills until and unless we can make someone else responsible. But it’s a two-step process.
This can be frustrating. It can also be a difficult system to navigate. This is why there are personal injury attorneys like me. Call me at 919-929-2992.
In Durham and Chapel Hill, there are a LOT of people walking about. With two giant universities and vibrant downtown areas, pedestrians are everywhere. As a result, there are a lot of accidents involving pedestrians. Why is this? Well, let’s talk about a few issues associated with pedestrian v. automobile accidents.
DRIVERS AND PEDESTRIANS
Part of the problem is these accidents don’t happen in a vacuum. It’s not always just this one car struck this one pedestrian. Often times, a pedestrian has begun walking in a crosswalk and one car stops for them, but a car in the other lane doesn’t see them or understand why the car has stopped and BOOM, there’s trouble. If you’re operating a vehicle in a multi-lane road and a car in the lane next to you stops for a pedestrian, YOU MUST STOP TOO! This can be frustrating for drivers because it takes the decision out of their hands, but this rule is right. Once someone has stopped for a pedestrian, it’s best to just let them get across safely and not have to play real life version of the video game Frogger.
RIGHT OF WAY…WHO HAS IT?
Traffic lights give us a good idea as to who has the right of way, but NC law can be a bit squishy on this. Once a pedestrian is in the roadway and/or crosswalk, that creates a duty on the part of the driver to yield to the pedestrian, even if the pedestrian shouldn’t have been there because of what the light is doing. This seems somewhat unfair, but think of it this way: We can’t just run over people simply because they’ve made a bad decision. Of course, that doesn’t mean it’s ALWAYS the driver’s fault…
CONTRIBUTORY NEGLIGENCE
I’ve written and talked about this issue ad nauseum…check out this vid for a more detailed description, but the short version of Contributory Negligence is if a victim is even 1% at fault, they are statutorily prevented from being awarded ANYTHING from the person who is 99% at fault. North Carolina is one of only 4 states who still have this fossil of English Common Law on the books, sadly. It can be a very difficult barrier for many pedestrian claims in that it’s fairly easy to make an argument that even if the pedestrian had the right of way, the pedestrian had the duty to exercise reasonable care, too, and maybe they didn’t and that’s at least PART of the reason why they were hit. The take-home message here is that Contributory Negligence can really be a killer for pedestrian cases, so you should call an attorney if you have one.
Call me for help with any injury claim. 919-929-2992.
Most of what I do is personal injury claims arising from auto accidents. So normally, I’m on the other side of this so I don’t really actively seek out this kind of work. Having said that, I like to give out useful info, so if you caused an accident in Orange County, North Carolina and got a ticket for it, here’s how I would handle it:
First, make sure your auto insurance company is aware of the accident. Once a claim is set up, they’ll determine if they’re going to pay damages to the other side. If they are accepting liability, that will make things easier for you vis-a-vis the ticket.
Second, once they’ve resolved the property damage claim of the other party, get a letter from your insurance company stating the following info:
they insured you at the time of the accident
they HAVE PAID (past tense) the property damage of the other party(ies)
and have them spell out the amount paid
Normally, though not always, that is enough to get your ticket dismissed in Orange County, NC. Just take that letter with you to your court date and knock on wood that will work. If the accident was more serious and/or if you have more serious charges, then it might not be as simple as that.
You will likely be concerned that your rates are going to go up now. They are.
Hopefully you don’t need me for this kind of thing, but if you want to hire me to deliver that letter instead of doing it on your own, I’m happy to talk to you (as long as I don’t represent the injured party already).
At the end of the day, what I am supposed to do is get people money for the injuries. I can therefore understand why people are often very focused on the settlement value of their injury claim. But we CANNOT start the conversation with that. It’s not that I’m being coy, it’s that I’m being smart. Let’s discuss…
How do we value your claim? There’s A LOT that goes into that analysis. Here are just a few things that I consider when valuing a claim:
Liability issues
Potential defenses
Pre-existing injuries
Causation concerns
Type & timing of medical treatment
Duration of recovery
Diagnoses
Cost of treatment
Out of pocket expenses
Lost income and the proper documentation thereof
Presentation of the plaintiff in light of potential jurors
County of venue
…and that’s not even an exhaustive list!
So when you call me 2 days after your accident, when most of the above list is no where near sorted, I simply can’t tell you what your case is worth. And I shouldn’t even try! Anyone that is worth their salt in this business won’t try to guess what a case is worth. It’s not worth the trouble that an off answer might result in.
What you SHOULD be looking for is an attorney that’s focused on the RIGHT parts of your claim. The first priority is your health and that should override all other concerns. The second priority is handling your claim in the best way possible, and that does NOT involve making random stupid guesses about the value of your claim when we just don’t know what it will look like over time.
If you want thoughtful advice and guidance on your case, call me at 919-929-2992.
Can I tell you a figure on what your claim is worth? Well, kinda…
I don’t mean to be cheeky, but this is a very inexact process, so I try to explain to clients what we look at before I talk about what I think I see. First, no need to reinvent the wheel. Here are some blog posts I think you should read: https://www.jeffreyhowardlaw.com/newsite2025/expectations-are-your-worst-enemy/
OK, so you have an idea as to what I’m looking at now and how you shouldn’t necessarily get your hopes up about anything. Now, let’s look at what I see – about 80% of my cases – in most injury claims…
The average case that I see involves an auto accident with no problems with liability (no defenses, that is) one ED or Urgent Care visit, followed by some form of PT or Chiro for about three months, and a mostly full recovery within 6 months (even those that don’t feel perfect after 6 months tend to feel fine after or less than a year later). In general, those cases tend to garner something in the realm of $1500 for pain and suffering, after fees and bills are paid from the settlement. So, what I try to do is compare each case with its resultant offers (with the math, of course) to what the average looks like, and I judge them from there.
Now, I’d have to dissect how your case presents:
In a nutshell, there are are going to be good things about your cases and some bad, too. Don’t take it personally, it just is what it is.
What it comes down to at the end of the day is how much can YOU take home after fees and costs. That has a lot to do with what your treatment costs are and how much we have to pay back. There is a fine line between having high enough treatment costs to make the carrier take your case seriously vs. having perhaps artificially high treatment costs that make the carrier devalue your case and make settling actually more difficult. But this is what I have to work with.
Bottom line is I’ll get you as much as I can and I’ll work to put as much of that money in your pocket and not your health care providers’ as I can.
If you want some help with your injury claim, call me at 919-929-2992.
Every case is different but there are certain factors you can look at to determine who quickly you might look into settling your injury claim.
Most of the time the standard play in resolving an injury claim is a step by step process…
Get the treatment you need;
Wait until you’re released by your health care providers at “maximum medical improvement” (as good as you’re gonna get);
Then get all of your damages documentation and evaluate the claim for settlement
That’s a fairly standard play and can/should work for most cases. But every case has its own peculiarities, and depending on what those are, you might be able to speed up the process.
If you have really catastrophic injuries, there is a statistical likelihood that the defendant’s liability limits won’t be able to cover all of your losses, so in that situation it might make sense to make a stab at them early on.
That doesn’t mean you “settle” the claim, though. That’s just an attempt to find out what they have and whether or not they want to make a limits offer. And even if they do, you’re still not done. You still want to investigate other methods of recovery, such as other liability policies, umbrella coverage, and underinsured motorist coverage for example.
But even if you do have catastrophic injuries, that doesn’t mean you should be in a rush to get the claim resolved. Once again, cases shouldn’t be looked at as files that need closing. Your case is an important event in your life and it deserves individual attention tailored to the specific facts you’re facing. If you’re not getting that you should call me at 919-929-2992.
