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Personal Injury FAQ's

Q. What is a Personal Injury?

A. A Personal Injury (PI) is any physical or mental injury to a person as a result of someone's negligence or harmful act. Many insurance companies refer to Personal Injury as Bodily Injury (BI).

Q. Are auto accidents the only type of Personal Injury?

A. No. Auto accidents are the most common type of Personal Injury recognized by the general public. Along with auto accidents, Personal Injury law also includes home accidents, boat accidents, airplane crashes, dog bites, defective products, failure to provide adequate security, and malpractice, including the failure to diagnose ?to name a few.

Q. What should I do after an accident?

A. The most important thing is to get well - see your doctor & follow your doctor's orders.

Do not discuss the accident or give a statement to the insurance company or attorney for the "at-fault" driver. Remember: "What You Say Can and Will Be Used Against You!" Instruct them to call your insurance company or your attorney.

Call an attorney to discuss your claim. Most attorneys do not charge for an initial consultation in accident cases.

Q. What should I do if an adjuster from the "at-fault" driver's insurance company calls me?

A. Do not speak with the adjuster. Refer the adjuster to your insurance company or attorney. Also, do not speak with the attorney for the "at-fault" driver.

Q. Why would the adjuster call me?

A. Initially, the adjuster may tell you the reason for the call is to conduct a preliminary investigation. At that time, the adjuster may attempt to sound like your friend and even offer to pay your medical bills, which is an indication that the insurance company believes it is liable for an even larger payment to you. If this happens, the adjuster's real purpose is to convince you to settle your claim for a modest amount of money before you know how seriously you were injured. The insurance company may ask you to sign a Release. Unless you are ready to close your claim, DO NOT SIGN THE RELEASE.

Q. What should I do if an attorney or attorney's representative calls me after my accident?

A. Get the name and phone of the attorney. Report the attorney to the Bar Association or licensing authority in your state in your state. It is an ethical violation for an attorney to solicit accident victims. Click here for a list of state agencies.

Q. What should I do if a chiropractor or other health care professional calls me after my accident?

A. Get the name and phone of the health care professional. Report that health care professional to his or her licensing association in your state.

Q. I'm not sure whether I have a case or not! What should I do?

A. Protect your rights. Call a lawyer. Get a professional opinion. You have nothing to lose. Most attorneys do not charge for an initial consultation in Personal Injury cases.

Q. I'm not the lawsuit type. We all make mistakes. What are my options?

A. Most Personal Injury claims do not become lawsuits. After you are fully recovered from your injuries, your attorney will file a claim with the insurance company. In most cases your attorney (with your approval) and the adjuster negotiate a fair monetary settlement for your injuries.

Q. What are damages?

A. Damages are any loses or expenses you incurred as a result of the accident.

Q. What monetary recovery is permitted in a Personal Injury claim?

A. Personal Injury Victims are entitled to recover money damages for all losses and expenses they incur as a result of an accident. The following is a partial list.

  • Medical bills (doctor bills, hospital bills, surgery expenses, diagnostic charges, physical therapy, personal care nursing fees, prescription medicines, and others),
  • Lost Wages, including overtime,
  • Pain & Suffering,
  • Physical Disability,
  • Disfigurement,
  • Permanent Scars
  • Emotional Trauma,
  • Mental Anguish,
  • Loss of Enjoyment,
  • Loss of Love & Affection,
  • Embarrassment,
  • Mental Disability,
  • Property Damage,
  • All out of pocket expenses (transportation charges, house cleaning, grass cutting, and others).

Q. How do I know if I have a Personal Injury claim?

A. Whether a Personal Injury claim (a "tort") exists is a matter of law. There are four elements to a "tort" claim:

  1. The "at-fault" person is under a duty to do or not to do something,
  2. The "at-fault" person breaches that duty,
  3. You suffer Damages, and
  4. Your Damages are the result of the "at-fault" person's actions.

Q. Do all Personal Injury claims go to trial?

A. No. In fact, most Personal Injury claims are settled with the insurance carrier for the "at-fault" party.

Q. Will the insurance company for the "at-fault" party pay for my doctor bills as they are incurred?

A. No. It is your responsibility to handle your medical bills.

Q. How can I handle my medical bills until my case is settled?

A. Depending on state law and the type of insurance coverage in your policy, your medical bills can be paid under your Personal Injury Protection (PIP) coverage, your Medical Payments coverage (MPC), your health insurance coverage, or your Worker's Compensation plan, if applicable. Although under most policies providing these types of coverage, the insurance company is entitled to reimbursement from the settlement funds of your Personal Injury claim for the medical expenses actually paid on your behalf. For people with no insurance and who are unable to pay for medical services, if prior arrangements are made, there are doctors, hospitals, and other medical facilities that will agree to be paid out of settlement. Generally, you will be required to sign a lien against your settlement funds.

Q. Will the insurance company for the "at-fault" party pay for my lost wages while I recover?

A. No. Lost Wages are your responsibility prior to settlement of your claim.

Q. What can I do about my Lost Wages until my case is settled?

A. Depending on state law and the type of insurance coverage in your policy, your Lost Wages may be covered under your Personal Injury Protection (PIP) coverage. Also, if you qualify, you may file a claim for short-term or long-term disability under your employer's disability coverage. Generally, PIP and disability coverage require reimbursement from your settlement funds. You may also use your employer provided "comp" time, sick time, personal time, or vacation, which generally do not require reimbursement.

Q. What should I do if I do not feel hurt at the scene of the accident?

A. Remember: You are in shock and your adrenaline is doing its job by working to cover up the pain of your accident trauma. This is normal.

Q. Do I have a claim if I did not feel hurt at the scene?

A. At the scene, you may not feel injured. Many people begin to feel the pain later. Although you may not believe that you were seriously injured, you may feel pain later, including significant pain, when the emergency is over. See your primary care physician for a complete examination and treatment as soon as possible.

Q. What if I'm "sore" - not hurt?

A. If you are "sore", you are probably hurt. Consult your doctor. If you simply "tough-it-out" and do not see your doctor, you give the insurance company the ability to deny that you were injured in the accident.

Q. Do I have to go to an MD?

A. You do not have to go to your primary care physician for treatment. You can go to a chiropractor, acupuncturist, or other health care professional.

Q. Do adjusters only believe my injuries if I go to an MD?

A. Unfortunately there are adjusters who view chiropractors, acupuncturists, and other alternative health care professionals in a less favorable light than MD's. However, going to an MD is not a requirement for filing a valid Personal Injury claim. The most important factor is that you to go to the healing practitioner you believe will have the greatest success treating your injuries. Remember: Your job is to get well. The most important thing for you to do is recover from your injuries as quickly as possible so that you can return to your normal life.

Q. I'm a working person, how can I afford an attorney?

A. In most Personal Injury cases, an attorney will accept a case on a contingent fee basis.

Q. What is a Contingent Fee?

A. A fee is contingent when it is conditioned upon your attorney's successfully resolution of your case. And is often referred to as: "No fee unless you win." However, the client is generally responsible for the "out-of-pocket" costs of litigation. A Contingent Fee is paid as a percentage of your monetary recovery (either settlement or court award).

Q. What percent is the Contingent Fee?

A. In Personal Injury cases the general fee is 33% if your case is settled and 40% if a lawsuit is filed. In complex cases (such as Medical Malpractice), the typical fee may be 40% if your case is settled and 50% if a lawsuit is filed. In extremely complex cases, the fee might be higher. Most state Bar Associations require that you and your attorney enter into a written Employment Agreement. The agreement must set forth the Contingent Fee percentage in your case in the event of settlement, trial, or appeal, whether litigation expenses are to be deducted from the settlement funds, and if the deduction so to be made before or after the contingent fee is computed. At the closing of your case, the attorney must give you a written Settlement Statement which sets forth the funds collected, the deductions from that amount and the net amount paid to the client.

Q. It seems like the lawyer gets a lot of money. Are Contingent Fee agreements fair?

A. Since rich people can afford to hire any attorney and since poor people have access to free attorneys, a long time ago, our society determined that Contingent Fee agreements provide a fair and just system in which middle Americans are able to hire competent attorneys to represent their interests in difficult legal matters. Contingent Fees insure that all Americans have equal access to our Justice System. Contingent Fees are advantageous to people who have a valid case but do not have the funds to hire an attorney. And Contingent Fees are especially beneficial if there is no recovery.

Q. How long will it take to settle my claim?

A. There is no set answer. All cases are different. The more complex the case is the longer it takes to settle. If you have substantial injuries, the longer it will take. The more money there is at stake for the insurance company, the longer it will take. In most cases, the settlement process starts when your doctor releases you from treatment. Assuming your attorney has all of your accident-related records, your claim could be filed with the insurance company in five to ten business days. It may take the adjuster two to four weeks to evaluate your claim and make an initial offer. At this point, it's a matter of both sides negotiating a dollar amount that is reasonable for your case and acceptable to you. If you receive medical treatment for two to four months, it is possible that your claim could be settled within six months.

Q. What is the value of my claim?

A. Until all the information on your injuries is available and all the facts of your case are known, the value of your claim is unknown. Attorneys are prohibited by state Bar Association rules from promising that they will obtain a certain amount of money for you. If an Attorney promises you that he or she will win a certain amount of money, report the attorney to the Bar Association in your state. It is an ethical violation for an attorney to predict the outcome of a case as an inducement to you to become a client.

Q. After I approve the settlement of claim, how long will it take for me to get my money?

A. Once a settlement is reached, the adjuster is very motivated to close your file and get it off his or her desk. The adjuster will probably mail the Release to your Attorney within 24 hours of an agreement. Some insurance companies send the Release and settlement check at the same time. If this is the case, you can anticipate closing your claim within three to five business days after reaching a settlement agreement. Some insurance companies send the settlement check after the Release is signed and returned to the adjuster. In this case, you can anticipate closing your claim within five to ten business days after reaching a settlement agreement.

Q. How do I get my car fixed?

A. Call the Property Damage (PD) adjuster with the "at-fault" driver's insurance company who is handling your claim. Do not discuss anything with the adjuster except your Property Damage. Most insurance companies have separate adjusters for the Property Damage claim and the Personal Injury claim. Nevertheless, Remember: "What You Say Can and Will Be Used Against You!" If the adjuster does not have a copy of the Accident Report, fax or mail a copy to the adjuster. After the adjuster admits liability, make arrangements to have your car assessed. If for some reason the adjuster does not admit liability, you will need to file a claim under your policy's Collision coverage.

Q. Can I make the insurance company buy me a new car?

A. No. Although, it certainly seems very fair. After all, your car will never be the same again. Or, if it is "totaled", you will not be able to get as good a car with the money the insurance company is willing to pay for the value of your car.

Q. What are my Property Damage rights?

A. The duty of the insurance company for the "at-fault" driver is put you back in the place you were in immediately before the accident. You are entitled to have your car repaired to its pre-accident condition or receive its "fair market value".

Q. I'm the victim. I hate getting estimates. Do I have to get estimates?

A. The old rule about getting three estimates is gone. Many insurance companies have drive-up claim centers. If you can drive your car, make an appointment to have your car's damages estimated. If you cannot drive your car, the insurance company will send an adjuster out to appraise your car's damages, whether your car is at your residence, at your dealer's lot, or at a salvage yard.

Q. Do I have to take my car to an insurance company "approved" repair shop?

A. No. You can have any repair shop fix your car. Take your car to your most trusted repair center. Give them the insurance company's claim number, the name of the adjuster, and the adjuster's telephone number. The service advisor will handle the rest. If the repair center accepts your car for repair, it accepts the terms of the insurance company's policy. You should not encounter any "hidden" or "uncovered" charges. If additional damage is found while working on your car, the service advisor will contact the adjuster to get approval for the additional repair charges.

Q. Do I have to accept "aftermarket" repair parts?

A. Yes. Only if they are "as-good-as" the Original Equipment Manufacturer's (OEM) parts. As State Farm learned in a recent class-action lawsuit, generally aftermarket parts are not "as-good-as" genuine OEM parts.

Q. What about a rental car?

A. You are entitled to a rental car. However, you are generally limited to the terms of the insurance policy on the "at-fault" driver's car. Whether you drive a new Lexus 400 or a ten year old Olds Cutlass, you will both be given the Mazda Protigi or other small car. Rental policy limits are generally $20.00 or $22.00 per day. If you have special circumstances that require you to use a vehicle like yours, it is important for you to maintain adequate rental insurance on your vehicle. (For example, if you use a long bed truck for work, or if you need to drive clients in a Minivan). If your car is deemed a "total" loss, the insurance company is no longer responsible for the rental car payments after a reasonable offer has been made on your car.

Q. How do I get a rental car?

A. Some insurance companies will establish a "direct" billing arrangement with the rental car company. Other insurance companies will ask you to pay for the rental car with your credit card and reimburse you when you submit the rental bill.

Q. How do I insure the rental car?

A. If you have adequate coverage on your own car, you do not need the additional coverage the rental company will try to sell you. When you are using a "temporary replacement vehicle" (that's an insurance term for a rental car when your car is being repaired), your car's insurance is transferred to the rental car. If you purchase the additional insurance, it is "excess" insurance. Your car's insurance provides the primary coverage if you have an accident. The additional insurance is a "profit" center for the rental car company.

Q. When is a car considered "Totaled"?

A. A car is considered a "total" loss if it will cost more to fix it than its "fair market value".

Q. How is the value of "my" car determined?

A. Most insurance companies use a service that maintains late model vehicle values. Like, Kelley Blue Book, or Edmunds. Establishing a value for your car is simply using one of the available formulas to compute the value of your car based upon the general condition of your car, its mileage, plus the options and equipment package on your car and other allowed factors.

Q. What if my car is "Totaled"?

A. If you've been offered a fair and reasonable price, accept it, find a new car and get on with your life. If you are not satisfied with the insurance company's offer, you must prove to the adjuster that your car deserves a higher valuation. You can get the prices of similar cars from your local newspaper. You can document the value of your car by researching your car's price in an appraisal guide or by checking the price of your car on the Internet At sites like, Kelley Blue Book, or Edmunds. Or you can hire an independent appraiser to value your car. If you and the adjuster are unable to agree upon the value of your car, you will have to sue the "at-fault" driver. However, with all the tools available to value cars, almost all Property Damage claims are settled.

Q. What if the "at-fault" driver does not have insurance?

A. You file your claim against your insurance company under your Uninsured Motorist (UM) coverage. For all practical purposes, your insurance company becomes the "at-fault" driver's liability carrier. At that time, think of your insurance company as the "at-fault" driver's company, because it will process your claim like it is the "at-fault" driver's company. Hopefully, you have UM coverage. In the case of a severely injured person who requires extended hospital care, his or her medical bills may be several times the liability limits on the "at-fault" driver's vehicle with average coverage. By some estimates, one in four drivers are uninsured. Everyone should have adequate UM coverage. If the uninsured "at-fault" driver hits a car in which you are the passenger, it is your UM coverage that will handle the claim. If your injuries are significant, it may be possible to "stack" insurance.

Q. What if the "at-fault driver does not have "enough" insurance?

A. If you have a claim that is larger than the coverage on the "at-fault" driver's insurance policy, you file your claim against your insurance company under your Underinsured Motorist (UM or UIM) coverage. Hopefully, you have UM/UIM coverage. In the case of a severely injured person who requires extended hospital care, his or her medical bills may be several times the liability limits on the "at-fault" driver's vehicle with average coverage. By some estimates, most vehicles are underinsured. Everyone should have adequate UM/UIM coverage. If the underinsured "at-fault" driver hits a car in which you are the passenger, it is your UM/UIM coverage that will handle the claim. If your injuries are significant, it may be possible to "stack" insurance.

Q. What does "stacking" insurance mean?

A. Depending on your insurance company's policy language, you may be able to collect insurance money from every family member's car who lives in the same residence with you.

Q. I don't need to hire an attorney. I can trust the adjuster to help me. Their TV ads say they are my friend. Right?

A. Insurance companies spend a lot of money on friendly advertising asking you to think of them as a neighbor you can rely on to lend you a helping hand. The "at-fault" driver's insurance company is very experienced at handling auto accident claims. The adjuster's goal is to settle your claim as cheaply as possible. Unless you are an experienced claims processor, you should hire an Attorney to represent your interests (to be your Advocate).

Q. What is a "Release"?

A. You will be required to sign a GENERAL RELEASE which will state that your settlement is a COMPLETE, FINAL AND IRREVOCABLE SETTLEMENT AND DISPOSITION OF ANY AND ALL CLAIMS, RIGHTS OR DEMANDS OR CAUSES OF ACTION, KNOWN OR UNKNOWN, WHICH YOU MAY HAVE AS A RESULT OF YOUR ACCIDENT (NOTE: both SPOUSES ARE GENERALLY REQUIRES TO SIGN WHEN THE INJURED PARTY IS MARRIED). This means that you will no longer have any claim against the "at-fault" driver, or any potential defendant, or their insurance company as a result of this settlement.

Q. What happens after the settlement check arrives?

A. The Settlement Check will be made payable to you, your spouse (if applicable) and your attorney. Your attorney will prepare a Settlement Statement. The Settlement Statement will set forth the amount of money collected. From the total collected, your attorney will deduct the agreed upon attorney fee, any unpaid medical bills, any insurance reimbursements (subrogation), and the expenses of litigation. After you sign the Settlement Statement, your attorney will issue a check to you from his or her Trust account in the "net" amount of your settlement.

Q. I have "full coverage". I'm protected, right? What exactly is "full coverage"?

A. A lot of people believe they have "full coverage" on their cars. Each one of them probably has a different understanding of what "full coverage" means. Generally, all states require that every vehicle on the road have a minimum amount of Liability coverage. Each state sets its own standard with minimum coverage generally beginning at 15/30/15. Some people only have "Liability" coverage, which they may incorrectly believe to be "full coverage" because their agent told them you are fully covered under the law. Other people assume that Liability coverage plus some additional coverage is "full coverage". To these people "full coverage" may mean having a little amount of each type of insurance coverage available. Other types of coverage include Collision, Comprehensive, Theft, Towing, Rental, Medical Payments, and Uninsured Motorist, to name a few. Whatever your definition, "full coverage" may not mean full protection.

Q. Do I need all of the coverages on my car?

A. All vehicles do not need all types of insurance coverage. If you have more than one car, you may not need Rental coverage. If you have good health insurance, you may not want Medical Payments coverage. If your car is very old and worth less than 10% of the Collision premium, it may not be a good value to purchase Collision coverage. It is important to get the coverage that is right for you in your circumstance. Talk to your agent. Learn what each coverage buys for you. The important thing is to understand your risk.

Q. What does 15/30/15 coverage mean?

A. It means a maximum of $15,000 for any one person who is injured, a maximum or $30,000 for all the people who are injured, and $15,000 for damage to property.

Q. How much insurance should I buy?

A. As much as you can comfortable afford to buy.

Q. How much insurance do I need?

A. It is a good idea to have a minimum of 100/300/50, which means a maximum of $100,000 for any one person who is injured, a maximum or $300,000 for all the people who are injured, and $50,000 for damage to property. If you can afford 250/500/100, it is probably a good buy. For example, if you are the "at-fault" driver in an accident, and you cause someone to be paralyzed for life or even kill someone, $15,000 is not very much coverage. If you are involved in a three-car accident and total a new Lexus and an "almost" new Mercedes, $50,000 property damage coverage may not be enough. Also, get the same amount of Uninsured Motorist (UM) coverage as your Liability coverage. Consider getting an Umbrella Insurance Policy.

Q. Everybody must have Liability coverage, so why should I insure the other driver? Why should I buy Uninsured Motorist coverage?

A. Even though every state requires that all vehicles be insured, by some estimates, as many as 25% of all private passenger cars and small trucks are uninsured. If you are seriously injured by an uninsured driver, or by a driver with very low coverage, you will be able to make a claim against your own insurance company to take care of your injuries. You are not insuring the "at-fault" driver, you are insuring yourself and your loved ones. High matching UM coverage is a good buy for you and your family.

Q. What is an Umbrella Policy?

A. An Umbrella Policy is an insurance policy that provides additional liability coverage above the amount on your car and home (also, boats and airplanes). Generally you are required to carry the maximum amount of coverage available on your cars and home (boats and airplanes) before you can purchase an Umbrella Policy. With an Umbrella Policy you can get liability coverage of One Million Dollars or more. The cost for this additional coverage is modest.

Q. What is "no-fault" insurance coverage?

A. "No-fault" insurance, also called Personal Injury Protection (PIP), provides immediate coverage of your medical bills and the medical bills of your passengers no matter who caused the accident. Because coverage is not dependent on who caused the accident, this coverage is called "no-fault". Also, under most "no-fault" or PIP coverage plans, another benefit is that a portion of your lost wages is covered.

Q. What if the accident happened while I was working?

A. In this case, you also have a Worker's Compensation claim. Under your Worker's Compensation coverage, your medical bills will be paid. Although under most Worker's Compensation plans, the insurance company is entitled to reimbursement from the settlement funds of your Personal Injury claim for the medical expenses actually paid on your behalf.

Q. What if the accident is partly my fault?

A. If an action of yours (i.e. driving 5 or 10 mph over the speed limit) contributed to the accident, you can still recover from the other driver's insurance company as long as the other driver is determined to be at least 51% "at-fault". The percentage is merely a matter of negotiation with the insurance adjuster. Courts refer to this rule as the rule of "comparative negligence". A few states use the rule of "contributory negligence" which prohibits you from recovering even if you are only 1% responsible. However, in practice the degree of your responsibility for the accident is a matter of negotiation with the insurance adjuster.

Q. Can I recover is I have a "pre-existing condition"?

A. Yes. The fact that you have a "pre-existing condition" will not prohibit you from recovering from the "at-fault" driver. Your "pre-existing condition" is merely a factor to be considered in resolving your claim. The question is whether the "at-fault" driver aggravated your "pre-existing condition". The "at-fault" driver takes you in whatever condition you are at the time of the accident. The fact that someone else would not have been injured is irrelevant. A person in a weakened condition may actually recover more than an extremely fit person would recover in the same accident.

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