There are many people involved when it comes to car accident claims. Here is a brief list of some of the most important "cast members" involved in your personal injury claim.
1) The Insurance Adjuster - This is the person who works for the insurance company. They might work for the responsible party's insurance company or they might work for your insurance company. Sometimes, they are called "claims adjusters" or "claims examiners." Either way, they represent the interests of the insurance company. Like anything else in life, there are some who are better than others. Some are more compassionate and others think everyone making a claim is lying. Some are actually doing their best to help you, and other are bitter and jaded. There is nothing you can do about this. At first, you might speak with an general "intake" person at the insurance company. Their job is to figure out what your claim is about and assign you to another adjuster.
2) Property Damage Adjuster - In many companies, they have insurance adjusters who only handle property damage claims. This is the person who will interface between you and the body shop. This person also works with appraisers whose job is to get out "in the field" and examine vehicles all day. They also might help with a rental car claim, damage to child car sets, and other "property" loss resulting from the car accident.
3) Bodily Injury Adjuster - This is another type of claims adjuster whose job is to evaluate your claim for bodily injury. In some cases, they use software to analyze your case. In other cases, some injury adjusters will use their own independent judgment based on various guidelines. They are always trying to figure out if your treatment was "necessary" and/or "reasonable." They almost always conclude your treatment was unnecessary and/or unreasonable. In more severe accident cases, they are generally more forgiving. Again, I'm generalizing. Again, we are talking about human beings here so there will be differences among them.
4) The Claimant - That is the person actually making the claim. If you are making the claim, then you are the "claimant."
5) The Insured - This is the person insured by the company. For example, if Mr. John Smith has insurance with Mercury Insurance, then he is their "insured." Sometimes the insured is both the driver and the owner of the vehicle. Sometimes, it's one or the other. You are also an "insured" of your own insurance company.
6) Plaintiff's counsel (aka plaintiff's attorney) - This is the attorney representing the injured party.
7) The Plaintiff - Once a lawsuit is filed, you are no longer the "claimant" (unless it's an uninsured motorist claim). You become the "plaintiff."
8) The Defendant - This is the person being sued. In most cases, you are not going to be suing the responsible party's insurance company. Many people have the mistaken belief that they are going to sue someone's insurance company. The insurance company wasn't the party that hit you. It was Mr. Jones who hit you so he is the person you are going to sue. Now, his insurance company will hire a lawyer to defend Mr. Jones, and it will be his company's decision whether or not to settle your claim with you or not. In most cases, Mr. Jones will have little to nothing to do with your case unless liability is disputed. In some cases, other than being sued, Mr. Jones will have very little involvement with the lawsuit your attorney filed against him.
9) The Defense Attorney - If you file a lawsuit against someone for a car accident, the insurance company for the responsible party will hire a lawyer to defend their "insured." In some cases, they will hire an outside law firm. Be mindful of that because that law firm usually gets paid by the hour, and they arguably have no incentive to settle your case as long as they can keep billing that insurance company. Some outside firms will defend the case on a flat fee basis. In many cases, the insurance company will have "in-house" lawyers who will defend their insureds in a lawsuit. Now, while the defense attorney is technically defending the "insured' individual, their salary is paid by an insurance company. To some extent, it presents a dilemma for the defense lawyer because they are arguably beholden to the insurance company - at least to some extent. I use to work as a defense attorney for a major insurance company, and I can tell you there were many times I was frustrated because of insurance company decisions. They were controlling the litigation, and my hands were often tied. That's one of the main reasons I left my defense job and starting representing victims of serious auto accidents.
If you have a question about the process and/or need help with your serious injury case, please contact our office at (661) 414-7100 to see if we can assist you.
During a recent consultation with a personal injury client, I offered tons of tips as to how the client should conduct himself and things he should do with respect to his case. The prospective client said, "Gee, this is kind of like a game?" I agree but explained that we weren't trying to "trick" anyone. However, there is a strategy to presenting your case in the best possible light. You see, your opponent (the insurance company) is going to do everything it can to minimize your claim. That means you have to do everything you can to counter that - and that requires a strategy. If you know you're essentially playing a game, then you know you have to employ a strategy. Some people wait too long and never realize they were in a "game" until they lose the game.
Here are 5 common mistakes I have seen lately in my personal injury practice:
1) Clients waiting far too long before seeking medical attention.
If you are injured, make sure you get medical care. The absence of medical attention will be used against you. Calling a lawyer 6 months after an accident while you've had minimal to no medical care is not helpful. I'm only a lawyer - not a magician.
2) Clients who post stuff on social media.
The first thing the insurance company will do is look you up on social media. They will "Google" your name, look for you on Facebook, Twitter, Instagram, etc. They will look for any evidence of you acting inconsistently with your claim of injury. In fact, we now routinely look up our own clients to see what they are posting online. I encourage them to do the same. You need to know what the insurance company is looking for.
I once had a client who was claiming a shoulder tear for which he needed surgery (the MRI actually showed a tear). However, a few weeks later, there he was playing drums on Facebook with his rock band. The insurance adjuster was jumping for joy when he came across that! Of course, my client had a perfectly good explanation, but now we had something we needed to explain.
I've had clients post photos of themselves working out at the gym, mud running, hiking, on vacation, dancing at parties, and much more - all on social media while claiming to be injured. Here's some advice, if you've been injured in a car accident, don't post ANYTHING on social media until your case is concluded. If that means you are "off the grid" for a year or two, so be it. Social media is NOT your friend when it comes to injury claims. There's nothing technically "wrong" about posting stuff on social media. However, if you are claiming you're in pain, and then they find photos of you enjoying your European vacation, that's basically like sending the insurance adjuster a huge gift wrapped up in a big red bow.
3) Clients don't tell their medical providers about their accident.
I can't tell you how many clients tell me of all their medical care post accident, and then when I research those records, there is little to no mention of the car accident. If you don't mention your accident, most insurance adjusters will argue that you were getting medical care for reasons unrelated to the car accident.
4) Clients who don't realize that insurance adjusters will be reading their medical records.
I can't emphasize this enough. Don't tell your doctors you are "fine" if you are NOT fine. Remember, the adjuster is going to be reading those records and holding a magnifying glass to them. Anything in your medical records that can be used against you WILL be used against you. I always tell my clients to imagine the insurance adjuster is actually present for every medical appointment and every physical therapy session. Imagine they are standing there, recording every encounter. You want them to fully understand your injuries and the effects of the injuries. You want your medical records to be complete and well documented. If you imagine the adjuster standing next to you, I promise you will be much more vocal with your health care professionals. You are actually "speaking" to the insurance adjuster through those medical records.
5) Clients who ignore their past medical history or think it will never be an issue.
I'm convinced that many clients think their past medical history is irrelevant to their current case. If you are claiming neck and back pain from an accident, or any injury, you can bet any prior complaints of similar pain will be used against you. I often obtain my clients' past medical records to make sure I have a good handle on their medical history. I would say about 50% of the time, we find similar complaints, sometimes dating only a few days or weeks before the accident To complicate matters, my clients will actually deny any previous problems to their current providers. As such, the client looks like they are lying or hiding something when their past medical records are found to be inconsistent with their present medical records. Again, even if there was a perfectly good explanation, it just makes our hill much steeper to climb.
During every phase of a case, I try to be honest with my clients. That often means I have to give them bad news or something they don't necessarily want to hear. I don't do it to upset them. I do it because I'm trying to protect them. We have to be aware this is a "game" of sorts, and their opponent is the insurance company. My best clients understand that all I'm trying to do is be candid and offer them the best advice I'm capable of providing.
Make sure you know where your insurance policy is. There may come a day when you really need to review the language in that policy. It would be nice if you didn't have to order a copy of the policy and wait several days to receive it.
Make sure you have your "Declarations Page" handy. This is a summary of all the coverage you have on your policy (including comprehensive coverage, liability, property damage, etc.). If you don't understand the coverage you have, ask your insurance company and/or insurance agent for an explanation.
Make sure you have "uninsured motorist" coverage. Many people are driving out there without any insurance and/or without enough insurance. There will likely come a time when you need to turn to your own company after an accident. Also, get as much UM coverage as you can comfortably afford. Don't just get the minimum.
Consider rental car insurance. If you have an extra car, don't worry about this. However, there may come a time when you need a rental car and you don't want to be beholden to the other party's company. They may stall, delay, investigate, etc. In the meantime, you need a rental car and you may be out of luck unless you carry rental car insurance on your policy. If it's not too expensive, consider adding it.
You should report accidents to your insurance company. If you don't, there is a risk they will deny coverage later on if you (or another party) decide to make a claim. Timely reporting of an accident is typically required in most auto insurance policies.
After an accident, be very careful of what you say to any insurance company. Things you say to the responsible party's company and even to your company may come back to haunt you in the future. Keep your cool when making a claim. Also, consider getting advice first from an attorney who handles personal injury cases. They can certainly give you some guidance and things to keep in mind to help you navigate your claim. If you are injured after an accident, you should definitely consider getting care right away.
Hello everyone, this is Robert Mansour, and I want to spend a couple of minutes now talking about what to bring to your initial personal injury consultation with the attorney. Let's begin. The first thing you want to bring with you is the police report if you have one. If you don't have a police report, find out when it's going to be available. Usually the officers will give you a little card at the scene with a report number on it, and a phone number. You should call and find out when that police report is going to be available. Your own insurance company might have already obtained a copy of the police report. You might want to call them, and see if they have it, or if they have access to it. At the very least, find out when it's going to be available.
The next thing you should bring to your personal injury consultation is any and all photos you have of the damage to your car, any injuries to your body. Any photos of damage to the car that hit you. Pictures speak a thousand words, and it's very compelling when you have very good pictures. Take pictures from different angles, don't just take a real close up picture that doesn't really tell the story. Take a picture from different angles, different distances. Remember, the insurance adjuster's job is to belittle your case from the very beginning. Your job is to make sure that they don't belittle your case by taking decent photos to tell the story of just how bad your accident was.
The next thing you want to bring is insurance information. If you have insurance information of the responsible party, claim number, phone numbers of the claims adjuster you've been speaking to, the claims adjusters ... They have a policy number that you might have. Maybe you have a claim number. All of the information that you have about the other party. You want to bring your insurance information. You want to specifically bring something called your declarations page. People say, "What's the declarations page?" The declarations page is a summary of all the insurance that you have on your policy. Usually when you get that little card in the mail that you put in your glove compartment, and it's proof of insurance. Your declarations page is usually with that. It shows all the different kinds of insurance that you have. Here's why you need that. Number one, if you're going to bring a claim, you have to establish that you have insurance. Number two, we may need to approach your insurance company if the other party doesn't have adequate insurance, or perhaps they have no insurance at all. That would be important to bring.
You want to make sure that you bring any of your personal information, an address, phone number, all of that stuff the attorney's really going to need that to be able to help you in evaluating your case. If you have any information about witnesses, people who saw the accident, who could testify about the accident. That would be very helpful as well.
If you've been to a hospital or any other medical care, see if you can get your medical records that you already have. Let's say you have an accident and then you went to the hospital and then you went to urgent care. Maybe you went to your own doctor. You might want to try to get your medical records and billing from all of those places. That might be helpful as well. At the very least, a list of all the medical care that you have received up to that point. If you don't have any medical care after that point, that's okay, but if you do you want to make a list of it and bring it to your attorney, because they're not going to just know about that. You need to communicate that to them.
Armed with this preliminary information about how the accident happened, the attorney might be able to give you some advice about what your options are going to be. At your first initial consultation, present the attorney with the information, listen to all of the options. You're under no pressure, usually. Just go ahead and think about it, and then make the best decision that is best for you and for your family. By the way, that decision might be not to bring a claim at all. You might decide, "You know what, it's too much trouble, it's too much risk, I don't really want to go through all this." That's a perfectly legitimate decision.
You might decide that you do want to pursue a claim. In which case, you might be able to pursue on your own, or you might be able to pursue it with the help of an attorney. A good lawyer will tell you whether or not you are better served having a lawyer, or better served, perhaps, not involving an attorney, and just doing it on your own. I hope you found this video very helpful. Thank you very much. Please call my office if I can be of assistance.
Call us at (661) 414-7100 to see if we can help with your personal injury case.
Hello, everyone. My name is Robert Mansour. A question I get all the time is: I've been involved in a car accident. What should I be doing as soon as possible? When we're talking with a client on the phone, we are talking to them, they're generally just had an accident or they had an accident the day before. Here are some of the things that we try to focus on.
Number one: I tell the clients to see if there was a police report. The police report is very important because it might help establish fault. If you don't have a police report, the police might have given you a little card at the scene of the accident. You can call the number on the card and find out when that police report is going to be ready. Now if you don't have a police report, don't be surprised if the other side tries to change their story. This is one thing that we ask about. If you don't have one, it might not be a problem because the other side might already have confessed to the incident and taken liability, accepted fault. If they didn't accept fault and you don't have a police report, and there's no witnesses, you might have a big problem on your hands.
Number two thing you should do: You should get medical care as soon as possible. All of this is very interesting, but the most important thing is your healthcare. You've got to take care of yourself. Your injuries are more important than anything else. Plus, if you wait too long to seek medical care, the insurance company for the responsible party is going to doubt that you were injured.
So, for example, if the accident happens on this date and you wait a month before you do anything about it, and then the first time you go to the doctor is a month later, they're going to say, "Wait a minute, you waited a very long time before you did anything. You were probably not injured. You're probably faking it or you're probably embellishing it." You want to seek medical care as quickly as possible.
Also, you want to document what's going on. All of your injuries, all of your limitations, all of the ways the accident affected you, you want to communicate those to the medical professionals. You want them to write it down in their notes because, at some point in the future, if you do bring a claim, the insurance adjuster is going to be looking at these medical records and reading them very carefully. They're going to be looking for all the things that you complained about. What I tell my clients is the following: If it's not in the medical records, it's like it never happened. Documentation is very important.
Another thing I tell my clients is when you go get medical care, imagine the insurance adjuster for the other party is sitting on your shoulder, just a little insurance adjuster sitting there. They're listening to everything you say. If you say it, they will consider it, but if you don't say it, or you don't bring it up to your doctor, then they're just not going to consider it and you won't be able to bring it up later on.
The next thing that's very important is photos. You've got to have photos showing the damage to your vehicle, if possible damage the other vehicle. If you have bruises to your body, cuts, scrapes, those kinds of things, you need to take pictures of those kinds of things. Because, as they say, a picture tells a thousand words. A picture speaks a thousand words, rather. If you have photos, it's very compelling. On the one hand, you can tell people, "Oh, I got into a severe car accident," or "I had some bruises on my body." But if you show them the severe car accident and if you show them the damage to your vehicle, that's much more compelling.
Also, photos of injuries are very important as well. Bruises, cuts, and scrapes: very important. These are the most important things that we want to figure out in the very beginning. Then we want to figure out the insurance information. If you are injured and if you're going to think about bringing a claim, you have to ask yourself: Who's going to pay for all this? Well, does the other side have insurance? You'll be surprised, a lot of times they don't have insurance or they don't have enough insurance, in which case we need to look at your auto policy and take a look and see if you have something called uninsured motorist. Just because the other side has insurance doesn't mean you get to go all you can eat medical care. This is not a buffet.
You have to be very careful and judicious and you always have to ask yourself: How am I going to pay for my medical care? Perhaps you want to go through your own healthcare channels, your Blue Cross, Blue Shield, Aetna, Health Net, any variety of insurance companies. Or perhaps your own auto policy has some kind of medical benefits that we can use. Also, are you going to go through your own healthcare providers or are you going to find a doctor who perhaps specializes in personal injury cases?
These are some of the most important questions that we have. Finally, there's one more thing. With respect to insurance, the insurance company for the other party is going to call you. In most cases they're going to call you and they're going to ask you for a statement. They're going to want you to give what's called a recorded statement and they're going to ask your permission to record you. Usually that happens within the first few days of the accident. I am reluctant to do so. I tell my clients there's no reason to speak to the other side. Generally speaking, it doesn't serve your purposes at all. The insurance adjuster is usually trying to box you into a story. Their allegiance, if you will, is to their company and not to you. They may sound very friendly, but I assure you they are not acting in your best interest.
Finally, it might be a good idea to call a personal injury attorney and run some of the facts by them, and say, "Hey, listen. Is there anything else instead be doing? Should I hire an attorney? What are my options?" I hope you found this video helpful. If you'd like, you can call my office and arrange for an initial consultation. We'll see if we can help you with your accident case. Thank you very much.
Call us today at (661) 414-7100 if you've been involved in a serious auto accident.
After practicing personal injury law for over 20 years, you start to see patterns with respect to how people handle, or should I say mishandle, their medical care after an auto accident. Here are 10 mistakes people make when dealing with medical care after a car accident:
1) They don't get medical attention immediately after a car accident - If you are hurt, don't wait around. Go get examined by a doctor as soon as possible. Some people say, "Oh, I was waiting for the insurance company to tell me what to do." There is no such thing. Insurance companies aren't interested in your medical care. Frankly, they don't want you seeking medical care. They want to keep their money to themselves. It is up to you to get medical care. The insurance company is not going to arrange for it. Insurance adjusters and juries often believe that if you don't get medical care right away, then you must not be hurt that bad.
2) They hide their previous health conditions from doctors (and their lawyer) - If doctors ask you about your past medical history, you have to be honest with them. Hiding your medical history doesn't help anyone. First, doctors want to help you, and knowing your medical history may assist them in doing that. Also, failure to disclose your complete medical history will only come back to haunt you later on when the insurance company is reviewing your past medical history. I can't tell you how many clients tell me, "Oh, I never had back pain before!" Then, we review their past medical records and lo and behold, they complained of chronic back pain 6 months prior to the accident! In short, be complete and honest with your doctors (and your lawyer).
3) Discussing legal issues or lawsuits with their medical provider - The doctor's job is to treat your injuries, not to give you legal advice. Also, some doctors are reluctant to treat you if they learn you might be entertaining legal action in the future. Of course, you can tell them about the car accident and your resultant injuries, but you shouldn't get into deep legal discussions and strategy sessions with your doctor.
4) Their injuries are not properly documented - Juries and insurance companies aren't going to believe you are injured simply because you say you are injured. If something isn't in your medical records, it never happened as far as most insurance companies are concerned. Make sure your medical providers properly document EVERY injury and challenge you have from the accident. I tell clients to imagine the insurance adjuster sitting on their shoulder, writing down everything they say. The insurance adjuster will only consider what's in the records.
5) They skip medical appointments and physical therapy appointments - Again, if you skip appointments, insurance companies and juries will assume you're not injured - otherwise, you wouldn't miss your appointments. You may have a perfectly wonderful excuse, but now you have to explain things. Time spent explaining missed appointments isn't great for your case.
6) Forgetting to inform the doctor about how the injuries are affecting your work - You want to make sure your medical records reflect how, if at all, your injuries are affecting your work. Recently, I had a client who wanted a much bigger settlement than what I thought was reasonable. He told me about how much pain he had at work and all the difficulties he was having at work due to his injuries. Here's the problem - none of his medical records said anything about those difficulties. They were silent on the issue. It's hard to prove something was "significant" if it's not in any of the records.
7) Not taking the medications prescribed - I know that some medications can make you feel groggy or make your stomach upset. However, if you are having side effects, tell the doctor and perhaps he/she can prescribe something different. Simply not taking your medication as prescribed can be used against you - some will argue that you weren't getting better because you didn't follow the doctor's advice. Of course, do what's best for you, as there are always exceptions.
8) You stop treatment too soon - Most insurance adjusters and juries believe that if you stop medical treatment, you must be completely healed. We all know there are hundreds of reasons why you might stop treating, but your reasoning won't necessarily be adopted by the insurance adjuster. Just realize that if you stop treatment too soon, you might be hurting your case - especially if you have residual injuries.
9) Ignoring possible psychological injuries - Most injuries are physical. However, sometimes your injuries can be psychological. If you are having a particularly difficult time coping after a severe car accident, you might be experiencing tremendous anxiety or worse. Ask your doctor if seeing a therapist would be a good idea - at least for an evaluation or assessment.
10) Not keeping a journal - You should take the time to document how your injuries are affecting you. That way, when you visit the doctor's office, you will be able to tell the doctor how you are doing and what progress (or lack thereof) you are making. Those notes can also help your attorney when presenting your case to the insurance company.
In most cases, after an auto accident, parties exchange information with one another at the scene of the accident. In some cases, this is done between the parties without any police involvement, especially if there has been no injury and the property damage is minor. If someone was injured, the police may come to the scene to investigate. In that case, police officers often separate the parties from one another so they can get independent accounts of what happened.
The police officers usually will collect insurance information from each party. In many cases, that insurance information won't be shared with the parties at the scene. Instead, the officers will recommend you obtain the police report which will have all the information on it. The problem is that some police reports takes weeks, sometimes months, to be prepared and made available to the parties. This can be problematic when you are trying to get your car fixed or make a claim, and you effectively have no idea who to call because you don't have the insurance information.
Next, just because you obtain the insurance information (either at the scene or via the police report) doesn't mean the other party actually had insurance. According to the Insurance Research Council, about 15% of all California drivers are driving without insurance. Truth be told, I personally believe the number is higher but that's simply based on my unscientific anecdotal experience. In any case, don't assume the other party had insurance because there is a chance they did not.
Why don't people have insurance? Well, perhaps it costs too much and they've decided to forego the expense. In other words, they are taking the chance of driving without insurance. For some people, the cost of auto insurance is simply a financial burden. So they roll the dice and play the odds. Also, some folks don't have insurance because they forgot to pay their premium on time. In the meantime, they later find out their insurance policy had been canceled due to nonpayment of premium.
Also, perhaps the driver was engaged in fraud or deception with their company. I once had a case once where the responsible driver and his passenger decided to switch seats before the police arrived. Apparently, he wasn't supposed to be driving and he was concerned the police would catch him in the act. Well, since they changed seats and gave the insurance company false information, the insurance company later decided NOT to cover them for the accident since they had lied to the company about who was driving.
In some cases, coverage may not be available if the person was engaged in a commercial activity. For example, I had a case once where the responsible party was delivering a pizza for a local pizza restaurant. He had the pizzeria sign on his own personal vehicle. The insurance company decided not to cover him because he was engaged in a commercial activity (delivering pizzas), an commercial activities were prohibited by his policy. His insurance policy only covered him for personal use of his vehicle - not commercial use. Sometimes, insurance coverage is pulled if they find out the person driving wasn't supposed to be driving that particular car - he or she was an excluded driver on the policy.
The moral of the story is to make sure you have plenty of "uninsured motorist" coverage on your own auto policy because there is a decent chance the person who caused the accident may not have any insurance for one reason or another. Just because you are presented with "proof of insurance" at the scene of the accident doesn't actually mean the person had insurance. It's certainly a good sign, but there's no guarantee.
When you file a claim for personal injury against the responsible party's insurance carrier, you will usually be assigned an "adjuster" to help you with your claim. If your claim is for property damage, you will be assigned a "property damage" adjuster. If your claim is for injury, you will be assigned a "bodily injury" adjuster. In some cases, the assigned adjuster will handle both the property damage claim and the bodily injury claim.
Keep in mind that while the adjuster is "helping" you with your claim, their unspoken job is to save money for the insurance company. After all, you are not employing the adjuster. They are employed by the insurance company and that's really where their allegiance is. While many adjusters will certainly do their best to help you, it will be within their company's guidelines and parameters. If push comes to shove, don't bet on the adjuster siding with you. Once again, their allegiance and loyalty belongs to their employer...not you.
If you are dealing directly with any insurance company, most of the time the claims adjuster will try to get you to settle for a very small amount. Usually, it's far less than what you deserve. Oftentimes, these "lowball" offers are made shortly after your accident because they know you are probably upset, distraught, and generally confused. Sometimes you're simply not in a position to make a reasonable decision. They figure you will take whatever they offer you because you might be afraid you won't get anything at all. Also, insurance companies know claims can take a long time, sometimes years to bring a lawsuit against their client and win a judgment in court. They are betting you are more apt to take the money presented to at the beginning rather than wait years for something better. Whatever happens, do not make a decision on impulse. In most cases, there is no "emergency" and no reason to rush to settlement. Make sure you discuss your matter with an experience lawyer first.
Some adjusters will employ specific tactics to their advantage. Some will even try to convince you to call another insurance company - sending you on a wilde goose chase. Sometimes they won't return your calls or your emails. In some cases, they will argue that you "waited too long" to file a claim. If you are bringing a claim against your own company, there might indeed be time limits, but generally speaking, you don't have to bring a claim immediately. Keep in mind there is a difference between making a claim and filing a lawsuit. You must be mindful of the "statute of limitations." Technically you currently have two years in California to file a lawsuit for personal injury against the responsible party from the date the accident occurs, unless your claim involves a municipality or other public entity in which case other time limts may apply. Of course, this is the current law and may change.
The insurance adjuster may also tell you they can only pay for your "out-of-pocket" expenses. That is not true. Your out-of-pocket expenses are only part of your overall claim. If your bills were paid by a health insurance company, they may be entitled to reimbursement, but that is another issue. The insurance adjuster will also try to get copies of all your past medical records. To some extent, they are seeking to learn more about your injury. However, in most cases, they are simplly looking through your medical history for things to use against you. For example, if you injured your back in the car accident, they will find any mention of previous back pain from years ago and may make an issue of it. They will make mountains out of mole hills.
Talking with an experienced attorney will help you make an informed decision. Being represented by an attorney is not always recommended. However, it's always good to learn about your options.
Finding out what kind of car insurance you have and what specific coverage you have AFTER a car accident is generally not a good idea. However, that being said, it’s amazing to me how many clients I have who haven’t the foggiest idea what kind of coverage they have. Many of them tell me the same thing – “Oh, I have full coverage.” When I start to ask specifics, they give me the “deer in the headlights” look.
Auto insurance is hardly an exciting topic. However, you really should take a moment to review your policy to understand what aspects of coverage you actually have and what limitations there might be. It’s one thing to know you “have” car insurance, but an entirely different matter to actually understand what you have.
Here's a quick overview that may help you better understand what coverage you have:
Bodily injury liability covers you if you cause injury to another person due to a car accident. In California, liability coverage is required by law (known as “financial responsibility” laws). The minimum coverage is currently $15,000 which isn’t very much if you should do serious harm to another person. How much liability insurance you obtain should be partially based on the monthly premium but you should also assess how much risk you are taking if you’re not getting enough coverage. If your negligence puts a young child in a wheelchair for the rest of his life, do you really think his family will simply take your $15,000 policy and leave you alone?
You will also have property damage insurance to cover property damage causes to other vehicles. However, if you have a minimal policy, it may not be enough to cover damage to an expensive vehicle or if you cause damage to several vehicles. Again, be careful to obtain enough coverage. Consult with your insurance professional.
Remember bodily injury liability coverage protects other people, not your car. Therefore, it's a good idea to make sure you have property damage coverage to protect your car as well. We will discuss that in a few moments.
Medical Payments Coverage (MPC) usually pays your medical expenses and for the medical expenses of any passengers in your car. Basically, think of medical payments coverage as extra health insurance available to your under your auto policy. You probably don’t even know if you have it. In some cases, it can serve as “primary” coverage (you can use it right away) and in other cases, it might be considered “secondary” coverage (you can use it only if you don’t have health care insurance or you’ve exhausted your other available resources). Make sure you know which type you have before you go off running up medical bills.
Uninsured Motorist Coverage (UM) covers you if you get injured by someone who didn’t have auto insurance. Why wouldn’t someone have auto insurance? Well, maybe they didn’t buy it. Maybe they didn’t pay their premiums and their coverage lapsed. Maybe they were conducting a commercial endeavor while driving a personal vehicle. Maybe they are an excluded driver on a particular policy. Just because someone presents you with their insurance card at the scene of an accident doesn’t necessarily mean they had insurance. This type of coverage only covers you for injuries (not for property damage), so you should ask your insurance company if you are coverage for property damage as well.
You should also know that in most cases, “uninsured motorist coverage” is equivalent to “underinsured motorist coverage” (UIM) which applies when the other party has insurance but it wasn’t enough insurance.
So let’s assume you have a $100,000 UM/UIM policy. If you are injured, and the other party has NO insurance, you have the entire $100,000 available to you. If you are injured and the other party only had $15,000 of insurance, that means you have another $85,000 available to you assuming you accept the $15,000 from the other party. Just because the benefit is “available” to you doesn’t necessarily mean your insurance company is going to pay it without proof of injury that merits payment beyond what you received from the responsible party. So if your case is worth $25,000 (assuming a fair assessment of your claim) and you got $15,000 from the responsible party, you would request an additional $10,000 from your UIM policy which would get you to a total of $25,000.
Comprehensive Coverage covers damage to your car if it is stolen, damaged by flood, fire or damaged by animals (such as hitting a deer while driving!). Basically, “comprehensive” means “comprehensive.”
Collision Coverage pays for damage done to your car if you’re involved in an accident with another vehicle or an object such as a pole. If you don’t have this coverage, your only chance to fix your car will be to pursue the insurance of the other person’s vehicle (assuming that person is responsible for the accident and he/she and their insurance companies agrees to it). Sometimes, you will think the other person is responsible (or perhaps they even apologized at the scene), but then they change their mind or their insurance company disagrees. If that is the case, then you will have fewer options since you can’t turn to your own insurance company to fix your car unless you have collision coverage. If your vehicle isn't worth very much, then getting collision coverage may not be the best idea. However, if you're out several thousand dollars after an accident, you might be wish you had it!
Rental Car Coverage provides you with a rental car if your vehicle is damaged in a car accident. This can come in quite handy if the other party had no insurance or if the responsible party’s insurance company is taking forever and a day to “investigate” the accident before admitting to liability. Sometimes you don’t have the luxury of time. However, even if you have rental car coverage, be careful not to exceed the maximum amounts allowed. Your insurance company should make it clear to you what they cover and what they won't cover. Don't go renting an expensive Mercedes Benz for 3 months and expect your company to automatically pay for it.
Discuss these issues with your insurance broker and make sure you not only “have” insurance coverage, but more importantly, you actually understand exactly what you have and what you don’t have. If you've been injured in a serious auto accident, call our office at (661) 414-7100 to see if we can help.
After practicing this area of law for over 20 years (for plaintiff and for the defense), we have found these cases boil down to five major factors:
by Robert Mansour
Robert Mansour is a personal injury lawyer serving Santa Clarita, Valencia,