Blog Archives

Getting stuck with medical bills

3/22/2013

Some people are afraid to proceed with pursuing a personal injury claim because they are afraid to get stuck with medical bills and attorney fees they cannot pay. Here are some things worth keeping in mind regarding these important issues.

First, in most cases, personal injury lawyers work on "contingency" which means they don't get a fee unless they recover compensation for you. This compensation is usually obtained from the responsible party's insurance company. However, in some cases, the compensation comes from your own insurance company (this happens if the other party didn't have insurance or not enough insurance, provided you have "uninsured" and "underinsured" motorist provisions on your auto policy).

In any event, if you don't recover anything, then you don't owe a fee to the lawyer. I've worked on some cases for 2 years before getting a fee. In most cases, you can choose to dismiss your claim for one reason or another - if you didn't get any recovery, then you still don't owe the lawyer. A good lawyer will not force you to proceed with your claim just so he/she can get a fee.

Clients worry about getting stuck owing a lawyer for services. In most cases, it isn't much of an issue. You might be on the hook for some "costs" such as filing fees etc., but before filing a lawsuit, there are rarely many significant costs. In many cases, the lawyers will waive minor costs as business expenses (i.e., obtaining the police report, getting medical records, photo printing fees, etc.).

Next, clients worry about owing the doctor money for treatment. While it is true that most doctors won't work for free, there are strategies you can employ to minimize the risks. Here are some common routes to entertain:

First, you can ask the doctor to treat you on a "lien." That means the doctor will provide treatment to you without up front costs. In most cases, they will do so only if you are represented by a lawyer. They will submit a bill to your lawyer after you conclude treatment. The bill is usually paid out of proceeds obtained when settling with the responsible party. However, if you don't recover any money from the responsible party (or from your insurance), you are still technically on the hook for the doctor's bill. The "lien" approach is good when you don't have any other insurance resources and/or if liability is clearly established in your favor.

Therefore, if that is a concern (i.e., liability is an issue and there is a danger the other party won't pay, or there is another concern you won't be able to pay the doctor), then you should consider having your medical bills paid by your health insurance company. If you choose to do that, the responsible party won't entertain the full amount of your bills, but they will instead consider the amount accepted as payment in full. That can be a fraction of your actual bills. Also, it depends if the health care provider has an agreement with your health insurance company (i.e., they are a preferred provider, etc.).

That means if your actual bills are $3000 but your health insurance paid $1000, the insurance company for the responsible party will only consider $1000 as your bills (if your provider accepted it as payment in full). That may be a detriment, because your case will seem "smaller" and less significant as a result. However, on the positive side, you will have peace of mind knowing your bills have been paid. Make sure your provider will accept the payment as payment in full if this is important to you.

Now, one more caveat to consider - your health insurance will expect to be repaid in most cases. You have to reimburse them from any settlement you may get. This expectation of reimbursement is usually contractual. The silver lining is that, in most cases, you only have to pay them back IF you recover any money. If you don't recover any money, then you generally don't have to reimburse them. That way, your medical bills are paid and you don't have to worry about any outstanding medical bills.

Finally, you can have your bills paid by your Medical Payments Coverage, if you have that kind of coverage under your auto policy. This is known as MPC. You need to find out if you have that kind of coverage, and you also need to learn how much you have. Typical amounts are $2000, $5000, and sometimes more. In some cases, your auto insurance will only pay secondary to any health insurance you may have. In other cases, they will go ahead and pay regardless.

Therefore, your health care provider can bill your auto insurance instead of billing your health insurance (very helpful especially if you don't have health insurance). Again, that doesn't mean your MPC will pay every dollar billed, but you need to ask the health care provider if they are going to accept payment from the MPC policy as payment in full or if they are going to hold you responsible for the balance. You see, your health care provider may have a contract with your health insurance company to accept payments as payment in full, but they probably don't have the same agreement with your auto insurance company. Similarly, your auto insurance company will expect to be repaid the MPC benefits IF you recover from the other party. If you don't recover anything from the other party, you generally don't have to repay your auto insurance company for payments made under the MPC provisions. Therefore, your medical bills are paid and you don't have to worry.

Just keep in mind that how your bills are paid is important. Strategically, you may consider one avenue over another. Just talk to your lawyer about the pros and cons of each approach. At the end of the day, you want to proceed cautiously, and your lawyer should offer you some direction about which path to take.

If you have been involved in a serious car accident and you want some legal advice, call Robert Mansour at (661) 414-7100 for a free consultation. Robert serves Santa Clarita, Valencia, Saugus, Canyon Country, Newhall, Stevenson Ranch, Castaic and surrounding communities.

Waiting too long before seeing a doctor after an accident

3/10/2013

It's probably one of the top five reasons people screw up their own personal injury case - waiting too long before seeing a doctor after they've been injured in a car accident. How long is too long? Generally, anything beyond a week is too long. Some insurance companies believe three days is too long.

The point is this - if you've been injured, and even if you are not sure, you MUST go seek health care immediately because any delay will be used against you. However, even if you did delay, all is not necessarily lost. Some insurance companies will entertain any kind of self-help you did as "active" treatment. In other words, you have to demonstrate what you did at home to alleviate your pain. Did you ice the injury, did you sleep in and rest, did you take ibuprofen, did you lay down on your couch to rest, etc? You need to explain that you didn't just sit around and do nothing for two weeks, then decide to see a doctor.

However, the key is "convincing" an insurance adjuster you did more than sit around. How can you do that? Well, the best way to convince the adjuster is by telling your doctor about your self-help remedies during your first visit. Therefore, you must not only tell the doctor or the intake person at the doctor's office but also write it down on any intake forms. Documentation is everything. Remind the doctor to include such information in any reports generated by the doctor. At the very least, it needs to be in your records. For example, the doctor's report can say, "Mr. Smith came to seem me two weeks after his accident. He tried pain medication and ice at home to no avail. He tried hot showers and laying down, again without significant improvement. He eventually decided to visit with a doctor as his pain wasn't getting better." Do you see how this is much better than the inference that you just sat around doing nothing? Remember one of the biggest rules when it comes to personal injury cases: If something is not in your medical records or the doctor's reports, then it basically never happened as far as the insurance adjuster is concerned.

Robert Mansour handles personal injury cases in Santa Clarita and its surrounding communities including Valencia, Saugus, Canyon Country, Newhall, Castaic, Stevenson Ranch, Palmdale, Lancaster and beyond. Call (661) 414-7100 for help with your accident case.

Can I bring value to your accident case?

3/2/2013

3 Comments

During my initial consultation with a potential personal injury client, the fundamental question that I'm thinking about during our first conference is whether or not I can bring any VALUE to their case as their attorney. In many cases, the answer is "no." That doesn't mean I don't want to help the injured client or I won't offer them my advice....it just means that if I take the case and act as their attorney, it won't do them much good. In fact, in some cases, bringing a lawyer on board can complicate matters and result in a negative financial result for the client. Some lawyers will take almost any case if they feel they can make some money....they unfortunately do not consider whether doing so would be helpful to the client.

Here is a perfect example of how this usually happens. A client will come into my office and present me with a property damage estimate of less than $1000. Upon further inspection, we realize that less than half of that estimate is for "parts" and the rest is for "labor." Furthermore, photos show minor damage to the car and now the client comes to me expecting me to perform some kind of "magic" for them. In some cases, they fought with the adjuster and now they've come to me. Truth is, no matter what I do, the insurance company for the responsible party is going to treat their case as a "MIST" claim. MIST stands for "Minor Impact Soft Tissue." As such, insurance companies rarely offer much money on these kinds of cases unless the client's case is very unique in some way. Some insurance companies have a policy where they don't offer any more than $500 to $3000 on MIST cases, no matter what. If you have minor property damage, you're going to get a small offer. That's just the way it goes.

Every so often, a jury will disagree with the insurance company, but in most cases, the insurance companies know that juries are stingy and won't give much money to the injured party either. The insurance companies are banking on the fact they are probably going to win 80% of the minor cases that go to trial.

Therefore, if I can't bring any value to the case, I generally won't get involved. I tell the clients, "If I take a third of your recovery as my fee (which is a common attorney's fee), then you will be left with little to nothing after this case is done." In these cases, I generally give the clients some tips about how to resolve their case without a lawyer. Remember, if I can't bring value, then I'm reluctant to get involved.

Keep in mind that all cases are different and unique, so you should take this blog post (and anything else you read on the internet) with a grain of salt. At least talk to an experienced personal injury lawyer and get some advice. That way, you can make an educated decision. In some cases, you may even want to get two opinions just to make sure.

3 Comments