Hot Coffee Documentary Illustrates the Insurance Industries Goal of Limiting Access to the Judicial System

11/11/20111:43:30 PM Link 0 comments | Add comment

Accident Injury, claim, injury, injury claim, Personal Injury Lawyer, tort reform, trial

We posted a long time ago in anticipation of this movie.  Now that Hot Coffee has been released and shown to audiences for a number of months, we are again suggesting people take a look at the work that Susan Saladoff and others did in creating a movie that gives a great depiction of what the current landscape of personal injury litigation looks like.  Hot Coffee does a good job of presenting the side of insurance claims and injury lawsuits that is most often not experienced by the general public.  The movie uses the famous McDonald's hot coffee case as a backdrop for further discussion on how the insurance industry and big business lobby and spend enormous amounts of money to sway public opinion in an effort to limit their liability exposure.

http://www.hotcoffeethemovie.com/default.asp

Alternative Dispute Resolution and Mediation

9/20/20119:21:12 PM Link 0 comments | Add comment

accident, Accident Injury, alternative dispute resolution, arbitration, attorney, car accident, injury, injury claim, Insurance, mediation, Personal Injury, trial

Most people have heard the term arbitration, but few people truly understand what alternative dispute resolution entails and what options are out there.  Arbitration is typically a word you hear mentioned in the news or you see when rapidly scrolling through a contract on itunes.   The truth is many civil cases, including car accident injury cases, are resolved through alternative dispute resolution. 

The two most common types of alternative dispute resolution (ADR) are arbitration and mediation.  The main difference between the two is that arbitration is usually binding on the parties, whereas mediation is typically nonbinding and less formal.  Mediation can be a great tool for reaching settlement in inury cases where the parties have reached a stalemate.  During mediation a nonbiased person (mediator) serves as a go-between for the parties.  The mediator is usually trained in mediation practices and is often an attorney with experience in the area from which the dispute arises.

Every mediation is different, and different mediators have different styles and different ways of doing things.  Many mediators use caucusing during their mediations.  Caucusing is where the parties to the mediation are separated and the mediator goes back and forth between the parties in an attempt to facilitate discussion and further negotiation.  The mediator will try to give an unbiased opinion as to how he or she views the case, and will carry information back and forth between the parties.  

Mediation is a great tool for resolving legal disputes without trial  Having a knowledgeable unbiased party available to facilitate discussion and provide insight, combined with having both parties together at the same time to discuss settlement often times yields better results than the more adversarial trial process.  Furthermore, one of the best things about mediation is that it is nonbinding, and if either party is dissatisfied they can walk away at any time.

Injured Neck or Injured Back From Car Accident - Soft Tissue? What does that mean?

8/26/201111:44:13 AM Link 0 comments | Add comment

accident, Accident Injury, back injury, back strain, car accident, injury, injury claim, insurance claim, neck strain, Personal Injury Attorney, Personal Injury Lawyer, soft tissue

Two of the most common injuries caused in a car accident are injury to the neck and injury to the back.  For the most part, neck and back injuries sustained in an auto accident fall into two categories: (1) soft tissue or (2) not soft tissue.  

Soft tissue technically refers to the tissue, tendons, muscles and ligaments, etc. within your body.  In other words, not bone.  However, in the insurance claims world, insurance adjusters use the term "soft tissue injury" to refer to pretty much any injuries they deem as insignificant (i.e. muscle strains, sprains, strained ligaments, etc.).  Whiplash is an example of what is commonly referred to as a "soft tissue" injury.  However, those of us who have suffered from injuries to our neck or back know that these injuries can be very painful.  At the very least, these injuries create discomfort and inconvenience.  In more severe cases, neck and back injuries can be debilitating.

The difficulty with most neck and back injuries is that they are often very subjective.  Unless you have a fracture or a serious disc herniation/protrusion that shows up on an MRI, it is difficult, if not impossible, to show someone your injury.  It's not like a broken bone where you say here it is; look at my x-ray, I have a broken arm.  Insurance companies do not like things they cannot see, and adjusters are basically trained to believe that "soft tissue injuries" are not substantial injuries requiring treatment.  As far as insurance companies are concerned all strains and sprains are the same, chiropractors are frauds and no soft tissue injury should require more than three to four months of treatment.  The reality is even a "soft tissue" injury can be very serious and painful; and more serious strains can take months if not years to resolve.

If you sufferred a neck or back injury in a car accident make sure you know the extent of your injury before even attempting negotiating an injury settlement; and do not be afraid to get a second opinion or speak with an injury lawyer before entering into negotiations.  

Medical Records and Medical Release Forms

8/1/20119:24:00 PM Link 0 comments | Add comment

accident, Accident Injury, attorney, Auto, bills, car accident, injury claim, insurance, medical information, Personal Injury Lawyer, records

We have discussed medical release forms before, but this is a topic that comes up over and over again when discussing accident injury cases.  Because of current privacy laws protecting personal medical information, medical record release forms must be signed before a treatment provider will release records and/or billing statements to an insurance company or law office. 

Often times, the other driver's insurance company will send you medical release forms immediately following your accident.  You are NOT required to sign these forms just because the insurance company asks you to.  Many insurance medical record release forms are unrestricted and give the company access to pretty much any and all of your medical information, whether it relates to your car accident or not.  If you are injured in a accident, speak to an injury lawyer before blindly signing any forms requested by any insurance companies.

Now sometimes you are placing an injury claim with your own auto insurance carrier.  In this situation, you ARE required to provided medical release forms.  The reason for the difference is because of the direct contractual relationship that exists with your own auto insurance company. 

Do I need a Personal Injury Lawyer?

6/22/201110:08:59 PM Link 0 comments | Add comment

Accident Injury, attorney, car accident, insurance claim, lawyer, personal injury, Personal Injury Attorney, Personal Injury Lawyer

The terms "personal injury lawyer" or "accident injury attorney" can be a bit misleading.  For the most part, the only people who know exactly what a personal injury lawyer is are other attorneys, or people who have previously been injured in an accident.  The only time you need an accident injury lawyer is when you or a member of your family are the ones who are injured in the accident.  This could be most any type of accident.  For instance, my injury practice focuses on car accident injury and dog bite cases; however, personal injury lawyers handle cases involving all types of accidents: car accidents, dog bites, slip & falls, medical malpractice, workers compensation, etc.  I am often asked if someone needs an injury lawyer after they cause an accident which causes damage or results in injury to another person.  The short answer is no; not because the at-fault paerson does not need legal representation, but because they need a defense attorney, not an injury attorney. 

When someone is injured in an accident, and that accident was caused by someone else (even another family member), they need an "injury lawyer".  In that situation their attorney will help them with the claims process and file a formal lawsuit when necessary.  The insurance claim is based on a negligence action that could be filed against the person who caused the accident or based on other insurance coverages that may exist under the injured party's own insurance coverage.  There are usually multiple insurance policies and issues that come into play when handling an auto injury claim.

On the other hand, someone who causes an accident would be in need of a defense attorney(s).  If you are involved in an accident that is your fault, you will want to contact your insurance company and speak with an attorney who handles defense of criminal and traffic charges.  You may need two lawyers depending on whether you are sued by the person you injured or not.  Causing an accident presents two separate issues: (1) a potential criminal/traffic court issue prosecuted by the State and based on any citation you were issued by police (this is especially serious if you were arrested for DUI and/or if the other person was seriously injured) and (2) a potential civil negligence lawsuit filed by the person you injured.  Your auto insurance carrier will provide representation for you on the negligence claim; however, you are responsible for hiring your own counsel for any proceeding invloving the criminal court system.

Many attorneys offer free consultations, and when in doubt it is always a good idea to seek counsel before progressing with any situation that could have legal consequences.

Lawsuit Loans in Nebraska

2/17/20119:17:08 PM Link 0 comments | Add comment

Accident Injury, claim, insurance, Lawsuit loan, lawyer, personal injury

Car Accident Injury Cases and Other Types of Personal Injury Claims

1/10/201010:15:44 PM Link 1 comment | Add comment

Accident Injury, Auto, Insurance, Personal Injury, Personal Injury Attorney, Personal Injury Lawyer

Many questions arise after being injured in a car accident or any other type of personal injury accident, such as: do I need a personal injury lawyer, why do I need an attorney/lawyer, which personal injury attorney should I hire, who is going to cover my medical bills, will my health insurance cover bills for injuries caused as a result of my car accident, how long does the personal injury process take, what is the benefit of having an attorney to help me with my personal injury claim, and the list goes on and on. Throughout my next few blog posts, I will attempt to answer many of the most frequently asked questions that arise after being injured in an accident. I will discuss the benefits of having a lawyer to help you through the process. I will look at the personal injury claim process as a whole, discussing: how long the process can take, litigation versus other forms of dispute resolution, and valuation of claims.

Personal Injury Lawyers/Accident Injury Attorneys--Medicare Reporting Requirements

10/28/20093:40:42 PM Link 0 comments | Add comment

Accident Injury, Insurance, Medicare, Personal Injury, subrogation

The following was recently issued by the AAJ regarding new Medicare reporting requirements and "Set-Asides" on auto liability cases. Long story short--reporting requirements to stay the same for Plaintiff's lawyers in auto accidents.

EMERGENCY MEDICARE SET ASIDE INFORMATION

Dear Colleague:

In cases involving Medicare beneficiaries, attorneys for both the plaintiff and defendant are required to report certain information to the Centers for Medicare and Medicaid Services (CMS). In addition, any case settlement or judgment must reimburse Medicare where the Trust Fund has made conditional payments for medical costs. Under the Medicare Secondary Payer Act, attorneys have been settling cases involving liability claims without completing a Medicare Set Aside (MSAs) to account for future medical costs. However, attorneys representing claimants in workers' compensation cases have been preparing MSAs on a case-by-case basis.

It has come to our attention that some defense firms and insurance providers are now claiming that CMS requires MSAs in liability cases pursuant to Section 111 reporting requirements included in the Medicare, Medicaid & SCHIP Act of 2007 (MMSEA), Public Law No. 110-173. This is false. Section 111 contains reporting requirements for responsible reporting entities(1) (RREs) only. Section 111 does not impact or change the requirements for plaintiffs' attorneys.

Moreover, statements from CMS, and other federal entities, make clear that the agency does not require set-asides for liability claims. Since the MMSEA's passage, CMS has held several Town Hall teleconferences to discuss the Section 111 requirements. During the March 24, 2009 call, Barbara Wright, CMS' Acting Director of the Division of Medicare Debt Management, made several statements reiterating that Section 111 has no impact on liability MSAs.(2) For example:

* In response to a question as to whether liability set-asides will be required under Section 111, she said "the point is the set-aside process is totally separate from the Section 111 reporting process. As we've said in more than one call we don't anticipate changing our routine recovery process." (Transcript, pg. 24)

* When explaining that worker's compensation agreements use a formal review process which makes set-asides recommended, she said that was in contrast to liability agreements. Liability "does not have the same formal review process although our regional offices will consider review of proposed liability set-aside amounts depending on their particular work load and whether or not they believe significant dollars are at issue."
(Transcript, pg. 24).

In addition, CMS also has released several Alerts explaining Section 111, which do not indicate any intent to require MSAs for liability claims. For example:

* "Unless you are a business entity which qualifies as [a required reporting entity (RRE)] for purposes of Section 111, you do not need to initiate any specific actions in connection with Section 111." (CMS Alert, 2/23/09).(3)

* "The new Section 111 requirements do not change or eliminate any existing obligations under the MSP statutory provisions or regulations." (CMS Alert, 2/23/09).

Moreover, the Congressional Research Service (CRS) provided Congress with an "objective and non-partisan analysis" analysis20of the MMSEA. As there was no legislative history regarding the bill, the CRS research report is the most reliable analysis of the MMSEA, including the Section 111 reporting requirements.

CRS' analysis of the Section 111 reiterates that it is a reporting requirement, and makes no mention of the need for set-asides in liability cases. The Section 111 analysis states, in part:

This provision requires an insurer or third-party administrator for a group health plan (and in the case of a group health plan that is self-insured and self-administered, a plan administrator or fiduciary) to (1) secure from the plan sponsor and participants information required by the Secretary for the purpose of identifying situations where the group health plan is or has been a primary plan to Medicare, and (2) submit information specified by the Secretary. If an insurer or third-party administrator for a group health plan fails to comply, then a $1,000 per day civil monetary penalty will be imposed for each individual for which information should have been submitted.(4)

If CRS believed that the legislative language implies any Congressional endorsement of liability set-asides, it would have been included in this analysis.

We hope this information will be useful in your settlement negotiations. We will keep you apprised of any changes regarding this issue. In the meantime, if you have additional questions, please contact Linda Lipsen, Senior Vice President for Public Affairs at 202-965-3500, ext. 305.

Sincerely,

Anthony Tarricone
President