Once a client contracts to retain me to represent them regarding their injury claim, the first thing I do is find out what insurance coverage the at fault party has to compensate the client for the damages sustained by them. In auto accident cases, many times the adverse owner/driver may have minimal coverage, if any at all. If my client does not have uninsured/underinsured coverage (UMI), there may not be much I can do for them.
If there is sufficient insurance to compensate my client, then I secure a copy of the police report. I then will contact any witnesses listed on the report for their version of what happened. I also will visit the accident scene to confirm the information in the report.
Next, I will begin to secure the clients medical records. This will include the records from all of the healthcare providers who have seen and treated the client since the accident i.e. hospital, walk in clinic or physician emergency treatment providers.
Then I will obtain the medical records of any physician who have seen my client for follow-up care and treatment. Also important is whether or not the client has health insurance to pay for the medical charges to receive treatment. Most clients have PIP coverage on their own auto insurance to cover the beginning treatment. PIP usually has a $2000 deductible and then pays 80% of the medical expenses up to $ 10,000.
After that, the client needs to rely on their own personal health insurance to pay for their care. Unfortunately, many people do not have health insurance to pay for continuing health care. If that is the case, I will talk to the client’s doctors to see if they will accept a Letter of Protection (LOP). What this means is the doctor agrees to continue to care for the client and the client agrees to pay for the charges once the case is resolved. If there is a recovery, the medical charges are paid before the client the client receives any settlement proceeds. If, there is no recovery, the charges are still due and payable from the client.
Many health care providers will not agree to accept an LOP. It may take an extended period of time for the case to be resolved and there is no assurance that the client will prevail. I, fortunately, work with outstanding orthopedic physicians who will provide care with an LOP if the chances of a recovery is good.
Next, I will secure lost wage information and other employment information for the client. Keep in mind that PIP also pays 60% of lost wages in addition to medical payments. However, the maximum PIP pays is $10,000 for both. Future loss of wages must also be determined as well as the need for future care and treatment before any settlement can be agreed to.
Once the client has reached Maximum Medical Improvement (MMI) and no future care will improve the injuries and disabilities, then the claim is ready to proceed to settlement discussions with the opposing party’s insurance carrier.