The following is a question I was asked on WAVE Listens about being hit by a cars that presented invalid insurance cards at the accident scene. I explain the ways you can go about recovering your out of pocket expense for fixing the damage to your carfrom a Kentucky car accident.

Q. In the span of about 11 months, I was hit by two different people and they presented fake insurance cards or invalid insurance cards at the scene and come to find out I had my insurance company both times take care of my car, paid my deductible through them, and now I find out that the insurance was not valid at the time of the wreck so I am out two deductibles.

A. There are several things that you can do, Mindy. It depends on whether or not these accidents have been within the last year.  There is a one-year statute of limitations on a criminal charge of no insurance where you can go down to the courthouse and take out a warrant for a no-insurance charge.  Once that warrant is issued the police will pick up or they will notify the individual of the court date.  When the individual comes to court they’ll bring you in, you bring in proof that you were in the accident, things such as the accident report, you bring in proof that your car was fixed and that you were out the deductible and any other out-of-pocket expenses.  When that individual is convicted or pleads guilty to that, one of the things the court will do is order restitution to be paid which is the money that you are out.  It will not be something that would pay, be paid immediately.  Usually it’s $100.00 a month or something like that, but that is the best way for you to get your money back.  It would be a separate charge on each one of these individuals.

Another way to do that would be to take a civil small claims action out against each one of those individuals but, in this case you’re going to have a filing fee.  Once you get the judgment against them, then you have to worry about collecting which often, is often more difficult than getting the judgment because tracking down bank accounts, where they work, and that sort of thing is extremely difficult.  I found that it’s a very big hammer to know that you’re, you could go to jail for 90 days if you don’t pay back the individuals so, I would take out these no insurance warrants.

According to a recent report the United States could save 2,000 lives a year if all 50 states established comprehensive programs of phased-in privileges for young drivers. A report from the Allstate Foundation and the National Safety Council stated that an estimated 20 lives can be saved in Kentucky from the implementation of a more comprehension graduated driver licensing law.

Auto accidents are the leading cause of death among teens. Every State has a form of GDL, which rewards novice drivers with additional driving privileges as they gain experience and maturity. John Ulczycki of the National Safety Council and other experts say that the most effective GDL programs contain seven components.

The seven components are:

1. Minimum age 16 for a learner’s permit;
2. Six months before unsupervised driving;
3. Minimum 30 hours supervised driving during learner’s stage;
4. Intermediate licensing at 16 ½ minimum;
5. Intermediate nighttime driving restriction beginning no later than 10 p.m.;
6. No more than one non-family passenger for intermediate license holders;
7. Minimum age 17 for a full license

New York and Delaware are the only states that have programs with all seven components. In Kentucky, the GDL program includes:

a) A six month learning permit at age 16 that requires adult supervision;

b) A restriction on driving after midnight during the permit level;

c) A six point limit on traffic violations to age 18, with a penalty of license suspension; and

d) A four hour driving education class. Under the current National Highway Traffic Safety

Kentucky’s program no longer meets the minimum requirements for a full GDL program with seven components recommended by the National Safety Council.

This is an issue that Kentucky Lawmakers should consider. As a Kentucky Personal Injury Attorney and a father of a teenage daughter, I am concerned about the number of car crashes involving teen drivers. I agree that more lives and more money will be saved if GDL programs in Kentucky will be strengthened.  This is enhancements to the current law should defiantly be considered by Kentucky Law makers.

The Insurance industry has been trusted for many years. It protects us all from tragedies, at least so we think.  Do we always get what we think we are paying for? Insurance companies are required by law to work in good faith with their customers. Unfortunately, its weak regulation and delays in handing claims have ordered this trust.

Russ Roberts, a New Mexico-based management consultant and former business professor at Northwestern University who studied the insurance industry’s evolution from a service business to a profit-driven machine said that, “Claims has been converted into money-making process.” The change started when consulting giant Mckinsey & Company sold Allstate and other leading insurance a new system where a computer-driven method produced purposefully low offers to claimants in auto accidents.

There have been cases of complaints where consumers suffered financial hardships because of delayed payment of insurance claims. Studies have shown that insurance companies delay claims to help save millions of dollars. Some claimants who file cases against insurance companies will never see the end of their case because of death, other injury or lack of interest. Some insurance company purposely delay claims as tactic to manipulate or evade legal insurance claim settlements and to increase their own profit.

As of November 28, 2011, the NAIC had received 11,503 delay-related complaints this year. How can you keep yourself from being taken advantage of by insurance companies if you have been injured in a Kentucky car accident? You are the one injured you have experienced a loss.  You deserve to be compensated under the insurance policy.  Knowing your rights and the law is the first step to making sure you are not taken advantage of.  My book “7 Potholes That Can Wreck Your Kentucky Accident Case” was written to give Kentucky car accident victims thorough understanding of the claims process in a car accident case.  Order your complementary copy today so you can level the playing field and not be taken advantage of by the insurance industry.

The Strengthening Medicare and Repaying Taxpayers Act (SMART Act) was introduced on March 14^th, 2011 in the 112^th Congress by Representative Tim Murphy (R-PA) and Representative Ron Kind (D-WI) with support from both the American Justice Association (AJA), which I am a member of, and a diverse coalition of businesses called the Medicare Advocacy Recovery Coalition (MARC).  The SMART Act will significantly improve the efficiency of the current Medicare Secondary Payer (MSP) system and speed repayment of amounts owed from Medicare beneficiary claims directly to the Medicare Trust Fund.  This means that accident victims will be able to receive their settlement checks more quickly.

The Medicare Secondary Payer (MSP) was created in 1965 to provide health care for America’s seniors.  It is the principal form of health care coverage for everyone over 65 and for millions of disabled Americans.  Medicare is the primary payer-that is, it pays health claims first, and if a beneficiary has other insurance, that insurance may fill in all or some of the Medicare’s gaps.  The MSP system saves taxpayers billions of dollars.  However, its existing rules are inefficient; unnecessarily delay personal injury settlements and waste government, beneficiary, and stakeholder resources.  This is why SMART Act was being promoted by MARC and AAJ.

Roy Franco, the Co-Chair of MARC and representing the MSP efforts for Safeway said, “The SMART Act will help to streamline our government in tight fiscal times by creating a MSP system that works effectively for all stakeholders.”  If the SMART Act is enacted, it will create a more efficient and effective system for all beneficiaries by:

• Implementing safeguards for Beneficiaries’ Personal Information
• Speeding up the Distribution Settlement Funds
• Help to Avoid Unnecessary Litigation
• Protect the Beneficiaries’ Access to Justice and our Court System

With the help of this bill, Medicare beneficiaries will be able to settle claims and the Medicare Trust Fund will be repaid quicker.  Companies will be able to resolve disputes faster and more efficiently.

As a personal injury attorney I have had to deal with the nightmare we call Medicare for years.  It has progressively become harder to deal with and frustrating for those who have been seriously injured in car accidents.  I am optimistic that the SMART Act will live up to its name.

I was recently asked a question by a concerned mother whose daughter was in a real bad car accident.  She was driving a friend’s vehicle, but unfortunately she did not have a valid Kentucky driver’s license.  She broke her neck, broke her back, broke her arm and had five staples in her head.  Altogether she was in the hospital for about a month.  The insurance company stopped paying for her medical bills. Now she is getting all these medical bills mailed to her. Can her daughter get the remaining medical bills paid? Can she recover for her injuries even though she didn’t have a valid Kentucky driver’s license? Does she have any legal leg to stand on?  Is there anything she can do, as far as getting these medical bills paid?  Can she sue insurance company to finish paying these bills?

Let’s get to the bare bones of the law and what needs to be done. The first thing you need to realize is that you’re only entitled to $10,000.00 of medical payments under Kentucky PIP or No-Fault law. These are benefits that are paid under your cars’ Basic Reparations Benefits. Once these benefits are exhausted there’s no more money that you can get from your PIP to pay your medical bills as they are occurring.

Your next step would be to turn the remaining unpaid medical bills over to your personal health insurance. Hopefully, you have health insurance. Why should your health insurance company pay the medical bills when the injuries were caused by someone else’s negligence? This keeps the bill collectors from calling and gets the bills paid! Don’t worry; your health insurance will be reimbursed when the case is over. That is part of the damages collected from the at-fault party that caused the injuries. The bottom line is let the health insurance company pay those bills.

If you don’t have health insurance there is nothing immediate that can be done to get those medical bills paid.  The at-fault party would have to pay the medical bills when the case is settled.  That’s part of the damages that you would claim, but there’s nothing to force them pay it right now.  This is where a personal injury attorney is extremely helpful.

I would get an attorney involved in your case to look at the options with the medical bills.  A lot of times an attorney can write guarantee letters to the health care providers. This can help stop the harassing phone calls.  That would mean that you would have to pay the medical bills from the proceeds of the accident case.

The final issue in this question was the daughter did not have a valid Kentucky drivers’ license. Kentucky is a comparative fault state. This means that an injured party can still collect if they were partially to blame for their injuries. This will affect your settlement by lowering the settlement by the percentage amount you caused your injuries.  This means your wrong doing can affect your recovery.  If a jury decides that not having a valid drivers’ license was a factor that contributed to the accident, your recovery could be lowered.

The bottom line is there should be a recovery of the medical bills and a dollar amount for pain and suffering, but an experienced Kentucky personal injury attorney should review the case to make the determination.

You were in an automobile accident last year and have endured many months of physical therapy for your injuries.  The at-fault driver’s insurance company made a settlement offer pretty quickly, but it was a very low amount.  You did the smart thing and said continue with treatment.  You are still continuing with treatment.  How do you figure what an appropriate settlement amount would be?  Is there some sort of formula?  Does it take into account your medical bills and medical treatment?

In the old days (about 20 years ago) there used to be a ballpark formula for what a personal injury case was worth.  Most cases would settle for 3 to 5 times the medical bills. This is not the case anymore.

20 years ago most insurance companies went to computer programs to determine what your accident case is worth.  The purpose of these programs was to lower the amount paid out on injury claims and turn the insurance claims department ionto a profit center. There are various names for these programs like COLOSSUS, TEACH and SMART.  They’re all basically the same.  You’re not just a number now, you’re 10,000 plus numbers.  There are over 10,000 items that can be entered into these computer programs to determine what your case is worth.

When the insurance company has made an initial low offer is extremely difficult to get them to raise the offer without contacting an attorney that understands how these computer programs work and is prepared to take your case to trial if needed.  You need both.  Call someone to discuss your case and settlement to make sure that you’re on the right track and that you’re able to get the best settlement possible on your case.  If a low offer was made it’s probably not going to go up.  Based on insurance company statistics and their own reports, they pay almost double for an injury case to somebody that has an attorney as opposed to somebody that doesn’t have an attorney.

There are many insurance companies we can choose from.  We all see their commercials everyday that concentrate on trust for example, “You’re in good hands” or “Like a Good Neighbor”.  Insurance Companies make money by collecting premiums from us, the consumer.  Do you know what tactics insurance companies use that will increase their profits?  What do they not want you to know?  How do they get the most money possible from you and keep it.  Here is a list of the insurance industries’ 10 dirty little secrets:

1. Ratings are used but consumers are not allowed to see them

ISO, a New Jersey-based company, provides information to car insurance companies about the likelihood of certain models of cars being involved in accidents and how severe those accidents will be. A company press release states that its’ rating plan leads to surcharges of up to 25% for some cars.  For other cars there are discounts of up to 20% against the insurance rates.  This service looks at nearly 300 makes and models of vehicle.

This information would be useful to consumers to use when buying a car whether a safer car or to keep car insurance rates down.  Unfortunately, these ratings are not available to the public.  How easy would it be to put these statutes on a new or used car sticker?  I would love to see them the next time I buy a car.

2. FICO risk scores are used but cannot be seen

An insurance risk score developed by FICO is used by insurance companies to help determine what to charge consumers for auto insurance. You can get a copy of your FICO credit report you cannot get or see but the insurance risk score.  I didn’t know I was charged based on my credit history!  Even worse the insurance companies own interpretation of my credit history.

3. Proprietary software might be used to shortchange you

Information about your injury after a car accident can be fed into a computer program called Colossus, TEACH or SMART.  These programs are used to generate settlement offers for bodily injury claims from motor vehicle accidents. The Consumer Federation of America warns that chances are better than average that this software is rigged to keep offers low.  In other words, as others contend, the software is “tuned” to lowball injury claims.  As a Kentucky personal injury attorney I have reviewed documents that show that settlement dollars paid have decreased substantially since insurance companies began using computer programs to put values on injury claims.

4. They know if your attorney is a wimp

Insurers have better sources of information on this topic. In evaluating the value of bodily injury claims, Colossus evaluates the attorney who’s representing you. Defense attorney says that insurance companies want to find out if your attorney is likely to roll over for an inferior settlement offer – or has the backbone for a courtroom fight.  Your attorney makes a difference.

5. Insurers sneak percentage-based deductibles into your police

According to the Lawyers.com website, a renewal contract could have a $1,000 deductible for fire losses include or up to a 25% deductible for hurricane damage in some high-risk areas. That 25% can translate into significant dollars out of your pocket and significant savings for the insurance company.

Percentage deductibles may be necessary to provide coverage to storm-prone areas but homeowners must review on the insured value of their property whenever they make improvements.  Look at your renewal policy to make sure there have been no changes.

6. Pottery Barn items might be replaced with Wal-Mart

Insurance company adjusters often dispute the value of furniture, jewelry and other items lost in a flood or fire. They might offer discount-merchandise prices or the current value rather than the true replacement cost. Insurance companies might also try to wear you down with lowball offers by switching adjusters and forcing you to start the process over again.  Keep all your receipts so you can prove where you bought an item and the real value of it.

7. They make hospitals charge smaller insurers more

If you’re not a Blue Cross customer, you may end up paying more in premiums.  This is because your insurance company did not negotiate a deal with a hospital or doctor before Blue Cross did.  Officials say that in some cases, Blue Cross required hospitals to charge other insurers as much as 30% to 40% more than they charge Blue Cross.  Ask what the negotiation prices are when shopping for insurance.

8. They force you to buy a more expensive homeowner’s policy

In some cases, the deck is stacked against a consumer who seeks affordable insurance. Homeowners who fall behind in their home insurance payments are penalized. Mortgage lenders may obtain another insurance policy and bill you for it under your mortgage agreement.  Then you are stuck with force-placed insurance.

9. ‘Preferred providers’ may cut costs without telling you

Insurance companies may refer you to ‘preferred providers’ for remodeling work when your home is damaged. These providers are usually contractors who have an ongoing business relationship with the insurer.

In cases like this, the insurance company gives you a check based on the estimate the insurance company gives you.  They want you to take the claim money the insurance adjuster sets aside for repair and hire your own licensed contractor and to be in control over the process.  Sometimes you can’t get the work done for this amount.

10. They do not contact your beneficiaries when you die

Insurers use a Social Security file called “Death Master” to cancel a life insurance annuity when a policyholder dies which will benefit the insurer. Millions of dollars remain unclaimed since insurance companies did not contact beneficiaries of the policies after the death of the insured member because the policy was cancelled.

This is alarming, isn’t it?  Insurance companies create the perception that they will do anything to please the consumer. They allow customers to pay more while smiling and knowing they have hidden agenda that will benefit the company’s personal interest and pocket book.  Be informed on the process.  Ask the right questions so you can get the insurance coverage you need to protect your family, and a good value.

You have just been in a car accident. You may not think that you’re injured.  You may not have any immediate pain, so why go to the doctor? Two weeks down the road you may start to feel a little bit of pain in your neck.

• What do you do then?
• Can you go to the doctor?
• Will your medical bills be paid?
• Can you still collect for your pain and suffering?

When you’ve been in a car wreck you are in shock. You are running on adrenaline right after the accident.  This masks any pain that you may be feeling.  You don’t always know whether or not you are hurt.  There are many people that don’t feel the pain until the next day, or even a week, or ten days after an automobile accident.

One of the tactics that insurance companies and insurance defense attorneys use is focusing and talking about that gap in treatment or the accident victim’s delay in seeking treatment.  They use argue that you weren’t really injured.  They say that if the pain was that bad why didn’t you go to the doctor immediately?  If the pain was that bad why did you wait the seven, eight or ten days?

Anytime you have a question like this that you have to address in a trial it can have an effect on what happens in your case.   Accident victims should go to the doctor and get checked out immediately following an accident just to make sure that they are not injured.

If you have car insurance, or you’re a passenger in a vehicle, in Kentucky you have Personal Injury Protection, or No Fault Benefits.  There is a minimum of $10,000.00 that will go towards your medical bills and/or lost wages.  Any medical treatment you receive will not come out of your personal pocket as long as there’s insurance there. There is no reason not to seek immediate medical attention following a car accident.

As parents, our number one priority is our kids. I have two daughters and am probably over protective. We set a lot of limitations, precautions and care for them. It is hard to trust others with our kids, maybe even with our own parents (their grandparents!).

Guess what? Maybe we are wrong. There’s a new study which shows that children are less likely to be injured if grandparents are driving as compared to the parents. That is your kids are more likely to be involved in a car accident when they are with you. I find this unbelievable!

The study was based on data from nearly 12, 000 children from 15 U.S. states between 2003 and 2007 injured in car crashes involving children younger than 16. This study was published in the journal Pediatrics. Dr. Fred M. Henretig, an emergency medicine physician at the Children’s Hospital of Philadelphia, is the lead researcher on the study. 0.7 percent of children were injured in the crash when grandparents were driving compared to 1 percent when parents were the one driving.

Older drivers are just not as safe. That is the general consensus. We think that grandparents driving is worse because they used old cars and they lack knowledge in new technologies.

There are factors that Dr. Henretig cited as reasons for the lower injury risk of children when with their grandparents.

* Grandparents drive at a lower speed
* Grandparents do not following the car in front of them quite as closely,
* Grandparents think that grandchildren are special cargo,
* Grandparents are less distracted than busy working parents tend to be.
* Grandparents focus on their driving and refrain from distractions like using cell phones, fiddling with the radio, eating while driving or thinking about their work.

The bottom line is that the risk of being injured in a Kentucky car accident goes down when we care about what we are doing and are not distracted. Focus on driving and your risk of being injured in a car accident will likely decrease.

Steven Wilson was the passenger of a Jeep Grand Cherokee and was insured by State Farm.  The car was involved in an injury car accident on August 29, 2009. Unfortunately, the driver of the other vehicle who was at fault was uninsured.  Wilson had significant medical bills due to the accident. Some of these medical bills were paid by the Medicare (This is the practice in Kentucky after the PIP benefits are exhausted. The payment creates a statutory lien requiring the recipient of the Medicare benefits to repay Medicare. This is called a super lien because the attorney and the insurance company are also liable if payment is not made). The State Farm insurance policy available to Wilson was an uninsured motorist policy. The policy limits were only $50,000.

State Farm asked permission to discuss the lien with the Medicare. This was refused by Wilson.  Wilson then demanded the insurance settlement be deposited in an attorney escrow account.  State Farm suggested including Medicare as a payee on the settlement check which was also rejected by Wilson.  Eventually, State Farm issued separate checks to Medicare and Wilson while waiting for Medicare’s determination of the value of its lien.

Dealing with Medicare is frustrating for accident victims as well as their personal injury attorney. They are typically slow in responding to lien amounts which will hold up finalizing a personal injury settlement.  Unfortunately, there is nothing that can be done to speed up the process. Patience is the key.

In Wilson v. State Farm Mutual Automobile Insurance Company Co, Steven Wilson claims State Farm acted in bad faith by delaying payment of the policy limits more than 30 days.  According to the Courts opinion State Farm learned the value of the Medicare lien after two months when they paid both the Medicare and Wilson.

Judge John G. Heyburn, II signed a Memorandum Opinion and Order on June 14, 2011 granting State Farm’s motion for summary judgment and dismissing the complaint with prejudice.  Wilson’s motion for summary judgment was also denied.  The Court concluded that delay or withholding of payment until a determination is made with respect to Medicare’s conditional payment amount alone does not constitute bad faith.  State Farm had the willingness to settle its accounts. The fact that they attempted to determine the amount to be paid to Medicare was considered a reasonable precaution to protect itself from overpayment.

Under Kentucky law in order to withhold payment on an insurance claim the insurance company must:

1. Have an obligation to pay the claim;
2. Not have a reasonable basis for failing to pay the claim; and
3. Know that it lacked a reasonable basis to delay payment or act in a reckless disregard to the existence of the basis.

Although I understand the Court’s ruling, I see this opinion being used to delay payments in accident cases. This will allow the insurance company to hold onto the settlement amount and earn interest while the injured accident victim struggles to make ends meet. Surely there is a better way.