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.

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.

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.

You were rear ended in a Kentucky car accident last night while sitting at a red light waiting for the light to change and listening to Toby Keith. BAM! It was like a fire cracker going off. You thought you were okay, but when you get out of bed you realize that something isn’t right. Your back and neck hurts and your head is killing you. What do you do? You told the police officer that you weren’t hurt. Can you still go to a doctor? The answer is absolutely yes.            

As a personal injury attorney accident victims ask me one of these questions:

• Can I choose my own doctor?
• Do I have to go to a doctor the insurance company tells me to go to?
• Do I have to go to a doctor that I’m referred to by my family doctor?

The answer is you can go to whomever you want. You can go when you start experiencing pain. You can choose any doctor to go to to be treated for your Kentucky injury claim as long as you have No Fault Benefits or PIP benefits on your car insurance policy.  You can go to a chiropractor if you choose.  You can go to your family doctor if you choose.  You can go to the emergency room if you choose.  You can go to an orthopedic doctor. And it can be the doctor of your choice!  You do not have to take a referral from your family doctor and your medical bills from the Kentucky car accident will be paid for up to $10,000.00 under the basic PIP insurance on a Kentucky auto insurance policy.

If you have been in a Kentucky automobile accident and an insurance adjustor has told you that you have to go to their doctor, which is not the case.  If they have said it is too late to go to the doctor it is not the case. You can go to whatever doctor you choose whenever you choose and those bills will be paid under your PIP insurance.

Should Kentucky car accident victims use their personal health insurance to pay their medical bills for the treatment they receive for injuries they sustained in an automobile accident?  This is a question frequently asked by clients.

·         Do I Give my health insurance card to my doctors?

·         Why should my car insurance pay for my medical bills from an automobile accident that wasn’t my fault?

·         Isn’t it the at-fault cars’ insurance company that should have to pay?

In other words should they use their health insurance to pay for their treatment from a car accident?  The answer is no and yes. Why No? Your first and primary insurance in a car accident in Kentucky is your Personal Injury Protection or PIP benefits.  Your own car insurance will pay the first $10,000.00 of medical bills for treatment from a car accident under most circumstances. 

The “yes” comes after this $10,000.00 amount is fully paid or exhausted. You can then use your health insurance. Your health insurance will pay the medical bills from this point on.  The confusing part and what some consider the bad part about this is there’s something called subrogation. Ninety percent of all health insurance plans require you to reimburse the health insurance carrier for anything they pay toward the treatment of injuries sustained in an automobile accident. Federal ERISA laws cover this area. It is a very specialized area of law and would require pages to fully explain. Your health insurance company generally entitled to reimbursement, and they can recover what was paid out under most circumstances.

If there is a requirement to pay your health insurance company why should use your health insurance to pay the bills from your car wreck case? The answer is twofold. One is to make sure that you get the treatment you need. The second is that they pay at a reduced rate, which ultimately saves you money. Realize that you will have to reimburse them out of the proceeds of your accident case, but only what is paid.

There are some good points for the Kentucky accident victim. When a health insurance company pays a bill they will pay the provider the agreed upon price for any treatment. In other words, they will pay only a portion of the charge. You only have to reimburse the health insurance company what they have paid, not the total amount of the bill. Usually this amount will be discounted even further at the time of payment by you.

You are also responsible to pay any co-pays or deductibles to the health care provider, unless you can work out other arrangements with your doctor. You will eventually be reimbursed but that may be several months or even years later when your accident case is settled.

The bottom line is you should use your health insurance to pay your medical bills once your PIP benefits have been exhausted. Your health insurance is secondary insurance. This allows you to get the treatment you need without being hassled by bill collectors for payment.

Kentucky is a No-Fault Insurance state. What does this mean? There are a lot of Kentucky accident victims who hear this term and believe that this means that it doesn’t matter who caused a automobile accident. People come into my office all the time and are confused by the term No-Fault. They believe that anyone who is injured in a Kentucky automobile accident can recover for their pain and suffering. Some people believe that no matter whose fault the accident is they are going to get paid for their injuries. This is not what it means at all.

What No-Fault means is that no matter whose fault the accident is your own personal car insurance will pay for your medical treatment for injuries from the car accident.  This means that even if the car accident was your fault you can go to the doctor. You can receive medical care and treatment for your injuries. This is where the term No-Fault comes from.

You don’t have to worry about how you are going to pay for your medical care. Your medical bills will be paid. You can go to the doctor of your choice. You don’t have to worry about the insurance company of the person that caused the accident agreeing to the treatment. There is no pre-authorization that a doctor needs to get before they can treat you for your injuries.

The name of the No-Fault Statute is actually the Motor Vehicle Reparations Act. You can find it at KRS 304.39 et seq if you really want to read the statute. It is not the most entertaining reading I have ever done by any stretch of the imagination, but it does contain the rules that cover how insurance company handle medical care and the payment for that care in auto accident cases in Kentucky.

The purpose of the No-Fault Act, as it is called, is to make sure that people that are injured in accidents are able to get the treatment they need.  This helps to give you peace of mind. It has nothing to do at all with whether or not the accident was your fault and whether you can collect for what is commonly called pain and suffering. There must be an at-fault party to sue for you to have a personal injury case and collect for your pain and suffering. No-Fault only deals with the payment of medical bills. It has nothing to do with a pain and suffering settlement.

The bottom line is if medical care is related to injuries sustained in a motor vehicle accident in Kentucky they will be paid by your No-Fault benefits.

Kentucky car accident victims always want to know how their medical bills are going to be paid.  They have been in an accident, they’re injured, and they’re not able to work.  Many people nowadays don’t have health insurance. The assumption that is made is “If I don’t have health insurance I will have to pay the medical bills for treatment from a car accident out of my own pocket”.

In Kentucky your own insurance company will pay those medical bills.  You have what is called PIP benefits. This is short for Personal Injury Protection. You may also hear these benefits referred to as No-Fault Benefits or Basic Reparations Benefits. It’s something you pay for under your automobile insurance policy. The first $10,000.00 of your medical treatment will be paid for by your insurance company.  You fill out a PIP application  that is sent to you by your insurance company. This triggers the payment to your doctor automatically from that point on until those $10,000.00 of benefits are exhausted. 

Once the PIP Benefits are exhausted you will send your medical bills to your health insurance company. Any additional treatment will be paid by your health insurance carrier. You are personally responsible for any co-pays or deductibles. Any money you pay out of your pocket should be reimbursed by the at-fault party’s insurance company at the time your personal injury case is settled. 

You might be concerned that hey, why should my car insurance company pay for this if the accident wasn’t my fault?  This is done so that you can immediately go to the doctor of your choice. Well at the end of the case they will get reimbursed by the at-fault party’s insurance company minus a $1,000.00 inner company deductible, so your insurance company will not be on the hook for those benefits.

Many Kentucky accident victims have suffered serious and life changing injuries from an automobile accidents, truck accidents or motorcycle accident. They come into my office looking for answers. They are concerned about the fact that they only have $10,000.00 in medical benefits available to them from their PIP Benefits (Personal Injury Protection) in their car insurance policy.  If you’ve been in an accident and have a serious injury and are in need of surgery this may not be enough to cover the medical bills for treatment you receive for injuries suffered in the accident. It’s a real concern if you don’t have health insurance. 

         After an accident your options are limited if you don’t have health insurance. Unfortunately you can’t go back in time. You are forced to go to a free clinic or find a doctor who will agree to treat you or perform surgery on a promise to pay later. This just doesn’t happen very often.

You really must take action right now before you are even in a serious automobile accident in Kentucky. You must do something long before you even think about contacting a car accident attorney. One thing that you must do is ask your insurance agent to increase your PIP benefits.  These additional benefits are called Added Reparations Benefits.  You can increase your benefits to $20,000.00 per accident, $40,000.00 per accident, $50,000.00 and even more with many insurance companies. 

You might think, well if I’m getting five times the benefits, I don’t want to pay five times the amount, but in many circumstances your premium will go up a relatively insignificant amount compared to the increased benefits you are getting.  One of the most important things you can do right now to protect yourself and your family is contact your insurance agent and request additional medical benefits on your auto insurance policy.  I would suggest that you call your insurance agent today to ask him how to go about this.  You’ll be amazed at how little it will really cost you and the peace of mind you will have knowing you have protected your family should you be in a serous car accident.

Kentucky is a PIP state for automobile accidents. PIP is short for Personal Injury Protection. You may also hear these benefits referred to as Basic Reparation Benefits or No-Fault Benefits. I am not going into great details hear as to how these benefits work. Here is the nut shell. You have $10,000.00 of benefits that will pay your first $10,000.00 of medical bills and or lost wages.

Those of you that know me have heard me say that this is simply not enough for most accidents. I urge everyone to I run into (just figuratively) to purchase additional benefits called Added Reparation Benefits. For a small increase in your premium you can dramatically increase the coverage that is available to you.

With all of the talk about health care reform I have been looking at what is going on north of the border in Canada. In Ontario government is making plans to reduce their medical rehabilitation benefit from $100,000.00 to $50,000.00 for non- catastrophically injured people.  This is part their no-fault benefits. While I am urging people to increase their benefits in Kentucky the Canadian government is forcing everyone to take a reduction in these benefits. This will significantly alter the quality of care victims of automobile accidents will receive.

Interestingly enough it will increase the attorney fee collected. I am sure that most Personal Injury lawyers in Ontario don’t care about this change because of this.

I ran across an interview done by Brenda Hollingsworth, an Ottawa personal injury attorney, which was a breath of fresh air. Brenda is speaking out against the decrease in medical rehabilitation benefits that will be available to seriously injured car accident victims starting in the summer of 2010. In the video, Brenda talked about how injured car accident victims will run out of their Ontario rehabilitation funds long before the ten-years they are supposed to last. The 50% reductions in benefits will have catastrophic affects on many families.  

Brenda believes this change will increase the number of lawsuits required because injured people will have to sue the drivers who hit them to ensure they can pay for physiotherapy, medication and other medical needs.

I salute Brenda for standing up for the victims of auto accidents. In Kentucky we already have a low amount of PIP benefits that is required. Do yourself a favor and call your insurance agent and raise your coverage today!

Kentucky accident victims have a serious problem that I am seeing over and over again in my office. Unfortunately the frequency has increased. The problem is not with the accident victim but with the person that caused the accident. The at-fault party has been charged criminally with a variety of charges that include “Operating on a Suspended License” and “No Insurance”. I believe this has a lot to do with the economy and the “R” word. People are forced to make a choice between keeping their car insurance paid up, renewing the registration on their car and even paying speeding tickets as opposed to going to the grocery. The grocery is winning out.

How does all of this affect the Kentucky accident victim? There are a variety of reasons that Kentucky driving privileges are suspended for. It can be as a result of a Drunk Driving conviction or for habitual speeding. Those with suspended drivers licenses are dangerous drivers that keep driving. Unfortunately, they often cause serious automobile accidents. What is even worse, many car insurance policies will not cover the accident because the driver is in violation of the law, and thus the terms of the policy.

Other times the at-fault party doesn’t have car insurance to cover an accident. The coverage was not available because they have not paid their premium. As I said I am seeing this more and more frequently. What can be done?

There is new technology on the horizon, which may beat the low tech solution of simply impounding the offending party’s car (which is a short term fix at best). I read about a potential option on TheTennesseeAutoAccidentAttorney blog that is in the development stage called the Electronic Drivers License (EDLs). What is an EDL? It is similar to a bank card or a “smart card” that works together with an ignition interlock system (these are used to prevent habitual drunk drivers from getting behind the wheel). It is an on board computer that would verify the drivers identity in order to authorize the operation of the car. Along with verifying the identity of the driver the EDL system will have the ability of providing travel information such as time of day and speed prior to an impact. This is similar to a black box that we often hear about in airplanes. This is also standard equipment on many luxury automobiles and is referred to as an Event Data Recorder. I believe they will be required equipment on all cars in the near future.

This sounds great and will prevent some serious automobile accidents, but how will we know that the person behind the wheel is not using someone else’s card? There will need to be some sort of authorization system, such as voice recognition, finger print identification or maybe a Home Incarceration style of bracelet. Another option would be a system similar to the Owner Compliance Key that blocks cell phone usage within a three foot radius of the driver. I will be following the development of EDLs and keep you posted.

But what can you do to protect yourself from these uninsured drivers? You must make sure that you have uninsured and underinsured motorist coverage on your own car insurance policy. This is not an option anymore. Never ever waive uninsured and underinsured motorist coverage. If you are injured in an automobile accident in Kentucky and the person that hit you does not have insurance you will not be compensated unless YOU have this coverage on your policy. There will be no compensation for loss of power to labor and earn money. There will be no compensation for medical bills. There will be non compensation for pain and suffering. That is unless you have uninsured motorist coverage. Call your insurance agent today and ask if you have this coverage. If the answer is yes and you do have this coverage; raise the limits. If the answer is no; add it immediately!

Should you have any questions about insurance check out my book: “What You Don’t Know About Buying Car Insurance Can Hurt You”, Kentucky’s Ultimate Guide To Buying Car Insurance”. Go to my website and I will send you your book valued at $14.95 free of charge. Protect yourself and make sure you have the right coverage.

Don’t put yourself in a situation where you are injured in an accident and the at-fault party doesn’t have insurance. I don’t want to be the attorney that has to tell there is nothing I can do for you because you don’t have uninsured motorist coverage.