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.

There is nothing worse then being injured in a Kentucky car accident. You are in pain. You look for a lawyer to guide you and help you deal with the insurance company. You want to get a fair settlement and the best legal advice. Your lawyer sends you to a doctor for treatment. They even arrange for you to fly to another state for surgery. You settle your case and get your settlement money, after your attorney and doctors are paid. This is the way it suppose to go, isn’t it? I would say yes unless you are Sharon Langford.         

We have all seen the billboards and the television commercials about the “aggressive attorneys” formally “Winters, Yonkers and Rousselle” now “Winters and Yonkers”.  Whether you are a fan of this type of legal advertising or not, you have to admit that it works because everyone in Louisville, Kentucky knows the name of this Florida based law firm.  The firm has recently been sued in Jefferson Circuit Court by a former client, Sharon Langford.

            Ms. Langford was injured in a car accident in June of 2008.  She alleges that she was not told that her personal health insurance would potentially pay for her medical bills after her PIP benefits were exhausted. PIP benefits are also known as No-Fault Benefits or Personal Injury Protection. She was referred to a medical care clinic called First Physicians Rehabilitation Inc. by the law firm according to the lawsuit. She was told they would take care of injuries suffered in a car accident.  It is reported that the medical facility did not accept health insurance only PIP car insurance. 

Later when Langford needed surgery the firm flew her to another clinic in Florida.  In the lawsuit Langford states that she discovered later that both clinics were owned by Gary Kompothecras, a chiropractor, who also owns the Hepley advertisement referral service 1?800?ASK?GARY.  Langford also alleges in her lawsuit that the relationship between the law firm and the clinic cost her money.  Her attorney, Sam Carl, states that medical bills paid after PIP totaled over $64,000.00.  Health insurance would have paid a portion of this leaving additional money to Langford after settlement of the lawsuit. You can read the courier journal article that I linked above with further details. 

The question that comes to mind is whether or not the referrals to and between the medical clinic and the law office should be disclosed to clients.  It is alleged that this is a requirement.  I would argue that a client should be referred to the best doctor available and not a doctor that is only referring business to the law firm.  I often refer clients to doctors. Those clients would otherwise have no idea where to go.  I give them the name of several doctors based on their needs.  Many family doctors do not want to handle lawsuits or auto accident suits nor do they understand how to bill car insurance for payment for their medical services. 

The question always comes down to what is best for the client.  Any relationship between a doctor and a lawyer should be disclosed to the client. I will watch with interest Sam Carl’s case to see what direction it does go.  It’s safe to say it should be educational for Kentucky auto accident victims and give them the knowledge they need to ask questions of their attorneys as to the relationship between the attorney and the doctor.

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!

I received a phone call yesterday from a potential client that I just shook my head after I hung up the phone. I was asked this question:

How do I get my $10,000.00? I was in a car wreck yesterday
and I need my money.

This question disturbed me so I inquired further and asked how the accident happened and what the injuries were. The reply was that there was no injury they just wanted their car wreck money.    I get a similar question from someone just about every week. The motive is usually not as clearly for money. It is usually just a lack of understanding of the Kentucky PIP statute and how it actually applies to a Kentucky car accident.

There are bus ads and television commercials you see everyday telling you that if you have been in a car accident you are entitled to $10,000.00. These ads are not lies but they do not tell you the whole truth. They make you believe that there is this magical pot of money waiting for you if you have been involved in a Kentucky car accident.

There is $10,000.00 of benefits available but it is not just because you have been in a car accident. They are there if you have been hurt! Not just because you were in a wreck. A car accident is not hitting the lottery. It is not a way to pay off your bills and put your kids through college. There is not a client I represent who wouldn’t give the money back if they could only be the way they were before the accident.

There are several names for this $10,000.00. It is called:

• PIP Benefits

• No-Fault Benefits

• Basic Reparation Benefits

• Added Reparation Benefits (If you are lucky and have a good insurance agent that has advised you of the availability of these in Kentucky)

The Kentucky No-Fault Statute was enacted by our legislature to make sure that motor vehicle accident victims would receive the medical care they need without being hassled by the insurance company of the car that hit them. I will not go into all of the different benefits here, as I  have written many blogs and a book that thoroughly covers this subject. Basically you are entitled to have your first $10,000.00 of medical bills and or loss wages paid(at a maximum of $200.00 per week). This is money to ensure you get the treatment and care that you need paid by your own insurance company. It doesn’t matter whether the accident was your fault or not. You can still go to the doctor. It is not a windfall, it is a method to ensure accident victims get the treatment and medical care they need.

The next time you see one of the commercials offering $10,000.00 for your car accident you can say I know what that money is really for. There is no give away or lottery. This is money to make sure the injured accident victim gets the medical treatment they need.

Just say NO when your insurance agent asks you if you would like to save a few dollars on your car insurance and offers you a PIP deductible. Saving money sounds like a great idea, but the few dollars you save may cost you $1,000.00 if you are in an automobile accident in Kentucky.(PIP is also referred to as No-Fault Benefits or Basic Reparations Benefit).

Most people have no idea what it means to have a deductible on the PIP coverage of their Kentucky automobile insurance policy. Unfortunately, most insurance agents do not adequately explain the consequences or what you are giving up by having a PIP deductible. Instead the agents’ focus is on the amount of money that you will save off of your premium, which is usually only a few dollars a month.

This is a great deal for the insurance company. The amount of money the premium decreases may be only $40.00 per year. Yet if you are in a serious car accident and seek medical treatment the insurance company will save $1,000.00.

Now here is where it gets really interesting. That $1,000.00 is the amount that your insurance company, or as we refer to them the PIP carrier, can not collect back from the at-fault insurance company. Any bills paid that are over $1,000.00 the PIP carrier will be reimbursed for by the at-fault insurance company. So you pay your insurance company a premium for the PIP policy and when it is all said and done they are out of pocket a grand total of zero. Not a bad racket to be in on.

The PIP deductible is as bad deal for you as it is a good deal for the insurance company. If you are in an auto accident in Kentucky, are injured and have to seek medical attention you are responsible for the first $1,000.00 in medical bills out of your pocket. This is because you elected to save $40.00 a year. It would take 25 years for you to be accident free to come out even. The odds are not in your favor.

Plus medical providers will want to be paid. Do you really need the added stress of dealing with bill collectors while you are recovering from injuries from the car accident? I think not.

In some cases deductibles are a good idea. On your health insurance it can save you a ton of money if you are healthy and are an infrequent visitor to the doctor. It is also beneficial on your auto collision coverage. Once again it can save you money. But never should you have a PIP deductible. It only benefits the insurance company and hurts your pocket book and possibly your medical treatment.