Taylor Law Firm, APC

•  After a car accident, remember to take photos and call 911. You want photos of the scene, your injuries, the parties/vehicles involved and the other driver(s)’ id and insurance. Admit nothing.
• Get in an ambulance or get a ride to a hospital and get treatment. Give the hospital your health insurance card so they can bill your health insurance. Insist that they bill your health insurance.
• When things have settled down, call a lawyer for advice.
• Don't talk to insurance adjusters until you have a chance to get all of the relevant information and consult with an attorney of your choice.
• Don’t sign anything!
•  To read more, check out: You Were Hit, Now What? 

• Navigating the legal world after an accident can feel like learning a second language. Here are simple, straightforward definitions of the terms you’ll encounter most often:
• Claim: A formal request sent to an insurance company asking for payment based on the terms of an insurance policy. It is the official "start" of your case.
• Liability: Legal responsibility. In an injury case, establishing liability means proving that the other party was at fault for the accident.
• Damages: The total amount of money needed to compensate you for your losses. This includes "economic" damages (medical bills and lost wages) and "non-economic" damages (pain, suffering, and emotional distress).
• Pre-litigation: The initial phase of a case before a lawsuit is filed. During this time, we gather evidence, manage your medical treatment, and attempt to negotiate a fair payout with the insurance company.
• Litigation: The formal legal process that begins when we file a lawsuit in court. This happens if the insurance company refuses to offer a fair settlement during the pre-litigation phase.
• Settlement: A voluntary agreement where you accept a specific amount of money to resolve your case and, in exchange, agree to drop any further legal claims against the other party. Most cases end in a settlement.
• Trial: A formal hearing where a judge or jury listens to the evidence from both sides and makes a final decision on liability and the amount of money (damages) to be awarded.

Unfortunately, when the other party’s insurance adjuster knows that you are unrepresented, they will take advantage. 

• At times, they will accept liability quickly and act like they are just trying to help; don’t be fooled. They will likely offer a quick settlement that sounds reasonable before you have the opportunity to see how unreasonable it truly is. 
• Other times, they take a more aggressive approach, denying liability and insisting that you cannot prove your case. If there is a liability or damages dispute, then you need to work with someone who knows how to overcome these hurdles. 

Nope.

Still no.

Every insurance policy has a limit. No matter how the sales people try to sell it to you, there is always a maximum that the insurance carrier will pay. This is listed on the ‘declarations page’ of the policy. The minimum in California is 30/60 which means a driver at fault for causing harm to another could have as little as $30,000 in coverage for harm to an individual and $60,000 in coverage for harm to multiple other people in an accident. 

UM coverage is coverage you can purchase on your own policy that protects you from irresponsible drivers. If you are injured by someone with lower (liability) policy limits than your (UM) policy, then you can make a demand for your own UIM coverage to kick in additional funds on top of the at fault party’s policy limits (assuming the case value is there).  

To protect yourself from irresponsible people on the road, the most important number on that policy is the limit of your uninsured motorist coverage. That is the amount of coverage you have to protect yourself from medical bills and pain caused by someone else with insufficient coverage.

For more information, check out:  You (Probably) Need More Insurance 

Liability, collision and comprehensive.

• Liability coverage is what you pay for to protect yourself from being sued but it does not pay you anything. Liability pays out to other people harmed by your own conduct, up to the policy limit you have purchased. 
• Collision and comprehensive cover your vehicle for physical damage – collision when the damage occurs in an accident and comprehensive when the damage occurs for some other reason. 
• "Full coverage” does NOT mean that your insurance will pay any claim in full. You still have a policy limit. It also will not pay you for your medical bills under any circumstance

In addition to UM coverage, there is also the option of medical payments coverage. This generally has relatively low numbers (e.g. $2,500) which will pay directly for any out of pocket medical costs regardless of fault. So if you have a $1,000 copay following an accident, medpay will reimburse you. 

When you are hurt by the conduct of another person and your health insurance pays for it, your insurance gets a right to be reimbursed by the person who caused the harm. 

For instance, Bob runs a red light and hits you. You go to the ER. You are insured with Kaiser so you give the ER your Kaiser information. Kaiser pays the ER $5,000 on your behalf. Kaiser has a right to try to get their $5,000 back from Bob. 

• If you recover nothing, then Kaiser recovers nothing
• But if Bob offers you $50,000 to resolve the claim, Kaiser is going to want their $5,000 out of that $50,000. 
• The right to reimbursement/subrogation exists in all private health insurance contracts.

Public health insurers like Med-Cal, Medicare and the VA have liens based in statute, so the same principal applies. The only difference is they don’t have to write it into a contract because Congress already wrote it for them.

The alternative to health insurance treatment, is lien treatment. This is also often thought of as attorney-referred treatment. When you get medical treatment on a lien, you don’t pay anything up front. You simply sign a contract with the treating physician wherein you agree to pay them for the treatment out of the settlement/verdict when the case resolves. 

For this to work, the doctor needs both your signature and your attorney’s so they have the attorney’s promise that when funds come in, the attorney will hold them in trust and pay the doctor as well. 

On its face, getting treatment that you don’t have to pay for up front and having it paid for out of the eventual settlement/verdict makes sense, doesn’t it? Similar to how you don’t have to pay for your attorney until the case resolves. However, some major companies that have had to pay out for the harm they caused have taken issue with lien treatment. They call it overly inflated and even fraudulent.  

Case costs include the costs of obtaining medical records, police reports, investigators, experts; as well as, filing fees, court reporters, transcripts, exhibit production and so on.

Your attorney will put up the costs at the beginning but expects these to be reimbursed at the end of the case. This is in your retainer agreement and is standard practice among the plaintiff’s bar.