Ten Common Questions
For people who have been injured in an automobile accident, insurance issues and other legal concerns can create significant obstacles to obtaining justice. Sometimes, what is misunderstood to be a big problem can deter a victim from filing a lawsuit in the first place – even when he or she would have had a strong case.
Ostroff Injury Law is committed to providing clients with the tools and knowledge needed to help them make informed decisions about their individual situation. Below, Ostroff Injury Law attorney David B. Kline answers ten common questions people have asked our legal team.
1. The other driver’s insurance company already told me I definitely can’t sue because I have limited tort – is this true?
Answer: No, it is not true. You may indeed have a case. The other motorist’s insurance company is not on your side, and in fact, they should have told you that their interests are averse to yours. Their job is to settle your claim for as little as possible, as quickly as possible. They have incentives to do so. They don’t want you to contact a qualified personal injury law firm like Ostroff Injury Law. You have nothing to lose by talking to us. We have successfully handled hundreds of limited tort cases where the other insurance company initially told our client, “You know you can’t sue, you have limited tort.” The insurance companies say this with great certainty. This is deceptive and morally wrong.
If you call us, we will tell you honestly, and at no charge, if your case has the potential to meet one of the five limited tort exceptions. Our attorneys have written legal articles on this subject intended to educate other personal injury lawyers in this often tricky area of the law. Hire the teacher, not the student. We’ve taken dozens of limited tort cases that other lawyers turned down due to not knowing the exceptions or because they were not willing to take the risk of losing. We know how to build the case properly. We know how to obtain the necessary proofs and what those proofs are. Give us the opportunity to help you win compensation for what you have been through, physically and emotionally. You have nothing to lose by letting us try. You may have a lot to lose if you don’t.
2. How much is my case worth?
A: The answer is more complicated than you think. There are at least 15 factors that go into making this determination. It is not arbitrary nor easily decided. Some lawyers will tell you what they think you want to hear—whatever you want to hear—to get your case. We will give you a range of value once we have evaluated it, after all of your medical treatment has concluded, and after all of our attorneys have discussed your case. Some of the many factors which go in to our evaluation include: the specific injuries you have; the invasiveness of your treatments; the risk of future medical procedures or treatments; the cost of future medical procedures or treatment; the value of similar injuries in our many other cases; the venue where we would file suit; the presence or absence of any relevant pre-existing medical conditions you may have; the presence or absence of degenerative conditions; the relevant law to be applied to your case; tort thresholds; damages thresholds; possible statutory immunity; and more.
As you can see, it is by no means a simple answer — and you have to doubt any lawyer who is giving you a simple answer at the beginning of your case — because either they are telling you what they think you want to hear, or even worse, they don’t even know the complexity and all the factors that need to be considered in a proper evaluation. Call us, let’s talk about it.
3. I no longer have the same insurance company that I did when the accident happened, so how will the old one pay for my medical bills?
It is perfectly ok to change insurance carriers after your accident without jeopardizing your coverage with the previous carrier. What matters is the coverage you had in effect on the day of the accident, not the coverage you had the day after, or many days after. Switching won’t affect your original insurance company’s duty to pay your benefits in accordance with the terms of your policy. Your coverage is “locked in” for the day of the accident even if you modify it later or change to a different insurance company.
4. I won’t go to court; does it still make sense to even contact you? There is no way I will file a lawsuit; my parents or my job will find out, and I won’t do it.
We abide by our client’s wishes. We will never pressure you. We will advise you of your options, but you will make the decision. Some people think, “Why bother calling a lawyer when I know I will not file a lawsuit and don’t want to go to court?” The answer is, because it is not always necessary for an injured person to sue to receive fair compensation. In some cases, we are able to obtain fair compensation for our clients’ physical and emotional injuries without having to sue the responsible person. You are the boss. If you don’t want to sue, we won’t sue, but we still might be able to negotiate a fair settlement for you. Why not let us try? You have nothing to lose by letting us try, since you pay us nothing if we do not settle your case and obtain money for you. If we succeed, we get paid when you get paid, not before. We get paid out of the same insurance company check that you do.
5. If I get medical, wage loss or other benefits from my insurance company and I didn’t cause the accident, will my insurance premium go up or be affected?
No. Generally, every insurance carrier has its own underwriting rules about what will trigger a rate increase. These rules vary from one insurance company to another. However, it is generally true that your rates will not go up because your insurance company paid benefits to you as a result of an accident you didn’t cause. If you were not at fault, or not more at fault than the other driver, then generally your premiums should not increase. One major carrier uses a threshold of $850, for example; meaning if they pay out more than that sum because you were at fault in causing an accident, they can raise your rates. Sometimes, a rate increase is just coincidental in timing with an accident you didn’t cause. We will find out for you. In a recent case, a client was upset that her rate went up by about 50 percent after an accident in which she was not at fault. We put her mind at ease by getting proof it went up for two other reasons: a) loss of a combined policy discount, unrelated to the accident and b) the addition of a youthful male driver in the household. The point is, we will find out why your rates went up, we will get the answer in writing, and if warranted, we will help you file a complaint with the Pennsylvania Insurance Commissioner’s office in Harrisburg. When you hire us, you are not alone.
6. I own a registered but uninsured motor vehicle. What are my legal options?
Owning a registered but uninsured motor vehicle will essentially have the same effect as if you chose the Limited Tort insurance option. This means that you will only be able to recover money for pain and suffering if you sustained a serious impairment of a bodily function or meet one of the other Limited Tort exceptions. You will also be without medical benefits through any motor vehicle policy. However, your health insurance will still be responsible for paying for those medical bills that you incur as a result of the injuries from the motor vehicle collision. If you do not have medical insurance, do not worry. Ostroff Injury Law can still help you. There are doctors who are still willing to treat you without any insurance and get paid later, when we get you your recovery.
Even if you do not sustain an injury that would meet the criteria of limited tort, you are not completely out of options. While you may not be legally entitled to recover money for your pain and suffering due to your injury as a result of being uninsured or limited tort, you are still eligible to recover money for ALL economic damages that you sustained as a result of the motor vehicle collision caused by someone else’s negligence. The at-fault driver’s insurance company is still responsible for ALL of your out of pocket medical expenses and any wage loss that you have lost or WILL LOSE in the future as a result of your injuries from the motor vehicle collision.
7. I was injured at work due to someone else’s fault. Do I have a case?
You actually may have two cases. First, any time you are injured at work, you may have a Workers’ Compensation case. Ostroff Injury Law does not handle Workers’ Compensation cases, but Ostroff Injury Law will guide you to the right workers’ compensation attorney in your area to handle that case.
You may also have a second claim against the person or manufacturer of the object that caused your injury. If the person who caused your injury is not someone employed at your company (for example, you’re driving a company car and another individual causes an accident off company property, then you would still have a case against that party. If you are injured due to a defect in a machine at your job, you can sue the company that sold the machine to your employer or the company that manufactured it, or both. These are called “third party claims”. These are separate from a Workers’ Compensation claim. Your third party claim could be worth far more than your Workers’ Compensation claim.
8. Who will be responsible for paying my medical bills?
If you are injured in a car accident, your own car insurance, health insurance and/or workers compensation insurance (if you are working) will pay your medical bills. First party medical benefits and personal injury protection (PIP) coverage are standard in every car insurance policy in Pennsylvania. Pennsylvania is a “no fault” state, which means that regardless of who caused the accident, your car insurance company is responsible for paying for your medical treatment.
- If you own and insure a motor vehicle, your car insurance company will pay your medical bills up to the amount you have selected on your policy. While your car insurance is paying for your bills, you will not be responsible for paying any co-pays or the balance of your doctor’s bill. In other words, your doctor can collect no additional money from you, because your car insurance is responsible for paying them in full.
- If you do not own a motor vehicle, but you live with a relative who owns and insures a motor vehicle – for example, a parent or sibling – then your relative’s car insurance will pay your medical bills, even if your relative’s vehicle was not involved in the accident. NOTE: Your relative’s insurance premium cannot be raised as a result of having to pay your medical bills.
- If you do not own a motor vehicle and do not live with a relative who owns a vehicle, then the insurance on the vehicle you were occupying during the collision is responsible for paying your medical bills, regardless of fault.
- If you are the occupant of any insured car at the time of the collision, the insurance company for the driver of the other vehicle is not responsible for paying your medical bills. However, if you were injured as a pedestrian, the insurance company of the driver involved in the accident is responsible for your medical coverage if you do not own a motor vehicle or live with a relative who owns a motor vehicle.
The insurance company will send you a letter when the PIP coverage on your policy has been exhausted. It is important to send this letter to your health insurance company to shift the responsibility for paying for your medical care to them. At this point, you will initially be responsible for any co-pays and any percentage of the bill that your contract with your insurance company requires you to pay. These become “damages” in your personal injury case and may be recovered at the time of settlement or as part of a jury verdict.
Making sure your medical bills are paid can be a difficult task, as insurance companies are constantly trying to shirk their responsibilities. Call Ostroff Injury Law to protect your rights and ensure that you do not end up with medical bills that should be someone else’s responsibility.
9. Who can treat my car accident injuries?
When you have been injured in a non-work related motor vehicle accident, you are permitted to seek the treatment from any doctor of your choice. The car insurance company responsible for paying your medical bills is not permitted to make you obtain a referral before seeking treatment.
Seeking medical care right away is an essential action to take after a vehicle accident. Visiting the emergency room (ER) or your primary care physician (PCP), for example, will allow you to begin treatment immediately and get your injuries attended to and documented promptly.
You should follow your doctor’s advice after your initial treatment. That may mean undergoing physical therapy or seeing a surgeon or other specialist. You are entitled to see a specialist who treats your specific injuries without having to first go to the ER or your PCP. A specialist can guide you through the appropriate medical treatment to help you recover from your injuries as quickly as possible. If you are unsure about which medical professionals to visit for your specific injuries, Ostroff Injury Law can help.
10. How long will my case take?
This question is very common, but there is no simple answer. Every case is unique, and there are many factors that influence the length of time your case will take from start to resolution.
One major factor is your injury and the medical treatment necessary for you to fully recover or recover to a point that a doctor can render an opinion about what your future holds regarding your injury. The healing process and timeline is different for each individual. Your case may be ready for us to seek settlement when you have fully recovered from your injuries or your doctor says you have reached maximum medical improvement.
Insurance coverage is another key factor. Your claim may be ready for settlement discussions if the value of your injuries, lost wages, medical bills, and other losses exceed the insurance policy limits of the at-fault party’s insurance policy and/or your own underinsured or uninsured policy.
If we are unable to settle your case for a fair amount, Ostroff Injury Law may need to file a lawsuit to force the at-fault driver’s insurance company to accept financial responsibility for all of your injuries and losses. Once a lawsuit is filed, the court in which your case is filed has specific rules that affect the length of your case until the time of its completion. It is also important to note that filing a lawsuit does not always mean a case will proceed to trial, as many cases settle before a trial happens. Ostroff Injury Law will explain this process to you and keep you fully informed of the progress of your case throughout your lawsuit.