MedPay, Why You Need it.

Why you need MedPay with your Auto Insurance

When searching for ways to lower your car insurance premium, you may be tempted to drop medical payments coverage, aka MedPay, from your policy. After all, it may not be required in your state, and sounds redundant to your health insurance.

But you'd be mistaken to write off MedPay as unnecessary. In fact, the very limitations of most health insurance policies, combined with the slow pace of insurance settlements, as well as the risks and potential financial headaches you can avoid with this often-misunderstood optional coverage, argue strongly in favor of retaining, if not increasing, your MedPay coverage.

Basically, MedPay makes good on medical bills up to your coverage limit for you, your family and others riding in your vehicle in case of an accident, regardless of who's at fault. Your medical payments coverage moves with you (walking, riding with a friend or on public transportation, in-state or out), as well as with your insured vehicles, regardless of who's driving. It carries no deductible or co-pay.

If you're injured in an accident that another insured driver caused, it can take months for their car insurance company to pay your medical bills. Sure, your health insurance may pay, but increasingly many of us carry high deductibles and co-pays that can stretch our finances to the breaking point before the insurance settlement with the other driver closes.

The beauty of MedPay is it kicks in before the hubcaps stop spinning to pay your medical bills, health insurance deductible and co-pays. It covers myriad other out-of-pocket costs that your health policy probably won't touch, including ambulance fees, chiropractic, dental, prosthetics and, in a worst-case scenario, funeral expenses.

In the 12 "no-fault" states (Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Dakota, Pennsylvania and Utah), MedPay can even pick up the co-pay on the personal injury protection, or PIP, portion of your car insurance or kick in seamlessly with 100 percent coverage after you've exhausted your PIP.

The premium for MedPay is so minuscule -- often less than $20 per year for up to $10,000 in coverage -- that the benefits you'd receive on just one claim could pay for decades of peace of mind.

"For example, if your health insurance has a $1,000 deductible, a 20 percent co-pay and you have a $5,000 medical claim from an accident, with your health insurance you would typically pay $1,800 out of pocket," says Christy Moulton Perry, director of product management for Great Northwest Insurance Co. "But with your MedPay, you would pay zero out of pocket. That's a big difference."

MedPay can be especially important for drivers without health insurance. But forget about using it as a stand-alone substitute. You must carry auto liability coverage in order to purchase MedPay, and you'd have to be injured in an auto-related accident to use it.

Unlike liability coverage, MedPay policy limits do not refer to the total available coverage, but instead to the amount available to each covered injured individual. That means if you, your spouse and your two children were injured in an auto accident, each of you could collect the limit amount on your $5,000 MedPay coverage for a total of $20,000. However, your insurer won't pay the same bills under both your MedPay and liability coverage.

If you live in one of the nearly 30 states that allow "stacking" of auto coverage, you may be able to stack your MedPay coverage by the number of vehicles on your auto policy. That means that if you own three insured vehicles and stack your $5,000 MedPay coverage, you would have a total of $15,000 in MedPay available to you or other covered individuals in an accident.

Despite the compelling arguments in favor of MedPay, nearly one in four State Farm drivers chooses to roll without it in states where it is offered.  Those who choose to do so can either afford to self-insure for the cost of items covered under MedPay or are willing to roll the dice if it means saving a couple of bucks a month.

A better move for many would be to boost coverage from the standard levels of $1,000 to $5,000 up to $10,000 or more. The cost to move from $2,000 to $10,000 in MedPay can be as little as $10.00 a month.

Who Makes Personal Injury Laws?

Many personal injury laws date back to old "common law rules." Common law refers to law made by judges, as opposed to laws made by legislatures or passed in bills and statutes.

When a judge hears a case, his decision on that issue of law becomes a binding precedent on all other courts in the state that are "lower" than his court. These other courts then have to apply what the first judge said, and eventually, all of this creates a body of "common law."

Common law can differ from state to state, so the rules for personal injury law may not be the same in all states.

Common law is not the only source of personal injury law. Some legislatures have passed legislation or law that touches on personal injury issues. One example of this would be Workman's compensation laws where legislators took all cases of work-related injuries and removed them from personal injury law and made workman's compensation the way injuries resulting at a place of employment were handle, except under very limited circumstance.

Contingency Fees

What you need to know.

Before you arrange a contingent fee agreement with a attorney, you should know your rights as a client:

There is no legal requirement that a attorney charge a client a set fee or a percentage of money recovered in a case. You, the client, have the right to talk with your lawyer about the proposed fee and to bargain about the rate or percentage as in any other contract. If you do not reach an agreement with one attorney you may talk with other attorneys.

Any contingent fee contract must be in writing and you have three (3) business days to reconsider the contract.

You may cancel the contract without any reason if you notify your lawyer in writing within three (3) business days of signing the contract.

If you withdraw from the contract within the first three (3) business days, you do not owe the attorney a fee although you may be responsible for the attorney’s actual costs during that time.

If your attorney begins work on your case, your attorney may not withdraw from the case without giving you notice, delivering necessary papers to you, and allowing you time to hire another attorney.

Generally, your attorney must obtain court approval before withdrawing from a case.

If you discharge your attorney without good cause after the three-day period, you may have to pay for work the attorney has done.

Before hiring an attorney, you have the right to know about the attorney’s education, training, and experience.

If you ask, the attorney should tell you specifically about his or her actual experience dealing with cases similar to yours. If you ask, the attorney should provide information about special training or knowledge and give you this information in writing if you request it.

Before signing a contingent fee contract with you, an attorney must advise you whether he or she intends to handle your case alone or whether other lawyers will be helping with the case. If your attorney intends to refer the case to another attorney, he or she should tell you what kind of fee sharing arrangement will be made with the other attorney. If attorneys from different law firms will represent you, at least one attorney from each firm must sign the contingent fee contract.

If your lawyer intends to refer your case to another lawyer or counsel with other lawyers, your lawyer should tell you about that at the beginning. If your lawyer takes the case and later decides to refer it to another lawyer or to associate with other lawyers, you should sign a new contract which includes the new lawyers. You, the client, also have the right to consult with each lawyer working on your case and each lawyer is legally responsible to represent your interests and is legally responsible for the acts of the other lawyers involved in the case.

You, the client, have the right to know in advance how you will need to pay the expenses and the legal fees at the end of the case. If you pay a deposit in advance for costs, you may ask reasonable questions about how the money will be or has been spent and how much of it remains unspent. Your lawyer should give a reasonable estimate about future necessary costs. If your lawyer agrees to lend or advance you money to prepare or research the case, you have the right to know periodically how much money your lawyer has spent on your behalf. You also have the right to decide, after consulting with your lawyer, how much money is to be spent to prepare a case. If you pay the expenses, you have the right to decide how much to spend. Your lawyer should also inform you whether the fee will be based on the gross amount recovered or on the amount recovered minus the costs.

You, the client, have the right to be told by your lawyer about possible adverse consequences if you lose the case. Those adverse consequences might include money which you might have to pay to your lawyer for costs and liability you might have for attorney’s fees, costs and expenses to the other side.

You, the client, have the right to receive and approve a closing statement at the end of the case before you pay any money. The statement must list all of the financial details of the entire case, including the amount recovered, all expenses, and a precise statement of your lawyer’s fee. Until you approve the closing statement, your lawyer cannot pay any money to anyone, including you, without an appropriate order of the court. You also have the right to have every lawyer or law firm working on your case sign this closing statement.

You, the client, have the right to ask your lawyer at reasonable intervals how the case is progressing and to have these questions answered to the best of your lawyer’s ability.

You, the client, have the right to make the final decision regarding settlement of a case. Your lawyer must notify you of all offers of settlement before and after the trial. Offers during the trial must be immediately communicated and you should consult with your lawyer regarding whether to accept a settlement. However, you must make the final decision to accept or reject a settlement.

If at any time, you, the client, believe that your lawyer has charged an excessive or illegal fee, you, the client, have the right to report the matter to The Florida Bar, the agency that oversees the practice and behavior of all lawyers in Florida.

Your Rights as a Client

A Clients 10 Basic Rights

When I retain an attorney, I am entitled to one who:

Will be capable of handling my case.

Will represent me and seek any lawful means to present or defend my case.

Will preserve my confidences, or statements which I reveal in the course of our relationship.

Will give me the right to make the ultimate decision on the objectives to be pursued in my case.

Will charge me a reasonable fee and tell me, in advance of being hired and upon my request, the basis of that fee.

Will show me courtesy and consideration at all times.

Will exercise independent professional judgment on my behalf, free from compromising influences.

Will inform me periodically about the status of my case and, at my request, give me copies of documents prepared.

Will exhibit the highest degree of ethical conduct.

Will refer me to other legal counsel, if he or she cannot properly represent me.

Suing the State?

What you need to know.

Involved in an accident or injury with a city, town, county or state entity?  There are some special rules that you will need to follow.

When suing the state or local government, there are often strict time limits for bringing your injury claim. Some jurisdictions require that you file a claim within 30 days of your injury. Other states require a claim within 60, 90, or 120 days after your injury. Many states have one time limit for claims against a city, town, county, or municipality, and another for claims against the state or a state agency. However, not all states have a government-specific time limitation, and you may only need to be aware of the general statute of limitation for your injury.

Under Florida's statute of limitations for personal injury cases, you have four years from the date of the accident to file a lawsuit in Florida's civil courts. For injury claims against a city, county or state government, the time limit is three years.

Notice Requirements for filing a lawsuit against a government entity.
In most states, you cannot simply file a lawsuit in court against the government. Instead, you need to provide a “Notice of Claim” to the government. If you do not follow notice of claim guidelines, your lawsuit will be dismissed by the court. You must ensure that the Notice of Claim complies with laws of the applicable jurisdiction.

 In most jurisdictions, the Notice of Claim must be addressed to each person or entity that caused your injuries. The Notice of Claim is not filed with the court, but must be mailed (often by certified mail) to each government employee or entity. The notice may also need to be mailed to a single government agency that receives all Notice of Claim forms. In Florida, every Notice of Claim must be mailed to the Florida Department of Financial Services.

There is specific information that must be included in the notice. For example, in Pennsylvania, the notice must have the name and address of the injured person, the date, location, and hour of the accident, and the name and address of medical care providers.

After sending the Notice of Claim to each person or entity, you must wait for a period of time before filing a lawsuit in court. This period is typically between 30 and 120 days. The court will dismiss a lawsuit that is filed before the Notice of Claim period expires.

 Did you know the Government May Be Immune From Your Injury Claims?

The government is immune from certain injury claims. While this immunity is less broad than in the past, the government is still immune from many injury claims. Again, this immunity varies from state to state. Let’s take a look at the government immunity laws of two states.

In Illinois, there are several governmental immunities related to negligence claims. Under Illinois Law, the government is immune from lawsuit for negligence for:

Failure to supervise activity on public property.
Negligence related to health and safety inspections, and negligence connected to injuries caused by unsafe conditions on government property if the government did not have notice of the conditions.

In Pennsylvania, governmental employees and entities also have certain immunities from liability. These immunities relate to:

Operation of a motor vehicle.
Care, custody, and control of personal and real property in possession of the government.
Dangerous conditions of trees, traffic controls, street lighting, utility service facilities; streets, and sidewalks, and care, custody, or control of animals in possession of the government.

Most states will not allow injured persons to recover punitive damages from the government.

Punitive damages are compensation that is awarded to an injured person in order to punish the wrongdoer and deter future similar misconduct. The reasoning behind this policy (against punitive damages in these cases) is that, where the government is involved, punitive damages would not have the same deterrent effect.

Letter of Protection.

 What does it do, and why would I need it?

When a client is represented by an attorney, the attorney may issue a letter of protection (LOP) to a doctor or medical provider, asking the doctor to hold their bill for collection, and promising to pay the doctor out of the proceeds of a personal injury case.

The LOP does NOT make the attorney responsible for the bill, it remains a contract between the patient and the doctor.

Your attorney should not issue a letter of protection unless you agree and authorize them to issue such a letter.

The form, which you must authorize states that you agree that the bills of the medical provider will be paid out of the proceeds of your personal injury settlement.

If you are not successful in your case against the at-fault party, you are still responsible for paying your medical bills.

There are situations where billing sources unrelated to your injury case may request a letter of protection.

Most attorneys will not agree to issue a letter of protection for a bill unrelated to the injury case, such as for a car payment, or other non-medical type billing. Typically a letter of protection is only issued to medical providers who treated the client for the injuries that are the basis of the personal injury case.

A common situation in which letters of protection are necessary includes automobile accidents in which the medical bills exceed the $10,000.00 in PIP benefits, and for which there is no health insurance or other source of payment.

Additionally in motorcycle accidents or premises liability cases, where there is no personal injury protection (PIP) insurance, the injured client would have little chance to receive care for his or her injuries without a letter of protection.

Another common situation arises because PIP auto insurance in Florida only pays 80% of accident related medical bills, leaving 20% of your medical bills outstanding.

Without a letter of protection your medical provider may require upfront payments or refuse to provide treatment without assurance that he will be paid. For many injured persons, a letter of protection may mean the difference between getting treatment for their injuries or not getting treatment.

The letter of protection is a contract between the medical provider and the attorney, and is normally obtained through a process in which the medical provider contacts the attorney requesting a letter of protection.

Letters of protection differ from advance settlement funding, because under a letter of protection no money changes hands, no interest is charged, and the medical bills are not paid until the case is settled.

Once the case is settled, the attorney is obligated to honor the letter of protection and pay the medical providers in accordance with the agreed upon letter of protection.

Pre-settlement Funding?

When you’re in the midst of a personal injury case and are struggling to make ends meet, securing pre-settlement funding, using financial aid like loans, might be an option.

A pre-settlement loan, also referred to as lawsuit advance funding, can help accident victims who are seriously injured, unable to return to work, and have no other resources available for living expenses while awaiting their personal injury claim to settle.

It’s important not to jump into any loans or agreements, though, without first knowing how they work, the pros and cons, and speaking to your attorney about it.

What is a pre-settlement loan?

Some finance companies offer funding for personal injury accident victims who are in the middle of a lawsuit. According to statistics "Over 85 percent of the funds consumers get go to pay immediate household needs, such as the mortgage, rent, car payments, and putting food on the table. It is used to keep them above water until they wait for the outcome of their legal claim."

After the funding application process, the company will estimate the value of the claim and then provide the client with a cash advance. The clients must then pay back the “loan" (although it’s not really legally considered a loan; it’s “funding") upon a successful settlement, along with hefty fees.

Types of Cases Suitable for Settlement Loans

Any type of case that will result in a fairly large settlement may be a candidate for pre-settlement funding. Most lawsuit advance funding companies accept cases such as:

 car, bike, truck and motorcycle accidents, wrongful death, injuries to children, pedestrian accidents, product liability,  medical malpractice, slip and fall accidents and traumatic brain injury cases.

Pre settlement Loans, Pros and Cons

If you are currently considering a settlement loan, it’s important to fully understand the pros and cons before rushing into any funding options.

The most obvious benefit is that this type of funding will enable you to pay your bills until your case is settled. If you have exhausted all your other resources, a loan could help you stay afloat financially.

Another benefit is that victims will have a little more staying power and may be less likely to rashly settle on a lower offer because of financial desperation.

However, there is harsh criticism of lawsuit loans by lobbyists who are fighting to have the industry better regulated. The fees are often 60 to 100 percent or more annual interest rate. Fortunately, if you don’t win your case, you will not be obligated to pay back the funding company.

As always consult with your attorney when making this or any other decision that involves your case.

Letter of Protection

What does it do, and why would I need it?

When a client is represented by an attorney, the attorney may issue a letter of protection (LOP) to a doctor or medical provider, asking the doctor to hold their bill for collection, and promising to pay the doctor out of the proceeds of a personal injury case.

The LOP does NOT make the attorney responsible for the bill, it remains a contract between the patient and the doctor.

Your attorney should not issue a letter of protection unless you agree and authorize them to issue such a letter.

The form, which you must authorize states that you agree that the bills of the medical provider will be paid out of the proceeds of your personal injury settlement.

If you are not successful in your case against the at-fault party, you are still responsible for paying your medical bills.

There are situations where billing sources unrelated to your injury case may request a letter of protection. 

Most attorneys will not agree to issue a letter of protection for a bill unrelated to the injury case, such as for a car payment, or other non-medical type billing. Typically a letter of protection is only issued to medical providers who treated the client for the injuries that are the basis of the personal injury case.

A common situation in which letters of protection are necessary includes automobile accidents in which the medical bills exceed the $10,000.00 in PIP benefits, and for which there is no health insurance or other source of payment. 

Additionally in motorcycle accidents or premises liability cases, where there is no personal injury protection (PIP) insurance, the injured client would have little chance to receive care for his or her injuries without a letter of protection.

Another common situation arises because PIP auto insurance in Florida only pays 80% of accident related medical bills, leaving 20% of your medical bills outstanding. 

Without a letter of protection your medical provider may require upfront payments or refuse to provide treatment without assurance that he will be paid. For many injured persons, a letter of protection may mean the difference between getting treatment for their injuries or not getting treatment.

The letter of protection is a contract between the medical provider and the attorney, and is normally obtained through a process in which the medical provider contacts the attorney requesting a letter of protection.

Letters of protection differ from advance settlement funding, because under a letter of protection no money changes hands, no interest is charged, and the medical bills are not paid until the case is settled. 

Once the case is settled, the attorney is obligated to honor the letter of protection and pay the medical providers in accordance with the agreed upon letter of protection.

Types of Personal Injury

What is personal injury?


There are a wide variety of different situations where personal injury rules apply:


 Accidents.  Personal injury rules apply in situations where someone acts in a negligent manner, and that carelessness causes harm to another person.

 Examples include car accidents, slip and fall incidents, and medical malpractice, among other types of cases.

 Intentional Acts.Personal injury laws apply in situations where a defendant’s intentional conduct causes harm to another person.

Examples of this include assault and battery, and other intentional acts.

Defective Products. There are a few situations where a defendant can be found liable for injuries without any negligent or intentional wrongdoing.

Examples of this include certain types of product liability claims arising from a defective product.

Defamation. Personal injury laws apply when one person’s defamatory statement causes harm to another person’s reputation.

Uninsured/Under-insured Motorist Coverage

Uninsured Driver Coverage

You use your uninsured motorist coverage if you are hit by a driver who carries no car insurance, and the accident is deemed to be that driver’s fault. If that happens, you would generally not bother trying to sue the uninsured driver. Drivers who have no car insurance generally don’t have any money either. Instead, you would make a claim against your own insurance company up to the limit of your uninsured driver coverage.

Under-insured Driver Coverage

Under-insured driver coverage is for when you are hit by a driver who carries insufficient car insurance, and the accident is deemed to be that driver’s fault. Insufficient insurance means that the negligent driver does not have enough insurance to cover your damages. In that case, you would make a claim against your own insurance company up to the limit of your under-insured motorist coverage, but only if your under-insured driver coverage is greater than the negligent driver’s policy limits.

Let’s say that your case is worth $200,000, but the negligent driver only has $100,000 of coverage. In that case, you can make an under-insured driver claim against your own insurer as long as you have more than $100,000 in under-insured driver coverage. If you had $150,000 in under-insured driver coverage, you would settle with the negligent driver for $100,000, and would settle with your insurer for $50,000. You cannot take the negligent driver’s $100,000 policy and another $100,000 from your policy. You can only take from your policy that amount that exceeds the negligent driver’s coverage.

Another important thing to know about uninsured and under-insured driver coverage is that those coverage's cannot exceed the amount of your primary coverage. For example, if you have $100,000 in coverage for your own potential negligence, you can only have up to $100,000 in uninsured or under-insured coverage. That’s just a financial issue for insurers. Uninsured and under-insured coverage is very cheap compared to regular liability coverage, so insurers don’t want their clients purchasing only the minimum liability coverage and then loading up on uninsured and under-insured coverage.

How an Uninsured or Under-insured Driver Claim Works

If you have reason to believe that the driver who hit you is uninsured, you should give your insurer notice as soon as possible, letting them know that you intend to file an uninsured claim.

Some car insurance policies place strict deadlines on their clients' policies when it comes to notification of potential uninsured claims. Don’t delay. The deadline could be as brief as 30 days. If the other driver tells you that he/she does not have car insurance, or, if he/she refuses to give you any insurance information, and you can’t get the insurance information in any other manner, inform your insurer immediately that you intend to file an uninsured claim against your insurer.

An under-insured driver claim will generally take a little longer to develop. You usually are not going to know right away that you are going to have an under-insured driver claim until your medical treatment progresses and you and your lawyer get a better understanding of the value of your car accident case. But once you or your lawyer believe that your case is worth more than the defendant’s liability coverage, you must inform your insurer immediately that you intend to make an under-insured driver claim against it.

In general, an uninsured or under-insured driver claim progresses in the same way as a regular car accident claim, except that the claim is against your own insurance company. There will be pretrial investigation, disclosure of your medical records, and depositions of witnesses. But one very important difference is that, if you and the insurer cannot agree on a settlement figure, you cannot file a lawsuit against your insurer.

Instead, you have to submit your claim to binding arbitration, which is a more informal procedure than a court trial. An arbitration is a hearing in front of an arbitrator, and the arbitrator or arbitrators will decide who wins. The down side of binding arbitration is that, unlike a court trial, the losing side in an arbitration has very limited rights of appeal. Basically, the losing side in a car accident arbitration is stuck with the decision.

www.floridabar.org/www.allaw.com

Finding an Attorney

This week's blog covers some basic tips when looking for an attorney.

Most people don't have a "regular" attorney, in the sense that they have one or more doctors that they see at least annually.

So how do you find the attorney who's right for you?

Where do you turn for recommendations?

One way is to get recommendations from a trusted friend, relative, or business associate. Be aware that each legal case is different and that an attorney who is right for someone else may not suit you or your legal problem.

Are there any practical considerations to keep in mind when choosing an attorney?

Yes, the attorney's area of expertise and prior experience are important.

Eighteen states have specialization programs that certify attorneys as specialists in certain stated types of law. These states are: Alabama, Arizona, California, Connecticut, Florida, Georgia, Idaho, Indiana, Louisiana, Maine, Minnesota, New Jersey, New Mexico, North Carolina, Pennsylvania, South Carolina, Tennessee and Texas.

In states without certification programs, you may want to ask about your attorney's areas of concentration. You also may wish to ask about the type of cases your attorney generally handles.

To learn more about your states certifications, check your local bar association website.

Another possibility is a referral service.

Most communities have referral services to help the public find attorneys . These services usually recommend a attorney in the area—sometimes at a reduced cost.

Several services offer help to groups with unique characteristics, such as the elderly, immigrants, victims of domestic violence, or persons with a disability.

These services usually make referrals according to specific areas of law, helping you find an attorney with the right area of practice.

Many referral services also have competency requirements for attorneys who wish to have referrals in a particular area of law.

To contact a referral service, look in the telephone book's yellow pages under "Lawyer/Attorney Referral Service," or look under any local or state bar association listing. You can also 'Google' it on the internet.

How do I go about choosing an attorney?

Most attorneys will meet with you briefly to "get acquainted," allowing you to talk with your prospective attorney before making a final hiring decision.

In many cases, there is no fee charged for an initial consultation. However, to be on the safe side, ask about fees before setting up your consultation appointment.

I may want to hire a lawyer, but I do not have much money. Where can I find low-cost legal help?

People do not have a right to a free attorney in civil legal matters (they do in most criminal cases). However, several legal assistance programs offer inexpensive or free legal services to those in need.

Most legal aid programs have special guidelines for eligibility, often based on where you live, the size of your family, and your income.

To find free or reduced-cost legal services in your area, call your bar association or county courthouse. You can also search "Legal Aid," or "Legal Assistance' on a computer with an internet connection.

For more information on this topic and many other legal topics, be sure to visit your local bar association website.