How do I know if I have a case?
If you are in a car wreck caused by somebody else's wrong-doing, then the insurance company of the person that hit you, and otherwise caused the wreck, should pay for your property damage and for your physical injuries and medical treatment you receive for those injuries.
If I file a lawsuit against somebody, or make a claim for bodily injuries after a car wreck, does the other person have to pay for their own money, or does their insurance company pay?
Insurance pays. If the person that hit you had insurance, his or her insurer is responsible for paying for your property damage and for any injury to your body. That is why we all pay for insurance – for protection. You probably have liability insurance to help you if you are negligent on the road.
Lawyers, most of them, are not out there trying to go after people’s houses and assets, they are trying to get insurance companies to do the right thing. So, if you are hurt, don’t worry about your claim hurting somebody else – that is what insurance is for.
Why do I need a lawyer?
As an individual, when you get hit by somebody else, you’re not dealing with your neighbor, you are dealing with a sophisticated corporation that is trying to minimize their risk and maximize their profits.
You need a lawyer to help level the playing field. The average insurance company make hundreds of millions, if not billions of dollars a year. Insurance adjusters are trained to give settlements that will make the insurance companies money in the end. This is why it is important to have an expert with your best interests in mind on your side.
Lawyers are not perfect, far from it. But lawyers are trained to know the rules, and to make sure you know the rules. If you get a cold or a virus, you go to a doctor, because a doctor is an expert. If you get in a car wreck, you should consider going to a lawyer, because this is what they are trained to do. Insurers don't want people to go to lawyers, and don't tell you the rules, because they want you to settle quickly for the lowest amount possible.
Should I go to the emergency room for an acute care if I'm involved in a wreck?
Yes. First, car wrecks may involve trauma, often to the neck and back, sensitive and important parts of your body. This is true for people of all ages. Wrecks can cause injuries that you don’t notice at first, but come up later, so it is important to get checked out. Wrecks can cause cerebral hematomas (blood on the brain) that you don’t necessarily feel right away. Getting checked out by a doctor helps insurance companies and their lawyers from making your claim seem made-up or exaggerated.
In many cases, the insurance company will say something like, “well, if you were really hurting you would have gone to the emergency room.” Insurers and their lawyers take that position even though most people know it can take a few days to start hurting after a car wreck. Unfortunately, the failure to seek prompt care is used against you.
So if you are in a wreck and feel pain or soreness, get checked out because:
- doctors can tell you what is going on with your body and confirm if there is a problem or not;
- if pain or injury does come up later, you have documentation that the injury was not sustained before the wreck.
We would never tell people to go to the doctor without reason, but if you think you may be injured it is important to go!
Should I give a recorded statement shortly after my wreck to the insurer?
It depends. If you are involved in a wreck are not injured, it is okay to give a statement. However, if you have been injured, you want to make sure you do not mention an injury in the statement. More often than not it is better to avoid giving a statement. Insurers use your statements against you to make it look like any injuries that arise a few days or weeks after the wreck are not related to the car wreck.
A general rule is to use caution and talk to a lawyer before giving any recorded statement. Those statements you give in the hours or day after the wreck can stay on file years. You are not required to give statements to the other driver’s insurer, though sometimes may be required to give a statement to your own insurer within a certain period of time. Insurance companies train their employees to ask questions that can get you into trouble later on. Insurance companies act immediately to protect themselves. Our advice is to talk to a lawyer before giving a recorded statement, because once you give a statement, it is permanently on record.
Are my property damage claims separate from my bodily injury claims?
Yes. The insurer should either provide you with a rental while your car is being repaired or establish if the car is totaled and promptly pay you the “Blue Book” value of the car. Payments for your property damage are separate from payments for your bodily injury, so there is no need to be in a hurry to collect your injury claims. Be sure you have been treated for all of your injuries and have healed before settling your bodily injury claim.
Can I use my own health insurance to obtain medical care after being in a wreck?
Yes. There is a common misconception that automobile insurance companies will pay for your injuries and treatment at the same time. Unfortunately, that is not the case. When you are hurt in a car wreck, your health insurer should pay your health provider. At that point, your lawyer communicates with your health insurer and determines if reimbursement is due under the law. If you have health insurance, you should be able to obtain care.
What is uninsured/underinsured motorist coverage? Should I have it? If I use it, do my premiums go up?
Uninsured and underinsured motorist coverage (UM) is coverage that you can buy from your auto insurer to protect you and your passengers if you are:
- hit by someone with no insurance, or
- hit by someone without enough insurance
A typical situation of a person not having enough insurance involves the victim having serious injuries and/or high medical bills, but the at-fault party only having the legal minimum of $25,000 in liability coverage. For example, if your medical bills are $30,000+, but the at-fault person only has $25,000 in insurance coverage, this is when you would look to your UM coverage to help cover your bills and further compensate you for your lost wages, pain and suffering, etc. Most drivers in this area have minimum insurance, and many drivers have no insurance. If you are hit by someone with no insurance, or without enough insurance, sadly, you can be out of luck. Be proactive and ask your agent if you have UM.
There are 2 types of UM, and they are not usually explained. One type is “add-on” – this is the better type of UM. “Add-on” UM is what it sounds like, it “stacks” on top of the liability coverage that the other driver has. So if you are hit by someone with $25,000 in coverage, and you have $100,000.00 Add-on coverage, you have a total of $125,000 in available insurance coverage. The other type of UM coverage is called “reduced” or “traditional” UM. If you have “reduced” UM, then your auto insurer gets a credit for the insurance the other driver has. In other words, if you are hit by someone with $25,000 in liability coverage (like most people have), and you have $25,000 in “reduced” UM, then your insurer gets a credit, and you effectively have no coverage. In that situation, if you had “add-on” UM, you would have $50,000 in total available coverage ($25,000 in liability plus $25,000 in UM). So be conscious of the type of UM coverage you have.
If you live in Alabama, you can have significantly more UM coverage, because you can “stack” vehicles within a policy. In other words, if you have a $25,000 UM policy and own 3 cars, you have $75,000 in UM (this is not the case in Georgia). You also have additional rights against your UM carrier. For instance, if you are hit by a drunk driver, your coverage is issued in Alabama.
Are there different types of Uninsured Motorists?
There are 2 types of UM, and they are not usually explained. One type is “add-on” – this is the better type of UM. “Add-on” UM is what it sounds like, it “stacks” on top of the liability coverage that the other driver has. So if you are hit by someone with $25,000 in coverage, and you have Add-on coverage, you have a total of $125,000 in available insurance coverage. The other type of UM coverage is called “reduced” or “traditional” UM. If you have “reduced” UM, then your auto insurer gets a credit for the insurance the other driver has. In other words, if you are hit by someone with $25,000 in liability coverage (like most people have), and you have $25,000 in “reduced” UM, then your insurer gets a credit, and you effectively have zero coverage. In that situation, if you had “add-on” UM, you would have $50,000 in total available coverage ($25,000 in liability PLUS $25,000 in UM). So the TYPE of UM coverage you have matters. If you live in Alabama, you can have significantly more UM coverage, because there, you can “stack” vehicles within a policy. In other words, if you have a $25,000 UM policy, but 3 cars, you have $75,000 in UM (this is not the case in Georgia). You also have additional rights against your UM carrier (for instance, if you are hit by a drunk driver), if your coverage is issued in Alabama. This is the type of information you need to know.
Do my premiums go up if I use my own auto insurance coverage?
No. There are specific Georgia regulations that prohibit auto insurers from raising your insurance rates when you are involved in a wreck where you are at not at fault. You pay an additional premium for UM coverage, and you cannot be penalized by the insurance company for using a product you paid for.
Will my health insurance premiums go up if I file a lawsuit?
No. Health insurance is supposed to pay regardless of how the injury happened. This has been a controversial topic in Congress over the years. The short answer is no, there is no evidence that health insurance premiums go up because of lawsuits. More importantly, most of these arguments involve medical malpractice lawsuits, which some medical groups argue increase the cost of premiums for doctors for malpractice coverage.
In a car wreck case, there is absolutely no evidence that filing a lawsuit increases health premiums. These arguments are used to make people feel like filing a lawsuit is wrong. The law is in place to protect you when you are hurt by the negligence of another. In 2005, the Georgia legislature passed sweeping “tort reform” to address the arguments that medical malpractice suits increase premiums. There are now very strict requirements for filing these lawsuits.
If I have a pre-existing condition that gets worse in a car wreck, do I still have a claim for injuries?
Yes. If you are over a certain age, you almost certainly have what can be called a “pre-existing condition.” Some pre-existing conditions are more severe than others, e.g., if you have had surgery on your lower back, and then get in a wreck that hurts your lower back, you certainly had a pre-existing condition. However, that does not mean you can’t recover in a lawsuit or claim. In Georgia, the law holds that a person who causes a wreck “takes the plaintiff as they find them” – in other words, if you had a problem, but a wreck caused it to get worse, then you can recover for the “aggravation” of that injury. It’s very important to make sure your doctor is aware that you have new or increased pain. The ability of your doctor to be able to explain the difference between previous injuries and new injuries is very important.
Insurers will often tell you that X-rays at the emergency room just showed degenerative changes – or age related changes. But such testing and summary of results don’t always tell the whole story. This is why it is crucial to get to a doctor who can give you a clear diagnosis about what injuries were caused by the wreck.
How and when does the insurance company pay for my injuries?
Once you have completed treatment for your wreck-related injuries, in most cases. After you are released from treatment by your doctor(s), we gather all of your medical records and medical bills, as well as other information relevant to your claim. We discuss the information with you in detail then we prepare a “demand package” for the insurance company. This package is a compilation of documents that tell your accident story to the insurance company, and it also gives them a time deadline to respond to the demand.
After that point, we enter into settlement negotiations with the insurer. If a resolution is not achieved, we discuss your options including the filing of a lawsuit to pursue the matter. Some cases go straight to lawsuit when the facts and circumstances warrant or require it. An insurance company will pay you after a case is resolved.
Who pays my medical bills and lost wages?
Claims for lost wages and medical bills are an element of damages paid at the conclusion of a claim by the responsible party. Most insurance companies will not finance the case as it progresses. It is fair to say that insurance companies like to use economic pressure to force capitulation in certain circumstances. There are ways to combat that situation but every case is different.
Can I recover money damages for pain and suffering?
Money damages for pain and suffering is the part of a case that represents compensation for the changes in your life and impact on the pleasures of life. Pain and suffering deals with the elements of life that cannot be replaced at the store or quantified easily based on a wage. The “art” of the law is often found in how to define and value this element of damages.
What if my child is injured? Are there special rules?
Cases for children present several challenges. Parents and guardians have rights independent of the child but also an obligation to represent the child in a fair way. There are numerous safeguards required for children but it is still the parents who make decisions. We are happy to discuss the specifics of handling a case for protecting a minor.
What is a "lien"?
A “lien” is a formal claim against any recovery you obtain from the person that caused your injuries. Liens can take many forms including outstanding medical bills related to your injuries, subrogation/reimbursement claims by your health insurance for benefits extended to you related to your injuries, worker’s compensation benefits paid related to your injuries or lost wages, overdue child support, or judgment due against you. Some liens generally must be paid. For example, if Medicare pays some of your medical expenses, the government will assert a right to be paid back. However, many liens are arguably unenforceable for many reasons or at a minimum can be negotiated to a lower amount.
In many situations, there is not a true, valid lien. Many companies will claim a lien trying to extort a payment when they have not followed the law or made an appropriate claim. One of your lawyer’s jobs is to determine if any liens have been claimed against your recovery, whether those liens are valid, and if they can be satisfied for less than the full lien amount.
Why is the hospital calling me about my auto insurance and should I talk to them?
Hospitals want to be paid and have an ability to place a formal “lien” on an injury case. In most situations, a hospital can get more money from your injury recovery than they would if they billed your health insurance. Basically, the hospital is seeking auto insurance information to try to recover its full sticker price for services rendered, instead of the lower amounts a health insurer would pay which would require the hospital to contractually adjust off and lower the total payment it receives. By doing so, the hospital gets more money and you get less in the end. We strongly recommend limiting conversations with people who call to “help” because chances are, they are just trying to get paid.
If I am self-employed, do I receive compensation for my losses?
Yes, the law recognizes damages for loss of self-employment income as well as the value found in being able to work, even when you do not earn a living from the activity. Different standards of proof exist and income from a startup business is of course harder to prove than that or an established operation. This is something to be discussed with your lawyer on a case by case basis.
If I am a government worker or soldier, how should I pay for my medical bills?
You should use your health insurance to pay your medical expenses. The rules vary, but generally, you will be better off at the end of your case if your health insurance has paid down as many of your medical bills as possible. If you are a soldier with Tricare, your attorney will be required to communicate with the Office of the Staff Judge Advocate (JAG) on your behalf. The JAG office on behalf of the U.S. Treasury will handle a claim for reimbursement for benefits provided to you by the government. Fortunately, your attorney cannot charge a fee on any part of your recovery that goes to JAG to reimburse the U.S. Treasury.
My doctor refuses to see me because I was injured in a car wreck.
Often we hear that someone’s family doctor won’t see them after they have been hurt in a wreck. There are a few common reasons for this. The first is that there is a lot of misinformation about how wrecks and insurance work. Many medical offices have a misunderstanding about whether your health insurance will pay for your treatment like it normally does. Because of that they refuse care out of fear they won’t be paid even though your health insurance will absolutely keep paying them like it always did. Usually, this problem happens with receptionists and office managers without the doctor even knowing you tried to get an appointment. Remember, your doctor needs to know you were hurt in a wreck and the receptionist scheduling the appointment does not.
Another example is some doctors are convinced by big business and the insurance lobbyists that all lawyers are bad, all claims are bad, that lawyers and the injured want to sue all doctors, and that as a result the doctor has to pay more for his malpractice insurance. That is a flat lie. There is no connection between higher insurance and actual lawsuits against doctors. Insurance companies charge whatever they want and then scare people out of using the coverage.
A third reason is that many doctors just don’t want to be involved in a case by having to produce their medical records/bills and possibly have to provide testimony on a patient’s behalf. Family doctors are often extremely busy and can face a real burden by taking time from their job to provide opinions for a case. There are many ways to lessen that burden on the doctor, but again, many doctors are not regularly involved with lawsuits and are not familiar with how little of their time might be necessary.
Do I have to pay back my health insurance company if they pay for my medical bills?
Maybe. It depends on your health insurance plan and where your case is located. This is a very complex debated area of the law right now. If you have Tricare, Medicare, Medicaid, or some other type of government-funded insurance plan, the general rule is yes, you must pay them back. However, when it comes to other health insurance plans, they will often tell you they have the right to be reimbursed (the technical term is “subrogation”), but this is often NOT the case.
Georgia law favors the injured party over the health insurance company, but Georgia law does not always control, even in Georgia cases. The lawyers at the Law Offices of Gary Buce are well versed in this area of the law, and will do everything possible to minimize or completely prevent such a reimbursement claim.
What if I have a permanent injury and will need care in the future?
Assuming your doctors have documented this well in their records, both permanency and future medical care are elements of loss than can be claimed and valued in your recovery.
What if I've had a similar injury before?
Prior injuries make a case more complicated. The law allows recovery when there is an aggravation or exacerbation of an underlying condition or old injury. The law also requires a defendant take an injured individual as they are – meaning that whether you play a professional sport or you a couch potato, the defendant has to deal with whatever harm was caused to you regardless of your health prior to the incident. So having a prior similar injury does not automatically mean you don’t have a case. In fact, the prior injury might have made you more vulnerable to your current suffering. However, prior similar injuries can also be used by an insurance company or defense attorney to argue that you are still suffering from the same old problem for which the defendant has no responsibility. Prior injuries can also make your medical records less clear or otherwise affect value of a case.