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Auto insurer refuses to provide coverage for the jaws of life

Stephanie Day — Thu, 22 Jan 2009 10:26:32 GMT

Recently, State Farm refused to pay a fire department bill for the use of the "jaws of life" to extricate an injured person from an automobile collision. State Farm's basis for the coverage denial was that the extrication was a "non-medical" expense, and thus, not covered by the injured insured's medical payments coverage.

This position leaves me to wonder what we're really paying for when we buy automobile insurance coverage. I guess State Farm and other like-insurance companies expect its injured insured to be taken to the emergency room by the wrecker towing the mangled vehicle. Maybe the emergency room doctors and staff would enjoy working outside for a change.

Folks, question your insurance agent about your policy, and be sure to read your auto insurance policies carefully!

Originally posted at InjuryBoard by Stephanie Day

Who Does Tort or Medical Malpractice Reform Really Benefit?

Alison De Villiers — Tue, 15 Sep 2009 10:24:17 GMT

We have been told repeatedly over the years that medical malpractice claims are destroying the business of healthcare. Various groups have advanced this claim at various times, but the usual suspects are insurance companies, doctors, and conservative politicians. Today, let’s take a look at the insurance industry and see if we can’t sort out some of their claims. Perhaps we can take a look at the other groups a bit later.

Insurance companies claim that medical malpractice claims are the primary driver behind the high prices doctors pay for insurance. This seems reasonable, if the cost of being a doctor goes up, either doctors will stop being doctors, change to less risky fields, or pass the costs along to the consumers of healthcare. It is true that malpractice insurance premiums have drastically increased over the last 25 years. Are these price increases being driven by lawsuits? For this charge to be true, either the overall number of claims must have increased or the awards for individual judgments must have increased massively. If increases in damage awards were responsible, then one would expect to see lower payouts and lower premiums in states that have statutorily capped such damage awards. So, when we do the research, do we see such an explosion, of either claims or payouts? The short answer is no, we do not.

A study of malpractice claims in Texas 1988-2002 found after controlling for inflation and population growth that there had been a decline in the number of small claims (under $25,000) and that the number of large claims had remained roughly constant. In addition, the amounts of those paid claims only rose 0.8-1.2 percent per year. As for the effects of capped non-economic damages, one national study found that while payouts did decline in the nineteen states that then had caps, premiums in capped states rose far faster than those in uncapped states. In states with statutory caps, the median annual premium increased 48.2%, while those states without caps saw a median increase of only 35.9%. This suggests that while something is driving premiums higher, it isn’t malpractice claims. A slightly more recent bit of research shows that nationwide the number of claims declined by four percent between 1995 and 2000. (pages 24-25). Declining numbers of lawsuits doesn’t sound like a crisis.

So, from the perspective of the insurance companies, what is driving up the cost of insuring doctors? According to Martin Weiss, an analyst with Weiss Ratings, Inc., there are several factors, including: increases in the cost of medicine generally, the cyclical nature of the insurance market, a need to shore up capital reserves for policies already in force, and a decline in investment incomes due to poor investment choices. (pages 9-11). These are all real forces, and it is utterly rational for the insurance industry to raise its prices in response to them. What is wrong is for the industry to hide those increases behind a smokescreen of some phantom ‘crisis’ of lawsuits.

The tort system as we know it has existed for centuries. Its goal is to ensure that when a person is injured through no fault of their own, that the person responsible for the injury restore them to health. A secondary goal is to discourage negligence in general. It is difficult to argue with the morality of either of these goals. We want a society in which people are personally responsible for their behavior. Tort reform is about severing responsibility for causing an injury from the person who caused it. Insurance companies would have us do this as a mere convenience, so that they need not explain why they are raising their prices. This is an unacceptable reason for fundamentally altering a massive chunk of our legal system, one that has long served us well.

Perhaps the best way to end this is to ask who tort or medical malpractice reform doesn’t benefit? The answer to that is simple: consumers.

Originally posted at InjuryBoard by Alison De Villiers

Why Do Attorneys Charge Contingent Fees?

Alison De Villiers — Wed, 16 Sep 2009 08:49:14 GMT

What are Contingent Fees?

A client pays a contingent fee to a lawyer only if the lawyer handles a case successfully. In a contingent fee arrangement, the lawyer agrees to accept a fixed percentage (usually 1/3) of the amount finally paid to the client. This percentage must be a reasonable amount given the circumstances of the case. If you win the case, the lawyer's fee comes out of the money awarded to you. If you lose, neither you nor the lawyer will get any money, but you will not be required to pay your lawyer for the work done on the case.

What are the Benefits of Contingent Fees?

In most cases, a client will not pay any upfront costs for legal representation in a contingency fee arrangement. Filing fees, copying costs, long distance charges, computerized legal research, deposition costs, and mediation expenses are also costs of a lawsuit and sometimes expert witness fees can cost anywhere from $1,000 to $30,000+. Most clients cannot afford to pay these expenses and would not be able to pursue their claims if attorneys could not advance the costs. Fortunately, in a contingent fee arrangement the lawyer will pay these expenses for the client and be reimbursed if the client’s case is successful. This allows many people access to justice who would not be able to afford it if the lawyer charged by the hour or demanded payment upfront. In addition, if the case is unsuccessful the lawyer gets no fee. Therefore, there is an absence of risk for the client, because they will owe the lawyer no attorney fees if they do not win their case.

Another advantage of a contingent fee arrangement is that it aligns the interests of the client and the lawyer. The lawyer is motivated in a contingent fee arrangement to maximize the amount of money the client will receive. In a common fee arrangement, where the lawyer is being paid by the hour, it makes little difference whether the client wins or loses her case. In a contingency fee arrangement, because a lawyer’s fee is tied to the success of a client’s case, the client can be assured that the lawyer is putting in the time and effort to get the best result possible for the client. Furthermore, the fact that a lawyer has taken a case on a contingency fee basis reflects her belief that the case is strong and has a likely chance of succeeding. A lawyer would not advance the costs of a case she was certain she would lose. She would be out of business quickly if she did.

Why do Lawyers Charge Contingent Fees?

Lawyers charge contingent fees because it allows many clients to bring lawsuits they would not have been able to afford otherwise. By taking fees and costs out of the money awarded to the client, the lawyer can pay the expenses of going to trial so the client doesn’t have to. If the client loses, she pays nothing for attorney fees (must usually reimburse the lawyer for the costs) and the lawyer gets nothing. These cases entail big risks for the lawyer, but little for the client. A contingency fee assures the lawyer that she will be compensated for the risk she has undertaken. As a client, it is beneficial to talk about the proposed fee arrangements with your lawyer from the very beginning. Make sure the arrangement is in writing and that you know why your lawyer is requesting the contingency fee she is requesting. You’ll find that your lawyer wants you to get the money you deserve just as much as you do.

Originally posted at InjuryBoard by Alison De Villiers

What Jurors Probably Don't Know About Defense Medical Experts

Alison De Villiers — Mon, 22 Jun 2009 12:35:30 GMT

When a Plaintiff is injured due to the negligence of another, the Plaintiff must rely on her doctors to testify as to the nature and extent of her injuries. In most states, like Ohio, the attorney for the Defendant/insurance company is then allowed to hire a doctor to examine the Plaintiff and render an opinion on the nature and extent of the Plaintiff's injuries. In the Cincinnati area, my clients are repeatedly sent to the same few doctors to be examined. It is extremely rare that one of these doctors will agree with the Plaintiff's treating physicians regarding the extent of the Plaintiff's injuries.

To the typical juror, the defense medical experts may seem to be on equal footing as the Plaintiff's treating physicians. The attorney for the Plaintiff can do her best to show how much the defense medical expert is being paid for his time and how much that equals out to per year. But, it seems to have little effect on jurors. The defense attorneys often argue: Why would this doctor risk his medical reputation by sticking his neck out for me or my firm in this case?

What the jurors do not know is that if the defense medical doctors start agreeing with the Plaintiff's doctors, the attorney for Allstate or State Farm will not be as inclined hire them to do defense medical exams. Lose one insurance company and that could equal hundreds of thousands of dollars per year in lost income.

Although this article written for doctors about serving as an expert witness in cases was written in 2003, the information remains relevant. It emphasizes the high ethical obligations of medical expert witnesses, both for the Plaintiffs and the Defendants. It points out that one of the main problems in the legal system in regards to expert testimony is the lack of accountability for statements made by expert witnesses under oath. The article suggests peer review of expert witness testimony to ensure that it is medically sound. Another suggestion is to have court appointed defense medical examiners.

Originally posted at InjuryBoard by Alison De Villiers

Auto Insurance Coverage In Ohio

Brett Goodson — Thu, 02 Apr 2009 09:04:28 GMT

It is hard to believe that Ohio only requires proof of $12,500 in liability insurance coverage to be able to drive a car in Ohio. This minimum insurance requirement was passed in the early 1970’s, and has not been increased one penny in over 30 years. At that time a gallon of gas cost 30¢, a new car could be purchased for $3,000, and a dented fender could be fixed for $25. It is time to increase the minimum insurance limits to at least $100,000.

While medical expenses have soared, and incomes have increased with inflation during the last 30 years, minimum insurance coverage has remained stagnant. Here is how the problem affects all of us. If you are injured in an accident caused by another driver, that person is responsible to pay for your medical expenses, lost wages, and permanent injury. If your injury causes you to go to the emergency room, your family doctor, and physical therapy, your bills could exceed $12,500. That means the party causing the accident gets off without paying for all the damages. If your costs exceed $12,500, either your own insurance has to pay (underinsured motorist insurance), or your health insurance will pay, or you will pay out of pocket. These are all bad choices. The only way to protect yourself is to purchase uninsured/underinsured motorist coverage. Don’t carry less than $250,000. A one million dollar umbrella is recommended. Just be sure your agent includes uninsured/underinsured motorist coverage with the umbrella. There are a lot of bad drivers out there and most have state minimums for their insurance coverage.

Contact your state senator or state representative and tell them to raise the minimum liability coverage in Ohio to at least $100,000. There are bills pending in the legislature now to increase the required coverage. You can do something about this problem.

Originally posted at InjuryBoard by Brett Goodson

Medical Malpractice Myths Dispelled

Alison De Villiers — Mon, 16 Jun 2008 16:19:20 GMT

The Bush Administration and the insurance industry have been speaking out in favor of tort reform for years. Now, several years after the tort reform laws have been instituted, studies are showing that lawsuits were never really threatening the healthcare system and tort reform has not cured the "healthcare crisis." Instead, we are able to see how lawsuits protect citizens and help to institute necessary changes in the healthcare system. Those in favor of tort reform hope to take away the rights of those injured by the negligence of others by taking away their access to the judicial system.

The Center for Justice and Democracy has dispelled many of the myths about tort reform and medical malpractice lawsuits. One of those myths is that medical malpractice lawsuits are the cause of the healthcare crisis in the United States. In reality, medical malpractice lawsuits account for less than 1% of healthcare costs. Another myth is that medical malpractice insurance carriers are forced to raise premiums due to all of the medical malpractice lawsuits. In reality, in 2005, the 15 largest insurers saw combined profits of over $800 million. Those in favor of tort reform also claim that doctors are being forced to leave the practice due to lawsuits, when in reality, the number of practicing physicians is growing faster than the general population.

It is important that people educate themselves about the alleged need for tort reform and look at the facts. Taking away people's rights to the civil justice system will be far more detrimental to the healthcare system than a lawsuit could ever be. It is time for America to focus on the rights of patients, instead of protecting the profits of insurance companies.

Originally posted at InjuryBoard by Alison De Villiers

Full Coverage? Not For Your Family.

Brett Goodson — Thu, 11 Jun 2009 14:56:00 GMT

You’ve done the responsible thing and purchased full coverage automobile insurance. You want to protect your family should the unthinkable occur. Relying on the insurance companies promise of safety, security and peace of mind, you can count on their promise of full coverage in your time of need right? Unfortunately for you, the answer is likely no.

It may shock you to learn that the “full coverage” for which you are paying may not fully cover your family in the event of an accident. This insurance company loophole is called the “family exclusion” and allows an insurance company to deny all coverage to family members injured in an accident. An organization that is truly on your side, The Ohio Association for Justice, has released a detailed report explaining the history of the family exclusion, its modern day application, and how many insurance companies include it in their policies to exploit their customers. In short, the family exclusion (which can usually be found in small print buried within your policy) allows an insurance company to avoid its responsibilities to you, the customer. For example, if an insured individual with so called “full coverage” negligently causes an accident which seriously injures his or her family, those injured family members will not find themselves in the good hands of the insurance company, but rather left to fend for themselves. However, if there happens to be an unrelated party in the car when the accident occurs, that party will be fully covered by the insured’s policy. Same car, same circumstances, same accident, and yet the unrelated passenger is fully covered while the family members get no assistance from the policy they paid for. Even a caveman could see the absurdity and unfair nature of the family exclusion policy.

Acting as a good neighbor to his community, a Toledo attorney wrote an opinion piece for the local paper detailing his thoughts on the unfair family exclusion loophole. What can you do to inform yourself and stop the insurance company’s progressively bolder attempts to deny you the full coverage for which you are paying? First, you can contact your insurance agent and as them to explain the exception and if it is in your policy. If the exclusion is in your policy, shop for another insurance company. In addition, you can contact your local state representative and request they close the intra family exception insurance loophole.

Originally posted at InjuryBoard by Brett Goodson

How Much Auto Insurance Should I Carry?

Brett Goodson — Tue, 26 May 2009 14:48:29 GMT

Deciding how much auto insurance to carry presents some difficult issues. The most obvious reason to carry auto insurance is to protect yourself if you cause injury or property damage to another due to your negligence. None of us expect to cause an accident, but they do happen. It can be as minor as a fender-bender backing out of a parking space to as serious as causing the death of another because you briefly took your eyes off the road.

Ohio law requires you to carry at least $12,500 in liability coverage. This isn’t nearly enough to cover most accidents. Liability coverage protects you up to your policy limits for damages caused by your negligence. So what should your policy limits be? They should far exceed any assets you have to protect. If you own a house, car, and have money in the bank, the only way to protect it is by adequate insurance coverage.

The other aspect to auto coverage is uninsured motorist coverage. This protects you to some extent if the person who injures you in an accident is either uninsured or underinsured. In Ohio you can’t buy uninsured/underinsured motorist limits higher than your liability limits so you need adequate liability limits to get adequate uninsured/underinsured motorist limits.

Probably, the best and most economical way to protect your assets and loved ones is to buy an umbrella policy over your liability limits. Make sure the umbrella coverage includes uninsured/underinsured motorist coverage. For most people I would recommend a $1,000,000 umbrella over your auto liability coverage, uninsured/underinsured motorist coverage, and homeowner’s coverage.

Originally posted at InjuryBoard by Brett Goodson

Forbes Writer Recognizes Need for Tort Attorneys

Alison De Villiers — Mon, 11 May 2009 16:50:37 GMT

In a surprising article on Forbes. com, writer, William Baldwin, explores the important role that tort attorneys play in protecting Americans from unsafe food. He recognizes the need for tort attorneys in food-poisoning litigation, as the government has proven incapable of ensuring the safety of food on its own. Baldwin writes:

Government inspectors are on duty only some of the time, as we know from the Peanut Corp. of America fiasco. But the marketplace is a constant enforcer. Lawsuits do their part, along with the cost of recalls and the damage to brand names, to keep food companies alert. If it's expensive to make mistakes, more money will go into the detection and prevention of microbes.

Although Baldwin may disagree about the need to tort attorneys in other areas, it is undeniable that lawsuits have brought about many positive changes related to the safety of Americans. From dangerous drugs to trucking laws, tort attorneys have gotten the people's attention and forced big companies to make safer products and the government to pass laws that protect Americans. Baldwin recognizes that adding tort law to technology equals a powerful force in consumer safety. I think most of us on InjuryBoard would agree.

Originally posted at InjuryBoard by Alison De Villiers

Tort Reform In Ohio: What They Don't Tell You

Brett Goodson — Sun, 19 Apr 2009 22:52:14 GMT

Ohio’s recent wave of tort law changes has done nothing but enrich insurance companies and big business at the expense of those in the greatest need. When insurance companies lost money in the stock market a few years ago they ran to their Republican friends in the Ohio legislature and earmarked money and gifts to encourage the passage of caps on damages and other punitive measures against the citizens of Ohio. What used to be called bribery is now called lobbying. The result is the insurance industry “owned” the legislature.

The problem with the whole concept of tort reform is that there was never a need to reform in the first place. There was never any evidence presented that jury verdicts were too high or negligence victims over compensated. There was never any evidence provided that companies were leaving the state, or doctors were closing their practices. The legislature didn’t require proof to enact the changes asked for by the insurance industry because they had already been paid for their vote.

Now, in Ohio, one hospital can sue another for millions of dollars for breach of contract, but the quadriplegic victim of medical malpractice whose life is ruined has his/her damages capped. Why? To ensure insurance company profits. Most victims in Ohio suffer twice, once at the hands of the negligent defendant, and again by the legislature when they try to collect fair compensation.

What can we do? On an individual level we can call our state senators and state representatives and tell them you know there was no crisis, and you want those bad laws repealed. You can also help when you are called to jury service. In every case the defendant sits at counsel table looking sad and worried that he/she is going to lose their house in the lawsuit. In nearly every single case that defendant has insurance that you are never told about. His lawyer is hired by the insurance company to defend him. Please remember every penny of money that you don’t award to the injured plaintiff goes directly back to his insurance company. All you are doing is helping them hire more lobbyists to try to further erode the right of the citizens of Ohio.

Originally posted at InjuryBoard by Brett Goodson