Many doctors who have treated personal injury victims have themselves become victims due to nonpayment of the medical bills. The desire of physicians to help the personal injury patient is often peppered with the fear that the mounting bills will not be paid or may not be paid for several years. However, there are ways to significantly reduce the risk of delayed or nonpayment for this type of care. In fact, the automobile injury case affords the doctor many avenues of insurance coverage not available in other types of case.
This article will discuss the best means of protecting your rights to be paid, utilizing available insurance and avoiding the pitfalls inherent in these cases.
Know Your Patient's Attorney
Contrary to political grandstanding, not all injuries are compensated by the court system through awards of millions of dollars. In fact, a great number of juries render verdicts for the defendant and give no money to the injured party. Ask the patient's attorney for an evaluation of the likelihood of success, especially if you are asked to wait for your money until after settlement or trial. Your bill is an extension of credit and you are entitled to consider whether you should invest in this case. A skilled attorney will want to cooperate with the doctor for many reasons including the need for medical reports and expert testimony at trial.
The good attorney should search for and help process insurance in order to pay the medical bills as they accumulate. Unfortunately, many attorneys believe that their only obligation is to handle the legal case without regard to payment of the medical bills. Even worse, many lawyers will help clients obtain the insurance coverage payments and advise them that they are entitled to keep this money even if it means a failure to pay the doctor.
While competent counsel cannot guarantee a win at trial, an inexperienced or ineffective attorney will have a difficult task contending with the high-caliber law firms hired by the insurance companies. Even if no suit is filed, an attorney who does not specialize in this area of law will generally not obtain the same level of settlements as experienced counsel. Finally, be extremely skeptical of the patients who are handling their own personal injury cases; insurance companies will take advantage of this situation. Doctors treating self-help patients should insist on "pay as you go" or refer them to a lawyer.
Medical Payments Coverage
Most automobile insurance policies have medical payments coverage, which is a "no-fault" source of payment for medical bills. If this type of coverage is included in a Virginia policy, there must be a minimum of $2,000 available (typical coverage is $5,000) over a maximum period of 3 years treatment. Policies issued in other States have similar provisions. The medical office should process these bills to obtain direct payment to the office. Allowing the patient, to process these bills may result in loss of this income. Before you rely on the attorney, find out his philosophy in this respect because many attorneys consider this money to be the property of the client. The patient's insurance agent can explain the amount of coverage available.
Do not expect the insurance company to offer information regarding the availability of coverage. Quite often, the insurance company will tell you to go to the liable party's insurance even when there is medical payments coverage. An attorney's call or letter should overcome this difficulty.
Reimbursement is only required for "reasonable and necessary expenses." Under this standard the insurance companies regularly claim that the treatment was excessive, that certain procedures were not needed or that the bills were abnormally high for the type of injury. They will request the medical records, narratives and other proof; give them what is reasonable, but do not accept a determination not to pay. The doctor's office must often advocate on behalf of the patient and should get the lawyer to insist on payment.
Do not assume a lack of coverage. Medical expense coverage may be available to many unexpected parties, such as relatives of policyholders even when they are in someone else's vehicle or are pedestrians. Read the policy. Ask the lawyer to make inquiries.
Health Insurance
Under Virginia law, medical bills must be paid by the health insurance carrier even if there is a personal injury-third party claim. Health insurance should be handled in the normal manner.
The medical office should not agree to any reimbursement to the health insurance company by way of assignment, subrogation or other type of pay back. Except in limited circumstances, health insurance policies issued in Virginia cannot require repayment to the insurance company. Therefore, do not reimburse any insurance company for payment received on a paid bill without the specific permission of the patient, as this may cause tremendous problems in obtaining return of this money by the patient from the insurance company.
Lien or Assignment
The patient and the lawyer should always be required to sign a lien/assignment form which requires the lawyer to pay the medical office out of the patient's portion of any settlement or judgment. Be sure the form is sent to the law firm. Current billing should be sent in order to be sure that the latest amount is paid.
Oral promises to pay out of settlement are not enforceable. Just sending the bills to the law firm will only amount to a total lien of $300 under the Virginia Code. Do not send this billing and medical records information directly to the insurance companies, unless instructed to do so by the law firm.
***
The above is not meant to replace legal counsel. If you'd like to speak to one of Gross & Romanick's lawyers, please call 703-273-1400 or fill out our online Information Request form here.
Showing posts with label personal injury lawyer virginia. Show all posts
Showing posts with label personal injury lawyer virginia. Show all posts
Thursday, July 21, 2011
Thursday, January 7, 2010
The Automobile Injury Patient: How to get paid
Many doctors who have treated personal injury victims have themselves become victims due to nonpayment of the medical bills. The desire of physicians to help the personal injury patient is often peppered with the fear that the mounting bills will not be paid or may not be paid for several years. However, there are ways to significantly reduce the risk of delayed or nonpayment for this type of care. In fact, the automobile injury case affords the doctor many avenues of insurance coverage not available in other types of case.
This article will discuss the best means of protecting your rights to be paid, utilizing available insurance and avoiding the pitfalls inherent in these cases.
Know Your Patient's Attorney
Contrary to political grandstanding, not all injuries are compensated by the court system through awards of millions of dollars. In fact, a great number of juries render verdicts for the defendant and give no money to the injured party. Ask the patient's attorney for an evaluation of the likelihood of success, especially if you are asked to wait for your money until after settlement or trial. Your bill is an extension of credit and you are entitled to consider whether you should invest in this case. A skilled attorney will want to cooperate with the doctor for many reasons including the need for medical reports and expert testimony at trial.
The good attorney should search for and help process insurance in order to pay the medical bills as they accumulate. Unfortunately, many attorneys believe that their only obligation is to handle the legal case without regard to payment of the medical bills. Even worse, many lawyers will help clients obtain the insurance coverage payments and advise them that they are entitled to keep this money even if it means a failure to pay the doctor.
While competent counsel cannot guarantee a win at trial, an inexperienced or ineffective attorney will have a difficult task contending with the high-caliber law firms hired by the insurance companies. Even if no suit is filed, an attorney who does not specialize in this area of law will generally not obtain the same level of settlements as experienced counsel. Finally, be extremely skeptical of the patients who are handling their own personal injury cases; insurance companies will take advantage of this situation. Doctors treating self-help patients should insist on "pay as you go" or refer them to a lawyer.
Medical Payments Coverage
Most automobile insurance policies have medical payments coverage, which is a "no-fault" source of payment for medical bills. If this type of coverage is included in a Virginia policy, there must be a minimum of $2,000 available (typical coverage is $5,000) over a maximum period of 3 years treatment. Policies issued in other States have similar provisions. The medical office should process these bills to obtain direct payment to the office. Allowing the patient, to process these bills may result in loss of this income. Before you rely on the attorney, find out his philosophy in this respect because many attorneys consider this money to be the property of the client. The patient's insurance agent can explain the amount of coverage available.
Do not expect the insurance company to offer information regarding the availability of coverage. Quite often, the insurance company will tell you to go to the liable party's insurance even when there is medical payments coverage. An attorney's call or letter should overcome this difficulty.
Reimbursement is only required for "reasonable and necessary expenses." Under this standard the insurance companies regularly claim that the treatment was excessive, that certain procedures were not needed or that the bills were abnormally high for the type of injury. They will request the medical records, narratives and other proof; give them what is reasonable, but do not accept a determination not to pay. The doctor's office must often advocate on behalf of the patient and should get the lawyer to insist on payment.
Do not assume a lack of coverage. Medical expense coverage may be available to many unexpected parties, such as relatives of policyholders even when they are in someone else's vehicle or are pedestrians. Read the policy. Ask the lawyer to make inquiries.
Health Insurance
Under Virginia law, medical bills must be paid by the health insurance carrier even if there is a personal injury-third party claim. Health insurance should be handled in the normal manner.
The medical office should not agree to any reimbursement to the health insurance company by way of assignment, subrogation or other type of pay back. Except in limited circumstances, health insurance policies issued in Virginia cannot require repayment to the insurance company. Therefore, do not reimburse any insurance company for payment received on a paid bill without the specific permission of the patient, as this may cause tremendous problems in obtaining return of this money by the patient from the insurance company.
Lien or Assignment
The patient and the lawyer should always be required to sign a lien/assignment form which requires the lawyer to pay the medical office out of the patient's portion of any settlement or judgment. Be sure the form is sent to the law firm. Current billing should be sent in order to be sure that the latest amount is paid.
Oral promises to pay out of settlement are not enforceable. Just sending the bills to the law firm will only amount to a total lien of $300 under the Virginia Code. Do not send this billing and medical records information directly to the insurance companies, unless instructed to do so by the law firm.
***
The above article is not meant to replace legal counsel. If you'd like to speak to an attorney at Gross & Romanick, call 703-273-1400 or fill out their online Information Request form here.
This article will discuss the best means of protecting your rights to be paid, utilizing available insurance and avoiding the pitfalls inherent in these cases.
Know Your Patient's Attorney
Contrary to political grandstanding, not all injuries are compensated by the court system through awards of millions of dollars. In fact, a great number of juries render verdicts for the defendant and give no money to the injured party. Ask the patient's attorney for an evaluation of the likelihood of success, especially if you are asked to wait for your money until after settlement or trial. Your bill is an extension of credit and you are entitled to consider whether you should invest in this case. A skilled attorney will want to cooperate with the doctor for many reasons including the need for medical reports and expert testimony at trial.
The good attorney should search for and help process insurance in order to pay the medical bills as they accumulate. Unfortunately, many attorneys believe that their only obligation is to handle the legal case without regard to payment of the medical bills. Even worse, many lawyers will help clients obtain the insurance coverage payments and advise them that they are entitled to keep this money even if it means a failure to pay the doctor.
While competent counsel cannot guarantee a win at trial, an inexperienced or ineffective attorney will have a difficult task contending with the high-caliber law firms hired by the insurance companies. Even if no suit is filed, an attorney who does not specialize in this area of law will generally not obtain the same level of settlements as experienced counsel. Finally, be extremely skeptical of the patients who are handling their own personal injury cases; insurance companies will take advantage of this situation. Doctors treating self-help patients should insist on "pay as you go" or refer them to a lawyer.
Medical Payments Coverage
Most automobile insurance policies have medical payments coverage, which is a "no-fault" source of payment for medical bills. If this type of coverage is included in a Virginia policy, there must be a minimum of $2,000 available (typical coverage is $5,000) over a maximum period of 3 years treatment. Policies issued in other States have similar provisions. The medical office should process these bills to obtain direct payment to the office. Allowing the patient, to process these bills may result in loss of this income. Before you rely on the attorney, find out his philosophy in this respect because many attorneys consider this money to be the property of the client. The patient's insurance agent can explain the amount of coverage available.
Do not expect the insurance company to offer information regarding the availability of coverage. Quite often, the insurance company will tell you to go to the liable party's insurance even when there is medical payments coverage. An attorney's call or letter should overcome this difficulty.
Reimbursement is only required for "reasonable and necessary expenses." Under this standard the insurance companies regularly claim that the treatment was excessive, that certain procedures were not needed or that the bills were abnormally high for the type of injury. They will request the medical records, narratives and other proof; give them what is reasonable, but do not accept a determination not to pay. The doctor's office must often advocate on behalf of the patient and should get the lawyer to insist on payment.
Do not assume a lack of coverage. Medical expense coverage may be available to many unexpected parties, such as relatives of policyholders even when they are in someone else's vehicle or are pedestrians. Read the policy. Ask the lawyer to make inquiries.
Health Insurance
Under Virginia law, medical bills must be paid by the health insurance carrier even if there is a personal injury-third party claim. Health insurance should be handled in the normal manner.
The medical office should not agree to any reimbursement to the health insurance company by way of assignment, subrogation or other type of pay back. Except in limited circumstances, health insurance policies issued in Virginia cannot require repayment to the insurance company. Therefore, do not reimburse any insurance company for payment received on a paid bill without the specific permission of the patient, as this may cause tremendous problems in obtaining return of this money by the patient from the insurance company.
Lien or Assignment
The patient and the lawyer should always be required to sign a lien/assignment form which requires the lawyer to pay the medical office out of the patient's portion of any settlement or judgment. Be sure the form is sent to the law firm. Current billing should be sent in order to be sure that the latest amount is paid.
Oral promises to pay out of settlement are not enforceable. Just sending the bills to the law firm will only amount to a total lien of $300 under the Virginia Code. Do not send this billing and medical records information directly to the insurance companies, unless instructed to do so by the law firm.
***
The above article is not meant to replace legal counsel. If you'd like to speak to an attorney at Gross & Romanick, call 703-273-1400 or fill out their online Information Request form here.
Wednesday, December 16, 2009
Can I have a personal injury claim if I don't have automobile insurance?
Yes. A personal injury claim is filed against the person who caused the accident and that person's insurance company must pay. The fact that you were not covered by your own insurance policy at the time of the accident does not prevent you from making a claim.
If you'd like to speak to an attorney about your personal injury claim, contact the lawyers at Gross & Romanick at 703-273-1400 or by filling out their online Information Request form.
If you'd like to speak to an attorney about your personal injury claim, contact the lawyers at Gross & Romanick at 703-273-1400 or by filling out their online Information Request form.
Tuesday, November 4, 2008
Slip & Fall: Landlord's Should Take Notice
Virginia is one of the most difficult states in the country in which to win a slip and fall case by an injured party. Nevertheless, a jury recently awarded a Plaintiff $2.5 million against a landlord for a slip and fall. Yet, a previous jury hearing the same case presented by the same attorneys awarded $0. The vagaries of the jury system account for this stark discrepancy, but the ultimate verdict indicates that landlords need to understand their obligations to safeguard the public from injury while on their premises.
Three 1992 Virginia Supreme Court cases prevent most victims of slip & falls from succeeding. A&P Tea Co. v. Rosenberger, establishes that owners of property are not insurers or guarantors of the safety of business invitees. Colonial Stores v. Pulley states that plaintiffs must prove that the owner created the defect which caused the fall or at the very least should have known of the problem. A&P Tea Co. v. Berry instructs judges to dismiss the case if the jury must speculate in order to determine that the owner had notice of the defect.
Thus, in order to recover Plaintiffs must prove that the defendant knew or should have known of the defect which caused the fall. This standard of proof is extremely difficult since many victims do not know why they fell or cannot conclusively prove that the owner or lessor of the property actually knew a problem existed. However, violations of building codes and standards can overcome proof difficulties since many such violations are considered negligence per se with no requirement of notice.
The $2.5 million case was successful because Plaintiff introduced evidence that there was grease or greasy water on the floor of the fast food restaurant. Another case was successful because a leaky roof was not repaired after notification by a tenant. A more complex case succeeded when a succulent plant was shown to be shedding leaves because of improper care by the plant section of the department store, which also failed to sweep the area for 4 1/2 hours. In addition, a slight erosion of the owner's position is taking place regarding slip on ice cases, since the Supreme Court held that merely walking on ice or snow was not an assumption of the risk or contributory negligence.
Despite these and other cases, the landlord in Virginia has the upper hand if proper attention is paid to dangers for which there is actual notice and if proper maintenance schedules are followed.
***
For more information or to seek legal counsel for your personal injury case or a case filed against you, please contact Gross & Romanick by filling out their online form, emailing law@gross.com, or calling (703) 273-1400.
Three 1992 Virginia Supreme Court cases prevent most victims of slip & falls from succeeding. A&P Tea Co. v. Rosenberger, establishes that owners of property are not insurers or guarantors of the safety of business invitees. Colonial Stores v. Pulley states that plaintiffs must prove that the owner created the defect which caused the fall or at the very least should have known of the problem. A&P Tea Co. v. Berry instructs judges to dismiss the case if the jury must speculate in order to determine that the owner had notice of the defect.
Thus, in order to recover Plaintiffs must prove that the defendant knew or should have known of the defect which caused the fall. This standard of proof is extremely difficult since many victims do not know why they fell or cannot conclusively prove that the owner or lessor of the property actually knew a problem existed. However, violations of building codes and standards can overcome proof difficulties since many such violations are considered negligence per se with no requirement of notice.
The $2.5 million case was successful because Plaintiff introduced evidence that there was grease or greasy water on the floor of the fast food restaurant. Another case was successful because a leaky roof was not repaired after notification by a tenant. A more complex case succeeded when a succulent plant was shown to be shedding leaves because of improper care by the plant section of the department store, which also failed to sweep the area for 4 1/2 hours. In addition, a slight erosion of the owner's position is taking place regarding slip on ice cases, since the Supreme Court held that merely walking on ice or snow was not an assumption of the risk or contributory negligence.
Despite these and other cases, the landlord in Virginia has the upper hand if proper attention is paid to dangers for which there is actual notice and if proper maintenance schedules are followed.
***
For more information or to seek legal counsel for your personal injury case or a case filed against you, please contact Gross & Romanick by filling out their online form, emailing law@gross.com, or calling (703) 273-1400.
Wednesday, September 17, 2008
The Chiropractor: An Expert and An Expert Witness
If you've been injured in a car accident, you need to seek legal representation. We here at Gross & Romanick understand the pain and stress you are going through in dealing with your injury, lost income, and unexpected medical expenses. Our firm represents injured individuals and their families in serious personal injury and wrongful death cases--so please contact us today.
In the meantime, please review a recent article we published on whether or not you can or should use chiropractors as expert witnesses.
***
As recognition of the effectiveness of chiropractic increases, the acceptance of the chiropractor as an expert witness in the courtroom is also growing. This recognition may be grudging on the part of the "traditional" medical community, even after the American Medical Association's stinging defeat in Wilk v. AMA. However, any number of studies attest to what millions of auto accident victims and back pain sufferers have known for decades. Even Time, that most-read of the newsweeklies, gave its seal of approval in a report last fall headlined, "Is There Method in Manipulation?" "Now," the magazine piece said, "almost despite itself, mainstream medicine has started to take notice," and it cites reports of medical doctor groups holding symposiums on back manipulation and of orthopedic surgeons admitting they referred patients for such treatment.
In addition to this recognition by the public, the medical community and the media, chiropractic doctors have achieved considerable statutory recognition in many jurisdictions, including the Commonwealth of Virginia. The definition of reimbursable medical expense in a Virginia automobile insurance policy must include payment for chiropractic care (see "Helping Clients Negotiate the Insurance Maze"). That language appears because the Virginia Insurance Code, Section §38.2-2201, requires that any insurance company licensed to issue auto liability insurance in the Commonwealth of Virginia provide chiropractic benefits. Virginia's chiropractic doctors are licensed by the Commonwealth's Board of Medicine, the same body that licenses medical doctors. Becoming licensed as a chiropractic doctor involves rigorous testing, even after the awarding of the Doctor of Chiropractic degree.
Another provision of the Virginia code is important to both the chiropractic and the legal professions; viz., the admissibility of expert testimony in court by chiropractors. "A doctor of chiropractic," reads Section 8.01-401.2, "when properly qualified, may testify as an expert witness in a court of law as to etiology, diagnosis, prognosis, and disability, including anatomical, physiological, and pathological considerations within the scope of the practice of chiropractic ..." Thus chiropractic doctors by Virginia statute are considered to be experts and cannot be excluded as experts in their field of medicine.
Nearly 20 years ago, celebrated defense attorney Melvin Belli noted in an article in The Digest of Chiropractic Economics that, while the chiropractic doctor would scarcely expect to be called to testify on a matter that is out of his field, "... the list of what is 'out of his field' is daily being limited, at least by the courts." Of particular interest is Belli's contention, dramatically illustrated by a Michigan case, that chiropractors can testify successfully as to the permanence of an injury, and hence as to future pain and suffering, even against the opinion of orthopedists and other medical men. In that case, Corbin v. Hittle, a chiropractor testified that his patient's injuries were permanent and that he would never be free of pain. Challenged by the defense as reversible error, the testimony was allowed to stand by the appeal court, which said in essence that, since the state allows and regulates the practice of chiropractic as a restricted form of medicine, it must also allow it as expert testimony.
Edward Gross has represented many clients who are patients of chiropractic doctors, and he does not hesitate to call upon them as expert witnesses. Mr. Gross finds these doctors to be well prepared in offering expert testimony and able to demonstrate to juries that they understand their patients' problems.
In reflecting on his successful presentation of the case for Dr. Wilk and his colleagues, Plaintiffs' Attorney George P. McAndrews stated that one of the highlights of the case was the difficulty the plaintiffs had in finding a law firm that was willing to undertake the case. He was told by Dr. Wilk that 15 or 16 other firms that had been approached all found some kind of a conflict, usually representation of some part of the adversary medical community. It took three or four years, Dr. Wilk told him, to find a firm that would take this antitrust case. In retrospect, looking back at that landmark decision, perhaps some of those bashful lawyers would be less reluctant today.
When the victim of a violent collision enters the chiropractor's office seeking relief for his or her considerable pain and discomfort, the stress that patient is experiencing is apparent to the doctor. As the doctor's patient and as the lawyer's client, the victim needs an advocate, a role that the chiropractic doctor and an attorney who understands chiropractic are amply prepared to fulfill.
In the meantime, please review a recent article we published on whether or not you can or should use chiropractors as expert witnesses.
***
As recognition of the effectiveness of chiropractic increases, the acceptance of the chiropractor as an expert witness in the courtroom is also growing. This recognition may be grudging on the part of the "traditional" medical community, even after the American Medical Association's stinging defeat in Wilk v. AMA. However, any number of studies attest to what millions of auto accident victims and back pain sufferers have known for decades. Even Time, that most-read of the newsweeklies, gave its seal of approval in a report last fall headlined, "Is There Method in Manipulation?" "Now," the magazine piece said, "almost despite itself, mainstream medicine has started to take notice," and it cites reports of medical doctor groups holding symposiums on back manipulation and of orthopedic surgeons admitting they referred patients for such treatment.
In addition to this recognition by the public, the medical community and the media, chiropractic doctors have achieved considerable statutory recognition in many jurisdictions, including the Commonwealth of Virginia. The definition of reimbursable medical expense in a Virginia automobile insurance policy must include payment for chiropractic care (see "Helping Clients Negotiate the Insurance Maze"). That language appears because the Virginia Insurance Code, Section §38.2-2201, requires that any insurance company licensed to issue auto liability insurance in the Commonwealth of Virginia provide chiropractic benefits. Virginia's chiropractic doctors are licensed by the Commonwealth's Board of Medicine, the same body that licenses medical doctors. Becoming licensed as a chiropractic doctor involves rigorous testing, even after the awarding of the Doctor of Chiropractic degree.
Another provision of the Virginia code is important to both the chiropractic and the legal professions; viz., the admissibility of expert testimony in court by chiropractors. "A doctor of chiropractic," reads Section 8.01-401.2, "when properly qualified, may testify as an expert witness in a court of law as to etiology, diagnosis, prognosis, and disability, including anatomical, physiological, and pathological considerations within the scope of the practice of chiropractic ..." Thus chiropractic doctors by Virginia statute are considered to be experts and cannot be excluded as experts in their field of medicine.
Nearly 20 years ago, celebrated defense attorney Melvin Belli noted in an article in The Digest of Chiropractic Economics that, while the chiropractic doctor would scarcely expect to be called to testify on a matter that is out of his field, "... the list of what is 'out of his field' is daily being limited, at least by the courts." Of particular interest is Belli's contention, dramatically illustrated by a Michigan case, that chiropractors can testify successfully as to the permanence of an injury, and hence as to future pain and suffering, even against the opinion of orthopedists and other medical men. In that case, Corbin v. Hittle, a chiropractor testified that his patient's injuries were permanent and that he would never be free of pain. Challenged by the defense as reversible error, the testimony was allowed to stand by the appeal court, which said in essence that, since the state allows and regulates the practice of chiropractic as a restricted form of medicine, it must also allow it as expert testimony.
Edward Gross has represented many clients who are patients of chiropractic doctors, and he does not hesitate to call upon them as expert witnesses. Mr. Gross finds these doctors to be well prepared in offering expert testimony and able to demonstrate to juries that they understand their patients' problems.
In reflecting on his successful presentation of the case for Dr. Wilk and his colleagues, Plaintiffs' Attorney George P. McAndrews stated that one of the highlights of the case was the difficulty the plaintiffs had in finding a law firm that was willing to undertake the case. He was told by Dr. Wilk that 15 or 16 other firms that had been approached all found some kind of a conflict, usually representation of some part of the adversary medical community. It took three or four years, Dr. Wilk told him, to find a firm that would take this antitrust case. In retrospect, looking back at that landmark decision, perhaps some of those bashful lawyers would be less reluctant today.
When the victim of a violent collision enters the chiropractor's office seeking relief for his or her considerable pain and discomfort, the stress that patient is experiencing is apparent to the doctor. As the doctor's patient and as the lawyer's client, the victim needs an advocate, a role that the chiropractic doctor and an attorney who understands chiropractic are amply prepared to fulfill.
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