The Crash Course on Personal Injury Claims in Connecticut eBook

8/2/2019 The Crash Course on Personal Injury Claims in Connecticut eBook

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on Personal Injury ClaImsIn ConneCtICut

The

Crash Course


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Hastings, CoHan & WalsH, llPAttorneys at Law

W O R D A S S O C I A T I O N P U B L I S H E R Swww.wordassociation.com

1.800.827.7903

on Personal Injury ClaImsIn ConneCtICut

The

Crash Course

www.hcwlaw.com

1.888.842.8466


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Copyright 2010 by Richard P. Hastings

All rights reserved. No part o this book may be used or reproduced in any

manner whatsoever without written permission o the author. Published 2010.

Printed in the United States o America.

ISBN: 978159571-523-4

Designed and published by

Word Association Publishers

205 Fifh Avenue

Tarentum, Pennsylvania 15084

www.wordassociation.com

1.800.827.7903


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Authors Note

Thank you or considering our rm to represent you in your personal

injury case. We have prepared the ollowing inormation to give you a

better understanding o your personal injury case and to allow you to

enable us to potentially help maximize the value o your case.

We have decades o experience in representing injured clients and their

amilies who have received millions o dollars rom negligent parties and

their insurance companies in cases involving:

Motor Vehicle Accidents

Dog Bites

Wrongul Death Cases

Deective Products

Medical Malpractice

Premises Liability

Fall Down Cases

Sports Accidents

As a urther testament o our abilities, we serve as reerral counsel or

a variety o cases both rom local and out-o-state rms. We also have


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contacts with some o the best lawyers throughout the country and can

assist you or others with your out-o-state cases.

Our greatest source o business comes rom our clients. You can be con-

dent that i a relative or riend requires our services, we will provide the

same proessional hands-on attention that you will receive.

We understand that you could chose rom any number o other rms torepresent you in your important legal matter. We appreciate the con-

dence you have placed in us and we will work hard to gain and keep your

trust.

Please careully review and ollow the inormation which is set orth in

these pages. We are accessible and encourage you to contact us whenever

you have a question.


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Legal Disclaimer

The inormation contained in this book is presented or inormational

purposes only and is not meant nor is it construed to be legal advice.

Further, the inormation contained herein should not be relied upon and

you should always seek the advice o an attorney beore proceeding. No

attorney-client relationship can be established with the rm unless and

until a mutually acceptable written agreement is signed by all parties. I

you are interested in asking us to represent you, please contact us so we

may be able to decide whether or not we are willing or able to accept

your case. Any inormation submitted to us via our website or by other

means may not be considered condential. We assume no liability caused

nor occasioned by your reliance on any inormation presented in this

book nor do we guarantee the accuracy, completeness or representations

contained therein.

The author and the publisher make no representation or warranties o

any kind; nor are any such representations implied with respect to this

inormation. The author and publisher shall not be liable or any damages,

consequential or otherwise, resulting in whole or in part rom anyones

use o or reliance upon the contents o this book.


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Table of Contents

Chapter 1

Frequently Asked Questions . . . . . . . . . . . . . . . . . . . . . . . 13

Chapter 2

Tort Law: An Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Chapter 3

What To Do I You Are Involved In

A Motor Vehicle Accident . . . . . . . . . . . . . . . . . . . . . . . . . 23Chapter 4

Your Personal Injury Case . . . . . . . . . . . . . . . . . . . . . . . . . 27

Chapter 5

Why It Is Important To Hire A Lawyer . . . . . . . . . . . . . . 33

Chapter 6

Ten Things You Can Do To Improve

The Value O Your Case . . . . . . . . . . . . . . . . . . . . . . . . . . 41

Chapter 7Dealing With Your Health Care

Proessionals In Improving The Value

O Your Personal Injury Case . . . . . . . . . . . . . . . . . . . . . . 49

Chapter 8

Getting The Best From Your Health

Care Proessionals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Chapter 9

What Insurance Companies Dont

Want You To Know . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61


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Chapter 10

Bolstering Your Loss O Income Claim . . . . . . . . . . . . . . 65

Chapter 11What Is My Case Worth? . . . . . . . . . . . . . . . . . . . . . . . . . 71

Chapter 12

The Adjusters Point O View . . . . . . . . . . . . . . . . . . . . . . 79

Chapter 13

The Secrets Deense Attorneys Dont

Want You To Know . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

Chapter 14

The Litigation Process . . . . . . . . . . . . . . . . . . . . . . . . . . . 101

Chapter 15

The Pretrial Conerence . . . . . . . . . . . . . . . . . . . . . . . . . 107

Chapter 16

The Trial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109

Chapter 17

Mediation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

Chapter 18

Preparing To Testiy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

Chapter 19

Instructions To Clients Undergoing AnIndependent Medical Examination (IME) . . . . . . . . . . . 121

Chapter 20

How Insurance Companies Try To

Pay You Less Money For Your Claim

And What You Can Do About It . . . . . . . . . . . . . . . . . . 123

Chapter 21

How To Protect Yoursel And Your

Family From Irresponsible Drivers . . . . . . . . . . . . . . . . . 125


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Conclusion

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

Appendix AContingency Fee Agreement . . . . . . . . . . . . . . . . . . . . . . 131

Appendix B

Pain And Injury Questionnaire . . . . . . . . . . . . . . . . . . . . 135

Appendix C

Lost Wages And Prots . . . . . . . . . . . . . . . . . . . . . . . . . 159

Appendix D

Client Quarterly Report . . . . . . . . . . . . . . . . . . . . . . . . . 165

Appendix E

Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171


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13

C H a P t e r 1

Frequently Asked Questions

People who consider bringing a personal injury lawsuit usually come

to us seeking answers to certain basic questions. In an easy question-

and-answer ormat, this chapter addresses the concerns most commonly

voiced by current, new, or prospective clients.

Q: How Do I Know I I Need Your Services?

A: You probably will need our services i you have been seriously injured

or wronged in some way, as a result o an accident, medical malprac-

tice, a deective product, a slip and all, a dog bite, a sports injury, or

other cause. We provide a ree consultation to explore the acts o your

case and to advise you o your legal rights.

Q: Why Should I Hire An Attorney To Assist Me In Resolving My

Accident Or Injury Claim?

A: More money or you is the primary reason! An insurance-industry

research institution studied personal injury claims conducted by the

injured person alone versus those that were handled by attorneys. Thestudy determined that people represented by attorneys had a higher

net recovery or themselves (more money in their pocket ater attor-

neys ees and costs) than those without attorneys.


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Our attorneys provide you with the advantage o representation by

skilled proessionals whose experience and insight enable you to equal

the playing eld and help maximize the amount o money you can

recover when dealing with insurance companies and major corpora-

tions. Having our rm involved in your case allows you to ocus on

recovering rom your injuries, while we ocus on holding the respon-

sible party accountable or your injuries and damages.

Q: I Have Been Injured. What Will It Cost To Hire You?

A: We represent personal injury clients on a contingency-ee basis. In

other words, you pay attorneys ees only i we winand you pay no

ees i we lose. You are responsible or costs incurred, but these costs

do not include attorneys ees, and the costs are paid rom any settle-

ment or judgment entered against the person responsible or your

damage or injury. We advance costs so that the case can be properly

prepared and presented or settlement or trial. I there is no recovery,

you pay no costs as well. In addition, there are no ongoing out-o-

pocket expenses that you have to pay. We take all o the nancial risk

in representing you so that you can concentrate on getting better.

Q: Do You Oer A Free Consultation?

A: Yes, we oer an initial consultation or which we do not charge. The

purpose o this initial consultation is to review the acts o your case,

give you an indication o whether the case is one that we might be

interested in handling, and discuss with you the nancial arrange-

ments or our representation.


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Q: How Soon Ater I Am Injured Must I File My Lawsuit?

A: Every state has certain time limits, which are called statutes o limita-

tions that govern the amount o time you have to le a personal injury

lawsuit. In Connecticut, you may have as little as two years to le a

lawsuit arising rom an accident. There are also a number o notice

requirements that must be met within a much shorter period o time.

I you miss the deadline or a notice requirement or or fling your case, your claim

can be dismissed. Consequently, it is important to talk with us as soon aspossible ater you receive or discover an injury.

Q: What Is Negligence?

A: The critical issue in many personal injury cases is just how a reason-

able person would be expected to act in the situation that caused

the injury. A person is negligent when he or she ails to act like a

reasonable person. Whether a given person has met the reasonable

person standard is oten a matter that is decided by a jury ater the

presentation o evidence and argument at trial.

Q: What I I Cant Prove That Someones Negligence Caused

My Injury? Is There Any Other Basis For Liability Besides

Negligence?

A: Negligence is not the only theory o liability. Certain individuals

or companies may be held strictly liable or certain activities that

harm others, even i they have not acted negligently or with wrongul

intent. On the basis o strict liability, a person injured by a deectiveor unexpectedly dangerous product, or by a dog bite, or instance,

may recover compensation or the injury without showing that the

responsible party was actually negligent.


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Q: What Compensation Might I Receive I My Personal Injury

Lawsuit Is Successul?

A: Usually, a person who is liable or an injurywhich generally means

his or her liability insurance companymust pay an injured person

or:

Past and future medical care and related expenses

Past and future income lost because of the accident

Permanent physical disability or disgurement

Loss of family, social, and educational experiences

Emotional damages, such as stress, embarrassment, depres-

sion, or strains on amily relationships

Damaged property

You will be awarded damages, or compensation, which is

money, intended to restore you to the position you were in

beore your injury. This money is not considered income

(excluding monies paid or loss o income) and is not taxable

as income by the ederal government or state.


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C H a P t e r 2

Tort Law: An Overview

A tort claim is a cause o action (a case) that results rom a civil wrong

that does not involve a contract claim. Tort is derived rom the French

word or wrong, and tort law is a highly specialized and complex area

o practice.

Generally speaking, there are three types o torts:

1. Intentional Torts

An intentional tort involves an action or activity calculated to harm

or oend the victim. Examples o intentional torts include assault,

battery, alse imprisonment, intentional infiction o emotional distress,

deamation, trespass to land, and trespass to chattels (taking personal

property). In certain situations, the conduct involves not only tort law

but also criminal law.

The problem with intentional torts is that in many cases there is

no insurance coverage available to compensate the injured party or his

or her injuries. For example, i a person assaults you and causes you

serious injury, you could not successully submit a claim to that personshomeowners or automobile insurance company, as coverage would be

denied. To receive compensation, you would then have to look to the


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assets or property owned by the person who committed the tort. In many

instances, the oending party will have ew, i any, assets. Thereore, you

would have little chance o collecting any money or your injuries.

You might have a strong case in which the liability or ault o the

oending party is clear, and you may have sustained signicant damages

that would make your case worth a lot o money. Nevertheless, i an

attorney is not able to collect any o these unds, there is no economic

incentive or an attorney to take the case, because no one is likely toreceive any money even i the case is successul.

It is important to consult with us to review the acts o your case

and the various potential theorieso liability that might provide or insurance

coverage, perhaps even rom a third party. For example, i a bar serves

alcohol to an intoxicated person who later starts a ght with another

patron and causes an injury to that patron, then the bar might be liable

or serving too much alcohol to the party who started the ght.

2. Negligence

Negligence is a very broad area o tort law that deals with a great

many types and causes o action. Basically, negligence involves the ailureto exercise the level o care that a reasonably prudent person would

have exercised under the same circumstances. I a person causes a motor

vehicle accident, or example, an issue that would have to be determined

is whether or not the person who caused the accident was negligent; that

is, did that person do something that a reasonably prudent person would

not have done, such as speeding or going through a red light.

Negligence involves a breach o that duty that one person owes to

another person and the damage that results rom that breach.


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Because the laws vary greatly rom state to state, it is important to

consult with us to determine how the specic laws o a state impact your

case. In Connecticut, or example, we ollow a modied comparative negli-

gence standard. I you are injured in Connecticut and your case has a value

o $100,000 and a jury nds you to be 40 percent at ault, you would be

awarded $60,000 (40 percent less than the total value o the case).

There are many issues involved in these kinds o cases that could

include diering standards o care, a preexisting condition, statutoryduties, age, the use o alcohol or drugs, duties, attractive nuisances, Good

Samaritan laws, insurance issues, proximate cause, and oresee-ability.

These and many other nuances make this a very complicated area o the

law.

Typical examples o negligence cases include the ollowing:

Accident Cases, All Types

Slips And Falls

Medical Malpractice

Birth Injuries

Traumatic Brain Injuries

Spinal-Cord Injuries

Wrongful Death

Premises Liability

Lead Poisoning

Defective Products

Burns


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Explosions

Toxic Torts

Class Actions

A separate kind o negligence case involves medical malpractice,

which generally involves a standard o care expected o a medical proes-

sional that is not met, resulting in damages to the injured party.

Medical malpractice cases may result rom ailure to properly diag-nose a condition, surgical error, ailure to treat properly, ailure to prop-

erly monitor a condition or situation, ailure to get a patients inormed

consent, and a number o other causes.

Generally speaking, we will consult with a third-party specialist in the

same area o medicine to determine whether or not there was a departure

rom the standard o care (that is, whether malpractice was committed).

3. Strict Liability

Certain states have specic statutory provisions that make a person or

entity strictly liable or a persons injury. For example, certain states recog-

nize some or all o the ollowing strict liability torts: parents being heldstrictly liable or an act o their child; workers compensation making an

employer liable or an employees injuries; owners o pets that bite people

being held strictly liable or the pets actions; and certain cases involving

toxic torts.

I a party causes you to be injured through his or her negligence, you

are entitled to compensation or your injuries, which will entitle you to

monetary damages.


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Damages are supposed to compensate the injured party or a number

o losses, which could include the ollowing:

Medical Bills (Past And Future)

Out-Of-Pocket Expenses

Past Lost Wages

Future Lost Wages

Pain And Suffering

Permanent Injuries

Punitive Damages (In Extraordinary Cases)

The methods o calculating these damages and a great number oother issues involved make negligence cases an extremely complicated and

dicult area o the law.

The importance o contacting us at the earliest possible opportunity

cannot be overemphasized. Do so at the earliest possible moment.


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C H a P t e r 3

What To Do If You Are InvolvedIn A Motor Vehicle Accident

Every year, literally millions o people are injured in motor vehicle acci-

dents. Unortunately, many o those injured are unaware o their rights

or dont know what to do in such a situation.

In the event you are involved in a motor vehicle accident, it is impor-

tant or you to ollow a ew basic rules:

Stop The Vehicle and determine the nature, extent, and severity

o the damages or injuries.

Secure The Accident Site so that no other vehicles become

involved. Put on your blinkers, light a road fare, and use other

warning devices to alert others as to the potential or injury.

Check On Those Who Are Injured. Dont attempt to move

them unless there is an immediate need to do so, such as an

imminent re, explosion, or some other peril.

Obtain The Names And Addresses O All Witnesses. Gatheras much contact inormation as you can, and try to establish

whether the witnesses expect to remain at the address they have

given you or a reasonable amount o time.


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Contact The Police. Tell them why the other party is at ault.

Describe all injuries you or your passengers have suered,

and give your witness contact inormation to the responding

ocer.

I Your Injuries Are Signifcant Enough, you should be trans-

ported by ambulance to the nearest hospital. Dont be araid to

err on the side o caution. Some injuries may not appear until

hours or days ater the event.

You Should Immediately Begin To Keep A Diary O All

Matters that aect you as a result o your accident. Note in

detail any pain and discomort experienced, appointments with

your doctors, expenses incurred, sleepless nights, any missed

work, and any other problems you experience as a result o your

injuries. Write on the ront o your diary, Prepared or My

Attorney Which Contains Privileged Inormation.

I You Have Sustained Any Visible Injuries, you or another

person should photograph those injuries at regular intervals to

properly depict their nature and extent over time.

I Your Visible Injuries Are Serious Enough, your treating phy-

sician should also document those injuries. You should check to


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see i your doctor has created a photographic record o your

injuries and, i necessary, suggest that your doctor do so.

Report The Accident To Your Automobile Insurance Carrier

i your vehicle was involved in the accident. Nevertheless, beore

speaking with either the other partys insurance company or

your own insurance company, you should contact one o our

attorneys.

I You Have Received Personal Injuries as a result o the acci-

dent, you are entitled to be compensated or your losses. These

losses typically include payments or medical bills, lost wages

(past and uture), payment or disabilities, damages or pain and

suering, and loss o enjoyment o lies activities. They may

include a claim or spousal loss o consortium.

I You Consider Pursuing A Claim against the responsible party,

it is important that you contact us immediately. In Connecticut,

there is a two-year statute o limitations on personal injury cases

involving motor vehicle accidents. In other words, you must

either settle your case or commence suit prior to the expiration

o the two-year statute o limitations. In certain situations, or

example, claims against municipalities, there is a much shorternotice provision that must be observed in order to properly pre-

serve any claim. These time requirements are strictly adhered to


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by the courts, and a late ling or late or deective notice could

result in your case being dismissed by the court.

Knowing And Exercising Your Rights in an accident situa-

tion can aect your physical recovery (by reducing rustration

and stress) and your monetary recovery as well. The ollowing

chapters outline steps you can take to preserve your rights and

maximize the value o your personal injury case.

The oregoing inormation is only a brie summary o some o the basic

items that should be addressed i you are involved in an accident. Such

cases involve a great number o actors and necessitate urther instruc-

tions that should be ollowed to achieve the best possible outcome. Notknowing your rights or proceeding without the proper representation

could severely prejudice your case.


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C H a P t e r 4

Your Personal Injury Case

It is important to adhere to at least the ollowing steps ater you have

suered personal injuries.

Talk To No One About Your Accident

Do not talk to anyone about your accident except one o the lawyers

or representatives o our oce. Do not even talk to your own insurancecompany, or any lawyers hired by your own insurance company, without

notiying us so that we may be present i we wish. Generally, we will want

all statements to be taken in our oce. Remember, you may unknowingly

hurt your case by statements you make without our assistance.

Keep Your Doctors Inormed

You should return to each o your doctors as oten as necessary and

tell them about all o your complaints. You should not minimize your

ailments to your doctors. Your descriptions o injuries and symptoms

help them determine how to treat you, and doctors will keep records o

your complaints. It is important that you not cancel scheduled appoint-ments with your doctors, which might later be construed to mean that

you really were not in serious pain or in need o medical care. Be sure


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we are advised immediately o the names and addresses o all o your

treating physicians, including specialists you may be reerred to by your

amily physician or general practitioner. Please keep a detailed list o

every appointment and the amount o every bill.

Gather Your Insurance Policies

To ensure that you obtain all coverage and benets available, we will

examine your insurance documentation, including your health insurancepolicies. It is important that you provide us with complete copies o all

insurance policies, including the declaration pages that were in eect on

the date o the accident, as well as the policy and declaration pages o

all automobile polices o any relative living with you. Additional benets

may be available to you.

Arrange For Payment O Bills

You should submit all medical bills to your motor vehicle insurance

carrier (i your policy includes medical payments coverage) and then to

your health insurance carrier. You must also send copies o allyour bills,

including prescription charges, to our oce.

Keep A Record O Complaints

Please keep a daily diary o your complaints and your progress.

Make sure that you write on the ront o your diary Prepared or My

Attorney Which Contains Privileged Inormation. Your diary should

include problems you have encountered, such as sleepless nights, inabilityto perorm certain activities, visits to the doctor, and dates on which you

have to hire help. This diary can be very useul. A year later, you will not


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be able to recall your pain and diculties as vividly. This inormation

should be detailed on the Client Quarterly Report orm contained in the

appendix.

Stay In Regular Contact With Our Ofce

We will write to you at regular intervals to nd out how you are

progressing. The easiest way or us to do so is via e-mail, so please make

sure you provide us with your e-mail address, and be sure to answer allcorrespondence promptly.

Note Wages And Earnings Lost

Please keep an accurate record o all days lost rom work because o

your injuries. This inormation should be documented on the Lost Wages

and Prots orm contained in the appendix.

Retain Copies O Medical Bills

Obtain and duplicate copies o all medical, hospital, and drug bills.

Periodically, you should send these bills to us or our les. Also keep

a record o any other expenses you may incur in connection with your

injuries. Be sure to obtain and keep receipts. You should keep a list o all

your medical bills and all the costs incurred in visiting your doctor.

Deer Vehicle Repairs

I you have been injured in a motor vehicle accident, do not have

your vehicle repaired until you have taken numerous pictures o thevehicle. Please be sure to take pictures rom every conceivable angle and

rom dierent distances so that we will have a complete record detailing

damage to your vehicle. Write your last name and the date that you took


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the pictures on the back o each photograph. I possible, you should also

e-mail us these pictures.

Photographic Evidence O The Severity O The Crash

I you have received any bruises on your body caused by the seat belt

or by striking part o your body against something inside the vehicle, you

should take photographs o these injuries. The photographs will be used

to demonstrate the severity o the impact.Even though there may be slight or minimal damage to your vehicle,

it is important to take many photographs o any and all damage. You

should keep all photographs and provide this oce with copies o both

the photographs and any estimates or bills you are given or the repair o

damage to the vehicle.

Preserve Records O Medications

Another very eective way o demonstrating the amount o pain you

have suered is to keep a very accurate record o all prescribed muscle

relaxers, pain medication, or other medicines taken by you to obtain any

type o relie.

Contest Trafc Oenses

Never plead guilty to any trac oense. I you are arrested in

connection with the accident, call our oce immediately. We will see that

someone represents or advises you.


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Witnesses

Immediately urnish us the correct names, addresses, and telephone

numbers o any and all witnesses to the accident.

Save Your Cast

I your injury requires a cast, brace, traction, or other appliance, save

it or evidence at trial. You should notiy us that you are keeping these

items, and when the case is set or hearing, you should bring them with

you.

Send Photographs

Send us prints o and, i possible, e-mail us any photographs

pertaining to your case taken by you or any o your amily or riends. Be

sure to have pictures taken o all your injuries as soon as possible aterthe accident. I you are required to remain in or report to a hospital and

are administered any treatment, such as traction or physical therapy, have

pictures taken o that as well.

Submit Hospital And Doctors Bills

Have your own automobile insurance carrier pay as many hospital

and doctors bills as possible under the payment provision o your policy.

You should also have your medical insurance, such as Blue Cross and Blue

Shield, pay as many o your bills as possible. Doctors and hospitals are

more cooperative when their bills are paid. You should not expect them

to wait to receive payment until your case is tried or settled. You should,thereore, pay any balance as soon as you can.


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Copy And Send Us Bills And Receipts

It is very important to provide us with copies o allyour billsand

receipts or any and all accident-related expenses.

Settlement O Claims

This oce will attempt to settle any and all claims with the insur-

ance companies prior to commencing suit. We will not be in a position

to attempt to settle any claim until such time as your treating physician

declares that you have reached maximum medical improvement and

urnishes us with a nal medical report. Naturally, we will discuss the

value o your case at that time.

Contact And Questions

We may not contact you, except as already noted, to receive updateson your condition until we have something denite to report. We will be

contacting you or depositions, or answers to interrogatories, and when

your case goes to trial, which may be many years ater your suit is led.

I you have any specic questions regarding these instructions or want to

discuss any other matters concerning your case, please eel ree to call or

write us.

Your Address

Be sure to keep us inormed o any change in your physical address,

telephone number, or e-mail address.


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C H a P t e r 5

Why It Is Important To Hire A Lawyer

You should be aware that studies have shown that experienced lawyers can

negotiate settlements and obtain judgments that are oten considerably

higher than what the injured parties can negotiate or themselves. In other

words, in most cases, you will do better o ater paying a lawyer than you

would i you attempted to negotiate your own settlement with insurance

company claims adjusters.

Claims Adjusters

Insurance company claims adjusters are proessional negotiators who

have extensive experience in dealing with claimants who are not repre-

sented by attorneys. These adjusters use an array o psychological tech-

niques, including intimidation and beriending you. Their methods are

designed to get you to accept the least amount o money possible or

your claim.

Claims adjusters know that i they can keep the injured party negoti-

ating, there is a very great chance that a settlement avorable to the insur-

ance company will be obtained. Claims adjusters also know that in almost

every case, injured parties will not le a lawsuit on their own because theydo not have the required level o skill, expertise, or experience. They oten


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eel that their only option is to obtain some type o settlement rom the

insurance company.

In many instances, claims adjusters will discourage or dissuade injured

parties rom hiring a lawyer by telling them that lawyers ees will cost a

great deal o money, leading claimants to conclude that they shouldnt

pay a lawyer to do something they can do or themselves.

Insurance companies utilize a number o dierent types o computer

programs to analyze personal injury cases in an eort to give insuranceadjusters little, i any, discretion in negotiated settlements. This strategy

will ultimately result in lower settlements or injured parties.

In addition to the above considerations, there are many compli-

cated issues that arise in a personal injury or medical malpractice case.

These various legal issues are raught with potential problems and are

so complex that sometimes they can even be the subject o a malpractice

action against an attorney who improperly handles a case. A nonproes-

sional has little chance o navigating these depths successully without an

experienced attorneys assistance.

Statutes O Limitations

The statute o limitations is the time period specied by law within

which an action mustbe led. I you do not le within the applicable

statute o limitations period, your claim could be subject to dismissal,

preventing you rom pursuing the claim regardless o the merits o the

case.

Statute o limitations dates vary rom state to state. Some states

provide that the action be led within the applicable time period rom


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the date o the injury, while other states allow or a tolling, or extension,

o the ling period rom the date o discovery o the injury.

Under certain circumstances, i the claimant is incompetent or is a

minor, some states allow or a tolling o the statute o limitations until

the claimant becomes competent or reaches their majority.

Notice Provisions

There are also certain notice provisions that have very short limita-tion periods, especially those that relate to local, state or ederal govern-

mental entities. In certain circumstances, i you do not comply with the

statutory notice provisions, you may lose the right to le your lawsuit,

even i you act within the applicable statute o limitations period.

The statute o limitations in any particular case may be somewhat

dicult to calculate, because a claim may involve dierent causes o action

against dierent deendants. Once you miscalculate when the statute has

run or ail to properly provide statutory notice, your claim may be orever

barred despite its validity or the extent o your damages.

Joint And Several Liability

The doctrine o joint and several liability holds that a number o

deendants who engaged in separate and independent acts o negligence

that combined to cause a single injury are held to be jointly and severally

liable. In other words, i one party was 1 percent at ault and the other

parties were 99 percent at ault, the party who was 1 percent at ault

could be held responsible or 100 percent o the damages suered by the

injured party.


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The law o joint and several liability varies rom state to state, and a

number o states have somewhat complicated variations or modications

o this rule.

Vicarious Liability

Vicarious liability concerns the ability to hold institutions or

companies liable or the acts o their nonemployee aliated personnel.

For example, in some states, a hospital may be liable or the negligence oa physician acknowledged to be an independent contractor, while in other

states; hospitals may not be liable or the acts o nonemployee members

o the medical sta.

Expert Testimony

In certain states, a plainti in a medical malpractice suit must le acerticate o good aith, or a similar document, that states that a medical

expert has reviewed the le and has determined that there is a good-aith

basis or a malpractice claim.

Threshold Limits

In some states, your injuries must exceed a minimum threshold o

seriousness beore you are allowed to le suit. Some states dene serious

injury as an injury that results in death, dismemberment, signicant

disgurement, a racture, permanent loss o use o a body unction, or

other signicant permanent disability. In other states, beore you can le

a suit, your medical bills must exceed a certain dollar gure or you mustbe out o work or a certain number o days.


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Damage Caps

A growing number o states place articial caps on the amount o

money an injured party is able to obtain or his or her injuries. This cap

may apply whether the claim is or an injury or a death.

Collateral Source Rule

In certain states, the negligent party is allowed to oer evidence o

certain collateral or other payments that the injured party has received,

which inormation could then be used to reduce the award that the

responsible party has to pay.

Last Clear Change

This legal principle holds that i a plainti has the last opportunity

to avoid an accident or an injury and ails to do so, that party will thenbe held solely responsible or their injuries regardless o the negligence o

the person who caused the injury.

Prejudgment Interest

Certain states allow or the court or jury to provide interest on the

award made to the plainti. The interest rates and commencement period

or the accumulation o interest vary rom state to state.

Assumption O Risk

This legal doctrine provides that a plainti who has knowingly and

voluntarily exposed himsel or hersel to a dangerous condition or situa-tion that results in an injury may not be entitled to compensation on the

grounds that the plainti has assumed the risk and agreed to accept the

consequences.


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Immunities

A number o states provide immunities in specic cases, generally

to governmental entities and their employees. Certain states provide or

abbreviated notice provisions, which means that you have a much shorter

period o time in which to provide a required notice to a governmental

agency or employee by way o a state agency or claims commissioner

beore a claim can be reviewed.

Doctrine O Sudden Emergency Or Unavoidable Accident

Some states hold that even though a party causes an accident and

causes injuries to another, the responsible party may not be held liable

or the resultant injuries i it is determined that an actual emergency

existed, which perilous situation was not created by the party causing the

accident, and the responsible party when conronted with the emergency,

chose a course o action that would or might have been taken by a person

o reasonable prudence in the same or similar situation.

Contributory Negligence

Certain states ollow the principle o contributory negligence, which

states that a plainti is prevented rom recovering or damages caused by

someone elses negligence i he or she contributed to or was in any way

responsible or the negligence or injury.

Comparative Negligence

Certain states ollow the principle o comparative negligence, whichstates that a plainti s damages may be reduced i the plainti is in any

way at ault or the accident or injury. In some states, i the plainti is


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ound to be 50 percent at ault, no damages will be awarded. In other

states, whatever the plainti s percentage o ault is in the accident or

injury, the award will be reduced by the same percentage.

Overtreatment

Claims adjusters oten allege that the injured party was over treated

or the injuries that he or she sustained as a result o their clients negli-

gence. The adjuster may also claim that excessive tests were ordered orthat the injured party was overcharged or treatment.

This list o potentially problematic legal issues represents only some

o the matters that must be investigated beore proceeding with a claim.

I any one o these issues is overlooked or not dealt with properly, very

serious negative consequences could ensue, not the least o which could

be the dismissal o your case without any prospect o recovering anything

in the uture.

Conclusion

Although the aoresaid legal issues and principles have been discussed

in general terms it is important to consult with a lawyer at the earliest

possible opportunity to review the acts o your case so you can get

specic advice as to how to proceed.


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C H a P t e r 6

Ten Things You Can Do To ImproveThe Value Of Your Case

People oten make mistakes that can have a very negative impact upon

their serious injury case. Your actions are vitally important, and you can

help improve the value o your case by doing at least the ollowing:

1. Return To The Site O The Accident

I you have been involved in some kind o accidentwhether it is amotor vehicle accident, a slip and all accident, or an accident whereby you

received some type o injury through someone elses aultyou should

return as soon as possible to the site where you were injured (preerably

not later than the next day).

I your injuries prevent you rom returning to the accident site, you

should have someone else go there or you once you make that person

aware o exactly what happened, where it happened, and what you need

or them to do in your stead.

You want to return to the site o the injury as soon as possible in

order to identiy and locate any evidence that might assist you in the pros-

ecution o your case and to take photographs o any and all conditionsthat might have caused or contributed to your accident or that refect the

extent o the damage.


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Because an accident can happen so quickly, and because once it

happens, you may be in a state o shock, panic, or conusion, you may

not remember many details about the accident. People are sometimes

very surprised to learn o acts or situations that may have caused their

accident that they were not aware o at the time they were injured.

Your rst photograph should include a copy o that days daily news-

paper with the date o the paper clearly visible in the picture. This photo-

graph will ensure that you do not orget when the pictures were taken.At a motor vehicle accident site, you may be able to nd skid marks

that should be photographed. I so, measure the skid marks and record

these measurements with a magic marker on sheets o paper. Then place

the paper giving the correct measurement to one side o each skid mark

and photograph each mark. Each picture will thus show both the mark

and its length.

You might also nd that a stop sign that was supposed to be posted

at an intersection was not there, or perhaps a trac light turns green

in one direction while allowing let-hand turns in the other direction,

or maybe a trac light was not working properly. You should also take

photographs o all such items.You may nd evidence o the collision at the point o impact. It is

usually the area where dirt and broken glass remain as a result o the orce

o the collision. You should determine where that point appears to be

and photograph it. The evidence may indicate, or example, that the other

driver crossed over into your lane and caused the accident.

In the case o a all, you may be able to photograph some evidence

o a deect that caused you to all beore the deect is repaired.


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You should take a great many photographs rom every possible angle

so that people who are unamiliar with the accident scene will be able to

understand the physical layout o the site just by looking at your pictures.

Your pictures should answer any questions about where the accident scene

was and how it appeared.

I possible, photograph the accident site at the same time o day

as when your accident occurred, unless conditions are such that you are

unable to obtain good quality photographs (as when, or example, there isinsucient light). I you can, you should reproduce the same conditions

that were present when your accident occurred.

2. Protect And Photograph Physical Evidence

Determining who was at ault in a case can sometimes be deter-

mined by physical evidencesomething you can touch, see, or examine,

as opposed to just describing or talking about it.

Examples o physical evidence include: skid marks, to establish the

speed o the vehicles; the point o impact o the collision; damage to the

vehicles; holes in the sidewalk that caused a all; deective or broken stairs

or walkways; and damaged, ripped, or blood-stained clothing.Physical evidence can also show the extent o the damage. Photographs

o the vehicles can establish the orce o the impact; a copy o your motor

vehicle auto-body repair bill can establish the extent o the damage to

your vehicle; and torn or bloody clothing can dramatically show that your

injuries were very severe.

I your case involves a deective product, keep the product. I your

case involves an injury due to a oreign object, keep the object. I your


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injury requires a cast, a brace, screws, plates, or any other appliance, save

it as evidence.

When taking pictures o physical evidence and eatures o the scene

that may have contributed to the accident, it is best to use a digital camera

or a camera that makes negatives that later can be blown up or enlarged.

Have the lm developed immediately in case certain pictures did not

come out properly and need to be retaken, or e-mail us the photographs.

The person who took the photographs should also write on the back oeach one the date on which it was taken and what the photograph depicts.

You should also keep your receipt or the development o the pictures to

urther veriy when they were taken.

3. Keep Detailed Records And Document Your Case

Document all evidence and matters related to your case so that the

inormation can be reviewed and used by us. Specically, you should at

least do the ollowing:

Keep an accurate record of all days lost from work because

o your injuries.

Obtain and duplicate copies of all medical, hospital, and drug

bills, and keep a record o all other expenses related to your

case. Always keep receipts. Keep a list o the hospitals you

have been admitted to and the doctors and other health care

providers you have seen, noting the date and costs o eachsuch visit.


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Keep a very accurate record of all prescription muscle relax-

ants, pain medication, or other medicines you have taken to

obtain any type o relie. This can be a very eective way o

demonstrating the amount o pain you suered.

If you have been injured in a motor vehicle accident, do not

have your vehicle repaired until you have taken numerous pic-

tures o the vehicle. Be sure to take pictures rom every con-

ceivable angle and rom dierent distances in order to show

all the damage. Write your name and the date on the back o

each photograph.

If your vehicle has been damaged, get a repair estimate. Save a

copy o the estimate to help establish the collisions severity.

If you have received any bruises about your body, you should

take photographs o these injuries so that these can be used to

urther demonstrate the severity o the impact.

4. Write A Narrative O The Accident

Be sure to write a detailed description o exactly what happened on

the day and especially at the time o the accident. This description should

include very specic inormation as to the-who, what, when, where, why,

and how o the event, i.e., any question that could possibly be asked o

you. Include in your description times, places, people, the place that you

were going to and why you were going there, how the accident occurred,what parts o your body hit what objects and what injuries you sustained,

where you were taken and what was done or you and by whom, and so


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on. Make sure you write at the top o your narrative Prepared or My

Attorney Which Contains Privileged Inormation.

5. Locate Witnesses

A witness to your accident can be an invaluable resource to urther

explain what happened and who was at ault. Witnessesideally, disin-

terested third partiesmay be able to describe things you did not see or

provide inormation supporting your story.Witnesses sometimes hear responsible parties make statements

directly ater the accident, at a heightened level o excitement that he or

she would not have made later, ater refection or in a calmer moment.

Examples o such excited utterances could include the ollowing: Oh,

it was my ault, I meant to repair those stairs, or I just wasnt paying

attention.

As soon as possible, get the names, addresses, and phone numbers o

all witnesses to the incident or accident. You should also take notes as to

what each witness told you or what they would be willing to oer in the

way o testimony.

It is important that these witnesses be contacted as soon as possible.The longer you wait, the less a witness may remember. This could aect

both their credibility and their willingness to give us a statement. Another

concern is that it might be much more dicult or us to locate a witness

i too much time has elapsed.

6. Do Not Give Any Statements

Do not discuss your case with anyone except us. Do not even talk to

your own insurance company or any lawyer hired by your own insurance


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company without rst speaking with us. You may unwittingly hurt your

case by making statements without our assistance.

7. Do Not Delay Contacting Our Ofce

There are a number o reasons why you should contact us as soon as

possible. We will be able to counsel you regarding what you should and

should not be doing. Your case might require the assistance o a private

investigator, who will want to look into the matter as soon as possibleater the accident or incident. Evidence might need to be preserved and

statements might need to be taken. You will also want us involved at the

start o your case in order to preserve and protect any notice or statute o

limitations dates.

8. Do Not Discuss Your Case With Others

It is not a good practice to discuss your case with others, because

you could inadvertently say something harmul to another party that may

later be used against you. Additionally,you may sacrifce the attorney-client privi-

lege i you discuss your attorney-protected conversations with others.

9. Your Doctor

You should return to each o your doctors as oten as necessary and

tell them about allyour medical complaints in as much detail as possible.

You should not minimize your ailments to your doctors, as it is one o

the best ways or them to know how to treat you and because the doctors

will keep a record o your complaints.


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It is important that you not cancel scheduled appointments with

your doctor, because this can later be construed to mean that you were

not really in such severe pain or in need o medical care.

I you see any additional doctors, be sure to advise us immediately

o their names and addresses. You should keep a detailed list o every

appointment and the amount o each such bill.

10. Follow Your Doctors And Our Instructions

It is imperative to ollow through with any advice or instructions

that are given to you by us or by your health care proessionals. Failure to

ollow these instructions could severely jeopardize your case.

You should also be sure to provide our oce with copies o all

medical bills, prescription charges, therapy bills, your motor vehicle esti-

mate, all photographs and any other documentary evidence as soon as

possible.

I you ollow the steps in this chapter, you can avoid making costly

mistakes that could reduce the value o your case. It is important to

ollow all o the suggestions here to help us maximize the value o your

case.


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C H a P t e r 7

Dealing With Your Health Care Professionals InImproving The Value Of Your Personal Injury Case

When insurance companies evaluate a case, they consider your medical

care and treatment and how the injury has aected you. In order to

increase the value o your case, it is important to keep in mind the

ollowing points:

Insurance companies thoroughly examine an injured partys medical

records. It is extremely important to make sure that all o your injuries,symptoms, problems, and restrictions on activities are expressed to your

health care proessionals so that these actors are recorded in your medical

records. Today, doctors are very pressured and do not have much time

to spend with patients. Oten, they seem to be very rushed. Hence, it is

important or you to ocus on your visit beore you see your doctor.

Ideally, you will want to choose a primary care doctor who conveys a

sense o genuine concern, interest, and involvement in your medical treat-

mentsomeone who instills a sense o condence in you. Your primary

care doctor will unction as the gatekeeper who grants or blocks access

to specialists. Choosing a good primary care physician could become vital

in your ultimate recovery. Even i you are satised that you have chosena good primary care physician, i you eel you are being unjustly denied

services you need, dont be araid to request and, i necessary, ght or


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them. To nd out i your doctor is board certied and that his or her

certication is up-to-date, call the American Board o Medical Specialties

at 866-ASK-ABMS and inquire about your doctors status.

Although a physical examination and various tests will ollow, the

rst step in your proper care and treatment is your initial description o

your symptoms to the doctor. It is a good idea to prepare a ull and accu-

rate statement in advance o your appointment, in writing i possible,

rather than waiting to organize your thoughts when you are disrobingin the doctors oce. The added anxiety o the oce environment may

make it more dicult or you to clearly and accurately describe your

problems.

You should also be prepared to give your doctor your complete

medical history.

I you wish to minimize the amount o time you must wait to

see your doctor, you should ask or either the rst appointment in the

morning or or the rst slot ater the doctors lunch hour.

It would be helpul to tell your treating physicians about some or all

o the ollowing:

1. Tell Your Doctor About Every Pain You Are Experiencing As A

Result O Your Accident

Do you experience a sharp pain, a burning pain, a dull pain,

or an aching pain?

Is this specically dened pain limited to one body part?

Does it occur in other body parts, or does it radiate or travel

to other body parts?


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How frequently do you experience these pains? How long do

you experience these pains? Are they more requent during

certain times o the day, or do they tend to occur ater certain

activities, and, i so, which ones?

2. Tell Your Doctor How These Problems Aect You

Do you spend time in bed because of the pain? If so, when,

and how oten?

Do you have to rest more frequently? If so, when, and how

oten?

Do you miss time from work? If so, how much, and when?

Do you take medication for the pain? If so, what type, and

how requently?

3. Tell Your Doctor What Activities You Now Do That Cause You

Pain Or What Activities You Can No Longer Do As A Result O

The Pain

Do you have lighter duties at work?

Do you hire someone to do the housework?

Do you avoid certain sporting activities that you used to par-

ticipate in? I so, what activities?

Do you avoid certain hobbies that you used to enjoy doing?

I so, which ones?


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4. Tell Your Doctor About All Forms O Home Health Activities

And Aids You Now Require Or Use To Relieve Your Symptoms

Are you exercising at home pursuant to the instructions of a

health care proessional?

Are you using hot packs or ice?

Did you buy or use heating pads, creams, or other items?

5. Whenever Possible, Do Not Allow Large Gaps In Treatment

If your doctor wants to see you in two weeks, make sure you

keep that appointment.

If your doctor tells you to come back when you are in pain, be

sure to ollow these instructions. Make an appointment to see

your doctor again rather than bear the pain stoically. I youcannot make an appointment, at least call your doctor so your

complaints can be recorded.


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C H a P t e r 8

Getting The Best From Your Health Care Professionals

When you are a patient with a serious injury, condition, or other health

care challenge, there are many things you can do to get the best care rom

your medical providers. What you must remember is that you are the

captain o your health care team, and, ultimately, it is you who makes the

decisions that aect your care and treatment.

You Are In Charge O Your Health Care Team

Beore every doctors appointment, you should write down, in the

order o importance, all o your concerns, questions, and medical prob-

lems. I your doctor interrupts you, be sure you return to your list o

problems and concerns. Make sure you get answers to all o your ques-tions beore your examination is over.

Taking Charge. Want Answers? Ask Questions!

I you have questionsand, yes, you should have manyask them

o your doctors, nurses, therapists, and other health care providers. Dont

be timid or shy. You are the one who is most concerned about your health

care, so be sure to ask questionsand lots o them.


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When It Comes To Your Health, There Is No Such Thing As A

Dumb Question.

In act, its a good idea to start a health care notebook to keep a

record o your visits, symptoms, side eects, pain, complaints, and all

the medicines you take, your questions, and the answers you receive. Plan

to ask questions about your current condition and what to expect about

your uture care. Dont be araid to ask, Why? Make sure you write at

the top o your health care notebook Prepared or my Attorney which

contains Privileged Inormation.

Bring your notebook to all o your appointments so that you wont

orget anything. Write down all the answers the doctor or other people

give you. Dont eel rushed. This is the time to get the answers you need.

I you do not have time to write down all o the inormation during

the appointment, make sure you make notes immediately aterward

preerably in the waiting room o the health care proessionals oce,

while the inormation is still resh and clear in your mind. There is a lot

to keep track o, so keep a thorough written record o everything.

It you do not understand something, say so. Doctors are oten in a

hurry, but it is part o their job to listen to you and give you all the inor-

mation that you need. Your doctor wants you to understand everything so

that you can do your part and actively participate in getting well.

I You Still Dont Understand Something, Keep Asking Questions.

Do Not Be Intimidated By Your Doctor

Make a list o what you need to talk about and stick to it. Youshould always maintain eye contact when talking with your doctor. This

will show that you are very serious about participating in your care and


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treatment. Do not let the doctor avoid answering your questions or make

insensitive comments that go unchallenged.

Tell Your Doctor Everything

Be honest and detailed. Do not tell the doctor what you think you

should say or say you are doing better than you really are. You should

be completely honest about everything you are eeling, experiencing, and

thinking. Talk about your current condition- what is changing, what isbetter, what is worse, and how you are progressing. Tell the doctor about

other conditions you experience, what times o the day the symptoms

occur, what activities cause you the most discomort, and discuss all

the medicines you are taking. I you think a medicine may be causing

a problem, mention it. I you eel things are not progressing quickly

enough, say so!

Be completely honest about your health habits. I you miss taking

your medicine, say so. Tell your doctor exactly how much and how oten

you smoke, drink, exercise, and what you eat. Tell your doctor i you

have been depressed or anxious. Your doctor can only provide you with

the best treatmenttreatment developed especially or youi yourcomplete medical history is known.

Tell Your Doctor I You Are Unhappy With Your Medical Care

People will oten keep negative comments to themselves, earing that

complaints will create a bad doctor-patient relationship. In act, most

doctors respect open and honest communication and communicative

patients oten receive better health care.


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Keep All Your Health Care Proessionals Inormed

Tell each health care proessional about the other health care

providers you are seeing, what they are doing or you, and what they are

telling you. Whether you are receiving acupuncture, physical therapy, or

another treatment, each provider on your team needs to know the big

picture in order to provide you with the best care. You are the only person

who knows everything that is going on, so you should keep everyone on

the team inormed about your complete medical situation.

Network With Others Similarly Situated

Whatever your injury, condition, or situation, a national nonprot

health organization is generally available to help people like you. These

organizations can oer a wide range o support and helpul advice

rom people who know exactly what you are going through. They can

educate you about the latest news and research and have toll-ree phone

numbers, Web sites, newsletters, and sometimes even local support chap-

ters that can help you. Ask your providers about an organization or you,

or do some research on the Internet.

Educate Yoursel Completely

An inormed and knowledgeable patient will get better treatment.

The more you know about your situation, the dierent tests and treat-

ments that are used or your condition, and the typical symptoms and

how they can be expected to change over time, the more you can be an

active part o your health care team. When a health care provider dealswith an educated and inormed patient, the quality o their care and

attention is likely to improve.


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Take Someone With You To Your Appointments

There is strength in numbers. Sometimes, it is hard to keep track o

all the advice you get, the instructions you are given, and what you need

to do to ollow up. Bring a amily member or a riend along with you to

your medical appointments to assist you. This can make you eel more

comortable and more condent and help you to have a more inormed

conversation with your doctor or other health care provider. Your amily

member or riend can also help you take notes, ollow through on yourdoctors advice, and manage your care once you leave the oce or the

hospital.

Second Opinions Make A Lot O Sense

It is standard practice in the world o medicine to seek a second

opinion. When you have a serious condition or injury and are told that

you need a test or certain treatmentespecially surgeryit is a good idea

to get a second opinion rom another doctor. Find out i your insurance

plan covers a second opinion. Your doctor should understand this and

should not be oended when you say you plan to seek another opinion.

Here are some polite ways you can use to arrange or a second opinion.

If You Are Told You Need Surgeryor a complex test or treat-

ment, tell your doctor or the oce sta that you must rst

check with your health insurance carrier to see i it is com-

pletely covered.

Call Your Health Insurance Carrierto determine i the pro-

cedure itsel will be approved and i a second opinion is cov-

eredor required. I so, ask the health plan representative or


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a list o other providers whose services the plan will cover or

your second opinion. Be sure to write down the name o the

person you spoke to, the date and the details o the conversa-

tion in your health care notebook in case you have a problem

later.

To Find Other Health Care Providers, ask riends and rela-

tives i they know o doctors who have treated others with

your injury or condition. You can also call a local doctor-reer-

ral service or contact your state medical society. (The number

can be ound in the white pages o the phone book.)

When You Call To Make The Appointment With The

Second Doctor, tell the oce sta that you are seeking asecond opinion. Depending on your condition, you will be

asked to bring certain medical records, which you will need

to get rom your current doctors oce sta. Do not be shy

about requesting these records.

Once You Get A Second Opinion, compare the two ndings.Ask questions o the second doctor about the dierences in

opinions. Remember to bring your riend or a amily member

with you to this very important meeting. Again, write down

everything that is said in your healthcare notebook. When you

next visit with the rst doctor, you should again ask ques-

tions about the dierent opinions, making sure you under-

stand everything and then make an inormed decision about

what to do.


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Take Charge O Your Health Care Team

Keep in mind that your health care team is there to help you and

that ultimately you make the decisions regarding your care and treatment.

That means you need to let everyone on the team know what is working

or you and what is troubling you. Talk to each one o them openly and

cordially.

I you are not comortable with someone and eel that you cannottalk to that person about your health care needsor you are not getting

the care and attention you deserveyou are better o making a change,

no matter how dicult it may seem to do so.

Its Your Health . . . You Need To Be In Charge

I you have an injury or a medical condition that requires you tosee doctors and other health care providers, you have a compelling need

to manage your own health care team. You must take responsibility

or ollowing the instructions you and your providers have worked out

together. Step up! Ask questions! Educate yoursel! Tell your medical

providers everything, and keep everyone on your team connected. You

will improve your care and accelerate your medical treatment and ultimate

recovery.


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C H a P t e r 9

What Insurance Companies Dont Want You To Know

Many insurance companies currently use a computer sotware program

called Colossus to evaluate the value o personal injury claims. How

Colossus works is a mystery to the general public. Neither the insurance

companies nor the developer o Colossus will divulge exactly how they

determine their baseline values.

Essentially, this program is a database that evaluates claims based on

inormation entered by the insurance adjuster. Thereore, the evaluations

can only be as good as the inormation that the adjuster enters into the

program.

By utilizing Colossus, most insurance companies will try to arti-

cially lower the value o your claim by plugging in such things as damage

to your vehicle, expected length o treatment, expected cost o treatment,

and a number o other objective variables beore determining a value.

The Colossus program will not take into account such actors as

the extent o your pain and suering, the duration o your pain and

suering, how your injuries aect your ability to work and carry on

your normal lies activities, your inability to perorm certain activities,

emotional stress and trauma, how this has aected your relationship with


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your spouse (loss o consortium), or any number o other actors that a

jury would consider.

Perhaps the biggest problem with Colossus is that the insurance

adjuster assigned to handle your claim is usually locked into the settle-

ment gure that the program generates. Insurance companies will deny

this and will tell anyone who will listen that the program is nothing more

than an evaluation tool. The insurance industry claims that the settle-

ment gure generated by Colossus is merely a starting point rom whichthe adjuster can go up i additional acts and circumstances warrant it.

This representation is not true: the adjuster has little, i any, room or

movement.

Colossus is a well-kept secret o the insurance industry. It is the

leading bodily injury claims adjusting sotware in the world and is being

used by an increasingly large number o insurance companies. According

to Computer Sciences Corporation, the company that produces Colossus,

the sotware is used by thirteen o the top twenty U.S. property and

casualty insurers to minimize variance on similar bodily injury claims. A

ormer Farmers Insurance employee who let the company to consult or

plaintis lawyers estimates that insurance companies are saving rom1

5percent to 30 percent on injury claims payouts by using Colossus.

Thereore, in order to increase the value o your case, when dealing

with an adjuster who is relying on Colossus, you should consider the

ollowing:

The single most important thing you can do to increase thevalue o your case is to make sure all o your injuries, com-

plaints, problems, preexisting conditions, pain, depression,

anxiety, lost time rom work, loss o lies activities, and other


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relevant inormation are expressed to your doctors so that all

inormation is recorded in your medical records.

Be specic in describing your injuries. As a general rule, the

more specic you can be the better. I you cannot perorm

certain activities, tell your doctor. I you continue to go to

work but experience pain, tell your doctor about this as well.

Gaps in treatment will reduce the value of your case, so besure to ollow up with your doctors on a regular basis. I

you do have any interruptions in treatment, be sure you can

explain the reasons or these gaps.

Colossus generally opposes alternative medical treatments,

such as acupuncture. I you do seek alternative treatment,make sure that you do so with a doctors reerral.

Colossus typically values treatment according to time ranges

such as one to three months, three months to six months, six

months to nine months, and so on. This means that thirty-

one days o physical therapy would make a case worth morethan thirty days o physical therapy.

Colossus has other yardsticks for assigning values to the length

o treatment. For example, or the rst three months, physi-

cal therapy visits might be valued at $100 per visit, but in the

ourth month, they might be valued at $40 per visit, and bythe sixth month, the amount might go down to $10 per visit.

I you visit a medical doctor between the third and ourth


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month, then Colossus might bump the value back up to $100

per visit or the next ninety days.

Wearing a seat belt helps the value of your motor vehicle acci-

dent case. I you were wearing a seat belt at the time o the

accident, be sure to tell this to your treating physician so that

it appears in your medical records.

By properly describing your injuries, complaints and problems to your

doctor and ollowing up with needed medical care you can potentially

increase the value o your case when dealing with an insurance adjuster

who utilizes the Colossus sotware program.


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C H a P t e r 1 0

Bolstering Your Loss Of Income Claim

One o the many elements o your personal injury claim is the amount

o income that you lose as a result o the negligence o another. The

calculation o your loss o income can be either very easy or extremely

complicated, so it is a good idea to ollow the ollowing suggestions:

Assume That The Insurance Company Is Not Going To Believe Your

Claim For Lost Wages, So Be Prepared To Prove Everything

I you are injured and you work a orty-hour week, with no over-

time, then the insurance carrier will want to see some proo rom your

employer o your salary (paystub, W-2, tax return, etc.). You should keep

a complete record o all lost wages. At the very least, you should obtain

a statement rom your employer that outlines your salary, the number o

hours you work in a week, the time that you have missed rom work, and

any other monetary losses that you have incurred.

It is a good idea to obtain other orms o documentary evidence

such as paystubs, copies o paychecks, calendars, ledgers, time cards, and

anything else that will help to establish your losses. Additionally, youwill also need some documentation rom your employer establishing how

much time you lost rom work.


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It would also be helpul to have a note or notation in your medical

record rom your treating physician that you could not work or any

specic time due to the injuries you sustained in the accident. It is also

important or you to report to your physician your inability to work, and

why, so that it will be become a matter o record.

Overtime, Sick Time, And Vacation Time

I your doctor indicates to you, which should be in writing, that youcannot work, you are entitled to collect monies that do not include just

your lost salary. These losses can also apply to overtime, sick time, and

any vacation time that you use. These all have a value, and you are enti-

tled to be compensated or the loss o these values because o anothers

negligence.

It is important to note that you should always ollow your doctors

instructions. I your doctor tells you to take three weeks o rom work,

then it is much easier or us to argue that the loss o income incurred

during this period o time is the responsibility o the party at ault. It is

imperative that you be as detailed as possible when telling your doctor

about the physical problems you are experiencing. It is absolutely neces-sary that the physical nature and extent o your job duties and respon-

sibilities and what is required o you at work is ully understood.

I you lose overtime or are orced to use sick time or vacation time rom

your work, you should arrange to get a letter rom your employer (we

will arrange or this ater you speak with your employer) indicating how

much overtime you lost on each day and the value o that overtime. I you

had to use sick days or vacation time, have your employer drat a letter


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indicating how much sick time and vacation time you used and the value

o that time.

Trips To The Doctors

I you have returned to work but have to take time o to visit health

care proessionals, you are entitled to be compensated or any money you

lose or or the value o the vacation or sick time you have to use. Your

employer should clearly document the time you missed rom work orthese appointments. You should keep a calendar o all time missed rom

work, the reason you missed time, the hours you missed, and why you

missed this time. Make sure your employer knows that you are missing

time as a result o your accident related appointments and provide written

documentation to your employer to conrm this inormation.

Sel-Employed Persons

Unlike an employer-employee situation where the calculation o lost

income is much more straightorward, losing sel-employed income is

much more dicult to calculate. As a sel- employed businessperson, you

could be entitled to lost income, loss o earning capacity, lost prots, lost

business opportunities, and the loss o goodwill and/or the diminution

in value to your company. It is your responsibility to lessen or mitigate

your damages, to the extent possible.

Again, it is very important to be as detailed as possible in keeping

accurate records. Make sure your doctor understands your physical limi-

tations and how it aects your job so that your doctor can place this

inormation in your medical record to help support your lost income

claim.


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You will be asked to provide tax returns or approximately the last

three to ve years. Unortunately or many, this income history does not

adequately explain your current situation or what your uture may be. You

will also want to prepare a year-to-date nancial statement that indicates

your current nancial position. You will need to present as much evidence

and proo as possible to establish the losses you are claiming.

It is a good idea to make copies o your calendar o appointments and

get letters rom current or prospective clients or customers to provide abetter picture o lost income or loss o uture business or opportunities.

Another diculty or a sel-employed businessperson is that you are

generally doing your job and marketing or uture work at the same time.

For more complicated cases, it might be prudent or us to hire a orensic

accountant or an economist to help clariy your lost income situation.

Many times, claims o loss o income by sel-employed business-

people are speculative and dicult to prove. Because you know your

business better than anyone else, including your attorney, it is necessary

or you to provide the best possible documentation to help prove your

claim.

Commissioned Salespeople

I you are a commissioned salesperson and are out o work due to

injuries sustained in an accident, it may be very dicult to prove what

income you lost as a result o not being able to work. It would be dicult

to prove what new orders you might have received, how many new clients

or customers you would have gotten, and how much additional income

you would have had.


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You should make a copy o your day planner to show what accounts

you were working on or were scheduled to begin working on. You should

get a copy o your year-to-date commissions and make a list o all

prospects that you have in the pipeline. You should get letters rom

your employer and make a list o your current accounts and any uture

accounts that you may be working on. You could also get letters rom

your coworkers or other salespeople who can help veriy what you were

doing in the way o business.

Your Accountant

Perhaps the best type o documentation and/or proo to help estab-

lish your loss o income claim would be a detailed letter on your accoun-

tants letterhead that explains in detail your business, any seasonal changes

you experience in your income, why your business and income were on

the rise, orecasting what your income would have been and explaining in

great detail the reasons behind that calculation, and any other inorma-

tion that is relevant to explaining any loss o income or business which

you incurred or can expect to incur.

Proving Your Case

As the injured party, it is up to you and your attorney to prove your

case to either the nder o act, which can be an adjustor, arbitrator, j

Documents

The Crash Course on Personal Injury Claims in Connecticut eBook