If you have both medical and auto insurance, you may be wondering which will pay for your medical costs. In Washington, the hospital will start by billing you personally or billing the medical insurance company whose information you provide. Later, after you make your auto insurance claim, you or your health insurer may be reimbursed by the other driver’s auto insurer. If you are among the few drivers who have medical payment coverage on your auto insurance policy, your own insurance company may reimburse you.

If you have no-fault insurance or Personal Injury Protection (called PIP coverage), your auto insurance company should pay. The hospital may bill you personally at first, especially if you could not provide them with insurance information when you arrived, but it should be simple to transfer the obligation to your insurer. You may still have a deductible under your PIP policy. If your bills are higher than the amount of PIP coverage you have, any medical insurance will take over after your auto insurance coverage is used up.

If there are problems, keep in mind that in Washington you (the patient) are ultimately responsible for your own medical bills, regardless of whether some insurance policy should cover it. That means you should take action quickly if the insurance company refuses to meet its obligations.

If your PIP policy has been exhausted, then in most cases your private health insurer should beging paying the medical bills.  Sometimes your private health insurer will need written confirmation from your PIP auto policy carrier that the limits have been exhausted.  If so, just call your PIP claims representative and ask him or her to send this letter immediately.  You should  also follow up with the PIP adjuster in writing so you have a record of your communications.

But what if you don’t have private health insurance or PIP coverage?  This is a difficult situation.  If this is the case, you may be obligated to pay your healthcare providers out of pocket.  Sometimes we here at the Davis Law Group can work out a suitable arrangement with your doctors to either wait for payment, or make small monthly payments.  It really depends on how reasonable and willing your healthcare provider is.

There are some lawyers who disagree with me.  These lawyers will tell you that you should ALWAYS call a lawyer immediately after every accident — even before you go see a medical doctor for your injuries!  Some lawyers will go so far as to tell you that you should call a lawyer while sitting in your car waiting for the police.  That’s just bunk.

Those lawyers who tell you to call them within minutes after an accident are usually more interested in collecting a fee than on protecting your best interests.  Choosing a lawyer should be done thoughtfully and carefully.

So how do you know when you should contact a personal injury for your accident case?  Here are some questions to answer:

1. Will your injuries require more than just a few months of medical treatment?
2. Will your total medical bills exceed $3,000 to $5,000?
3. Are your injuries longlasting, permanent, or severely debilitating?
4. Are your injuries catastrophic (i.e., loss of limb, paralysis, brain injury, etc.)
5. Do your injuries involve loss of limb or body part, or is there permanent scarring?
6. Is there a dispute about who caused the accident?
7. Is the insurance company ignoring your calls, or acting rude and unhelpful to you during the claims process?
8. Does the case involve a claim for wrongful death?

If you answered yes to one or more of these questions, then you may likely benefit from the assistance of a qualified personal injury attorney.  You should definitely talk to an attorney to hear how that attorney evaluates your claim. 

That’s why I decided to publish my first book nearly 3 years ago for Washington state accident victims.  Even though the book sells on Amazon for $20, I give the book to accident victims for FREE so they could have good and accurate information about the claims process and personal injury attorneys BEFORE the person actually decides to hire a lawyer.  Do not fall for the lawyer who SCREAMS hire a lawyer immediately after an accident, at least not if you want to make the best decision possible for your personal injury case.

We at the Davis Law Group usually turn down at least 25-35% of new accident cases because we believe the claim does not require the assistance of an attorney.  Sure, we could certainly sign these clients up and collect a fee.  But that wouldn’t be in the client’s best interest because the person could likely recover more compensation without an attorney.

If you’re looking for a Washington state personal injury attorney, do your homework.  Don’t choose the first lawyer you may see on TV.  Choose a lawyer that is more interested in protecting your best interest, and not the lawyer who is more focused on collecting a quick contingency fee.

Jessie, 16, was severely injured in a car accident when she crossed the center line and hit a school bus head on.  Jessie received a traumatic brain injury among other injuries.  She was in a coma for two weeks.  Jessie has limited use of her limbs, but this is expected to improve over time with therapy.

This is touching story.  We wish Jessie an exceptional recovery, which may take time given the extent of her injuries. 

This story should remind parents to check their auto policies to make sure they have adequate coverage.  With teen drivers, who do have higher accident rates than adults, parents should have coverage of at least $100,000 but preferably higher at $300,000 or even $1 Million.  Without adequate auto insurance, one accident can cause financial ruin.

Why was this client of mine upset?  Well, there was no dispute that the defendant caused the accident, a fairly significant rear-end accident.  And there was largely no disputed that my client sustained a severe injury to her neck, where now two surgeons are recommending surgery to re-stabilize the disc herniation and deformity that is now present on her MRI scan.

Yet, the insurance company for the other driver continued to cling to the argument that this was only a minor soft tissue injury that should have healed within 3 to 4 months.  Understandably, my client was livid that the carrier was pursuing this line of defense.  What also infuriated my client was that the insurance company was trying to argue that she had a pre-existing neck condition so the auto accident in question was not the cause of her ongoing problems and the more than $40,000 in past medical charges so far. 

The at-fault carrier was relying on a single notation in my client’s medical records.  A chart entry made 3 years before the accident by my client’s family doctor where my client complained of neck pain and some hand numbness after suffering a minor strain picking up boxes at work.  It did not matter that my client stated this injury healed fully and that she had no neck pain complaints for 2 years before the accident.  My client simply could not believe that the insurance company was taking this route since it seemed so preposterous to her.  In my client’s view, this defense also inferred that my client was lying about her prior injury.  And this infuriated her even more.

To support its defense, the insurance company hired a well-known neurologist who examined my client, reviewed her records and proclaimed that yes indeed she had a pre-existing condition and it was this condition that was causing her current problems.  This defense neurologist also stated quite convincingly in his deposition that the neck injury my client received in the auto accident should have cleared up within 4 months because most people heal within this time fram.  So if my client was still having problems beyond 4 mos. following the crash, it was her pre-existing condition and not the accident that was causing it.

So I found myself again explaining to a client that this defense asserted by the at-fault insurance company was so common in my practice that I have taken the liberty of drafting a stock letter that explains basically what I’m saying here.  The insurance company will use ANYTHING in your prior history to minimize or defeat your claim.  It will hire any doctor (and believe you me, there are a number of well-credentialed doctors who will gladly help) to help it convince a jury that the accident victim’s symptoms or problems are not the result of THIS accident, but a prior one, or a prior condition, or a …..  You get the point. 

But when it’s your case, and you’re the one who has gone into debt and lost a significant time from work, and your pain is unremitting and constant, and it won’t go away…. it’s hard NOT to take the insurance company’s tactics personally.  I would be angry too.  Very, very angry.

It took me some time and effort to calm my client down.  I had to explain that her case was not unusual and that the only thing we must do is continue preparing for trial.  That is the only thing that is in our control.  I told the client that I will do everything I can to defeat the carrier’s arguments, but there is significant cost and risk involved.  Of course, I will do everything I can to try and settle the case for a fair sum, but often times that is not possible.  Especially, if the carrier takes a very aggressive approach to defending the case (which is happening to my client’s case here).  But that is our system of justice.  Even the insurance company has a right to have this case decided by a jury.  And a big part of my job is to make sure that insurance company ultimately regrets that decision.

I can tell you that roll-over collisions can cause the most severe and debilitating injuries.  I’ve handled dozens of these types of accidents.  The injuries are usually severe and long-lasting given the collision forces generated in the crash.  Roll-over accidents are notorious for causing spine injuries, to include fractured spine or vertebrae, disc injuries, facet joint problems, and strain/sprain injuries.

Hopefully the Seattle Police Department will take care of this by carefully investigating the cause of the collision.

Interestingly, the article suggests that the number of uninsured motorists is closely tied to the unemployment rate.  That shouldn’t be surprising since most people who lose their job will try to save money by cutting out certain expenses that they believe is expendable.  Auto insurance appears to be one of those unnecessary expenses, which may be true if the alternative is not paying your rent and/or buying enough food.

I previously wrote in the March 2008 volume of the Davis Law Group Newsletter that people should buy as much uninsured motorist (UM) as they can afford.  Now that the recession is here, I’m including a partial reprint of that article:

Uninsured motorist or Underinsured Motorist (UM/UIM) coverage is extremely important.  I have handled a lot of cases in my office involving accidents that were caused by an uninsured motorist or by someone who has the minimum amount of coverage that is legally required-just $25,000.  Yet it is the uninsured or underinsured motorist who is responsible for causing a much higher percentage of the accidents that occur on our roadways each year. 

The law only requires that a driver have at least $25,000 in liability insurance.  Yet, most of us know that a $25,000 policy does not go very far, particularly with the high cost of medicine today.   That’s why you should purchase as much UM/UIM coverage that you can afford.

Here’s a true story to illustrate just how important UM/UIM coverage is.  About a year ago, a woman called me about an accident she had several months earlier (I’ll call her Janet).  Janet was rear-ended by another motorist who was uninsured.  The other driver was 25 years old, job-less, and had neglected to buy any insurance on his 1990 Honda.  The collision was fairly significant, causing more than $8,000 damage to Janet’s Ford Taurus.  Janet received a significant neck injury that ultimately required surgery to repair the herniated disc in her cervical spine.  She had complications following surgery and another procedure was performed.  When she contacted me, Janet’s medical bills were more than $80,000.  And they were continuing to accrue because she was still getting treatment and medication for her ongoing symptoms.  Fortunately Janet had health insurance through her employer.  But her health insurance carrier only paid about 70% of her bills.  What was more unfortunate however, was

that five (5) years earlier Janet decided to reject UM/UIM coverage so she could save an extra $100 per year.  That decision proved tragic.  

Janet’s decision to reject UM/UIM meant that she really had no recourse against the other driver.  Oh sure, she could have sued him.  But litigating and going to trial is very expensive.  Even if she secured a judgment against this young man, he was essentially judgment-proof.  He had no assets and a low paying job.  She never would have been able to collect anything from that young man.  If Janet had adequate UM/UIM coverage under her own auto policy, she could have secured compensation from her own carrier.  But Janet had rejected UM/UIM coverage years ago to save money and she never thought to renew it after her financial position improved.  Instead, she had to pay thousands of dollars for her own medical treatment. 

In the end, Janet had to pay more than $20,000 out of her own pocket for an accident she didn’t cause.  An unjust result to say the least.

A serious car accident occurred today in the Interbay area, just south of Ballard in Seattle.  The accident involved a two-car, head-on collision which caused life-threatening injuries to both drivers.  Another passenger was taken to Harborview Medical Center by ambulance.

Negligent driving is the failure to exercise ordinary care, or the failure to act as a prudent motorist.  In head-on collisions, the most common cause is when one driver fails to pay attention and then crosses the center line.  There were no indications today from the police on which vehicle caused this collision.  But sources report that traffic was backed up for quite a while, forcing at least 3 metrol buses to try alternate routes and also causing significant delays to other motorists.

Sometimes in crashes like these an accident reconstruction expert should be immediately consulted, especially if there is a dispute about which driver caused this crash.  Skid marks should be measured, and other evidence preserved, like photos of the damage to both vehicles.  Damage photos may also be critical to help determine which car first crossed the center line.

This information is being brought to you by the attorneys at Davis Law Group in Seattle, a boutique personal injury law firm that specializes in car accidents, catastrophic injuries, wrongful death and medical negligence. You may also check out the firm founder, Seattle attorney Christopher M. Davis, on the Avvo attorney referral site.

When surgery is not recommended for many months or years following the accident, this gives the insurance company some room to argue that the surgery is unrelated to the accident in question.  How is this possible?  Well, there are a number of doctors, including surgeons, who routinely evaluate injured victims at the request of insurance companies.  Some of these doctors make a lot of money doing this.  I know of one Seattle neurologist who has made more than $2.5 Million testifying as an insruance company medical expert over the last 15 years.

Often times the doctor hired by the insurance company will look for anything in the patient’s medical history where it can be argued that the need for surgery was due to a pre-existing medical condition, like an old injury, a past back surgery, or some other event.  One time a defense doctor tried to blame my injured client’s surgery on an incident where she bent over to pick up her laundry which caused a severe aggravation of her already existing back pain.  It did not matter that my client had ongoing and severe back pain since the date of the accident two months earlier.

Often times the insurance company doctor will try to blame a car accident victim’s back pain complaints on a pre-existing “degenerative” condition, despite the fact that the person never had back pain complaints before the auto accident.  What is a degenerative spine condition?  It is mostly a normal occurrence that is somewhat dependent on the aging process.  As we age, our spines deteriorate to a certain extent.  The discs dry out and lose their shock-absorbing qualities.  The spinal joints become enlarged and/or develop osteophytes with normal wear and tear.  Most of us encounter these changes without experiencing any symptoms of pain and discomfort.  Some of us may experience symptoms but they usually go away with time.  But this “degenerative” condition allows the insurance company doctor to argue, sometimes quite convincingly, that the person’s ongoing or chronic symptoms are due to this pre-existing condition and not the car accident.

When a person experiences chronic neck or back problems following a car accident (defined as pain lasting longer than 3 months), it is usually a good idea to hire counsel to represent your interests.  Not every chronic back pain case leads to surgery, but many do.  I have represented several dozen car accident victims who developed chronic neck or back pain and then underwent surgery one or two years later.  In these cases, it is extremely important that you have an attorney who knows the medicine and can effectively cross-examine the insurance company doctor to reveal holes in that doctor’s opinions. 

It has taken me several years of reviewing medical journals, talking to doctors, attending medical seminars, and taking numerous depositions of insurance company doctors to learn the medicine of spine trauma and the treatment that is usually prescribed and recommended for these types of injuries.  Because of this, I know when an insurance company doctor is being “intellectually dishonest” when it comes to examining and offering opinions about my injured client.  Because spine medicine is incredibly complex, often with no clear consensus among practitioners about the exact diagnosis, it is easy for the insurance company doctor to offer “opinions” that stretch the truth and perhaps contradict the conventional wisdom of those doctors who actually specialize in spine medicine.