Do You Have to Stay in Network When Getting Care for Your Injuries?
One of the things a person should be compensated for when a personal injury occurs is medical expenses that were incurred due to the injury. But what if your medical bills total $100,000 and yet you only pay $10,000 out of pocket due to medical insurance?
This is a tough question because while it may seem the defendant is being rewarded for you having medical insurance, they are only going to be on the hook for what you have to pay out of pocket. But what if you don’t bill your medical insurance or you see a doctor who is out of network to get your injuries cared for?
A recent case shows that you can get your medical bills covered as part of the settlement, even if you decline to use your insurance. So don’t feel obligated to get your injuries cared for in the cheapest way possible if someone else is at fault. At the same time, don’t hold off on using your insurance assuming that you will be compensated. If the court rules against you in such a case (even though there is now a precedent), you could be on the hook for all of those medical bills.
Help When You Have Been Injured in an Accident in California
If you have been injured in an accident of any sort, you need the help of an experienced attorney who can help you to maximize your settlement and receive compensation for your expenses and losses. The personal injury attorneys at Petrov Law Firm proudly serve the residents of San Diego and the surrounding neighborhoods. To contact an attorney today, call 619-344-0360.
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Insurance for Medical Payments
Some insurance policies come with a line item often referred to as “medical payments” or “med pay”. The amount of the med pay line item in most insurance policies is typically low — less than $5,000. But with the cost of medical treatments being so high, why is the med pay so low? And what happens if the medical costs rise above that amount?
Med pay is an easy way to get an insurance company to pay for minor injuries. For example, if you are in a minor car accident, and your passenger gets a cut on his or her face, someone’s insurance policy should pay for treating the injuries. If the other driver was at fault, then the other driver’s insurance should pay. If you are at fault, then your insurance should pay.
Med pay cuts through all the red tape and simply covers the cost of treating the minor injury. There is no need to worry about who is going to pay and how. If you have med pay on your policy, then your policy pays for the treatment, and no one has to sit and wait and worry about the insurance claims process.
However, if you’ve been involved in a car accident, as a driver or passenger, you should consult with a personal injury attorney as soon as possible. Many injuries that have low, short-term costs, can have high long-term costs. For example, people often hurt their knees in car accidents. In the short term, there is little to do except wait for the swelling to reduce. In the long-term, however, the injured party could face expensive physical therapy and lost wages. A good personal injury lawyer can ensure those long-term expenses are covered by the right insurance policy.
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Insurance Claim Denials
Insurance Claim Denials
Some smaller insurance companies still operate by denying 99% of all claims that are filed. It’s not an ethical practice, and it’s likely illegal, but unless you use a lawyer, you aren’t likely to change their mind about their decision.
In many cases, an insurance company will deny a claim unjustly because they don’t take the time to review the entire case. Auto accidents are frequently complicated events, and insurance adjusters are fallible people who don’t have enough time to do all their work. Asking a lawyer to review your case is generally free, and the lawyer will be able to tell you if there is money to recover.
Generally, if the claim has been unjustly denied, a good personal injury attorney will be able to extract more from the insurance company then if the company simply approved the claim. Some insurance companies gamble with your losses. If they approve the claim, they have to pay out the money. If they deny the claim, you might simply give up and walk away. Only a small percentage of people have the time and energy to contact a personal injury attorney and challenge the decision.
If you try to confront an insurance company without a lawyer, you are confronting a cadre of lawyers and policymakers who are trying to prevent you from getting any money. You need your own advocate who can talk to them on their terms.
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As a Sole Proprietor, Do I Need Liability Insurance?
In short, probably, but not always. As a one-person operation, your need for insurance will depend on what kind of good and services you offer. If you can think of a way a client could sue you for injury (as opposed to breach of contract), then you are exposed and you probably need insurance. If you are a small business owner and you are being sued for personal injury, contact a personal injury attorney immediately.
Let’s look at a few examples:
Freelance graphic designer: Generally, the work you perform is alone and doesn’t generate any products that could potentially harm anyone. However, if you frequently have clients to your home office for consultations, you might be liable for the total cost of their injuries if they slip and fall while in your home. Although you can purchase a full commercial insurance policy, you might be able to avoid that cost by asking your homeowner insurance carrier if there is a home-business rider you can add to your policy.
Network Marketing Events: Companies like Tupperware and Mary Kay depend on sales consultants to host events at other people’s homes. Here there are two risks: 1) What happens if one of the guests gets injured? Generally, that dispute will be between the host (homeowner) and the guest. 2) What happens if the network marketing representative damages the house? That might be a possible problem. If the sales consultant accidentally burns the house down during a candle demonstration, he or she could be held liable for damages. However, the parent company could be named as a co-defendant in such a case. This is a vague area of liability, so if you are a network marketing consultant with significant assets, consult with an attorney about your possible exposure.
Small Shop Owner: If you run a small shop, the landlord for the property might require that you carry insurance. If not, then you should probably buy an insurance policy anyway. Having strangers come in and out of your shop exposes you to a major liability. One slip and fall, and you could be looking at an expensive lawsuit that could strip you of your personal assets. If you are being sued and you don’t have insurance, a good personal injury attorney can help minimize your losses.
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Why do I need a lawyer when I already have insurance?
If you are at fault for an auto accident, generally your insurance policy will cover the cost of the damages. Keep in mind, your insurance policy has limits, so if you have minimum coverage, your insurance policy might not cover more than a few thousand dollars.
If the accident costs rise above your insurance limits, you will want hire a lawyer to help you keep those costs as low as possible. Anything not covered by your insurance policy will come out of your pocket — either now or over the course of the next twenty years.
Even if the accident costs don’t rise above the limits of your insurance policy, it might be worth your time to ask a lawyer to review the case. If you’ve been deemed at fault, then you will be looking at a very steep hike in your insurance costs over the next five years. A good attorney can minimize the extent of your blame.
Lastly, if there is even the suggestion that anyone was injured, you will want a lawyer. The victims of an accident have years in which they can claim problems arising from an injury caused by the accident. Medical costs are high, and could easily use up your insurance coverage.
If you caused an auto accident, then you will probably have to pay — from delayed medical problems to expensive insurance hikes. Get an attorney to represent your best interests.
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