Displaying items by tag: Personal Injury

One might assume that the biggest risk for handling an auto accident or other injury case is that a non-lawyer will receive less compensation for their injuries. While that is statistically very true, we find the biggest risk is the long term issue with your credit due to mishandling of medical bills.

 

YOU are responsible for getting those medical providers paid

 

Most injury victims do not realize that the at-fault party will NOT pay your medical bills while you are treating. Only after settling the case, are you provided the money necessary to pay for those medical treatments. But, the trick is that you are deemed to know how much you should have settled for so those providers are all paid. That is a BIG challenge and risk! And, don’t forget that, if your medical insurance company paid the tab while you were treating, you are required to pay them back! If you have an ERISA plan, that could be dollar for dollar even if your settlement is less than the amount you owe back!

 

Even the most careful and clever folks become victims

 

Trick #1—You will rarely know what you owe back (i.e. subrogation) for at least several months following your treatment. If you do not know what you owe to every provider, you risk accepting too little money from the at-fault driver and you will be paying out of your own pocket! This happens to many people every year because they accept a settlement in the first few months after the accident and have no idea what their actual pay back will be.

 

Trick #2—The medical providers have up to one year to bill for their services. If they think they will get more money out of a personal injury settlement compared to the contractual amount with medical insurance, they wait that year out. Perhaps your regular insurance amount to pay back might have been $250 for the Emergency Room physician but, without that contractually reduced amount, you have to pay the total $950 since you settled under the one year mark.

 

Trick #3—In many cases, no one is paying those medical providers while you are waiting to settle your case. In rare cases, the provider will “hold” the bill or go ahead and submit to your medical insurance. However, a majority of providers will simply send you to collections or file medical liens. This causes many people to feel “forced” to settle before they really know the extent of their injuries and how much they will need to pay back. To avoid harming their credit, they prematurely negotiate an inadequate settlement with the at-fault party’s insurance company. Again, this leads to issues with trick #2 (over paying for services) and also undervaluing the actual out of pocket expenses you owe.

 

It's not you...even lawyers struggle with this stuff!

 

We recently attended a continuing education class that discussed the value of various software programs to manage medical records ledgers and records requests. The presenters made a point that, in a large survey of personal injury attorneys around the country, most reported that they spend between 30%-50% of their time simply managing medical bills and provider liens. That is a lot of time and we’re talking about people who do this every day!

 

Don’t get duped!

 

Don’t get duped by the insurance companies. You will get an offer within a week or two of your accident and a few more in the month or two following it. Insurance companies know they will pay pennies on the dollar if they can get you to settle before you realize what you owe for your care. Be very careful because you are deemed to know the law and the consequences of your actions when representing yourself. Don’t put yourself in a financial mess. Personal injury lawyers only make money if you make money. This is called a contingency fee. And, according the insurance council’s own inside study, injured parties who are represented by an attorney receive nearly 3x more in their settlement than those representing themselves.

 

Personal injury lawyers don’t get paid unless you do..so take the time for a free consultation!

 

So, on top of avoiding the risk to your credit or being “upside down” on medical bills, you are wise to partner with an injury lawyer to go over the facts of your case. Consultations are free and there is no obligation. Protect yourself from further financial injury by just taking a few minutes to know the risks of your case.

 

You do not need to live in Kitsap County to use our services! Just call. We have offices in Poulsbo, Gig Harbor, and Bremerton but, with new covid protocols, we are now handling about 95% of our cases via phone or zoom. You have no risk by calling or signing up with us. If calling isn’t your thing, you can start by texting or emailing. We’re flexible and we’re here for you 7 days a week so there is no reason to take the risk with medical liens! Get help today.

To Learn More About Handling Your Accident Case, Watch Our Video Below  

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November 12, 2020

Contingency Fee

How does a personal injury lawyer get paid?

An attorney who is working on a personal injury case has a very different set of rules and interests than other areas of the law. To avoid having an injured person unfairly treated due to a lack of funds to sue a tortfeasor (at fault party), the rules allow attorneys to charge a contingency fee for the case. This means the lawyer will not get paid unless the lawyer is able to successfully resolve the case for their injured client. The contingency fee for almost all personal injury cases is 33% for the law firm. If the case goes to trial and is very complex or costly in terms of experts, the law firm may raise that contingency fee to 40-50% of the verdict. If it is a simple auto accident trial and experts are not needed, some firms will keep the 33% fee in place. 

The unique value of the Witt Law Group attorneys handling your injury case is that we will never make more money than our clients—even if we are entitled to the 33% fee. Try to find another law firm that will put that in writing! 

We are different because our law firm receives nearly three-quarters of our cases on referral. This means we keep people happy and they think of us when their friends and family need legal help. It is in our best interest to make sure we treat our community right and we have been successful because of that philosophy. In a time when firms spend tens of thousands of dollars a month in advertising, we just have to treat clients fairly. Occasionally, it might cost a bit in cutting our fee but, so far, we don’t regret giving money to a client rather than spending it on an advertisement. 

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There are many factors that will contribute to the overall success of your case. An attorney will look at injuries, witnesses, whether the at-fault party was cited, when you began your medical care and where, how consistent that care has been, and, most importantly, are there any funds for recovery. Typically, a search for insurance policies is one of the first things a law firm will do when they take on a new client.

 

What kind of insurance concerns are there?

 

•  The most obvious concern for a fair settlement is whether the at-fault party has insurance. It’s even better when that insurance company has a good reputation. Some companies have very clever commercials but very terrible policies when it comes to reimbursing injury victims.


•  Another relevant insurance question is whether you, the victim, have good insurance. Basically, do you have PIP to cover medical bills immediately or even lost wages. If not, you will have to wait until the resolution of the case to get paid back for lost wages. Additionally, if you have UM/UIM, you are in a better position in the event the at-fault party has a small policy ($25,000). If your bills are $50,000, the small policy won’t adequately compensate you. Your attorney would get third party to tender the policy limits and then open a UIM (underinsured motorist) claim to seek additional money from your own carrier. This way, your medical bills are covered and, if subrogation can be reduced, you should end up with a fair amount of money in your pocket.


•  If neither you nor the negligent party has insurance, you can always try to seek compensation from the• Washington State Crime Victims Compensation Fund. There are a significant number of limitations to using these funds, including subrogation should you recover money in a lawsuit, but it is worth looking into if no insurance exists.


•  Finally, if the at-fault party was charged with a crime at the time you were injured, you can reach out to the prosecutor and see if there is an opportunity for restitution. Typically, the prosecutor’s office will send out a form called the Victim’s Impact Statement and this should include instructions to include your losses. However, since every jurisdiction handles criminal matters differently, it is best to reach out to the prosecutor’s office handling your situation within a few weeks of your accident.

 

Should I be concerned about other insurance tricks?

 

Absolutely! These are just some of the initial concerns to consider when valuing your case. Of course, all medical care must be deemed relevant and necessary, too. Insurance companies like to devalue a case by claiming your treatment was not related to the accident—even when it clearly was. They also like to argue that you had gaps in your treatment and, therefore, you are not truly injured. There are many tricks insurance adjusters use to keep from paying fair settlements and it is always a good idea to seek legal counsel at the beginning of your accident.

 

Does it cost any money to get advice from a personal injury attorney?

 

No. It costs you nothing to speak with a personal injury lawyer because they are only paid based on contingency—meaning, if you don’t get paid, they don’t get paid. Always take the time to do a free consultation and learn whether you are on the right track for your case and whether a lawyer can help you get a better settlement based on the facts of your case.

 

The lawyers at Witt Law Group are always available to discuss your case. We work evenings and weekends, too. Don’t delay in getting advice. It will cost you nothing to call but, long term, it might cost you significantly if you don’t. 360-792-1000.

 

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A fair number of clients come to us after trying to settle their own personal injury case. There are certainly times when a lay person can neatly wrap up an accident case by themselves but those cases usually do not involve bodily injury. For example, if someone hits your truck while you are inside a store, you shouldn’t have much trouble getting your truck repaired or replaced with a third party property damage adjuster (particularly where you have video). However, be very cautious about accepting a settlement amount and signing releases if you are unrepresented. The primary reasons for this caution is:

1) If you received medical treatment, most providers have an entire year to bill you for services. Quite often, the hospital will bill for services but the ER physician’s bill is separate and comes later. If you missed that bill, you are still on the hook to pay it (the average ER doctor bill is about $900). You might also have X-ray or imaging bills that will be coming separately. All of these providers must be paid with your settlement. The third party (at-fault) insurance adjuster will send a release that clearly indicates that you must pay any bills related to the accident.


2) In almost all cases, if your insurance (PIP, medical insurance, L&I, Medicare/Medicaid, etc.) paid any bills, you are required to pay them back. This is called subrogation. If you accepted a settlement that is smaller than what you owe, you will be in debt after your settlement. This is the reason third party adjusters call a lot right after the accident. They want you to settle the case before you realize how much you owe back in medical payments. A settlement of $1000 might sound like a lot until you realize that you have $10,000 in medical bills simply from the one ambulance ride, the 3 hour visit to the Emergency Department, the ER doctor, the imaging, and lab work. More often than not, we see well over $7,000 from the initial hospital visit immediately post-accident (that is for victims who have no broken bones or serious head injuries).


3) Even if the offered settlement says the third party insurance will pay “all reasonable and necessary medical expenses” to date plus $3000 for your trouble, that does not mean all of your medical bills will get paid. Every month, we have insurance adjusters decide that certain aspects of someone’s care was not “necessary” in their eyes. Likely, it will be ridiculous but they will simply refuse to pay that portion of a bill. If you signed the settlement, there won’t be much you can do to refute their version of “necessary.”


4) If you have Medicare or Medicaid as insurance, realize that you may be precluded from having coverage for any additional medical care related to the accident following your settlement. In certain cases, you are supposed to get a “set aside” that acts like a savings for accident-related future care. If you accept a settlement without a set-aside (and it was required), you will be personally responsible for any further medical care.


5) If you accepted settlement money for lost wages, this is a taxable event. Just like paying taxes on earned income, you could be required to pay taxes on the portion that you accepted specifically for lost wages. So, if you accepted $2,000 in lost wages, it may not in fact be $2000 in your pocket. Your gross settlement is not always the amount of money you are “entitled” to under all of the rules and tax realities.

There are many other reasons you should be cautious in handling your own personal injury case. First and foremost, the adjusters do not owe you any fiduciary duty and will not advise you of all of the legal ramifications of your settlement. In most cases, you will receive more money in your pocket if you have a lawyer handle the case and manage the above noted risks.

If you are unsure whether your injury case warrants hiring a lawyer, call for a free consultation. Every case is unique and it doesn’t cost anything to ask the questions. Since personal injury lawyers work on a contingency basis, it will cost you nothing to hire a lawyer at Witt Law Group. We are based in Kitsap County, Washington with offices in Poulsbo, Bremerton and Gig Harbor. We’re here 24/7 so don’t hurt your case by delaying!

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Check Your Auto Policy Today

 

In the State of Washington, auto insurance carriers are required to offer PIP, or Personal Injury Protection, to their insured. This type of benefit is essentially a no-fault coverage that kicks in when you are injured in an auto accident. It can also be used where the driver of a car injures a pedestrian. The pedestrian is allowed to use the driver’s PIP coverage to assist with medical bills.

 

Why Do I Need PIP If I Have Bodily Injury Coverage?

 

The reason that PIP is so important is that, following an accident, the at-fault driver’s insurance does NOT pay your medical bills. Many people mistakenly hand over the at-fault driver’s insurance information at the hospital or doctor’s office believing the medical provider can simply bill third party from the start. This is not true. And, if you do not have medical insurance or PIP, you will be immediately on the hook for those bills. Your Bodily Injury Coverage will possibly cover injuries to your passengers or to those you injure if you cause an accident.

 

So When Does Third Party Pay My Bills?

 

After your case is settled through negotiation or a trial (assuming you prevail), your attorney will take the proceeds of your settlement and pay the medical providers. Prior to settling your case (which can be many months or years), the medical providers will file a medical lien against your case or may send your medical bills to collections. If your medical bills were paid through PIP, you will likely need to pay that amount back (subrogation) at a reduced rate. However, there are situations where your carrier will waive subrogation.

 

What Does PIP Cover?

 

PIP can be used to cover medical expenses and loss of income due to your accident. The minimum that a non-commercial policy can offer for PIP benefits is: (a) $10,000 medical, (b) $2,000 funeral, (c) $10,000 income continuation limited to $200/week, and (d) $5,000 loss of services limited to $200/week. There are larger PIP policies available so it is important to ask your agent to provide quotes if you would like a higher policy. If you do not reject PIP, the minimum policy will be included.

 

How Can PIP Help Avoid My Bills Going To Collections?

 

The standard PIP policy is usually $10,000 but you can opt to have a much higher policy. Occasionally, we see a $35,000 policy, which is very helpful. This means that your medical providers will bill your PIP policy just like it was medical insurance (however, there is not negotiated lower rate). The providers will bill your PIP until you reach the maximum benefit and the remaining balances are your responsibility. If you have medical insurance, the provider may then start billing insurance. As long as medical providers are paid, they will not send you to collections.

 

What If My Insurance Carrier Says I Don’t Have PIP?

 

In the State of Washington, you must affirmatively reject PIP in writing. If there is a dispute about coverage, the insurance company must provide your attorney with the document with your signature indicating your rejection. If the company cannot provide proof of your signature, they must offer at least the minimum $10,000 policy to you.

 

What Are Some Of The Challenges With PIP?

 

For PIP to apply, your care must be (a) reasonable, (b) necessary, (c) related, or (d) incurred within three years of the injury. So, your physical therapy will likely be reasonable and necessary but your subscription to a mail order food service is not. Certain insurance companies really like to mess with this type of denial. They will assert that, after paying out $2,000, they feel your care is no longer medically-necessary. They will have an “independent” review done of your records or have you submit to an Independent Medical Exam (IME). These are not really independent as the chiropractor or doctor will be chosen and paid for by the insurance company.

 

When Does PIP Not Apply?

 

There are some restrictions to using your PIP policy. If you intentionally hurt someone, such as ran them over or intended to cause damage and someone was injured in the process, your policy would not apply. There is also an exclusion for coverage if you commit a felony while you are injured. Similarly, if you are injured while racing your vehicle (under the statute that covers this term), your insurance company would likely deny your benefits. Most importantly, make sure you have all of your vehicles listed on the declaration page of the policy. If you or a relative are injured in a car that you own but was not on the policy, the company will not pay benefits. There are a couple of other random exclusions such as war and nuclear events that are included but the basic take away is that you should not commit a felony while driving and that all of your vehicles are listed on your declaration page.

 

Can A Company Stop Paying My Benefits?

 

Yes. If the insurance carrier believes that your treatment does not meet one of the basic requirements such as reasonable and medically-necessary, the company can refuse to pay bills in the middle of your treatment. If this happens to you, your attorney will assist in trying to regain your PIP benefits. If you are not represented and your insurance carrier has refused to pay under your PIP benefit or ordered a PIP Termination Exam (PTE), contact a lawyer today. Depending on the facts, they may be facing a bad faith insurance claim. There are many reasons for using your PIP benefits (reduced pay back and avoiding bills going to collections) but there are also certain requirements under Medicare Secondary Payer Rules that PIP be used before Medicare or Medicaid pays for any treatment. It is important to understand your benefits and how to maximize them in the event you are injured in an auto accident or were hit as a pedestrian by a car.

 

PIP benefits are critical to covering you in an accident yet they can be confusing in how and when they apply. For any questions regarding PIP benefits or your car accident, please do not hesitate to give our office a call.

 

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If you are tuned into current events, you recently heard mention of efforts to require more transparency in healthcare costs. One of the challenges that consumers face is not understanding how medical facilities code their services for billing. Additionally, there is very little consistency in the coding—even within the same facility.

Why Are There Multipe ER Bills?

 

For starters, a visit to your local emergency room will typically produce two or three bills. The first bill will be a facility bill. This bill will list a charge of level I up to level V based on the complexity of your visit. Level V is the most complex and, therefore, the most expensive. Most often, another bill will be sent to you for the emergency room physician’s services. In our experience, these collection services tend to be the most aggressive and the least flexible. Finally, if you had any X-rays or a CT scan done while at the hospital, you will likely receive a separate imaging bill. Any lab work performed can also be billed separately but, depending on the facility, might be included in your facility bill as a separate line item. That’s a lot of billing!

Of the bills generated by an Emergency Department, the one most ripe for review is your facility bill. The reason is that there are no exact standards for assessing the complexity of your visit. Basically, there is a lot of gray area in facility coding. For example, if two individuals seek care for chest pains, one emergency department patient might be billed level III and the other at level IV or V. One of the patients might be older and the symptoms might look like a potential heart attack so many more resources and testing is necessary. A young healthy patient might have a history of heartburn and the doctor provides a prescription level medication for the discomfort without performing an EKG or labs.

How Are My Bills Coded? And What Does That Mean?

 

While there are no hard and fast rules about coding your visit, there are some general rules that the provider uses to properly bill you for services. First, there is a valuation of resources. This means the provider is looking at how a patient with your symptoms or presentation uses resources such as nursing, staff, ER room, and even the cost to create a medical record and bill you. Second, the number of diagnostic tests used to determine your diagnosis or rule out more serious concerns is a factor in cost. Finally, the level of complexity of your presentation is a big factor in determining the proper level of coding. For example, if you are brought to the ER unconscious with no guidance on how or why you are unconscious, there will be many doctors, nurses, lab technicians and specialists trying to quickly determine whether you are in a life or death situation. Your presentation to the facility has pulled so many resources for only one patient that the bill will reflect that “draw” on resources.

Can You Really Afford To Go To The Emergency Room?

 

The problem for the average consumer is that, when you have to use the emergency department because the urgent care is closed, how can you decide whether you can afford to treat your strep throat tonight or whether you should manage until tomorrow? Honestly, the bill might kill you so it’s worth thinking about! The difference in receiving antibiotics via pills versus intravenous treatment can cause the facility bill to go from level II to level IV, which can be a difference of more than a thousand dollars. There are many factors to consider when your medical issue is not really an emergency. If you are paying the balance, it is important to know what you could be charged.

To illustrate, we randomly pulled 5 personal injury files and reviewed the billing for emergency department visits.

The first four clients were treated at facilities on the Kitsap Peninsula:

1) ER level IV bill = $2,773.00
ER physician’s bill = $953.00

2) ER level III = $1,793.00
ER physician’s bill = $1,057.00

3) ER level IV = $2,641.00
ER physician’s bill = $1,407.00

4) ER level IV = $2,773.00
ER physician’s bill = $603.00

Client treated on the Olympic Peninsula:

5) ER level IV = $727.50
ER physician’s bill = $169.50

 

As you can see, the difference of a level IV facility bill on the two peninsulas was a difference of nearly two thousand dollars!

Can An Urgent Care Handle Your Needs?

 

If you know that an urgent care can handle your needs, it is important to consider that your out of pocket expenses are likely to be far lower. Additionally, if you do not have insurance, there is no “allowed amount” reduction as is done for those who have private insurance or Medicare. In fact, CMS has greatly reduced allowed amounts so the patient will never be forced to pay $2,700.00 for a facility charge. Additionally, the Center for Medicare Services has been reviewing these charges with more scrutiny and refusing to pay bills where hospitals are “upcoding” a patient’s visit. This is good news for those using Medicare or Medicaid. However, for the rest of consumers, there is more to be done to avoid a financially devastating bill.

Hopefully, the medical transparency bill will lead to better outcomes. Part of the equation to improving outcomes means taking some responsibility as the patient. If you are not in a life-threatening situation, you might consider driving to a less convenient location for a greatly reduced bill. A high level trauma center, with the high cost of running such a facility, might not be the hospital you want to visit. The facility bill for a level I trauma center is likely to be five or ten times higher than an urgent care. Without transparency in the billing by these facilities, it becomes impossible for the patient to make informed and cost-saving decisions.

Why Do We Care About Your Billing?

 

So why would a personal injury firm care about all of this billing? After all, won’t the insurance companies pick up the tab? Yes and no.

The explanation regarding subrogation could cover 10 blogs but, in a nutshell, if you “over spend” when treating a soft tissue injury (whiplash) your “pay back” to your medical insurance provider could mean there is nothing left in your pocket for pain and suffering. For example, our clients with straight forward “whiplash” cases often visit the emergency room immediately following the accident, follow up with a primary care doctor, and seek chiropractic treatment or physical therapy. If the hospital visit included a CT scan and other X-rays, you can assume that the imaging bill will be somewhere between $3,000 and $5,000, a level IV facility bill of nearly $2,000, an ER doctor bill of approximately $1,000 in addition to the $3,000-$5,000 for chiropractic or physical therapy. If none of those bills are reduced, the injured person who has no medical insurance or poor coverage is looking at a potentially terrible situation.

Despite the “injury calculators” all over the internet (the ones that say you will get 5x medical expenses), soft tissue cases have a ceiling. The insurance companies know what juries will award in every jurisdiction and they aren’t about to hand out extra money in settlements because the injured person is stuck with a massive ER bill. The insurance adjuster is considering whether the care is reasonable and related to the accident but the patient or her attorney has to keep in mind that the cost of the treatment should also be reasonable and fall within an average settlement award for those injuries.

Speak With An Auto Accident Lawyer As Soon As Possible!

 

If you have been injured in an accident, it is important to talk with a lawyer as soon as possible. Occasionally, we have been able to help clients qualify for insurance that has retroactively covered an emergency visit. Knowing how to handle accident cases and get the best outcome for an injured person often means having an advocate immediately following your injury. A delay in legal advice can mean the difference in getting stuck with your medical bills due to someone else’s negligence or actually being able to treat your injuries and also receive compensation for your pain.

If you have been injured and have questions about your case, we offer free consultations. You can visit one of our offices in Gig Harbor, Bremerton, or Poulsbo. However, if it is more convenient, we can also handle everything over the phone.

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If you have searched the internet to find a value for your injuries, you have likely noticed a big difference in estimates. In part, this is due to the fact that “whiplash” injuries (sometimes called minor impact soft tissue injuries or MIST) vary so much in their physical damage to the vehicle, emergency response at the time of the accident, medical treatment, follow-up care, loss of income, as well as pain and suffering. Additionally, depending on the state you are located in and even the specific county in which a jury would be empaneled, your odds of a jury finding in the plaintiff’s favor can vary widely.

 

Victims always want a nice calculation such as three times medical expenses. However, that is simply never the case. If you “under-treated” “over-treated” or were inconsistent in making your medical appointments, be prepared for a fight from the insurance company. If you’re handling your case without a lawyer, be prepared for the adjuster to spring this on you at the end of your treatment period.

 

Despite the inconsistent settlement amounts and jury verdicts, there are some truths for soft tissue injury victims. First, because your injury is not visible to a jury, it is important to have your injury documented by a medical professional. Second, because juries tend to be skeptical about injuries they can not see, make sure your treatment behavior is consistent with someone claiming to be truly hurt. For example, do not plan to successfully assert that you have been in so much pain that you can’t get out of bed but, at the same time, you never went to see a doctor. This can be tricky for a person without insurance but, if you talk with an experienced personal injury lawyer, he or she will typically know of service providers who will hold your bill until the case settles. Third, do not exaggerate your claim. Sometimes, people get bad advice from friends that if you “rack up your medical bills, you will get more money.” This could not be further from the truth. Reasonable care is the key. If you “over-treat” be prepared to get stuck with some of the medical bills and no money in your pocket for pain and suffering.

 

The moral of the story is that you need to seek legal advice from an injury lawyer in your area. If you were injured in Bremerton but seek advice from a lawyer who practiced in Los Angeles, be prepared for quite a shock when it is time to settle your case. Geographical differences in personal injury cases are quite substantial. The insurance companies are well-versed in the jury verdicts of every county in the country. They know the range in value of your case and they are rarely going to venture outside of the range.

 

If you want accurate information, make sure you keep all of these factors in mind. Contact a local personal injury lawyer so you are prepared. Let the attorney know if law enforcement did a report (determining who was at fault), whether you were transported to the hospital, who responded to the accident, and any treatment providers you have seen since the date of the accident. Your lawyer will confirm whether the at-fault driver had insurance and whether the policy will be large enough to cover your treatment.

 

For more information about valuing your injuries from an auto, pedestrian or bike accident, contact Witt Law Group for a free consultation. Do not seek legal advice about your accident, injury treatment, or how to value your case from random “injury calculators” or generic non-local websites. On top of your physical injuries, you will likely injure your case!

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There is a lot to deal with following a car accident. Most injured victims will deal with pain, healing, medical bills, stress and even anxiety about the accident. However, many of our clients are unpleasantly surprised to find that their insurance rates will be raised even when the accident was not their fault. Talk about adding insult to injury!

 

In the State of Washington, approximately 20% of drivers on the road are uninsured. If you are hit by one of them, your UIM/UM and PIP coverage can help. It’s never great to have to use your own insurance when injured due to someone else’s negligence but it is better than nothing. Make sure you have that coverage! 

Will My Premiums Increase?

While your own insurance can help in this situation, there might be a financial consequence—your premiums increase. We have been asked in the past to “do something” about the unfair practice but our hands are tied. In most states, insurance companies are permitted to raise your rates. You can complain but it will rarely make a difference.

 

What is particularly troubling about this practice is that it is often the poorest in our community who get hit with the greatest premium increase. The study done by Consumer Federation of America found that the insurance companies added a greater premium hike to people who were deemed less educated and lower income. Hopefully, the lawmakers of Washington will crack down on this practice. 

Insurance Company Decisions Are Tied To Profits

As we have said in the past, insurance companies are tied to profits. The bottom line dictates most of their responses. Whether it is “low balling” the settlement offer or raising rates on innocent accident victims, get prepared. The State of Washington does not prohibit “not-at-fault premium penalties.” However, since not every company does this, find a knowledgable insurance agent to help you navigate this issue. Drop the unfair company and find one that will truly stand by you!

 

If you have been injured and need help navigating all of the insurance challenges, we are here for you. We truly enjoy getting accident victims the settlement they deserve. Our consultations are free and, if you are too injured to come into one of our offices, we can handle everything over the phone or come to you. Don’t delay. Personal injury cases have a statute of limitations and you can be barred from bringing a case if you wait too long.

 

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If you have been injured in an accident and have been told by your treating physician that you will likely need future care, it is important that you understand what that means for your personal injury case. For those victims who are on Medicare, will be a Medicare beneficiary within 30 months, or have a “realistic expectation” of becoming a Medicare beneficiary due to Disability Benefits, it is important that you keep in mind the concept of a Medicare Set-Aside Arrangement (MSA).

 

The purpose of a MSA is to avoid shifting the financial burden to Medicare if you are being compensated for future care in your personal injury case. For example, if part of your $300,000 settlement is in consideration for medical care you need in the future, Medicare should not be on the hook later to pay for that care. The Centers for Medicare and Medicaid expect that you have placed some portion of your settlement into a specially designed Trust for future medical care.

 

Things To Consider For An MSA

 

When determining whether your case might fall within the conditions for a MSA, here are some criteria to consider:

Are you a Medicare beneficiary (due to age or disability benefits) and your total settlement value is greater than $25,000?


Is there a “reasonable expectation” that you will become a Medicare beneficiary within 30 months of the settlement date and the anticipated settlement amount for future medical expenses, disability, and lost wages is expected to be greater than $250,000.


A “reasonable expectation” occurs when:


a) you have applied for Social Security Disability

b) you have been denied Social Security Disability Benefits but plan to appeal

c) you are in the process of appealing a denial of Disability Benefits or re-filing for Disability Benefits

d) you are 62 years and 6 months old

e) you have End-Stage Renal Disease (ESRD) but do not yet qualify for Medicare based on ESRD.

 

Things To Consider For An WCMSA

 

If you are settling a Workers’ Compensation case and a portion of the settlement is to pay for future medical services related to the workers’ compensation injury, you will need to do a separate analysis to determine if a Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) is necessary. 

 

These issues can be complicated but the purpose is simple. The Centers for Medicare and Medicaid Services (CMS) want to make sure the victim is not burden shifting future medical payments to CMS. If you receive money for future medical care, that money may need to be put in a special Trust to ensure that future care is paid for with this money rather than CMS money. To avoid future penalties, being denied future benefits, or facing other civil actions taken against you, contact our office for a free consultation to determine if you need an experienced attorney to assist with your case. Most personal injury victims have a much better financial outcome if they have legal representation and hiring an attorney can be critical for someone who is receiving benefits from Medicaid or Medicare.

 

Witt Law Group is a personal injury / auto accident law firm based out of Kitsap County Washington. We have offices in Bremerton, Poulsbo and Gig Harbor for your convenience. If you have any questions about an MSA, please give our personal injury lawyers a call. 

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Choose your insurance coverage wisely 

Recently, we were dealing with a first party agent regarding a car accident case. We were commiserating about the difficulty of dealing with the agent of a certain company. This person mentioned that everyone in the industry knows this company is intentionally difficult. They are terrible as third party but also terrible with their own insured as first party. She stated that, “Everyone in the industry knows they are impossible to deal with!” Even if you just need a rental car, they will make it so difficult that you give up. We would probably have to second that sentiment (although there might be a tie with another company). 

When you are choosing auto insurance, be sure to check the reviews of any company you’re considering. Saving a few bucks on your premiums may not be worth it. Check reviews online, ask around, and contact insurance agents. Make sure you make an informed decision. There can be a big difference in customer service among the various companies. Your premium might be higher for a certain company but your stress after an accident could be much lower!

 

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