Why did I receive a letter from Optum?

I received a letter from Optum. What do I do?

Why did I receive a letter from Optum? | ErieInjury.com Law Blog

After you get medical treatment for an injury rather than a chronic illness, it’s not uncommon to receive a letter from a third-party subrogation company, such as Optum (or The Rawlings Company, Equian, First Recovery Group, etc.), on behalf of your health insurance company. Optum (or one of these other companies) is probably calling you to find out how you got hurt. If your injuries possibly give rise to a personal injury claim or a potential lawsuit (for example, a car accident, a work injury, a slip-and-fall accident, etc.), Optum wants to know, because it’s their job to find out if your health insurance company might have a right to be reimbursed out of your settlement. If you received a letter from Optum after an accident, you should call our law firm immediately at 1-800-999-0750.

Should I reply to Optum’s letter or call them back?

Optum cannot make you sue somebody if you don’t want to sue them! That being said, you should still talk to a personal injury attorney before talking to Optum. You need to know your rights (and responsibilities) regarding this accident, your health insurance policy, your medical treatment, and your medical bills. Our personal injury law firm offers a free consultation that can be either over the phone or in person! Give us a call today at 814-452-6232.

DO NOT FORGET: If you were hurt because of someone else’s negligence, you should immediately give Optum’s letter to your attorney! If you have a lawyer, you should not be contacting Optum directly. You want your personal injury lawyer to know about Optum’s letter, because failure to properly consider your health insurance’s lien against your settlement could potentially have devastating consequences to both your case and your finances. The last thing you want is to settle your case for so little that you can’t pay back Optum, should they be entitled to some of the money!

If you were hurt in an accident but don’t have a lawyer, you should hire a personal injury attorney to contact Optum on your behalf. Our personal injury lawyers work on contingency and only get paid if we get you a financial recovery. We represent injured victims throughout Western Pennsylvania, from Pittsburgh, to Erie, and all the way to Bradford and Smethport.

What if I don’t want to sue the person who hurt me?

In Pennsylvania, Optum can’t make you sue somebody if you don’t want to sue them! That said, it is still a good idea to talk to a personal injury attorney before talking to Optum. You need to know your rights and responsibilities regarding this accident, your health insurance policy, your treatment, and your medical bills. Our law firm offers a free consultation that can be either over the phone or in person—you decide! Give us a call today at 814-452-6232.

The Household Exclusion in PA Car Insurance Policies

In Pennsylvania, the “household exclusion” is a clause that insurance companies began using in the 1990’s in auto insurance policies to limit the amount of uninsured motorists (UM) and underinsured motorists (UIM) coverage they had to provide after claims made by their insureds after a car accident.  Under the Motor Vehicle Financial Responsibility Law (MVFRL), any relatives who live in the same residence could seek benefits from policies issued to other “resident relatives” in the household.  While the MVFRL clearly stated this, insurers used these clauses to deny claims against the policies of the other household members that would have been permissible under the MVFRL.

While the language of the exclusion could vary, it essentially prevented injured household members from seeking underinsured motorists benefits from other policies applicable in the household, unless they were insured under the same policy.  As an example, suppose mom and dad each have a vehicle and they are insured under a policy with Erie, which includes stacked UIM benefits.  Their daughter, a college student still has a permanent residence in the household, and she has her own car which is insured with Progressive. 

By applying the household exclusion, Erie could deny any claim against the parents’ UIM coverage if daughter was involved in an accident while driving her own vehicle because their vehicles were insured under a different policy from their daughter.  In fact, if a parent was in daughter’s vehicle at the time of the accident, they would most likely have not been able to file a claim against their own UIM coverage.

In January 2019, the Supreme Court of Pennsylvania issued an opinion in Gallagher v. Geico Indemnity Co., which held that household exclusion clauses were no longer enforceable in Pennsylvania as they were contrary to the express provisions of the MVFRL.  Hence, a person seriously injured in an auto accident has a right to seek benefits from the policies of any resident relatives at the time of their accident.  This can involve complicated legal questions regarding “residency” and damages and you should seek legal advice in attempting to pursue such a claim.

In fact, if you were in an accident within the last 4 years, and you were advised that you could not pursue a claim against UM (uninsured motorists) or UIM benefits because of the applicability of a household exclusion, you should contact our car accident lawyers immediately, as you may still be able to pursue claims for additional UM or UIM benefits. Our office offers free consultations and doesn’t take a fee unless we make you a recovery.

Why did I receive a letter from The Rawlings Company?

I received a letter from The Rawlings Company. What do I do?

Letter from The Rawlings Company

After you get medical treatment for an injury, it’s not uncommon to get a letter from a third-party subrogation company, like The Rawlings Company (or Equian, Optum, First Recovery Group, etc.), on behalf of your health insurance company. The Rawlings Company is most likely reaching out to you to discover out how you got hurt. If your injury possibly gives rise to a personal injury claim or a potential lawsuit (for example, a car accident, a work injury, a slip-and-fall accident, etc.), The Rawlings Company’s job is to find out, because your health insurance company might be legally entitled to reimbursement out of your personal injury settlement or verdict. If you received a letter from The Rawlings Company after an accident, you should call our law firm immediately at 1-800-999-0750.

Should I respond to The Rawlings Company’s letter or call them back?

Whether or not you’re legally required to respond to The Rawlings Company after getting their letter is going to be written in your insurance policy with your health insurance company. In all likelihood, this is a document you probably never read. With that in mind, if you weren’t hurt in manner as to give rise to a compensable legal claim, you’re probably safe to call and let them know, at which point they should leave you alone.

If you were hurt in an accident that gives rise to any type of legal claim, you should immediately give The Rawlings Company’s letter to your attorney! If you already retained a lawyer, you should never contact The Rawlings Company directly. Additionally, you want your personal injury attorney to know about The Rawlings Company’s letter, because any failure to consider your health insurance’s lien against your settlement might have catastrophic consequences to both your case and your finances!

If you were hurt in an accident (at work, in a slip-and-fall, in a car, et cetera) but don’t have a lawyer, you should hire a personal injury attorney to contact The Rawlings Company on your behalf immediately. Our personal injury lawyers work on contingency and only get paid if we get you a financial recovery. We represent injury victims throughout Western Pennsylvania, from Pittsburgh, to Erie, and all the way to Bradford and Smethport! If you’re not from Pennsylvania, we might be able to help you find a local lawyer who can helo.

What if I don’t want to file a lawsuit against the person who caused my injury?

The Rawlings Company cannot force you to sue somebody that you don’t want to sue. However, it’s always a good idea to at least speak with a personal injury attorney before you talk to The Rawlings Company. You need to know your rights and responsibilities regarding this incident, your medical treatment, and your medical bills. Our law firm offers a free consultation that can be either over the phone or in person—you decide! Give us a call today at 814-452-6232.

Do I have to sign a Medical Authorization for the Insurance Company?

Signing a Medical Authorization for the Insurance Company after an Accident

health authorization for insurance company

As Pennsylvania personal injury lawyers, our new clients frequently ask us if they must sign a medical authorization for the insurance company after a car accident, after a work injury, or after a slip-and-fall accident. Given the numerous types of insurance claims out there, there is no universal answer, which is why it is always best to call an attorney to discuss your rights before giving the insurance company what they want. Sometimes the insurance company is entitled to a medical release or authorization, and sometimes they’re just trying to pressure you to give them more than they’re permitted by law. If an insurance company is requesting that you sign an authorization for your private medical records, you should call our law firm at 1-800-999-0750 to speak with an attorney for free.

Medical Authorizations and Insurance Claims for Negligence (Car Accidents, Slip-and-falls, etc.)

In Pennsylvania, if you’re making an insurance claim for compensation, lost wages, medical bills, pain and suffering, et cetera, against someone else’s insurance company, you do not normally need to sign an authorization for the other insurance company to fish through your medical records to look for reasons not to pay your claim. That said, the insurance company does need relevant medical records to determine the extent of your injuries and fairly evaluate your claim. With this, there is a delicate balance that must be struck, which is why you should always hire a personal injury law firm to represent you in your case. Our lawyers front expenses for medical records (which can cost hundreds of dollars), review your records, and provide the insurance company with reasonable, relevant medical records to support your claim. When the insurance company fights for more and starts issuing subpoenas, we fight to protect your privacy. If an insurance company is requesting that you sign an authorization, you should call our law firm at 1-800-999-0750 to speak with an attorney for free. Not only will we protect your privacy, we’ll help you fight for a fair outcome.

Medical Authorizations and First-Party Insurance Claims (PIP, MedPay, UM/UIM Benefits)

In Pennsylvania, when you’re making a claim for your own insurance coverage, completely different rules might apply. In many insurance policies, individuals seeking their own first-party coverage (like Personal Injury Protection / PIP, Med Pay, Uninsured and Underinsured Motorist Benefits) contractually agree to provide their insurance company with executed authorizations such that their own insurer can gather whatever records they deem “reasonable” and “necessary.” While this discretion isn’t infinite, it is extremely broad. Failure to comply, in some instances, can result in a denied claim or worse. If your own insurance company is requesting that you sign an authorization, you should call our law firm at 1-800-999-0750 to speak with an attorney for free. We’ll review your policy and make sure your rights are protected.

Medical Authorizations and Workers’ Compensation Claims

In Pennsylvania, after a work injury, it seems like everybody wants to comb through your medical records to blame your injury on something (or someone) else. Even without you signing an authorization, treatment paid by workers’ compensation is normally exempted from HIPAA, which permits your medical providers to give your work-accident-related medical records to the workers’ compensation insurance carrier along with your accident-related bills. This exemption, however, isn’t unlimited. You do NOT need to sign authorizations for Nurse Case Managers (and, if you have been contacted a nurse case manager, you should read this article and call us immediately) and workers’ compensation insurance carriers are not permitted to embark on fishing expeditions throughout your entire medical history. Such behavior is especially important to avoid, given the close relationship between the workers’ compensation carrier and your employer. Why should your boss get to know about your medical history? If a workers’ compensation insurance company is demanding that you sign an authorization, you should call our law firm at 1-800-999-0750 to speak with an attorney for free. We’ll help protect both your privacy and your claim.

What should you do?

Regardless of what’s going on, if you’ve been injured and are dealing with an insurance adjuster who is pressuring you to sign an authorization for the insurance company to gather your personal medical records, you need a lawyer now. Call our personal injury law firm at 1-800-999-0750 for a free consultation with one of our experienced lawyers.

Why did I receive a letter from Equian?

I received a letter from Equian, Rawlings, Optum, First Recovery Group, etc. What do I do?

Medical Bills and Letter from Equian

After receiving medical treatment for an injury, it’s normal to receive a letter from a third-party subrogation company, such as Equian (or The Rawlings Company, Optum, First Recovery Group, etc.), on behalf of your health insurance company. Equian (or one of these other companies) is contacting you to find out how you got hurt. If you were hurt in such a manner as to create a personal injury claim or a potential lawsuit (for example, a car accident, a work injury, a slip-and-fall accident, etc.), Equian wants to know, because your health insurance company might have a right to be reimbursed out of your settlement. If you received a letter from Equian after an accident, you should call our law firm immediately at 1-800-999-0750.

Should I respond to Equian’s letter or call them back?

Whether you have a duty to respond to Equian after receiving such a letter is going to be spelled out in your insurance policy with your health insurance company—a document you probably never read. If you weren’t hurt in any sort of accident, you’re probably safe to call and let them know, at which point they should stop sending you letters.

If you were hurt in an accident that might be someone else’s fault, you should immediately give Equian’s letter to your attorney. If you have a lawyer, you should not be contacting Equian directly. Additionally, you want your personal injury attorney to be aware of Equian’s letter, because failure to properly consider your health insurance’s lien against your settlement can have devastating consequences to both your case and your finances.

If you were hurt in an accident but don’t have an attorney, you should hire a personal injury attorney to contact Equian on your behalf. Our personal injury lawyers work on contingency and only get paid if we get you a financial recovery. We represent injured victims throughout Western Pennsylvania, from Pittsburgh, to Erie, and all the way to Bradford and Smethport.

What if I don’t want to sue the person who hurt me?

Equian can’t make you sue somebody if you don’t want to sue them. That said, it is still a good idea to talk to a personal injury attorney before talking to Equian. You need to be aware of your rights and responsibilities regarding this accident, your treatment, and your medical bills. Our law firm offers a free consultation that can be either over the phone or in person—you decide! Give us a call today at 814-452-6232.

What is a Frivolous Lawsuit?

For years, the insurance lobby has been spending millions of dollars to convince Americans that civil lawsuits are largely frivolous. This lobbying has been so successful, that most of our clients say things like, “I know most lawsuits are frivolous, but not mine—I’m really hurt.” The truth of the matter is, while there exist some silly lawsuits, most are legitimate and serve the greater purpose of protecting the public and compensating innocent victims.

Recently, the Trial Lawyers Association in DC released a simple video that helps dispel the myth of the “frivolous” lawsuit

Our Erie, PA personal injury attorneys have been helping innocent injury victims put their lives back together since 1985. If there’s one thing we’ve learned over the years, it’s that there’s nothing frivolous about asking insurance companies to pay fair value for your lost wages, lost loved ones, and disabling injuries. Don’t be fooled.

If you’ve been hurt by someone’s negligence, call our Erie law firm today for a free consultation with one of our experienced lawyers.

Can my Car Insurance be Cancelled for a Late Payment?

Can they cancel my car insurance for a late payment?

Cancelled auto insurance for late paymentMost insurance companies typically offer options regarding the payment of premiums.  Almost all companies issue policies with a 6 month term.  The premium can be paid in one payment or multiple payments depending upon the selected payment plan.  Generally, the longer the payment period, the greater the premium actually paid.

Some of the insurance companies even offer monthly payments.  These carriers typically are an option for minimal coverage low cost options for coverage.  Unfortunately, people who select these options for coverage are the ones who typically run into problems with late premium payments because of tight budgets which forced the selection of a monthly payment option in the first place.

The Law

Pennsylvania law provides the consumer with some protection here.  Under Pennsylvania law, the insured is entitled to advance notice that his/her policy will be cancelled unless the premium payment is received by the carrier.  Typically, the insurer will send out this “notice of cancellation” a day or two after the premium’s due date.  Under regulations in PA Code, the cancellation date must be no earlier than 17 days after the date of the cancellation notice.  The actual form for this notice is included in the regulations.  The failure to provide a timely and adequate notice of cancellation can invalidate the purported cancellation of the policy.

The problem is especially complicated when the insured is on a monthly billing cycle.  In order to comply with the regulations, these carriers will actually try to combine the bill with a notice of cancellation.  There are many ways to challenge the cancellation notices under these circumstances and one of our car accident lawyers can help.

Jim Stuczynski, Pennsylvania Insurance Cancellation LawyerI recently had a case where a company sent out its bill/notice indicating the policy payment was due by June 29.  This was one day earlier than the previous month because of the fact there were 31 days in May.  On June 30, the insured’s payment was received, however, the insured was in an accident early on June 30.  The carrier denied coverage, indicating the policy was cancelled June 30 and reinstated on July 1.

There was no valid cancellation notice provided under the law and when threatened with bad faith, the carrier provided coverage and even paid reasonable attorney’s fees for forcing the insured to retain counsel to contest the denial of coverage.  If you should find yourself in such a situation, gather the last couple of months bills/notices and your policy and immediately schedule a free consultation with one of our Pennsylvania personal injury lawyers.  You may still be entitled to coverage.

As a final word of advice, do not select the convenient monthly premium payment plan.  This option is not only the most expensive, but it is also the one which can most easily lead to an unwanted cancellation of your policy.

Not only is the cancellation of coverage extremely serious in itself, it means you will have limited tort status despite any full tort selection in your policy.  Also, if you are uninsured for 30 days or longer, your carrier can charge you “high risk premium rate,” which is the highest premium rate permissible by law.

Our lawyers can help.

If your car insurance company is saying your policy was cancelled after an auto accident, our personal injury attorneys can help. Call one of our Pennsylvania lawyers today for a free consultation: 814-452-6232.

Do I need a lawyer if the insurance company offered me a settlement?

Do I need a lawyer if the insurance company is offering me a settlement?

Why do I need a lawyer?Let me answer that question with a question: Would you perform surgery on yourself? Settlement of a legal claim is a serious matter. It usually pays to have help from an expert; a review of your case by our firm is free.

Insurance companies usually want to settle quickly. The reason for this is they know that, in some cases, injuries become more serious over time. There are many examples of this. One known medical phenomenon is the masking of pain in one area of your body due to an injury in another. For example, you may have hurt both your neck and a knee in an automobile collision. The knee pain might be so severe that you don’t realize that you also hurt your neck until the knee pain subsides weeks, or even months, following the injury. We have had several cases of minor head trauma which, quite some time following the injury, turned out to have aggravated an aneurysm.

If you settle your case before the full extent of your injury is known, there is likely nothing that can be done for you if additional injuries are later discovered. In one notable case, we represented a client whose head trauma did indeed result in a ruptured aneurysm. However, when we contacted the insurance company, we found out that our client neglected to tell us that he signed a general release shortly after the accident for one hundred dollars. He gave up what was likely a six figure settlement for less than the cost of a week’s groceries.

Is it too late to get a lawyer if I already signed a release?

Please note that Pennsylvania law does impose some restrictions as to when and where a general release may be signed. In very rare instances, it may be possible to set aside a release that a client has signed, but this is unusual indeed. If you have signed a release while in the hospital, within 15 days of your injury, or while incapacitated in some fashion, please contact us to review the circumstances of your case.

Can a lawyer get me a bigger settlement?

The most important reason, however, for having legal representation is to make certain that you receive an adequate settlement. We often meet with clients who have received an offer from an insurance company. Occasionally a fair offer is made and we will tell you if we don’t think we can improve upon it. However, it has been our experience that even after payment of legal fees, the net amount that the client receives is usually greater than what the insurance company had offered. Often the net result to the client is substantially better, even after payment of legal fees. So in effect the client has the benefit of having a lawyer and it effectively costs nothing in circumstances where the net result is better than the insurance company’s offer.

Why is this true? You don’t need to accept our experience alone. Let me quote from a book that is little known outside the insurance industry. It is called An Introduction to Liability Claims Adjusting by Corydont Jons. This is a book that has been used in training courses for insurance adjusters. Let me quote from the text:

If you have offered everything the case is worth, there is no more to offer. The case has no increase in value simply because an attorney has been engaged. Therefore, the widely recognized principal: “Never spend your top dollar until you think you can buy something with it.” This dictates caution and restraint in one’s final offer to a claimant.

The author is correct that merely because you have a lawyer your case is not made more valuable. However, insurance companies recognize that when they make an offer, the person receiving the offer may hire a lawyer. Once an attorney is retained, the client will usually not settle unless they net at least what they were originally offered. Therefore, if the insurance company wants to settle the claim, they will have to pay more.

While we usually are able to improve upon what the client has been offered, of course there is no guarantee. There may be facts that come to light that affect the value of the case one way or the other. Even if the client does not realize any improvement over what the insurance company had offered, they have received the benefit of professional representation. The client may have other issues or concerns beyond the settlement of the claim. The client may have concerns about future medical bills or providing for their family in the future. These are types of things which the other party’s insurance company couldn’t care less about, but our lawyers will be glad to help you with these concerns.

When should I hire a lawyer?

Remember that the best time to retain a lawyer is as soon as possible after an injury. At Bernard Stuczynski & Barnett we are always happy to provide a free evaluation of your claim. If you have received an offer from an insurance company, it makes sense to contact us to review if your offer was fair. Once we review everything that is known about your case, we will likely advise one of three steps to take:

  1. The offer is reasonable and you should accept it;
  2. We think there is a good possibility we can do better; or
  3. Further investigation is necessary to determine whether it is a fair offer.

If you’re curious as to whether or not you are being offered a fair settlement, call our firm today for a free consultation. We’ll let you know.

What is the difference between State Courts and Federal Courts?

State Courts, Federal Courts, and your Pennsylvania Insurance Claim

Federal CourtEveryone knows that we have a federal court system and state court system, but when asked to explain the differences, few people are able to do so. The purpose of this blog is to provide a short, basic summary of the difference between the two court systems and how it can affect your personal injury claim.

The federal courts are established by Article III of our Constitution. Federal judges are appointed by the President of the United States and are confirmed by the Senate for life. The federal courts decide cases that arise under specific federal laws which establish jurisdiction (the power to hear the case), in the federal courts. Examples of federal question jurisdiction are securities fraud, income taxation, bank robbery, and laws regarding the environment and telecommunications. In general, matters which affect “interstate commerce” can be regulated by Congress through law and the question of what is “interstate commerce” has been very generously decided in favor of the federal government.

Finally, federal courts are empowered to hear cases under what’s called “diversity jurisdiction.” This requires that the parties be citizens of different states and the case or controversy have a good-faith value of more than $75,000.00. While federal courts are usually regarded as more important by ordinary citizens, this is not the case. It is simply that the federal courts have distinct areas over which they have jurisdiction.

State courts hear cases which arise under the state or local laws of the state. The laws which impact us in most of the aspects of daily life usually arise under state law. For instance, laws regulating controlled substances, the operation of your vehicle (while intoxicated or not), real estate, decedent’s estates and our complete crimes code all arise under the state law. This also includes auto accidents, workers’ compensation, and various defective products cases. Under Pennsylvania law, these cases are all brought in the particular county in which the case or controversy arose.

Appeals are heard by either the Superior Court or the Commonwealth Court and further appeals can be heard by the Supreme Court of Pennsylvania. Pennsylvania judges are elected positions with a ten-year term, at the expiration of which the judge must stand for a “retention vote” to serve another term.

Federal and State Courts oftentimes have concurrent jurisdiction. In other words, a case can be heard by either of them. This frequently happens with insurance disputes.

While the regulation of insurance is a matter of state law, insurance carriers can and frequently will remove the case to federal court under diversity jurisdiction. There are many strategic reasons why this strategy is employed. For instance, in state court, Pennsylvania courts have decided there is no right to a jury trial in an insurance bad faith case, However, the federal courts in Pennsylvania have held that there is a right to jury trial in such cases.

This blog is intended to provide a basic summary on this topic. For more information and the application to a particular situation, you should obviously consult an attorney.

Four Signs the Insurance Company is Not Offering a Fair Settlement for your Case

Hiring a lawyer can save you moneyIs the insurance company offering me a fair settlement?

As experienced personal injury lawyers in Pennsylvania, we get calls from injury victims every day asking “is the insurance company offering me a fair settlement?” Although it happens once in a blue moon, the answer is usually “no.” Insurance adjusters are highly skilled at negotiating claims and convincing you that your case is worth less than its true value. Further, without an attorney, the insurance company has all the leverage. They know that you, without a lawyer, do not have any power to force the insurer to pay more than they’re offering by filing a lawsuit. Here are some things to watch out for in your negotiations and signs the insurance company is trying to take advantage of the fact that you don’t have a lawyer.

Four signs the Insurance Company is trying to take advantage of you:

  1. Telling you that you don’t need an attorney

Insurance adjusters frequently tell people, “You don’t need an attorney; I’m offering you a fair value and attorney will simply take a third of whatever you get.” Although the adjuster might seem friendly and act like they have your best interest at heart, don’t let them fool you. The insurance company makes more money by paying you less money; it’s as simple as that. Why would you take advice from the person negotiating against you?

The fact of the matter is, a skilled personal injury attorney typically pays for himself in establishing the true value of your case and getting you paid what you deserve. The insurance adjuster doesn’t want you to retain an attorney because it saves them money.

It never hurts to at least sit down for a free consultation. Although rare, I have personally told people during a free consultation that the insurance company’s offer is reasonable and that it doesn’t make sense to hire me—it just doesn’t happen often. I’m always happy to sit down with people to figure out what’s best for them. If someone tells you that you shouldn’t speak to a lawyer, red flag should go up in your head that they’re trying to take advantage of the fact you haven’t retained counsel.

  1. Making quick settlement offers within weeks or months of the accident

Very few cases are ready to settle within weeks or a few months from the accident. As a practical matter, a case should almost never settle before the full extent of your injuries is known. After a bad accident, it’s common for insurance adjusters to call you with quick, easy settlement offers, hoping to settle your case for pennies on the dollar. They want to settle before you’re diagnosed with something more serious that entitles you to more money.

Unfortunately, it is more common than you’d expect for serious injuries to go undiagnosed for months or even years after an accident. That “crick” in your neck could be a herniated disc requiring a fusion and discectomy and could be the difference between a missed week of work and a lifetime of disability with crushing medical expenses. Our office can help show you how to make the insurance company pay for your medical treatment so you can have a specialist figure out whether or not that pain is something serious. Don’t let the adjuster make your medical decisions.

Even though you might be losing wages and need money now, there are always more options. Don’t make the mistake of settling too soon. If something seems too easy or sounds too good to be true—it probably is. Our lawyers will make sure you don’t settle your case before you’re ready.

  1. Telling you that you aren’t entitled to pain and suffering because of “limited tort” car insurance.

If you have “limited tort” car insurance, the insurance adjuster will almost certainly try to tell you that you aren’t entitled to money for your “pain and suffering.” What the insurance company won’t tell you is that there are a number of exceptions to limited tort. Although the exceptions are narrow and difficult to meet, an experienced personal injury attorney knows how to build your case and prove that you’re an exception to limited tort.

Moreover, there are certain things your own insurance company needs to do after you elect “limited tort” in order to restrict your rights. We know how to order the records to see if you truly even picked limited tort at all.

If you have limited tort, the insurance company is going to underpay you on your claim. You need an attorney to help you prove you’re the exception.

  1. Asking you to sign authorizations for your personal medical records

Never sign anything without having a lawyer look it over. While it’s true that you give up some privacy rights when you make a claim, you don’t give up all your privacy rights. The insurance company simply isn’t entitled to blank authorizations to get all the records they want. They’re only entitled to relevant records. The adjuster is looking to get all your medical records from your past in order to look for that one time you complained of back pain in order to say that all your problems are preexisting conditions. In court, we call this sort of request a “fishing expedition.” Regardless, we can prove that the insurance company is liable for aggravations of preexisting conditions anyway. Don’t let them tell you otherwise.

When you hire our firm, we order and front all costs for obtaining your medical records ourselves so we can pull out things that are irrelevant and private. The insurance company doesn’t get to know about that weird bump or whether or not you’re pregnant—they get records on your injury.

Do I need a lawyer?

While this list could go on and on, those are four big signs that that the insurance company is trying to take advantage of you. When it comes to negotiating a claim with an insurance adjuster, the old maxim remains true: If you have to ask whether or not you should get a lawyer, you should probably get a lawyer. If you’re still not sure, call my office for a free consultation. I’ll show you what my firm and I can do for you. And if you want to hire us, remember that we don’t charge a fee unless we get you a financial recovery.