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PERSONAL INJURY FAQS

Contents

Q:

I spoke with the insurance company adjuster. The insurance company acknowledged my claim in writing. Does that mean my claim is filed?

A:

No.  There is only one way to file a claim and that is to file, in the right courthouse, a properly worded lawsuit naming the proper defendants.

Q:

Do you always have to file a lawsuit to receive compensation from a motor vehicle accident?

A:

No.  A lawsuit is only necessary if you cannot agree on a fair settlement with the insurance company.  If there is an agreement, the claim can be paid and resolved without suit.

Q:

Are there disadvantages to waiting until the deadline to file suit?

A:

There can be tactical and financial reasons why an attorney might wait until nearly two years after the accident to file an injury claim.  But there can also be problems in waiting until the deadline to file.  If suit is filed well before the limitation period, sufficient time exists to amend the complaint or to add new defendants or different types of claims if that proves necessary.  If suit is not filed until the deadline, it might be impossible to make necessary changes.

Q:

What if the two-year deadline falls on a Sunday? The courthouse is closed. Do I have less than two years to file suit then?

A:

No.  If the last day to file falls on a Saturday, Sunday, or legal holiday, the deadline to file is the next day.

Q:

The adjuster for the driver of the car that hit me left a message on my answering machine telling me I have to return his call. Do I?

A:

Of course not.  He wants to talk to you.  He is required by his employer to try to interview you.  But you are under no moral or legal obligation to take his call.

Q:

When I answer the adjuster’s questions, I will just tell the truth. How can that hurt me?

A:

Telling the truth is fine.  Your attorney will insist you always tell the truth whenever you discuss this case with anyone.  The problem is that you might not understand the significance of a question.  For instance, the adjuster might ask you questions about time or distance, and you might try to tell “the truth” by providing a guess as to how fast you were going or how far you were from the stop sign.  But your recorded answers about time, speed, and distance can be converted into mathematical formulas that can be used to establish how fast you were traveling or how long it took you to react to the situation.  Your innocent guesses might turn out to be used against you as “mathematical proof” against you in a courtroom.

Q:

The adjuster wants me to sign medical authorizations. Should I do this?

A:

Maybe.  But you should talk to an experienced injury attorney to see whether this is in your best interest, before you sign any document.

Q:

Do I have to talk to an insurance adjuster?

A:

There are certain circumstances when it can be advantageous, or sometimes even necessary.  If you are making an underinsured motorists claim against your insurance company, there are circumstances in which you must give a recorded statement to the adjuster.  Determining when to talk and when to be silent can be confusing.  Ask a lawyer, if you are unsure.

Q:

What is a release?

A:

A release is a written agreement, in which a person waives or relinquishes the claims that the injured person has against the negligent driver for pain and suffering, lost wages, and other damages.  The person who is releasing the claims is called the “releasor,” and the person who is being released from the claims is called the “releasee.”

Q:

Do I have to sign the release tendered by the insurance company?

A:

No.  But, the insurance company is not going to pay the claims or settle the case unless you sign a release.  It is perfectly acceptable and prudent to sign a release if the terms of the settlement are fair and reasonable and if, prior to the signing, you have considered all of the issues relating to reimbursement (paying back health insurance, Medicaid, Medicare, etc.), future medical care, and pain and suffering.  A release is a complicated document, and typically it is difficult for non-lawyers to fully understand and interpret the significance of the clauses and terms set forth in it.

Q:

How can signing a release extinguish my underinsured/uninsured motorists claims against my insurance company? After all, the release I am signing is produced and distributed by the negligent party’s insurance company, not my insurance company.

A:

An automobile insurance policy is a written contract.  Ohio courts enforce the terms of that written contract, whether those terms are beneficial to the insurance company or beneficial for the insured person.  Almost all, if not all, underinsured/uninsured policies include a clause that the underinsured/uninsured claim will be extinguished if the injured party signs a release prior to obtaining the consent of the underinsured/uninsured insurance carrier. The Ohio Supreme Court has upheld these clauses.

Q:

The person who caused the automobile accident has a small insurance policy, providing only $12,500 of coverage. I have sustained damages far in excess of that. The insurance company for the negligent party has offered to settle my case if I accept $12,500. I want to accept that $12,500, and then bring a claim against my insurance company for underinsured motorists coverage. How can I do that?

A:

The appropriate steps in this situation are to obtain a obtain a written offer from the negligent party’s insurance company in which that company provides a copy of the insurance policy (showing the amount of coverage available) and, in writing, offers to pay the policy limits.  That letter and documentation should be forwarded to the underinsured/uninsured carrier, requesting the written authority to accept the insurance limits and to issue a release.  The UM/UIM carrier will either have to provide the authority to issue a release or, in the alternative, advance the amount of coverage available in exchange for your agreement not to issue a release.  These are all fairly complicated steps and typically would require the assistance of legal counsel.

Q:

I was involved in a mild-impact automobile accident. I went to the emergency room and complained of neck pain. The emergency room doctors did some x-rays and released me. I went to my family doctor, and he ordered some physical therapy, which I completed. I seemed to be doing a lot better, and, about four months after the accident, I settled my claim with the insurance company, and I signed a release. A few weeks after that, my neck started hurting again, and I went back to my family doctor, who ordere

A:

No.  That is why settling a case too early is a big mistake people can make in resolving their Ohio injury claims.  A release is binding and will be enforced by Ohio courts.  Do not sign a release unless you are confident that you fully understand all of the physical injuries, ailments, and complications caused by the motor vehicle accident.

Q:

What photographs would help my motor vehicle accident injury claim?

A:

In most motor vehicle accident claims, it is helpful to have photographs of all vehicles that were involved in the crash.  This will show the type and extent of damage to the vehicles.  It is always helpful to have photographs that depict the suffering the accident has caused.  Photographs of the injured person wearing an orthopedic device, in a wheelchair, or in a hospital bed, can be very persuasive evidence.

Q:

I lost wages because of this motor vehicle accident. What evidence would be important?

A:

The primary evidence necessary to establish a wage-loss claim is proof that the injured person was, in fact, earning wages or income at the time of the motor vehicle accident.  For injured persons who receive a paycheck, the following evidence helps establish this:  

  1. Pay stubs for the period before the motor vehicle accident and during the period of recovery;

  2. Tax returns for one or two years before the motor vehicle accident and the years of and after the motor vehicle accident;

  3. Letter from employer (on company letterhead) setting forth the rate of pay and time missed from work.

For self-employed persons, proving a wage loss can be more difficult.  The self-employed can establish their wage loss with tax returns and profit-and-loss statements, which can be used to establish the historical compensation that was being earned before and after the injury.

Q:

What is uninsured/underinsured motorist coverage?

A:

Uninsured motorist coverage is automobile insurance that provides coverage in the event you sustain physical injuries caused by someone without insurance.  Underinsured coverage provides insurance when the wrongdoer has some, but not enough, coverage.

Q:

How does uninsured/underinsured coverage work?

A:

Consider this example: Steve Injured is driving his car on I-75 near Dayton when the driver of a pick-up smashes into him and flees the scene.  The police cannot determine the identity of the negligent truck driver.  Steve Injured has sustained a broken leg and will be off work for two months.  Since Steve cannot recover damages from the negligent driver (because that driver cannot be found), he could assert a claim under his own automobile policy for uninsured motorist coverage.

Q:

Is there any limit on the amount of money I can receive when making an uninsured coverage claim?

A:

The top limit of coverage available is the amount of coverage purchased.  If uninsured coverage was not purchased (it is optional), then there will not be any coverage available.  If you only purchased $15,000 of uninsured coverage, then the most that you can recover is $15,000.  (MORAL: Purchase high-limit uninsured coverage.  It is relatively inexpensive, and it can be the difference between full recovery and bankruptcy.)

Q:

I am a 17-year-old boy who was driving my girlfriend’s car. A drunk driver went left of center and crashed into the car. The drunk driver fled the scene. My girlfriend did not have any auto insurance, and I just had a bare minimum auto insurance policy without any underinsured coverage. Am I totally out of luck with respect to recovering from any source, since the negligent driver cannot be located?

A:

Maybe not. Underinsured/Uninsured coverage can exist from a number of unexpected sources.  For instance, you might have coverage under your parents’ automobile coverage —even though you were not in your parents’ car.  You might even have coverage under your employer’s automobile policy.  Experienced injury lawyers can help you determine whether there is coverage available.

Q:

What is reimbursement?

A:

Reimbursement typically refers to the scenario where an injured party in an automobile accident or some other injury situation has a contractual obligation to repay the insurer after recovery from the negligent party.  In the typical situation, a health insurance company will pay medical bills that the injured party sustained as a result of the automobile accident.  The health insurance policy will contain a clause providing that if the injured party is compensated by the negligent party for the injury sustained, he or she is required to reimburse the health insurance company for the medical bills paid by the health insurance company.

Q:

What is an example of how this might work in a typical case?

A:

Steve Injured is driving his car on I-75 near Dayton, when the driver of a semi tractor-trailer negligently collides with Steve’s car and causes injuries to Steve.  Steve incurs medical bills of $30,000.  Steve’s health insurance company pays all of the medical bills that Steve incurs.  The semi tractor driver is willing to compensate Steve with $100,000 for the injuries that Steve has incurred.  The health insurance company may be entitled to some or all of the $30,000, which it paid in this case, because it has a right of reimbursement.

Q:

Do only private health insurance companies have a right of reimbursement?

A:

No.  If Medicaid or Medicare paid medical bills for which an injured person receives compensation from a third party, Medicare and Medicaid may have a right to reimbursement.  In Ohio, Workers Compensation and other government/administrative entities may have a right to reimbursement as well.