injured woman in neck brace

St. George man killed by distracted driver.

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We all know that we should not text and drive. We’ve heard the statistics; nine people per day are killed by distracted drivers, texting while driving is a greater impairment than drunk driving, those that text while they drive are twenty-three times more likely to be in a car crash. Those facts should be compelling, yet nearly half of all drivers admit to texting while driving.

On March 4th, 2013, David and Leslee Henson, of St. George, Utah, decided to go for a walk down Dixie Drive towards Sunbrook Golf Course. A driver, speeding down Dixie Drive on her way to work, decided to send a routine text message. Fred Konrath was also driving that day. His car was rear-ended at a high-speed by the texter. All he could do was watch as his car was sent in an out-of-control skid in the direction of the sidewalk where David and Leslee were walking. Fred witnessed Dave desperately attempt to push his wife to safety. They were both hit. Dave Henson lost his life that morning. Leslee underwent major reconstructive surgery and intensive care. Thankfully, she is expected to recover.

This is Leslee’s story . . .

 

Utah Personal Injury Attorney Question: What is a “Demand”?

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At McMullin Injury Law all of the work we do focuses on personal injury law.  Ultimately the goal of any personal injury case is to come to a fair and reasonable settlement—an amount of money that will compensate one party for injuries caused by the negligence of another party or parties.  We wish we could tell you that coming to a settlement were as easy as making a phone call to the liability adjuster and coming to an agreement over the phone.  The truth, however, is that the process of reaching a fair settlement requires meticulous documentation of everything that happens after an accident.  And that is where we are able to help someone who has been involved in an accident because we work with injured parties and liability adjusters every day to resolve personal injury cases.

For each client with whom we work, we submit a document known industry-wide as a “Demand” to the insurance company of the at-fault party.  The Demand is sometimes referred to as a “Settlement Offer.”  That is, it is a document in which the claimant (our client) offers to settle this case for the proposed amount of money.  Every Demand we submit is written for that particular client.  For that reason, some Demands have pertinent information for that specific case which we don’t have room to describe here, but every Demand includes documentation of the following:  an explanation of the facts of the accident, an itemization of all of the special damages, documentation of the pain and suffering our client experienced, and an offer of settlement.

The facts of the accident are clearly explained in a Demand.  If a police report was generated, we include it along with any relevant photographs.  Included in the facts are a description of the date and time of day of the accident, the names of all parties involved, and a “play by play” of what happened.  This set of details is provided in all accident scenarios including dog bites, slip and fall cases, Worker’s Compensation cases (where needed) and car accidents.  Essentially we lay out our clients’ cases from the very beginning so all the details are included.

We include an itemization of all of the medical bills to the liability adjuster. If you’ve been injured, you understand that there are multiple medical bills from many providers like the ambulance, the hospital where you were taken (not all people go to the hospital), doctors, physical therapists, radiologists, chiropractors, and other providers.  We collect all of the bills from all of the providers and present the total sum to the insurance company.  This comprises a list of “special damages,” or damages that in legal terms can be “specially proven” with a bill or a receipt.

We factor in our clients’ pain and suffering and a corresponding settlement amount to the liability adjuster as well.  Understandably, it is impossible to attach a dollar amount on anyone’s level of suffering, but we include a reasonable amount with justification why we seek that amount.

The “Offer of Settlement” is the amount of money that is being proposed to settle a case. Think of it as our client essentially saying, “I offer to settle this case for this amount of money.”  The settlement offer included in the Demand is derived not only based on your injuries and medical bills but also after we research what amounts have been awarded for similar types of cases both in and out of court.  We are prepared to negotiate on behalf of our clients when necessary.  It is important for you to know that we do not work for the insurance companies.  We work for our clients, and represent their interests. 

We do not send a “one size fits all” Demand when settling our clients’ cases.  While each Demand includes a description of the facts of the accident, a detailed description of that specific client’s medical treatment, an itemization of the medical bills as well as an explanation of the amount demanded for pain and suffering, we include pertinent information that is relevant only to that case.  Sometimes that includes a legal theory of liability.  Sometimes we cite relevant statutes that apply in that situation.  A great deal of time and attention is given to each Demand.

At our office we are skilled at documenting facts of an accident, understanding the law and applicable statutes as they pertain to specific accidents, and presenting a Demand to the liability insurance company so that your case can get settled.  If you or someone you know has been involved in any kind of a personal injury accident, contact our office at (435) 673-9990 for a free consultation.  We can show you your options and answer your questions.

At McMullin Injury Law, we are…In Your Community and On Your Side.

attorney in st george for dog bite

Three Reasons to Use Health Insurance to Pay Accident-Related Medical Bills

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At McMullin Injury Law, our focus is personal injury law and one of our goals is to educate our clients about the process of settling a personal injury claim.  To that end, we are happy to answer questions that you might have about your case.  One that we get asked often by new clients is, “If I didn’t cause the accident, why do my medical bills get sent to my health insurance company? We believe this insightful question warrants an in-depth answer.

Determining Options  If, for example, you have been injured in a car accident and we represent you, one of the first things we determine are the options available for paying the medical bills.  Every case is different, but usually accident-related medical bills can get paid using a combination of the following four options:  No Fault (PIP) benefits, your own health insurance, out-of-pocket payments made by you, and the liability insurance of the at-fault party.

Utah’s mandatory No Fault (Personal Injury Protection, or PIP) benefits currently provide a minimum of $3,000 per person in an accident.  Granted, that amount doesn’t go very far these days due to the high cost of medical treatment, but we look to No Fault coverage as the first option for our clients.  After the No Fault benefits have been used up, or exhausted, the client’s health insurance (if they have it) is the next available option for paying those medical bills.  Now to answer the question we started with:  If a person didn’t cause an accident, why are the medical bills paid by their own health insurance?  There are three main reasons:

  1.     When a medical provider’s office bills your health insurance, that provider can be paid throughout the course of treatment. Because you pay for the coverage, and the purpose of health insurance is to pay for medical treatment, it’s beneficial to use it.  While it is likely that you may have to pay a co-pay for each visit, that is far less expensive than paying out of your own pocket for each visit.  Most providers are willing to work with our clients if the treatment lasts over a period of months.
  2. If you get treatment from a provider who is in your insurance network, the charges will be lower due to the contractual writeoffs that the provider agrees to accept as payment in full.  Therefore, each visit will not be as expensive as if you had to pay out of pocket.
  3. When your case settles, a portion of your settlement will go to reimburse your health insurance because the company has the right to be repaid for the treatment you received because your accident was caused by someone else.  While not always the case, sometimes our office is often able to negotiate with the insurance company to accept a lower reimbursement amount.

These are the three main reasons that medical bills generated as the result of an accident are sent to your health insurance company.  If you don’t have health insurance, contact our office to learn about how we can work out other options with medical providers.

As mentioned above, the final two options involve out-of-pocket payments by our clients and, finally, settlements from the liability insurance company.  Because each person’s case is different, we work closely with you and the medical providers when these two options are used.

If you or someone you know has accident-related medical bills and have questions about how to get them paid using health insurance, contact our office at (435) 673-9990.  We have the experience and skills to work with health insurance companies.

At McMullin Injury Law we are… In Your Community and On Your Side.

Paying Medical Bills When You Don’t Have Health Insurance

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Imagine yourself in this situation: you were injured in a car crash and treated at the hospital emergency room.  Ever since the accident, your daily routine has been disrupted because you have to make time for doctor and physical therapy appointments, and, perhaps, appointments with additional medical providers because of your injuries.  To make matters worse, you don’t have health insurance and are not sure how you’re going to be able to pay your medical bills that are piling up.

Common Situation  Whether the cause is the downturn in the economy or other reasons, many people don’t have health insurance these days, yet they find themselves with mounting medical bills after an accident. They’re extremely frustrated because they need the medical care and treatment, but are perplexed as to how they are going to be able to pay their bills.

Why Doesn’t the At-Fault Party’s Insurance Company Pay the Bills?  There are several reasons that the liability insurance company does not make payments while a person is being actively treated for their injuries.  One reason is that it is more efficient to make a one-time payment rather than piecemeal payments throughout the entire length of treatment.  Another reason is that the case may ultimately have to go into litigation which will affect the final settlement amount. For these reasons and others, the at-fault party’s insurance company will wait until a person has been released from medical care before making payments to medical providers.

The Starting Point  In Utah, the No Fault  portion of an automobile insurance policy carries a minimum of $3,000 medical payment coverage for accident-related medical bills.  This coverage is available to each person in the car—not just the driver. No Fault funds are not sent to the injured person; they are sent directly to the medical provider’s office.  For example, if you as an injured person have been transported via ambulance to the emergency room and No Fault funds are available, the ambulance company will submit its bill to the No Fault insurance carrier who will, in turn, send the payment directly to the ambulance company.

No Fault benefits are the starting point of coverage after an accident.  However, after the No Fault benefits have been completely used up, those funds are considered exhausted and no more medical bills will be paid from that source.  These benefits are extremely beneficial to pay medical bills that are incurred in the initial days following an accident.

The Question  As a patient, it is ultimately your responsibility to pay the bill that is incurred with a medical provider. What is to be done, however, when your medical bills exceed what is available through the No Fault coverage, and the liability insurance has not paid its settlement amount yet, and you do not have any health insurance?

We Can Help  Every day at our office we work with people who have accident-related medical bills but no health insurance to pay those bills.  If you or someone you know is in that situation, you are welcome to contact our office at (435) 673-9990 to schedule a free consultation to discuss the case.  We are able to let you know what your options are when it comes to getting and paying for medical treatment.

At McMullin Injury Law we are… In Your Community and On Your Side!