The 3 biggest pitfalls in any personal injury case include the following:
1) Failing to fully document all of your injuries and damages
2) Failure to adequately address subrogation and the right of your health plan or auto insurance company to recover medical bills that they paid relating to your accident.
3) Failing to aggressively litigate your case when the insurance adjuster isn’t paying you fairly.
Lack of documentation
The biggest pitfall that we see in personal injury cases is the lack of documentation and details that document our client’s injuries and damages. Under Ohio law, personal injury clients are entitled to recover all of their medical bills, all of their lost earnings, and all of their prescription bills. In addition to these damages, a client is also entitled to general damages that include compensation for their pain and suffering or the anxiety, stress, and emotional impact that the accident has had on a client, their limitations and restrictions, the nature and extent of their injuries and future medical costs if their injuries are permanent and directly caused by the accident.
We counsel our clients on the importance of documenting their injuries, limitations, and restrictions. More needs to be done to adequately document the full extent of our client’s pain, limitations, and restrictions from top to bottom. We advise our clients to take detailed notes that document their injuries in detail using descriptive words. As an example, we advise them that it is not enough to tell their doctor that they have back pain. We ask them to be more specific and describe what their pain felt like. For example:
- Did they have throbbing aches and pains in their lower back?
- Did the pain radiate from their lower back into their legs? We ask our clients to be specific and list as many details as they can relating to their pain, limitations, and restrictions.
When our client goes and sees their doctor, we urge them to list for their doctor all of the details relating to their injuries, limitations, and restrictions. It is critical that our clients describe to their doctor in detail what their pain feels like from top to bottom, their limitations and restrictions, and how the accident impacted them emotionally, physically, and financially.
Failure to adequately address subrogation
Another pitfall that we see in our personal injury cases relates to your health insurance and auto insurance company’s right to collect on any bills paid which are called a subrogation claim. When our clients are not represented, the adjuster for the negligent driver rarely informs our clients that they are responsible at the end of their personal injury case to pay back their auto and health insurance company for all medical bills that it paid on their behalf.
It is extremely important that you submit all of your medical bills through your health insurance carrier first to ensure that you get the contractual or reduced rate. More and more hospitals and doctors are telling our clients that their medical bills need to be submitted to their auto insurance and not their health insurance. They are telling you this because the medical provider does not want to be subjected to the contractual rate offered by your health plan. There is no contractual agreement between your medical provider and your auto insurance company.
When a client needs extensive medical care and treatment, a client needs to submit his or her bill through their health insurance company. It makes a huge difference because at the end of their case they will only be required to pay back their health insurance for the reduced rate charged by their medical provider.
As an example, if you see an orthopedic specialist and that specialist charges $500.00 for your visit, your health insurance company would only pay their contractual rate which is usually $100.00 to $150.00 and your doctor would have to write off the rest of the bill. You would only owe back $150.00. If your auto insurance pays the orthopedic, the auto insurance would pay the orthopedic the full amount of the bill of $500.00 and you would owe back your auto insurance $500.00. In a personal injury case with a lot of medical treatment, these expenses can add up.
Failing to aggressively litigate your case
The final pitfall that we see in our personal injury cases is a reluctance to aggressively pursue the claim in litigation in the event the adjuster drags his or her feet and doesn’t want to pay our client fairly. We only give the insurance company for the negligent driver one opportunity to settle the case fairly. When the adjuster fails to pay our client fairly, we immediately file a lawsuit and pursue litigation. Without aggressive advocacy, a client’s case gets delayed and there is a huge waste of time. We do not tolerate any delays from the insurance company.
