Managing Client Expectations in an Injury Case

A client is similar to a screenwriter. They have fantastical ideas, which turn into grandeur images in their head. Most of those ideas involve unrealistic expectations as to what the true value of their case is. For some reason they believe that an accident claim is a ticket to retirement. Most often, it is not.

Managing client expectations is not only important for the client, it is important for the attorney. For one, an attorney should never create a false impression. Controlling the narrative of what to expect will help an attorney remain disciplined in how he or she communicates with clients. Two, relationships are the foundation of a good law practice. One relies on referrals to survive. A happy client, which means a client who is not surprised with a result of a case, will refer family and friends in the future.

Communicating to the client about the value of his or her case can be difficult. Case value is subjective. That is why claims are fought over in litigation. As one may guess, the defense will value the case less than the plaintiff, and vice versa.

But evaluating a case can also hinge on objective factors. Any case has value when there are damages that can be proven. Damages can be shown via medical bills, lost earnings, etc. A bigger case may involve more medical bills because the accident required significant treatment. For example, if a plaintiff broke both legs, he or she will have higher medical bills than a person who only suffered whiplash (although many whiplash clients experience horrible nerve pain, which affects them for a lifetime). Indeed, the plaintiff with broken legs may not be able to work, while the whiplash plaintiff may continue on with work the very next day after the accident. Under the law, a plaintiff is compensated for those medical bills incurred and the earnings lost because of injury.

Other factors go into determining the value of a case. The reliability of the client will go a long way. Remember that the point of litigation is that both parties are satisfied with the case going to trial by jury. Each side is preparing for a jury trial, meaning that they are organizing when witnesses will testify, and what they will testify to. A client who comes across well-liked, truthful, sympathetic, and aggrieved will increase the value of a case. An attorney does not want a client who will testify poorly in front of a jury.

Putting all of the pieces together and telling a client what a case should settle for remains a risk. The judgment, or arbitration award, or agreed mediation proposal, could be lower than what was communicated. That is why an attorney should give a range, beginning with the worst case scenario (we could lose!) to the best case scenario (the best case scenario should be lower than what you actually think the best case scenario is). More importantly, the attorney should clearly communicate that it is an experienced guess but not a guaranteed opinion. Nothing in personal injury law is guaranteed. If someone tells you different, I would speak with someone else.

Always consult with an experienced injury attorney after an accident. An attorney should not only manage expectations, they should give you, or a loved one, peace of mind.

I Was Involved In a Motor Vehicle Accident; Now What?

Motor vehicle accidents are common in Los Angeles. In fact, it brings to mind the Saturday Night Live skit, "The Californians." All too often, Angelinos communicate about their commutes, experiences on the road, and traffic. Also, people talk about their unfortunate "accidents" on the highways.

When you, a loved one, or friend, is involved in an accident, there are some steps that should be taken immediately. By taking these steps, you can ensure that your injuries are addressed and that any future claims are protected.

One, pull over, if possible, to a safe location with the other driver involved. After an accident, it is easy to get distracted and careless. Remember to protect yourself by moving your vehicle to a proper stop area, if possible.

Second, call the police. Emergency personnel are trained to handle all types of accidents, including motor vehicle. This step addresses a few things: (1) you get to reflect on any pain and whether you are severely hurt; (2) you get to engage an independent third party who can testify as to what happened during the incident; and (3) you can receive immediate medical treatment, if necessary.

Third, exchange the proper information with the other party involved. This step is common knowledge, or so it seems these days, but it is essential. Have the other driver give you insurance information, personal information, like address and phone number, and ask him or her what happened immediately prior to the accident. Take mental notes as what happened during this exchange.

Fourth, give a statement to the police and see if any witnesses are at the scene. Let me be clear: it is extremely important that you seek immediate medical attention if you need immediate care. In the event that you do need immediate medical attention, do not stay at the scene of the accident. Inform the emergency personnel and proceed to a hospital. But, if your injuries do not need immediate attention, talk to any third parties who may have been near or at the scene of the accident. Collect their information too.

Fifth, take notes as to where your vehicle is going, if towed. Usually, vehicles are damaged to such an extent that they need to get sent to a body shop. It is important to have the body shop and towing information for the future.

Sixth, go to your doctor and if you do not have a primary care doctor, go to a hospital. Even if your injuries are not severe, it is important to seek treatment as soon as possible. Attorneys are not doctors, and more often than not, neither are the individuals involved in the accident (as a matter of probabilities). Doctors are the best professionals suited to ascertain the extent of your injuries and how to treat it appropriately. Do not hold off going to the doctor, because it could lead to more medical problems.

Seventh, open up insurance claims with your own carrier and the carrier of the third party involved in the accident. Automobile insurance, required by law, will have information about your coverage, including whether you can obtain a rental, and how quickly your vehicle can be repaired, if at all.

Eighth, contact an experienced personal injury attorney. Accident lawyers know how to resolve personal injury disputes, deal with insurance companies, and preserve your rights. It is simply not smart to move forward without representation, because of the nuances of personal injury law.

This is not an exhaustive list, but these steps should be taken after an accident. Of course, accidents are frustrating, painful, scary, and annoying. But hopefully, this short blog can make the experience less frightening. We welcome your calls and questions; our firm would love to help if you or a loved one has been involved in a motor vehicle accident.

Collateral Source Rule Today

Hospital bills after an accident

For most people who are injured in an accident, fretting over the medical bills is the furthest thing from their minds. But eventually, it becomes something that the injured must confront. It is common knowledge that medical bills are expensive and that there are often ways to reduce the amounts actually paid on those bills. For example, private insurance companies and government entities such as Medi-Cal routinely pay less than a hospital originally billed; either as a result of a previously negotiated discount contract or because of legislation that dictates maximum payments for certain procedures. Furthermore, many medical providers, particularly larger charitable hospitals, often offer need based discounts to individuals in certain income brackets. As a result, the amounts a provider bills out often bear little relationship either to the amount they will ultimately collect or to the actual hard cost of providing the included services.

Because of this widely known discrepancy, there exists an extremely complex medical services market in which different categories of patients pay different rate levels under different circumstances with insurance providers, lien holders, medical financiers, and government entities muddying the waters even further. Thus it is that when many accident victims are faced with choices about how to receive medical services, sometimes under the added stress of an emergency setting, the first thought on most patient’s minds is how to avoid as much of the potential expense as possible. It is important to understand that some kinds of payment can impact the amount and sources of any later legal recovery to which you may be entitled as a result of your injury.

Unfortunately, the world of hospital economics has become so convoluted in the United States that the advice of a qualified personal injury attorney is now recommended right from the beginning, if possible even before medical services are rendered, though not to the exclusion of emergency treatment. While the legal landscape surrounding medical payment recoveries is rough and currently in flux, a basic understanding of some of the key concepts at work can help.

What is tort liability?

Whenever a person does something carelessly which leads to another person’s injury, the first person – known in legalize as the tortfeaser – may be legally responsible for the injury. Usually by way of paying for medical costs associated with the injury. This basic concept underpins all of personal injury law, but it is limited or modified by several corollary rules which can apply in different combinations in different settings and by obscure rules of court which dictate the procedural aspects of a personal injury trial or settlement.

The collateral source rule

With the rise in private insurance many years ago came a concordant rise in the number of injured people who did not have to pay their full medical bills out of pocket because those bills were paid by a health insurance provider. To avoid allowing the party responsible for the injury to benefit from the injured party’s prudent choice to obtain health insurance, courts developed the collateral source rule to ensure that the defendant – the person responsible for an injury or accident – paid the full amount of the injury, not just that part the injured person had to pay out of pocket. Without the collateral source rule a defendant would reap the ultimate benefit of an insurance policy paid for by someone else. Moreover, the health insurance provider had to bear the costs of the defendant’s negligence.

For example, let’s say that two people are involved in a car accident. Driver A ran a red light hitting Driver B and broke his leg. Driver B goes to the hospital and is treated for the break. The hospital bills Driver B incurs is $1000 for treatment. However, Driver B is covered by an insurance plan that pays 80% of the bill meaning that Driver B only has to pay $200 out of pocket. In court, Driver A might argue that he should only have to pay for the $200 that Driver B actually paid out of pocket, contending that this amount is the real value of the injury. The collateral source rule steps in to prevent this injustice by requiring Driver A to pay for the entire hospital bill, unless other circumstances exist, even though part of the bill was paid off by Driver B’s insurance provider.

In a similar way, gifts made to Driver B from other third parties like generous hospitals or kind hearted doctors will similarly not be deducted from the amount demanded of Driver A under the law.

Previously negotiated rate discounts

While the collateral source rule is still very much in effect today, its application has been somewhat limited by recent court decisions; particularly with respect to the discounted rates many insurance carriers negotiate with medical providers as part of their in-network coverage agreements. Under these agreements, an insurance company and a hospital, for example, might agree that any patient covered under a policy written by the insurance company, who seeks treatment at the hospital, will only be liable for 50% of the billed rates. In other words, if Driver B were to visit this in-network hospital he would be charged only $500, instead of the usual $1,000, for the same broken leg, with the insurance company paying $400 and Driver B left with an only $100 out of pocket expense.

In several recent cases, the parties have argued that this type of discount should be treated the same as the earlier collateral source example we gave and therefore that Driver A should still be liable for the full $1000 the hospital would “normally” charge. However, California courts have not seen things this way. Several courts have decided that because the negotiated discount was arranged prior to the injury in question, and is not specifically related to the provision of care to Driver B, neither Driver B nor anyone else would, ever have to pay the full $1000 and therefore that the real value of treatment was at most the $500 negotiated rate. In short, because Driver B’s insurance company had the foresight to negotiate a lower rate for patients it insured, Driver A now gets to pay less for causing the same injury.

What does all this mean?

While the details are complex and filled with legalize and healthcare economics math, the outcome has real consequences for everyday patients. The bottom line is that if you are injured in an accident, your best bet is to seek immediate legal help; we understand the law in regards to evaluating the real damages that you have incurred.

An experienced personal injury attorney can help you to understand specifically how the various laws are likely to impact your particular case which might impact your later legal strategy. Ultimately, a good attorney can help to make sure that you are fully compensated for your injury whatever the circumstance under which your medical bills are paid.