Recently in Insurance Claims Category

Virginia Accident Lawyer's Advice about PIP

February 3, 2012

With the prominence of insurance company advertisements on the radio, on television, in print, and in online media, it can be difficult to differentiate between inexpensive coverage and prudent coverage. One feature that everyone shopping for insurance should look for is personal injury protection, also called PIP, or medical payments coverage. It allows for payments of an injured person's bills, regardless of fault, and it can be a great way to defer initial out-of-pocket expenses while waiting for a case to settle. Additionally, it can be invaluable in the rare instance where the driver is the cause of his or her own injury.

Once upon a time, PIP coverage was considered so important that several states made it a mandatory provision of their insured's policies, including Maryland and, more notoriously, Florida. Florida's PIP requirement, passed in 1972, requires all drivers to carry $10,000 in coverage. By contrast, a typical non-mandatory policy in other states is often issued in increments as low as $2,000. The Florida requirement has surely benefitted thousands who have found themselves injured as a result of another's negligence, or even their own negligence. But recently, the Florida PIP law has become a target for insurance reform. Insurance groups have estimated that PIP related fraud neared $1 billion in the 2011 fiscal year. Consumer advocate groups are likewise seeking reform because the cost of that alleged fraud, largely from staged accidents and other false claims, is passed on to the customer through higher premiums. And an unlikely partner, civil rights and civil liberty advocates, have joined the reform calls as they argue that the hostile nature of insurance adjusters towards claimants in Florida has invaded the personal freedom of the insured, including asking difficult and often embarrassing questions they argue are meant to chill the claims.

It is unclear what Florida is going to do with its PIP requirement. A whole generation of drivers has grown up with this coverage as part of their lives. Current proposals include requiring injured persons to seek medical care at an approved list of providers within a seventy-two (72) hour period and requiring the injured person to submit to an independent medical examination (IME).

From the prospective of a Virginia personal injury attorney, I cringe at the latter proposal. One of my first lessons in this fascinating area of law was that IME is the ultimate misnomer. A medical examination conducted at the request of the insurance company, or defense counsel advocating for the insurance company, and conducted by a physician being compensated by the same parties for his opinion can hardly be considered "independent." Another proposed provision limits reimbursements to certain providers, targeting groups that are perceived as more likely to engage in fraudulent behavior, including physician's assistants, dentists and chiropractors.

Similar to the proposed IME language, any restrictions on treatment options bring a chill to my spine. Not every injured person will have unlimited medical treatment options, some will be uninsured, some will be resistant to surgical procedures, and some will be seen by urgent care clinics and family practices instead of emergency rooms. The legislature should not dictate the freedom to seek treatment. Leave those decisions up to the patients and then allow the insurers and their skilled adjusters, with the help of trained personal injury attorneys, to evaluate the claims for merit. Yes, the few bad apples will make the news and leave a bitter taste for some. However, for the majority of those who are legitimately injured and seek the assistance of a personal injury attorney, the system will prevail and will prevail in a timely manner. Reactive and hastily drafted regulations are not the appropriate way to reform a largely self-regulating system.

For a Virginia personal injury attorney, of course, mandatory PIP or medical coverage is not something I worry about on a daily basis. Virginia allows its citizenry to make these important decisions about whether they are cost conscious or risk averse, and informed consumers can decide what is best for them. In my years of experience, however, I can confidently say that anyone who does not voluntarily add PIP or medical payments coverage to their existing policy is doing themselves and their loved ones a great disservice. Insurance is all too often seen as a luxury, until an accident or injury happens. When you consider Virginia's tough stance on liability, contributory negligence as a complete bar to recovery, PIP or medical payments coverage is even more crucial. Don't say I didn't warn you.

The Many Consequences of Car Accidents

December 27, 2011

The cost of a motor vehicle accident can harm more than your automobile and insurance premium. If serious injury or death occurs, you may experience immeasurable emotional and physical suffering in addition to lost wages and expensive medical bills.

The AAA estimates that car accidents cost $6 million per fatality and $126 thousand for each serious injury. In arriving at that estimate, the AAA considered values placed on the eleven effects of car crashes as determined by the Federal Highway Administration. These eleven effects were:


  • Property damage

  • Lost earnings/wages

  • Loss of household productivity

  • Lost time/productivity at work

  • Medical expenses

  • Emergency response costs

  • Vocational rehabilitation expenses

  • Legal fees and expenses

  • Administrative costs

  • Travel delays including highway congestion

  • Pain and suffering and loss of quality of life


In 2009, nearly 34,000 people died in car, motorcycle, and pedestrian accidents according to the National Highway and Transportation Safety Administration. That means fatal car crashes collectively cost Americans $204 billion in that year alone. With the astronomical costs incurred from injury or death in a car accident, you should not have to bear the brunt of the financial strain. If a driver was negligent in causing the crash, you can hold them accountable for their actions and collect damages from them or their insurance carrier.

Accidents can be caused through numerous negligent actions including driving under the influence of drugs or alcohol, driving while texting or talking on a cell phone, drowsy driving, or doing other non-driving tasks while behind the wheel like reading, eating, or putting on makeup. Drivers who engage in these dangerous driving practices negligently put others at risk and should compensate you for the harm they have caused. A qualified personal injury attorney can help you obtain the compensation you need.

Injuries or death can occur due to vehicle performance issues as well, derived from faulty manufacturing or defective safety mechanisms. In these cases, the automobile manufacturer failed to meet its duty to ensure that your vehicle met certain safety precautions before placing it in the marketplace. Attorneys often help shape the industry standards for safety while at the same time representing clients who were harmed as a result. By hiring a skilled personal injury attorney you can become whole again financially and simultaneously prevent the same harm from occurring to someone else.

If someone has caused you or a family member serious injury or death by driving negligently, seek professional legal advice to evaluate your claim. An experienced personal injury or wrongful death lawyer can investigate your accident to determine the actual cause and the responsible parties, and seek to collect payment on your behalf for the harm you experienced.

Personal Injury Claims In The Social Media Era

December 20, 2011

I remember distinctly an anti-insurance fraud television advertisement during my childhood that featured a man ripping off a neck brace once he got behind closed doors. The ad also featured the same man complaining of serious neck injuries to his doctor and a non-descript person in a tie, presumably an insurance claims adjuster. After he ripped off the brace, however, the screen panned out to a detective watching the entire scene. For the final act the man was handcuffed, the judge's gavel came down, and jailhouse gates closed. The message was clear, even to a child: "we are out there, we will catch you, don't lie, don't commit insurance fraud." I was an early convert of the insurance industry.

In this digital age, however, the detective is no longer sitting in a nondescript sedan down the block, the detective is on the Internet. And as I have told more clients than I can remember, and will continue to say as long as I practice, the Internet is forever. And never before has the permanence of the Internet become more visible than this past summer in a highly publicized case in the Charlottesville Circuit Court. After a record-setting jury verdict, the defense attorneys in the matter of Lester v Allied Concrete Co. , won a hotly contested post-trial motion on a discovery issue. That is, they felt that the plaintiff and his counsel committed an error to the prejudice of their case by not responding fully to questions or requests for documents during the pre-trial discovery process. The issue here was Facebook. The Plaintiff, Mr. Lester, was alleging serious and continuing injures, but Facebook pictures had allegedly surfaced of him partying without any obvious impairments. A request for the pictures was made but they were abruptly removed from the site. Was that legal?

Judge Hogshire of the Charlottesville Circuit Court said "NO," emphatically. Mr. Lester was slapped with $180,000 in sanctions, his counsel was given additional sanctions, and the two were made responsible for hundreds of thousands of dollars in defense counsel attorneys' fees for the forensic examination required to prove that the pictures existed, that they were deleted, and that they were deleted at the direction or with the knowledge of the plaintiff's attorney. My summary is for the purposes of illustrating the point that the Internet is forever and that a plaintiff's conduct is always being watched. If you want an in-depth summary of the events, check out Virginia Lawyers Weekly, it is one of the most-reported cases of 2011.

Facebook is often the example for the Internet gone wild, a largely unregulated platform where freedom of speech reigns. Facebook was not responsible for this plaintiff's behavior. And Facebook is not alone in being a minefield for plaintiffs seeking to exaggerate their pain and suffering. Photo sharing sites like Snapfish, Flickr, and iPhoto as well as messaging providers such as Twitter and Bebo are perfect fodder for posting "private" photos or sending spur of the moment messages, and they allow for a third-party to accumulate substantially more information than most consumers know about. Yes, these sites all have security features, but it is also easy to find so-called private images with any number of photo recognition programs and the investigators can also sign up as members of the services and access unprotected information that way.

A personal injury plaintiff claiming serious and continuing damages for pain and suffering needs to be aware that their claims put their whole lives under a microscope for a claims adjuster and defense counsel. In the digital age, that means a consistent approach to social media like Facebook and Twitter. An injured person who posts pictures of himself dancing the night away or who tweets "Just set a new bench press record" needs to be keenly aware that everyone is watching him and just like medical records, it will all be discovered. My point is two-fold. First, that as a plaintiff you must be honest and forthright with your counsel. Getting caught exaggerating damages is exponentially more damaging to your claim than having smaller damages. Second, nothing in digital and social media is truly private and you must consider that your adversary is always watching. And if the old anti-fraud commercials of my childhood have taught me anything, it is that they are watching, they have resources, and they know how to implement them.

Luckily, I learned that resources and candid advertising, whether it be through public service announcements or talking mascots, were largely directed at shifting the public attention away from the reality that these companies care about the bottom line and shareholders, not the real pain and suffering of the injured. As a Virginia personal injury attorney, I strive every day to bring attention to those that are seriously injured and get them the compensation that they deserve.