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General questions about claim process & expenses of suit

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Latest post Thu, Jun 15 2017 4:23 PM by Taxagent. 47 replies.
  • Mon, Aug 15 2016 9:08 AM In reply to

    Re: General questions about claim process & expenses of suit

    DanWard:
    3-4 is patient, case manager, lawyer, another case manager office person. The 3 of them are vigorously involved in likely dozens of cases. For this reason they use their memory from previous communications and misunderstandings do happen. One sends a message to one of the others. That person sends a reply but c/o of the others, All trying to remember what is going on in the case

    That's a description of life on this planet. :-)

    DanWard:
    If you were a lawyer (maybe you are) how often would you meet in person with the client (assume no court trial)?

    I'm not a lawyer. I spent 35 years in the insurance industry so I know some stuff.

    There is still no cut and dried answer to that question. Even if I was a lawyer it would still depend on the kind and severity of the case so don't take the following as gospel and certainly don't go back to your laywer and say "Adjusterjack says you should..."

    Anyway:

    1 - First meeting - Interview client to determine details of claim. Follow up with any necessary investigation and document gathering. Put other party on notice of claim.

    2 - Second meeting - Maybe a month or so after the first for a status. Could be done by phone.

    3 - Third meeting - After the client has fully recovered or reached maximum medical improvement. Status, update, tie up any loose ends prior to creating demand package. Could also be done by phone.

    4 - Fourth meeting - Review demand package. This is optional. Lawyers may not want or need the client's input in determining an amount to demand.

    5 - Fifth meeting - Sign settlement agreement.

    Some of those might not even be necessary. There may be a need for others. Lots of stuff can be handled by phone or email.

    Many years ago I was in an auto accident. The other driver was at fault. I went to a lawyer. He got all my information and said not to call him, to just forget about it and he would call me when he got a settlement. Two years later he called, told me I'm getting X dollars, come sign the papers..


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  • Mon, Aug 15 2016 10:09 AM In reply to

    Re: General questions about claim process & expenses of suit

    DanWard:
    If you were a lawyer (maybe you are) how often would you meet in person with the client (assume no court trial)?

    I am a lawyer and my answer is I  ask to meet with the client only when I felt it was necessary and productive to do so, which is not at all often; most of what I need from clients I can get by phone or by mail. There is little need to go to the trouble and expense of all sorts of in person meetings with clients. I'll meet with clients when they ask for a meeting, too, but then they pay for that.

    A lawyer working on contingent fee will want to avoid those unnecessary client driven meetings as much as possible.

  • Mon, Aug 15 2016 3:04 PM In reply to

    • DanWard
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    Re: General questions about claim process & expenses of suit

    In reply to both messages we visited one lawyer and the next day called one on the phone. That one sounded like a good one and we met them the next day. So that was meeting number one where we sign the contract, give police reports, etc.

    The next in person meeting was asked for by us as matters seem to become a little sketchy, and that occurred about 5.5 months in. We did get an e-mail every few weeks asking if our contact info has changed, any change in treatment, etc.

    Early on we did ask if we would be in the communication loop before a demand letter, and also a chance to explain some errors we know are in the medical records and we were told "absolutely."

     

     

  • Tue, Aug 16 2016 1:20 AM In reply to

    Re: General questions about claim process & expenses of suit

    DanWard:
    Early on we did ask if we would be in the communication loop before a demand letter, and also a chance to explain some errors we know are in the medical records and we were told "absolutely."

    A lawyer has a responsibility to keep his/her client informed on the significant events that occur during the course of the representation and seek the client’s input on major decisions in the case. But again, most of that can be done by phone, mail, etc., without the need for a face-to-face meeting. In litigation there can be long stretches of time where nothing happens. In my practice I send out status letters to litigation clients every 90 days updating progress on the case, even if nothing has happened, so that they know that the matter has not been neglected and we are just waiting for something to happen (whether it be judge’s ruling, a response from the other side, or whatever). Some lawyers simply contact clients when there is something to report. Nothing wrong with that approach under the rules that govern the practice of law, but my approach helps head off calls from clients wondering why they haven't heard anything in months.

  • Tue, Aug 16 2016 7:31 AM In reply to

    • DanWard
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    Re: General questions about claim process & expenses of suit

    That sounds reasonable.

    We are comfortable with the representation.

  • Fri, Sep 2 2016 10:50 AM In reply to

    • DanWard
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    Re: General questions about claim process & expenses of suit

     DanWard: Legal office person (not lawyer) misunderstood and thought the patient was requesting that the lawyer request an opinion letter. 

     

    I'm still lost on the significance or consequence of that.

    ------------------------------------------------------------------------------------------------------------

    The case manager thought we were asking for an opinion letter now. Not at all. 

    We asked if the online portal conversation between doctor and patient would be part of the medical records. That is all we asked.

    --------------------

    We get a message about once a month asking if we are still treating and by whom whether there are changes or not. Also if our contact information has changed. One in person meeting 11 months ago.

     

     

  • Thu, Sep 8 2016 9:44 AM In reply to

    • DanWard
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    Re: General questions about claim process & expenses of suit

    If the insurance company shares liability and that was done on the property damage, does that give the lawyer a negotiation tool?

    It appears the property damage was shared 65% and 35%.

    Can the lawyer cry foul if they try to go with 100% and 0% on the personal injury.

    How can someone be liable for a large percentage of the property damage and that driver not be partly liable for personal injury, "caused" by themselves per the 35% liability on property damage.

  • Thu, Sep 8 2016 11:43 AM In reply to

    Re: General questions about claim process & expenses of suit

    DanWard:
    If the insurance company shares liability and that was done on the property damage, does that give the lawyer a negotiation tool?

    It is a point the lawyer can make in negotiation with the insurance company. But the insurance company is not obligated to make the same settlement in the personal injury case or even to settle it at all, just because it did so regarding the property damage.

  • Tue, Jun 6 2017 5:52 AM In reply to

    • DanWard
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    Re: General questions about claim process & expenses of suit

    I think above a comment was made about what a jury is entitled to know and not know.

    -------------------------------------------------------------------------------------------------------------------------------------

    We were told that the jury might double the estimated future medical which would be a large number. Or they might double or triple the actual medical expenses. There could be a huge difference between the two. I know they can see the actual medical expenses but what about a cost list that was sent to the insurance company that gave an estimate of future medical cost? What numbers are the jury members allowed to know and not know?

    ..............................................................................................................................................

    I read somewhere that a jury can be more open minded toward a plaintiff that has no health insurance since they have had the burden of paying all medical expenses out of pocket or still owed through a lien. Then it was said a jury can not be told the status of health insurance. Why would they not be allowed to know that?

     

     

  • Tue, Jun 6 2017 8:01 AM In reply to

    Re: General questions about claim process & expenses of suit

    Whether or not a plaintiff has insurance is irrelevant as is whether or not their insurance covered medical bills.  The only issues are was the defendant responsible, what are the plaintiff's provable damages and what are they worth. 

  • Tue, Jun 6 2017 8:07 AM In reply to

    • DanWard
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    Re: General questions about claim process & expenses of suit

    Determination of liability has already been concluded.

  • Tue, Jun 6 2017 9:28 AM In reply to

    Re: General questions about claim process & expenses of suit

    DanWard:
    We were told that the jury might double the estimated future medical which would be a large number.

    Told by whom?

     

    DanWard:
    There could be a huge difference between the two.

    Between the two what?  Do you mean the difference between 2x meds and 3x meds is huge?

     

    DanWard:
    I know they can see the actual medical expenses but what about a cost list that was sent to the insurance company that gave an estimate of future medical cost?

    What about it?

     

    DanWard:
    What numbers are the jury members allowed to know and not know?

    Whatever is admitted into evidence.

     

    DanWard:
    I read somewhere that a jury can be more open minded toward a plaintiff that has no health insurance since they have had the burden of paying all medical expenses out of pocket or still owed through a lien. Then it was said a jury can not be told the status of health insurance. Why would they not be allowed to know that?

    Whether the plaintiff did or didn't have personal medical insurance is absolutely inadmissible.  In fact, if it were mentioned, the defendant probably could obtain a mistrial.

  • Wed, Jun 7 2017 6:09 AM In reply to

    Re: General questions about claim process & expenses of suit

    DanWard:

     

    I read somewhere that a jury can be more open minded toward a plaintiff that has no health insurance since they have had the burden of paying all medical expenses out of pocket or still owed through a lien. Then it was said a jury can not be told the status of health insurance. Why would they not be allowed to know that?

    The plaintiff is entitled to have the jury award him based on his provable damages. Telling a jury that the plaintiff had insurance migh lead the jury to think it need not award him anything for what the insurance has already paid. Disclosure that the plaintiff did not have insurance wouldn't help the plaintiff increase his award, but disclosure that the plaintiff had insurance that paid for all or some of the injuries certainly could hurt the plaintiff. Thus as a plaintiff you wouldn't want anything mentioned about insurance.

    As for future medical, that is something based on what the plaintiff can prove as to what future medical expenses are likely to be. It isn't just some multiple of the damages already suffered.

  • Thu, Jun 8 2017 2:52 PM In reply to

    • DanWard
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    Re: General questions about claim process & expenses of suit

    Quotes do not work like they do on other forums. And we can not see the previous comments as we type here. 

    We were told by a lawyer that the jury might double the estimate of future medical cost which could be a triple digit result. Or they might double or triple the actual medical bills which would be very small compared the a double of estimated medical. The estimated medical and actual medical was on a cost list given to the insurance company. Can the jury be given these numbers? I'd assume so or they could not consider to double the estimae of future medical cost.

    How does the plaintiff know when an insurance company has made the final offer. What words or phrases can adjustors use to give clues?  The last we saw in writing was "our offer remains....." That does not sound like their final offer. 

     

  • Thu, Jun 8 2017 9:57 PM In reply to

    Re: General questions about claim process & expenses of suit

    DanWard:
    Quotes do not work like they do on other forums. And we can not see the previous comments as we type here. 

    All you see is the post you are responding to. But the quote feature itself does work nicely. After you hit reply to the post to which you want to replay and get the box to compose your message, put the cursor where you want the quote to be inserted. Then highlight the part you want to quote and hit the quote link at the bottom of the post you are quoting.

    DanWard:
    We were told by a lawyer that the jury might double the estimate of future medical cost which could be a triple digit result. Or they might double or triple the actual medical bills which would be very small compared the a double of estimated medical. The estimated medical and actual medical was on a cost list given to the insurance company. Can the jury be given these numbers? I'd assume so or they could not consider to double the estimae of future medical cost.

    Juries might do a lot of things. But there is no standard multiple that juries are told to give for future medical nor any standard amount that they typically award. Your attorney needs to prove the future medical with reasonable certainty to the jury. That means expert medical testimony regarding what future medical care you are likely to need and what that care is likely going to cost. The estimated cost list given the insurance company would be hearsay and not admissible.

    DanWard:
    How does the plaintiff know when an insurance company has made the final offer. What words or phrases can adjustors use to give clues?  The last we saw in writing was "our offer remains....." That does not sound like their final offer. 

    There are no magic words for this. Any offer made might be the final offer. The insurance company does not have to say "this is our final offer.” If the insurance comapny makes an offer and never comes up on that offer then it is the final offer it is willing to make. Thus in negotiation you cannot assume the offer will get better simply because the other side has not said something to the effect of "this is the final offer.” What good would it be to offer some amount and yet signal at the same time that you are willing to come up and offer more? There would be no incentive for the other side to accept that offer. Your suggestion that an insurance company must be willing to come up if it doesn't say the offer is final would blow up effective negotiation. So not saying that the offer is final does not logically compel a conclusion that the insurer will offer more. By the same token, if the insurer does say it is the final offer, that doesn’t preclude the possibility the it might be willing to come up more later. Until a deal is reached, either side can change its position.

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