In Utah, insurance companies are required to provide their own customer, or insured, with certain basic benefits. These are called PIP benefits. PIP stands for “personal injury protection.” They are designed to cover you if you get injured in a motor vehicle crash – even if the crash is your own fault. There are three components to these benefits. They are: (1) $3,000 for medical bills, (2) one year of lost wages (this will be the amount of your actual wages or $250 per week, whichever is more) and (3) household services reimbursement of up to $20 per day.
First, the $3,000 is used to cover medical bills which are directly related to the crash. (Some policies may actually have higher limits, although all must have at least $3,000 available.) This is why after the crash, medical providers will ask you to give them the name of your insurance company and the claim number. They ask for this because they will bill your insurance company directly. Some health insurance companies, such as IHC, will not begin to pay any benefits until they are satisfied that the $3,000 from your insurance is used up. Also, if your insurance company suspects that your treatment is not related to the crash, they might cut off benefits and have you examined by one of their insurance company doctors. You should keep in mind that this coverage is available to you even if you caused the crash to happen.
This is why it is sometimes called “no-fault” coverage. Second, PIP coverage allows for lost wages if you have been released by your doctor from work. Even if you are put on “light duty” and there is no light duty work for you to perform, you are still eligible for this benefit. The benefit, though, is pretty small: a maximum of $250 per week. This is basically $6.25 per hour for 40 weeks. Most Utahns make more than this. Still, as I tell my clients, it’s better than nothing.
Your doctor will need to provide a note that you can submit to your insurance company before they will approve benefits. If your injury is more serious and it’s clear in the records, then those records may also suffice. Finally, if someone is helping you with household tasks following your injury, then they are entitled to be reimbursed up to $20 per day. This would apply, for example, if your spouse is doing the laundry, or mowing the law or cooking the food, where before, you used to do all that. The pay isn’t much, and there is a form from your insurance company that you need to fill out to claim this benefit. But it still is, again, better than nothing. In fact, this benefit is good for up to $600 per month.
Not too bad. And, it can help supplement a wage earner who usually makes more than what his insurance company will cover in lost wages. Of all the three benefits, this one is most likely not to have been offered by the adjuster when they discussed your case with them.
1. Make sure you get a police report. If you haven’t, and it hasn’t been that long (2-3 days) call them and have them do one.
2. Get medical treatment if you haven’t done so already. If you have auto insurance or live with someone that does, you should have at least $3k for med treatment. If you have been to the ER and released, you should follow up with your own doctor. You can also “self-refer” to a chiropractor if you have neck or back injuries. If your injuries are more severe, you should see a specialist, either by referral from your own doctor or by setting an appointment yourself.
3. Document with Photos. Document the crash with photos, especially in more moderate to severe crashes. This is not as important if you have a bumper scuff.
4. Inform your insurance carrier of the crash. They will have forms that they will send you that you should fill out to qualify for benefits, including at least $3k in medical benefits, lost wages up to $250 per week for one year, and “household services” benefits of up to $20 per day for one year.
5. Continue your treatment and be compliant with all the doctor/therapist wants you to do. If you have to miss an appointment, make sure you have a good reason and you give your doctor/therapist advanced notice of this.
6. Decline a recorded insurance statement. There is no law that says you have to give one. The danger with these is that the insurance person may ask questions to get information that they can later use against you. If you do give a statement, stick to describing how the crash happened, e.g. “I was at a stop and this car rear ended me.” You have to be really careful if you could be blamed in any way for the crash because they could try and elicit confessions out of you. The same thing applies with describing where you were injured. Suppose your back is hurting really bad and they ask you to tell them everywhere it hurts. So you tell them about your back but can’t at that point appreciate a shoulder injury you also sustained.
Later, they will say that your shoulder injury is not related because you didn’t mention it to them. This is why there is a rule in Utah that says if the statement is taken within 15 days of the accident, they can’t use it against you unless they gave you a copy of it and gave you a chance to make corrections.
7. Be honest. Be honest to your doctors: don’t try and exaggerate (or minimize) your injuries.
Firing your attorney is something that you should carefully consider. Sometimes, even if you feel like your attorney is not doing their job, the detriment to doing so may greatly outweigh the benefits to be gained. For example, if your attorney has started negotiating with the insurance company and they have made an offer, then that attorney will probably have a “lien” on your case. You can find out by looking at the retainer agreement that you signed with them. A typical agreement will allow the attorneys to have a lien of 30% on cases that they get a settlement offer on. Typical language also allows them to make a claim for the value of the time they have put into your case. So, if they can claim that they put 20 hours into your case, then at an hourly rate of $200 per hour, they have a lien of $4,000. Not a small amount. The problem arises for clients who have large liens because of the problem of finding an attorney who will want to take their case with a lien attached to it. This is so because the second attorney will basically be working for the first one to get their lien paid before the second attorney can get a fee on the case. Unless the lien is well below the expected value of the case, most attorneys will not want to get involved. Some attorneys don’t want to get involved anyway on the assumption that you are a “problem client” or “damaged goods.” This is why on a number of occasions, I have attempted to talk prospective clients out of leaving their attorney.
You also need to consider who your next attorney will be after you fire this one. Do you have an exit plan in place? Is there an attorney waiting in the wings who has told you they will help you with your case?
The last thing you want to do is fire your lawyer, who may have gone out on a limb in the first place by taking your case, and then find out you can’t replace him or her. And then you find out that the original attorney, who actually now feels relieved that you fired her, doesn’t want you back. This is a bad situation to be in. If your case is very strong, however, some of these concerns may not be there and finding a good replacement attorney won’t be that difficult.
In cases where the injury has just happened and where there is no offer on the table, the lien will be much less. Sometimes in the early stages, there is no lien at all. And in cases where you can honestly say that your attorney has done nothing on the case, or “dropped the ball,” you have a good argument to use for getting out of the lien.
Which brings us to actually firing the attorney. This can be done in a number of ways. The quickest way is to call up your attorney (or their assistant) and tell them that they are fired. You should also tell them that you want a copy of your file. You can either have them send it to you or tell them that you will be by to pick it up personally. When you call, you should be prepared to defend your decision to fire them. In other words, you need to be firm about it or they may try and “talk you out of it.” (If your are ambivalent, then this may not necessarily be a bad thing.) Another way to leave your lawyer is to write them a letter and mail it to them. In your letter, you should let them know they are fired and request a copy of your file. You don’t have to give any explanation, but I would recommend in cases where you feel that they weren’t doing their job, tell them so. Perhaps this will cause them to take a closer look at fixing problems that may be there. This will also make it less likely that they will impose a lien on your case.
Yet another way to fire your attorney is to simply show up at their office and tell them that you are firing them and for them to make a copy of your file while you wait. Depending on where the file is and who has it, it may take some time to put this together. All things considered, it is probably best to give them advance notice that you will be asking for a copy of your file.
Which brings us to the next point I want to make: you are entitled to a copy of your file. Don’t let your attorney’s office tell you that you are not entitled to it or that you have to pay for the records they collected or that you have to pay their attorney lien before you can get your file. If they say this, tell them that you will be calling the Utah State Bar. Their phone number is (801) 531-9077.
If you have a “larger” personal injury case, you can usually get what is called an “advance” on your case. This is usually easier to arrange in auto accident case because issues of liability and damages tend to be more straight forward. You should keep in mind, however, that lawyers are never allowed to loan money. This is against the ethical rules that lawyers are required to follow in Utah (they are also the same in most states). There are a number of companies, however, that will do this. The interest rates are quite high, and so going into it, you will want to be sure that this is what you want to do. The companies all have their own rates and payback terms, so you will want to check with them. And they will only do advances if you have an attorney, since the attorney has to pledge to pay back the company as part of the settlement of the client’s case. As an example, if a client wanted to get an advance of $1,500 with an advance company we have used in the past, they would owe the company $2,100 up to six months after the advance is given. While the interest is high, it is much less than that charged by some of the pay day lenders.
And so, you need to carefully consider whether the benefits justify the high interest paid. In some circumstances, they just may. For example, I have had clients reclaim vehicles that had been repossessed because the client was out of work and couldn’t make payments. They have been able to make rent or mortgage payments. They have been able to put down payments on expensive medical treatments the doctor is recommending.
They have been able to buy food for their family, etc. I have even used an advance to get my client out of jail (he had warrants for some unpaid traffic tickets) so he could attend his physical therapy sessions. Most important in my mind is that these advances allow an attorney additional time to negotiate or litigate a case to get fair compensation for the client, without a client giving in because of intense financial pressure.
Depending on the type of case you have, you may not actually need a lawyer. If your case is small, then there’s a good chance that you could get by on your own without having to retain one. Your case is a “smaller” if it meets the following criteria: (1) your vehicle was only lightly damaged, e.g., bumper scratch/dent, (2) the medical treatment was for a “soft tissue” injury and lasted only 2-3 months, (3) the bills were at least $3,000 (this is a Utah-state minimum level to make a claim) and were no more than $5,000, and (4) the injuries were not permanent. Cases that can qualify as “small” cases are typically rear-end collisions where there is only damage to the rear bumper that is less than $1,000.00, where the injured person only saw a chiropractor and was diagnosed as having a “soft tissue” injury, who recovered fairly quickly and had no long-term permanent effects. In these cases, it is possible to settle them yourselves, and quite honestly, people do this every day.
In fact, right or wrong, consumers settle larger cases with the insurance company every day.
If you have a small case, and your bills are more than $3,000, you will first want to finish your treatment and get “released” from your doctor. Frequently doctors, such as chiropractors, will tell you that you have reached “maximum medical improvement,” or MMI. At this point, they will release you from treatment and tell you to come back if you have any problems. Once you are released, you will want to collect the bills and records from all medical providers who have treated you for your injury. If you were initially transported by ambulance and were treated in the ER of the hospital, you will want to collect these records as well. (An exception to collecting these bills and records is if you signed the at-fault insurance company’s medical authorization and gave them authority to collect your bills and records for you-generally a bad idea!) After you have collected your records, you will want to write a letter to the insurance company with your “demand” or request for settlement.
In your letter, you should ask to be reimbursed for your medical bills (and future medical bills if applicable) as well as the pain and suffering you went through and/or expect to go through in the future.
You can present your own offer or ask them to make you an offer. The insurance company will then contact you and give you their offer. In most cases, their offer will be less than what you were hoping for. You are free at that point to make a counter offer and to “negotiate” with them. Keep in mind, that the settlement will include the at-fault insurance company paying back your own car insurance for the $3,000 that they already paid toward your medical bills. (Your insurance has he right to be reimbursed.) So, for example, the insurance company might say that they will settle your case for the cost of medical bills plus $500 to $1,000 for your pain and suffering. They might offer you less. Maybe more. But this is probably in the range of what you might see if you negotiate with them directly for this kind of “small” case. If you are negotiating a larger case, you should expect more than this. Some law firms offer a free service where they will review the offer from the insurance company, compare it against your records, and let you know whether the insurance company is making a fair offer or not. Now if your case is larger, you will really want to carefully consider whether you want to settle it on your own. Generally speaking, the larger your case, the more important it is to retain a Utah Personal Injury Attorney that is familiar with personal injury cases. The reason for this is that they know, or should know, what the value of these cases is. And, they have the ability to “push the envelope” to get you the compensation that is fair. The result is that they can remove the decision on what is fair value for the case from the insurance adjuster to a jury. Insurance companies know that the typical person trying to resolve their own case does not have this ability. And you should also consider that even when an attorney charges their typical 33 1/3 percent contingency fee, the injured person is still more likely to come out again than if they went it alone. A study that was done in 1999 by the Insurance Research Counsel, a non-profit agency, confirmed this. The study found that people who hired a lawyer received on average 3 1/2 times more compensation than those persons who settled their own cases. These findings go against those insurance adjusters who tell the injured claimants that shouldn’t hire a lawyer because the amount of money to them will be less.
If your case is larger, you should ask the attorney you are considering hiring whether they will “guarantee” to you the amount offered by the insurance company. In our office, for example, I tell our clients that I will not penalize them for allowing us to help them in their case, and if for some reason the insurance company isn’t offering significantly more, than they are “guaranteed” the amount offered by the insurance company, even if we have to cut our attorney fee to do it. I can tell you that in the cases where we have made this guarantee, the client has always ended up with more money in their pocket than if they had done it alone. Ask the attorney you are thinking of using whether they will do this for you.
The answer to this question is: it depends. If your injury is significant and there is only a small amount of insurance money (say around $25,000 or $50,000), the settlement could happen quite quickly. In fact, in many situations, the insurance companies, once they learn of the severity of the injury, are actually calling us to see if they can pay their policy limits and settle the case. Honestly, in these cases, you really don’t need an attorney to receive insurance money (you would probably benefit from having one, though, for other reasons, such as negotiating medical bills or medicaid liens). In situations where your injury is not as severe, or where the policy limits are high (say $100,000 or more), then the claim will generally take longer to resolve. In these cases, we wait to see what the full scope of your medical treatment is. We wait until we have all of your medical bills. If the treatment looks like it will extend into the future, we will ask your doctor to give us an opinion letter outlining the expected costs of those procedures. In certain cases, we will also send our client for a medical examination to see what level of impairment they might have.
Now, sometimes your treatment might end fairly quick, say 2-3 months. Sometimes, it can take over a year. Sometimes over two years. It really depends on the nature of your injury and the medical treatment you get. Generally speaking, cases involving a “soft tissue” injury resolve quicker than cases involving an “objective” injury, or one that can be seen on an X-ray or MRI.
So once we have a handle on your case, we will package up all the documentation regarding it and send it to the insurance adjuster with a demand for fair payment. (You should keep in mind that almost all injury cases – especially car accident cases – involve an insurance company.) The case at that point is in “negotiation.” In the demand, we ask the adjuster to contact us within 15 days. We will usually will get a response to our demand back in 2-3 weeks. The negotiation can sometimes go very quickly or can drag on for a while. It can go quick if the insurance company comes to the table with what we feel is an above-average offer for that kind of case. And you should know that this is the goal that we have for our clients: to get them fair value for the injury they experienced. It is not to get them a million dollars, unless that is the fair value of their case.
In our negotiation, we never accept the first offer from the insurance company. The only exception is when offer to pay the maximum amount of the policy (which does happen if the case is worth that amount). Once we receive the first offer, we continue our negotiation by making a counter-offer. The insurance company then responds with their counter-offer, and so forth. Depending on how easy it is to contact the adjuster, this process might take a few days (if it goes quickly), or if the adjuster is hard to contact, weeks.
In situations where the insurance company is paying less than what we feel is fair value, then the whole process will take longer. As a consumer, you need to be wary of attorneys that tell you they will get you money fast. What this means is that they (or what is the more likely case, their non-lawyer “negotiator) are going to take the first or second offer from the insurance company and settle the case there.
However, in cases where the insurance is offering less than fair value, the negotiation will usually take 1-2 months to get the settlement into the “fair” range. Sometimes longer. The bottom line is that you usually will not get to the “fair” offer in only 1-2 rounds of negotiation. And sometimes we never get in negotiation to what we feel is fair. In those situations, we will either arbitrate the case or request a jury trial.
We serve clients throughout the entire State of Utah.