Can my car insurance company raise my rates if I did not cause the accident?

ccident claim

 

Personal injury clients involved in motor vehicle accidents commonly ask me if their auto insurance company will raise their premiums if they make a claim even if they did not cause the accident.

Under Ohio law, assuming you did not cause the accident, auto insurance companies cannot raise the premiums or rates of their insured if it is the first accident within the policy period or the insured is bringing a claim for uninsured or underinsured motorists benefits.

Ohio Revised Code §3937.22 states:

No insurer shall increase the cost of a private passenger automobile insurance policy based on the insured’s involvement in a single motor vehicle accident during the policy period when both of the following apply:

(A) The insured’s action is not a proximate cause of any loss, damage, injury, or death arising out of the accident;
(B) The insured has not been convicted of, pleaded guilty to, or pleaded no contest to, a violation of law as a result of the accident.

Ohio Revised Code §3937.23 states:

No insurer shall increase the cost of a private passenger automobile insurance policy based on the insured’s involvement in a motor vehicle accident with an uninsured or underinsured motorist, when both of the following apply:

(A) The insured’s action is not a proximate cause of any loss, damage, injury, or death arising out of the accident;
(B) The insured has not been convicted of, pleaded guilty to, or pleaded no contest to, a violation of law as a result of the accident.

It is typical that those injured in car accidents and motor vehicle accidents access medical payments coverage under the own auto insurance and bring uninsured/underinsured motorists claims for additional benefits. Generally, as stated above, an individual injured in a car accident or motor vehicle accident should not worry about increased insurance premiums.

Medical Payments Coverage generally pays for medical costs after you are hurt in a car accident, regardless of who is found at fault for the accident. Additionally, medical payments insurance may help pay for:

  • Funeral expenses;
  • Injuries sustained by your passengers; and
  • Injuries you sustain as a pedestrian or bicyclist after a car hits you.
  • Benefits and restrictions of medical payments coverage will differ between car insurance companies.

Uninsured/Underinsured Motorists Coverage protects those injured in car accidents and motor vehicle accidents from drivers that do not have auto insurance or do not have auto insurance sufficient to pay for all of the damages incurred by the injured party. Uninsured/Underinsured Motorists Coverage covers the following:

  • Past and Future Medical Expenses;
  • Past Lost Earnings and Future Lost of Earning Capacity;
  • Out of Pocket Expenses;
  • Past and Future Physical Pain and Suffering;
  • Past and Future Mental Pain and Suffering; and
  • Past and Future Loss of Enjoyment of Life.

The personal injury layers at Cowan & Hilgeman have recovered millions in compensation for clients. Our lawyers create plans of attack for each case specific to the client’s needs and expectations. The personal injury lawyers at Cowan & Hilgeman are committed to the aggressive pursuit of compensation and fully explain the claim process throughout the entire case.

We offer free case evaluations and only get paid an attorney fee if we win your case.

Who Pays for Medical Bills After a Car Accident in Ohio?

There is no easy answer or “one size fits all” approach to paying medical bills.

Each case is fact specific to the client and should be discussed in-depth with an experienced Ohio personal injury lawyer.

Health care laws and insurance billing mandates vary from state to state, so an experienced Ohio personal injury lawyer should give each client specific advice to (a) make sure the bills are timely processed to be promptly paid and (b) maximize the client’s recovery.

As the party receiving medical treatment, the client is responsible to make sure the medical bills are properly submitted and paid by insurance, although, the client’s Ohio personal injury attorney should assist in the submission of these bills.

1. Private Health Insurance

traditionally pays for medical treatment provided by medical facilities and doctors. However, in a personal injury case, it is not always easy to get your private health insurance to pay for medical treatment which is related to an accident or negligence of another. Ohio Revised Code Section 1751.60 limits medical providers to seek compensation for covered services solely from a health insurance company, however, the decision to submit medical bills to your private health insurance will hinge on the contractual language of your health insurance policy. These policies are typically very long and contain more than 100 pages of medical definitions, terms and procedures that must be followed by the injured party, including coordination of benefits language.

2. Medicare and Medicare Advantage Plans

are health insurance programs for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).  Medicare is a federally backed health insurance plan while Medicare Advantage Plans are provided by private health insurance companies.  These plans include Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance, Medicare Part C (Advantage Plans) and Medicare Part D (Prescription Drug Coverage).  Generally, medical payments coverage and PIP benefits must be exhausted before medical bills will be paid by Medicare.

Medicare Advantage Plans are governed by health insurance contracts and differentiate between health insurance companies, although, Medicare Advantage Plans are provided many of the safe-guards and protections of traditional Medicare.  An accident victim must review his or her Medicare Advantage Plan policy to determines the rights, responsibilities and requirements as it pertains to submitting and paying medical bills.

3. Medicaid and Medicaid Health Management Organizations

are government backed health insurance plans for low-income and needy people. Medicaid is a jointly funded, Federal-State health insurance program providing coverage for children, the aged, blind, and/or disabled and other people who are eligible to receive federally assisted income maintenance payments. Medicaid Managed Care plans act just like regular private health insurance but are qualified as Medicaid plans.

4. Medical Payments Coverage (also known as medical expense or “MedPay”)

helps pay for medical expenses associated with auto accidents. It is an option available with auto insurance policies and usually covers expenses for the policyholder, passengers, and family members driving the insured vehicle at the time of an accident. The policy can also extend to cover any injuries you sustain outside of a car. There are a number of expenses related to an automobile accident that can fall under your insurance policy’s medical payments coverage. These typically relate to any costs incurred for medical care that you, or any covered member of your policy, sustain in a motor vehicle accident. They include:

  • EMT and ambulance fees
  • Hospital visits and stays, doctor visits
  • Surgery and X-Rays
  • Professional nursing services and care
  • Prostheses
  • Dental procedures needed as a result of an accident
  • Injuries sustained as a pedestrian or riding a bicycle if a vehicle hits you
  • Funerals

Medical payments coverage follows the policyholder. In other words, if you’re walking, riding in a friend’s vehicle, or using public transportation, your medical payments coverage remains active. This applies both in and out of the state you’re insured in too.

5. Liability Insurance

is coverage provided by the tortfeasor or at-fault party. Liability insurers (the auto insurance of the at-fault party) typically will not pay medical bills or treatment related expenses until the conclusion of a personal injury claim. Additionally, and which makes matters more frustrating, is that liability insurers often deny, delay, refuse and/or try to pay a reduced amount of the medical bill despite physician support that the medical treatment is reasonable, necessary and related to the underlying accident.

6. No Health Insurance

for injured victims can cause significant frustration because medical providers may refuse to provide medical treatment, outstanding bills accumulate which can affect your credit and lead to collection actions and stress of mounting bills can cause financial collapse.  An experienced personal injury attorney will communicate with medical providers, hold off collection actions and work with medical providers to assure your medical bills are paid in full.

What Makes a Good Personal Injury Case?

As a personal injury lawyer that has handled hundreds of cases, there is one common question that is often asked by my clients: do I have a good personal injury case?

The answer can be complex and requires significant analysis of many factors.

As a personal injury lawyer devoted to helping those that are injured and obtaining maximum compensation, it is important that my clients understand how to make a strong case to recover their medical bills, lost wages, out-of-pocket expenses and pain and suffering. I have listed 10 important factors which lawyers use to determine the strength of your personal injury claim.

1. Facts of the Accident.

While many cases may be very similar, no two cases are identical. An experienced personal injury lawyer is well-aware that insurance companies use dirty tactics to deny, delay, refuse and confuse injured parties and claimants. This practice is so common, literature has been published on the dirty practice. However, facts that are not in dispute and support the injured party’s claim make it less difficult to present a claim for the full value of the injured party’s case. On the other hand, an accident involving “he said, she said” without any witnesses, traffic cameras or video, or reliable traffic crash report, make it far more difficult and expensive to determine fault. The clearer the facts, the stronger the claim.

2. Are You Injured?

Every personal injury case requires injuries. So, while you may have been lucky to walk away from the accident, you must have suffered bodily injury to make a claim for personal injury compensation. You are not entitled to compensation simply because you “could have been injured” or the other party was not paying attention. Just because the accident could have been worse, does not mean you get more compensation.

3. Medical Treatment.

All injuries must be documented by proper medical personnel, including EMS technicians on the ambulance, emergency room physicians, nurses and staff, primary care doctors, physical therapists, specialists, surgeons and any other individuals associated with your medical care. If you do not document your injuries with medical treatment, you will not have a very strong case or be entitled to much compensation. Documentation is key to any successful claim.

4. Keep Doctor Appointments.

Life is busy and we all have daily responsibilities that must be kept. However, failure to keep regularly scheduled appointments with your treating medical providers will not only impact your health and recovery, but it will deprive you of valuable compensation in your claim. A significant portion of compensation in any personal injury claim is related to your medical bills. Insurance companies will find any way to deny and

reduce payment of medical bills and an injured party’s failure to keep regular appointments provide the insurance company with ammunition to devalue your claim.

5. Lost Wages or Missed Work?

If you missed work due to your injuries and have medical support to stand behind this claim, you are entitled to 100% of your lost wages. Under Ohio law, even if using paid vacation time or sick leave, you are still entitled to 100% reimbursement for these amounts. For example, if you earn $100 each day and missed ten days of work, the insurance company must reimburse you $1,000 ($100 multiplied by ten days equals $1,000). However, assume you use ten paid vacation days so that you would not be without income, the insurance company must still reimburse you for your missed time in addition to the vacation time paid by your employer. In other words, your employer must pay you $100 each day using your paid vacation pay and the insurance company must also pay you $100 each day.

6. Pre-Existing Conditions

A common tactic used by insurance companies and their adjusters is to blame injuries, pain, discomfort, stiffness, loss of strength and range of motion, soreness and other physical abnormalities on “pre-existing conditions.” If you had a low back condition prior to a car accident and this condition was aggravated or exacerbated due to the accident, it is typical that an insurance company will attempt to deny your medical treatment as unrelated to the accident because the condition existed prior to the accident. This is, of course, not the law in Ohio and injured parties are entitled to compensation if conditions were aggravated or exacerbated by a car accident. In fact, Ohio has the Egg Shell Plaintiff rule to protect those that are more likely to be injured in accidents due to prior medical conditions. An experienced personal injury lawyer should present a claim to the insurance company that forces it to compensate the injured party for the aggravated condition.

7. Conservative vs. Invasive Medical Treatment?

It seems like common sense, but there are many misconceptions when it comes to valuing personal injury claims. Conservative medical treatment and management is an approach to treating pain and medical conditions utilizing non-surgical treatment options, such as physical therapy, medication and injections. Invasive medical treatment includes operative procedures in which skin or mucous membranes and connective tissue are incised, or an instrument through a natural body orifice. These procedures including minimally invasive dermatological procedures (e.g. biopsy, excision, or deep cryotherapy for malignant lesions), extensive multi-organ transplantation, all procedures involving surgery, angioplasty and cardiac catheterization and minimally invasive procedure involving biopsies or placement of probes or catheters. Clients that require invasive medical treatment often receive greater consideration for pain and suffering than those that receive conservative medical treatment, only. However, many times invasive medical procedures are performed after conservative medical treatment fails to relieve the physical pain or abnormality caused by the accident.

8. Future Treatment & Permanency?

It is important that the need for any future treatment and claims of residual/permanent injury be included in the potential settlement. All insurance companies require that the injured party sign a “release of claims” in exchange for compensation through a settlement. This means that all future damages and claims for compensation are disallowed. Therefore, if an injured party may need future medical treatment (physical therapy, surgery, medications, etc.), a medical opinion supporting this claim must be submitted to the insurance company before settlement. Additionally, if an injury causes a permanent condition that will cause future pain, discomfort, etc., it is important to have medical evidence from a physician so that the insurance company will properly consider the value of this portion of the claim.

For example, if an injured party suffers a knee injury which requires surgery shortly after the incident, but the orthopedic surgeon believes that a total knee replacement is likely in the future, the injured party must obtain an opinion from the orthopedic surgeon which confirms the need for a future surgery is within a reasonable degree of medical certainty and the cost of the future surgery. If you do not include both of these items, you will not receive any compensation for future medical treatment.

9. Impact on Daily Activities?

In the event an injury impacts your daily activities, even if only for a short period of time, it should be well-documented through medical records so that the insurance company will fully appreciate the inconvenience and impact of your injuries. In addition to medical records, it is helpful if there may be friends, family members or other potential witnesses that observed the impairment.

10. Emotional Injuries.

Ohio law recognizes compensation for injured parties that experience past and future mental suffering and past and future loss of enjoyment of life. While these claims for compensation have similar factors to those impacting daily activities, they can extend to how your mental health is impacted from the accident, including treatment for anxiety, depression, fear of getting back in the driver’s seat or even riding in a car. Of course, documentation of these complaints is crucial to the proper presentation of your claim and mental health care professionals should be consulted.

The personal injury layers at Cowan & Hilgeman have recovered millions in compensation for our clients. Our lawyers create plans of attack for each case specific to the client’s needs and expectations. The lawyers at Cowan & Hilgeman handle claims involving personal injury, medical malpractice, nursing home negligence and product liability. We routinely recover compensation on cases that other law firms reject. We offer free case evaluations and only get paid an attorney fee if we win your case.

Slip and Fall on Ice and Snow

Slip and Fall on Ice or Snow – Do You Have a Case?

Ohio residents have grown accustom to cold winters that often see accumulations of ice and snow. Unfortunately, these wintery conditions can lead to slip and falls on ice and snow that cause serious injuries and require medical treatment.

There are many legal misconceptions regarding slip and falls on ice in Ohio. While the foregoing is not meant to serve as an exhaustive analysis of Ohio law because each case presents a unique set of facts, we hope you will better understand your rights or responsibilities for both customers and businesses as it pertains to accumulations of ice and snow.

What Type of Visitor Are You?

Ohio law categorizes visitors into three categories: trespasser, licensee, or invitee. The status of the person who enters upon the land of another (i.e. trespasser, licensee, or invitee) defines the scope of the legal duty that the landowner owes the entrant. Invitees are persons who rightfully come upon the premises of another by invitation, express or implied, for some purpose which is beneficial to the owner. A customer on the property of a business owner will likely be considered a business invitee. However, if the customer’s presence in the business exceeds the scope of the business owner’s invitation, the customer will lose the status of a business invitee, and become either a licensee or trespasser.

What Duty Does the Business Owe to Customers?

A landowner owes a duty to an invitee to exercise ordinary care for the invitee’s safety and protection. Conversely, a landowner owes no duty to a licensee or trespasser except to refrain from willful, wanton, or reckless conduct which is likely to injure him. An owner or operator of a business premises owes its invitees a duty of ordinary care in maintaining the premises in a reasonably safe condition so that its patrons will not be unnecessarily and unreasonably exposed to danger. Such a business owner is not an insurer of the customer’s safety.

The Ohio “Winter Rule.”

It has been held that in Ohio, the hazards of ice and snow are a part of winter. Generally, no liability will attach to the occupier of premises for a slip and fall occurring due to natural accumulations of ice or snow, these being deemed open and obvious hazards in Ohio’s climate, from which persons entering the premises must protect themselves. It is well-established under Ohio law that where a danger is open and obvious, a landowner owes no duty of care to customers lawfully on the premises. An occupier of a premises has no duty to remove natural accumulations of ice or snow. Ice accumulation when there is snow, however, is completely expected and thus, an individual should exercise appropriate caution.

Unnatural Accumulations of Ice and Snow

Business owners may be responsible for unnatural accumulations of ice and snow. An unnatural accumulation of ice or snow is one that has been created by causes and factors other than meteorological forces of nature such as the inclement weather conditions of low temperature, strong winds and drifting snow. Unnatural accumulations therefore are caused by the intervention of human action doing something that would cause ice and snow to accumulate in unexpected places and ways. Where a construction defect in the premises, existing for a sufficient time, causes injury to a pedestrian by creating an artificial condition such as an unreasonable accumulation of ice or snow on a walkway, the business owner is responsible for injuries to its customers. Ordinary thawing and freezing of snow or ice is typically not going to lead to a successful injury claim.

Defects Hidden by Snow or Ice

While Ohio law makes it challenging to bring a claim for personal injury caused by slip and falls on snow or ice, there are often dangers in walkways, parking lots or driveways that are hidden due to cover from snow or ice. These hidden dangers are not known to unsuspecting customers or entrants, but should be known to the business or property owner. As a result, the business or property owner will be at-fault if a customer or entrant is injured by the snow-covered or ice-covered danger. For example, a business owner was responsible for injuries to its customer when the customer fell in a seven-inch-deep hole covered by snow. While the business owner had knowledge of the snow-covered hole, the customer had no way to know of the hazard.

Compensation

Under Ohio law, if you can make a successful personal injury claim as a result of a slip and fall on ice or snow, business owners are responsible to pay for injuries to their customers. Injured parties are entitled to recover compensation for medical bills, lost wages, out-of-pocket expenses, past and future pain and suffering, past and future mental suffering, and past and future loss of enjoyment of life. You can read more about personal injury compensation here.

The personal injury layers at Cowan & Hilgeman have recovered millions in compensation for our clients. Our lawyers create plans of attack for each case specific to the client’s needs and expectations. The personal injury lawyers at Cowan & Hilgeman will help maximize the value of your claim and fully explain the claim process throughout the entire case. We offer free case evaluations and only get paid an attorney fee if we win your case.

5 Common Car Accident Myths!

Far too often potential clients call the personal injury lawyers at Cowan & Hilgeman and have very inaccurate perceptions of car accident injury claims.

There are common car accident myths that are spread by the insurance industry in an effort to deny, delay, confuse and refuse benefits they are obligated to pay to injured parties.

1. Low Impact Collisions

Insurance companies often deny and refuse to pay benefits for injuries arising from what they determine to be “low impact” car accidents and collisions. However, as case studies and research support, rear-end impacts of as little as five mph can give rise to significant symptoms and injuries. Injured parties should be not afraid to seek reasonable and necessary medical treatment simply because an insurance company determines the car accident was “low impact.” Failure to seek medical treatment for injuries will only cause greater problems in the future.

2. Medical Bills

The insurance company of the at-fault driver rarely, if ever, pays medical bills as they come due. While the insurance claims adjusters will make promises that he or she will pay the bills, they often are only partially considered or never paid at all. The failure to pay medical bills can be fatal to your credit and significantly impact your credit score if the medical bills go to collection. As the injured party, you have many options to make sure your medical bills are paid and should not let the insurance company of the at-fault driver determine how you pay the medical bills.

3. Don’t Use a Lawyer

Insurance companies often discourage injured parties from seeking the advice of a lawyer. It is in the insurance company’s interest that an injured party be unaware of the compensation available to him or her. An experienced personal injury lawyer will be able to form a strategy to maximize the value of an injured party’s claim, including properly framing medical bills, obtaining opinions regarding future medical treatment, lost wages, out-of-pocket expenses, emotional injury, and pain and suffering.

4. Recorded Statement

An injured party does not need to provide a statement to the insurance company of the at-fault party. It is standard practice that the insurance company will try and obtain a recorded statement from the other party in an effort to deny or reduce the value of the potential claim. Injured parties are not required to provide a recorded statement to the other insurance company. While an injured party must cooperate with his or her own insurance company, an injured party should not provide a statement to the insurance company of the at-fault party.

5. Settlement Value Formula

A few minutes browsing the internet will lead injured parties to “settlement value calculators” and “pain and suffering calculators” which advertise as ways for injured parties to determine their claim value. These tools are worthless and should be ignored. The proper determination of a personal injury case requires many factors to consider, including the venue or jurisdiction of the accident (i.e. the county where your accident case would be submitted to a jury), a total review of all damages allowable under law and the facts of the accident.

The personal injury layers at Cowan & Hilgeman have recovered millions in compensation for our clients. Our lawyers create plans of attack for each case specific to the client’s needs and expectations. The personal injury lawyers at Cowan & Hilgeman will help maximize the value of your claim and fully explain the claim process throughout the entire case. We offer free case evaluations and only get paid an attorney fee if we win your case.

Will a Personal Injury Lawyer Help Get More for My Settlement?

The answer is YES, if you hire the right attorney.

Countless clients have hired the personal injury lawyers at Cowan & Hilgeman after receiving low-ball offers from insurance companies and our attorneys have gone on to recover 6 times, 12 times and even 50 times the original offer. While past cases do not guarantee future results, the personal injury lawyers at Cowan & Hilgeman are committed to aggressively pursuing your compensation.

 

Not every personal injury lawyer can obtain the results you may want or need. When evaluating personal injury lawyers, you must consider the following to ensure your claim is being properly presented and framed so that you receive maximum compensation:

Aggressive Pursuit of Compensation

Your lawyer should create a plan of attack to maximize the compensation available under your claim and make sure there is evidence to force the insurance company to pay what you deserve. Insurance companies and defense lawyers will not consider claims that lack sufficient evidence to support the demand for compensation. A skilled and aggressive personal injury lawyer will make sure every aspect of your claim is maximized.

Track Record of Success

Insurance companies know which personal injury lawyers accept low-ball offers and which lawyers will go to court to obtain maximum compensation for their clients. You do not want a personal injury lawyer or law firm that does not go to court or litigate their own claims. There are several of these law firms in Dayton and throughout Ohio. During your initial consultation with the lawyer, be sure to ask if he or she is the lawyer that will represent you if your case goes to court. The personal injury lawyers at Cowan & Hilgeman are recognized as some of the top personal injury lawyers in Ohio.

Client Reviews and Testimonials

Developments in technology and the ability to quickly and securely share information has allowed former clients to leave reviews and testimonials about their experience with a lawyer and/or law firm. Client reviews and testimonials are a great insight into the outcome obtained for the client. While each case is different and presents unique facts and circumstances, client reviews will give you an indication of what you can expect from the lawyer regarding skill, communication and genuine concern for the client’s interest.

The personal injury lawyers at Cowan & Hilgeman are aggressive in their creation of a plan to maximize your claim under Ohio law, which includes compensation for three types of damages: special damages; general damages; and punitive damages.

Special Damages

Under Ohio law, an injured party is entitled to the following types of economic (special) damages:

  1. Past Medical Expenses
  2. Future Medical Expenses
  3. Past Loss of Earnings
  4. Future Loss of Earnings or Earning Capacity
  5. Out of Pocket Expenses

General Damages

Under Ohio law, an injured party is entitled to the following types of non-economic (general) damages:

  1. Past Physical Pain and Suffering
  2. Future Physical Pain and Suffering
  3. Past Mental Pain and Suffering
  4. Future Mental Pain and Suffering
  5. Past Loss of Enjoyment of Life
  6. Future Loss of Enjoyment of Life

Punitive Damages

Under Ohio law, an injured party may be entitled to punitive damages if the injured party can prove that the defendant’s actions showed “malice or aggravated or egregious fraud” or the defendant knowingly “authorized, participated in, or ratified actions” that were malicious or egregious. The purpose of punitive damages is not to compensate the plaintiff, but rather to punish the defendant for his actions and to deter others from committing a similar offense.

Many times, unrepresented claimants and inexperienced attorneys that do not limit their practice to personal injury claims will leave valuable compensation on the table because the injured victim’s claim is not properly presented to the insurance company. Each and every personal injury claim requires an exhaustive review of the damages listed above so that the injured party receives the compensation he or she deserves. A small mistake can cost the injured victim lots of compensation.

The personal injury layers at Cowan & Hilgeman have recovered millions in compensation for our clients. Our lawyers create plans of attack for each case specific to the client’s needs and expectations. The personal injury lawyers at Cowan & Hilgeman will help maximize the value of your claim and fully explain the claim process throughout the entire case. The personal injury lawyers at Cowan & Hilgeman offer free case evaluations and only get paid an attorney fee if they win your case.