PIP Benefits – In an auto accident case:
Your insurance carrier is obligated to pay:
- All medical bills related to your auto crash injuries which your health insurance does not pay. This includes co-pays, prescription and even mileage going to and from health care providers;
- 85% of any lost wages;
- Replacement Services for household duties you performed prior to the auto crash and can no longer do as a result of your auto crash injuries. These include cooking, dishes, cleaning the house, laundry, driving, lawn mowing, snow shoveling, plus much more.
- Attendant Services. Any nursing service at home. For example, a spouse or child who assists you with bathing, dressing, massage, exercise, medications, changing bandages and other services of a personal nature.
It is important that you document all expenses and services as proof. Keep track of mileage, replacement services and attendant services on the forms we provide you, or the insurance company provides.
Bear in mind, the law provides for up to $20.00 per day for household/replacement service reimbursement. Therefore, it is important to have at least 1-2 hours assistance per day everyday, 7 days per week. Keep track by noting what services were done on both a calendar and the form. You also must have your doctor write a prescription on a month-to-month basis for replacement/household services as well as attendant/nursing services, usually for a certain number of hours per day for a specified period. These are PIP benefits you pay for when paying your insurance premiums. The replacement benefits alone can add up to more than $7,000.00 per year if the doctor prescribes them and the claimant and helpers properly document these services.
3rd Party Liability against the negligent driver
You also have a case against the third party driver who was at fault for the car crash. This is for non – economic damages or pain and suffering, loss of consortium, and wages lost beyond the three year period which your own insurance carrier is liable to pay. In order to sustain a 3rd party claim you must sustain a threshold impairment of body function. In other words your injury must be severe. It must be objective and supported by your medical records and doctors opinion. It must be caused by the auto crash. Typically this means your injury must result in at least three months off of work. It must also affect your ability to lead your normal life style. These cases are difficult and are dismissed most often because the injury is not severe enough.
Remember Facts and Details
I encourage you to do everything possible to remember any facts and details about the incident, any conversations you had with anyone concerning the incident and any statements you may have given to anyone in this regard. It is also important for you to give me the names of any witnesses who could testify either on your behalf or on behalf of the defendant about the incident and when, how and why it occurred. Similarly, it is important for you to give me the names and addresses of any potential witness who could testify about any injuries you claim to have suffered from the incident as well as any pain, discomfort or limitations that have resulted therefrom.
Keeping a Personal Journal
You also need to document your injuries as completely as possible. I encourage you to keep a personal injury journal, or diary, in which you should describe daily how you are feeling, what limitations you have on your activities, how much pain you are experiencing, where you are experiencing that pain, whether you are taking any medication or undergoing any treatment and how the injuries and/or pain have affected your lifestyle on each particular day. Your journal will help both of us during depositions and at trial to be as specific as possible about the kinds of damages and injuries you have suffered.
In preparing your case for trial, I may need to know some personal things about you which you may initially consider to be private, irrelevant or immaterial to your claim for damages. The purpose in asking questions in this regard is not to invade your privacy, but to prepare your case thoroughly for trial. If there are any difficulties with your case, or there are points which need further documentation or clarification, we should know about them as soon as possible to prepare your case adequately and effectively and to counter any possible defense counsel attacks. You must be candid with me about any prior problems you have had with the police, the courts or any other third party. You must also let me know whether you have experienced any prior injuries or have undergone any medical, psychiatric or counseling treatment in any regard, including alcohol or drug dependency treatment. Be assured that the defendant, or his attorneys and investigators, will obtain this information and will attempt to use it to their advantage at trial. Only if I know about it can we work together to prevent introduction of that evidence, if any such evidence exists, or to limit its use at trial.
You May Be Asked Questions
The defendant will also have the right to conduct discovery under our rules of procedure. In this regard, it is likely that the defendant will be sending interrogatories or questions to you which will seek answers to a variety of facts concerning your personal background, the incident, any injuries you sustained and your claim for damages. The questionnaire which you have completed for me records much of this information already and will help both of us prepare appropriate answers to the defendant’s interrogatories.
The defendant may also want to take your deposition, which is a statement made under oath. At the deposition, you must be prepared to respond to certain questions about you, your injuries and your claim. The defendant’s attorney will ask these questions. I will be present along with a stenographer. You and I will prepare for this deposition testimony well in advance of trial and at the deposition, I will protect and guard your rights.
Additionally, because we have claimed both physical and psychological damages as a result of your personal injuries, the defendant may have a right, as allowed by rules of procedure, to have its own physician and psychologist/psychiatrist examine you at its own expense. If such a request is made, we will have an opportunity to review and question, if appropriate, the qualifications of the examining physicians, psychologists or psychiatrists and we will also have an absolute right to obtain any copies of evaluations and reports that result from such examinations.
Finally, as I have described previously, a great deal of mutual effort and cooperation will be necessary to ensure that we make a well prepared, well informed and persuasive presentation of your claim and that we move forward in an organized, efficient and positive manner to reach a prompt and fair resolution of your claims.
During the course of this case, you may from time to time wonder what conduct is expected of you. For example, many clients ask questions such as “Would it hurt my case if I returned to work?” or “Would it help my case if I refrained from doing certain kinds of activities?” You should refer these types of questions to your physician, who should guide you on all decisions on health related issues. If, however, you have any question whether a matter should be referred to your physician, please contact me and I win be happy to attempt to guide you.