What Evidence of Injury is Necessary to Recover Damages in a Florida Auto Accident Case?
The key evidence in a Florida auto accident case is your medical records. That’s the most important piece of evidence in your case. For example, if you suffered a back injury in connection with an accident, then you might have an x-ray or an MRI, but you also need to show that your injuries are directly caused by the accident. For example, if you have an MRI, and all it shows is degenerative changes, which are injuries that were caused by the body just degenerating in general and not the result of a traumatic injury, then you might be able to recover for that type of degenerative injury.
However, if you can show that there was a herniation, and you can have a doctor give an opinion that they believe the herniation was directly caused by the accident, then that’s the type of evidence that you need to establish your injury and recover damages in an auto accident case.
Does The Insurance Company Have Access to My Hospital Records if I Do Not Give Them Consent?
No, you have a right to privacy, especially under HIPAA laws. Therefore, no medical provider, including hospitals, urgent care, and doctors should give access to an insurance company without your express consent.
How Do Insurance Companies Determine the Value of My Injuries?
Honestly, most insurance companies use software like Colossus to determine the value of your case. Colossus asks the insurance adjuster to input different variables to determine the total value. For example, who your attorney is is one variable, the time of day, the weather on that day, the type of injuries that you suffered, and the total amount of the medical bills you incurred are also variables. Once they add up all these variables, then it will have an output of a total settlement value of your case.
Now, many adjusters are limited to what’s given to them by this software. Other adjusters will look at the same type of information and do their own independent assessment, but the key factors for most insurance adjusters are what is the total amount of injuries that you have, what are the types of injuries that you have, if those injuries are permanent, what your future, expected medical expenses are, and finally, what your total bills are, to date. Once they have all that information, then they can come up with a good assessment of the settlement value of your case.
Who Pays For Your Medical Bills After an Accident?
This is a major concern because you don’t want your doctors and other medical providers to send your medical bills that aren’t paid to collections, which may ultimately ruin your credit and cause some people to file for bankruptcy. We’ll address the order in which you want your medical bills paid, why that order, and then we’re going to address your concerns that the at-fault driver should be the one paying your medical bills.
First, you should be aware that Florida is a no-fault state (click HERE to learn more about what no-fault means). We are a no-fault state, which means that you are required to have personal injury protection coverage under your insurance (PIP, for short). So, when you go to see a doctor or hospital, you want to tell them that your treatment is in connection with an accident and that they should be billing your insurance company under your PIP coverage. Your coverage should be for up to 80% of your medical bills, minus any deductible, which also means that you might have a 20% co-pay. Also, keep in mind that your PIP only carries up to $10,000 in coverage, so they’ll pay 80%, up to $10,000. That may go towards paying your medical bills and any lost wages, and the lost wages would be paid at 60%. What about the other 20%? If you have health insurance, then you want your health insurance to pay for the other 20%. Or, you may also have an optional coverage under your auto insurance called Medical Payments Coverage (Med Pay, for short). If you happen to have purchased Med Pay, then that may cover the other 20% not covered by your PIP.
Now, where do you look to find this PIP coverage? If you’re the driver, then it should be under your own insurance. If you’re a passenger and you own an auto, then it would be under your insurance. If you don’t own an auto as a passenger, then it would be under the driver of your vehicle’s insurance. The order of payment is very important, because if you bring a claim against the at-fault driver, then you do not need to reimburse your insurance company for any payments under the PIP part of the coverage that they paid. However, if your health insurance pays for anything, then you do typically have to reimburse them out of your settlement, under what’s called subrogation, for any payments that they made. So, if your health insurance pays first, you may be obligated to pay them back more, but if the bulk of your bills are paid by PIP, then you don’t have to pay them back.
Again, I know what many of you are thinking, and that is, “why should my health insurance and my auto insurance be paying for my bills when somebody else may have caused the accident? And that’s a legitimate concern. You still have the right to bring a claim against the at-fault driver in the state of Florida. You just want to bring that claim once your treatment is complete or mostly complete when you’ve reached maximum medical improvement. Your claim against the other driver will include all your out-of-pocket losses, which include all the medical bills that you had to pay, your health insurance had to pay, and your Mad Pay had to pay as a result of this accident. It will also include a claim for any future treatment that you may need in connection with the accident. Now, what can you claim against the other driver? That depends on whether you’ve suffered a permanent injury in the accident. If you have not suffered a permanent injury, then you can make a claim against the other driver for any out-of-pocket expenses that you have and medical bills that have not been paid. If you have a permanent injury, then in addition to your medical bills and your wage loss, then you can also make a claim for pain and suffering, and other of what we call non-economic damages.
What If I Do Not Have Medical Insurance And Am Concerned About My Medical Expenses?
If you do not have health insurance there still may be options available to you. First and foremost, you should look to your insurance policy to see if you have MedPay or medical payments coverage. This will cover you for any bills that you have in connection with treatment for your accident. Second, if you work with an experienced attorney they may direct you to some doctors who would be willing to give you treatment in exchange for deferred compensation at the end of the case. What that means is that they may have a lien on the case such that they’ll provide treatment for you now and then the payment for their services will be paid out of the ultimate recovery at the end of the case.
My Physician Determined That My Injuries From My Florida Car Accident Are Permanent. How Can I Protect My Future?
If you have permanent injuries from a Florida car accident, then you have the right to bring a claim for not only your medical bills and lost wages, but also for pain and suffering, because you’re deemed to have satisfied what’s called a tort threshold. With a permanent injury, you are allowed to make a claim for mental anguish and other pain and suffering with respect to your physical injuries, and therefore you are allowed to make a claim for your past, present, and anticipated future medical bills and for your pain and suffering.
What Is A Permanent Injury, And What Is The Tort Threshold In Florida?
Florida law defines the term permanent injury. Under Florida’s no-fault law, which is §627.737, subsection two, a permanent injury is: a) significant and permanent loss of an important bodily function; b) permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement; c) significant and permanent scarring or disfigurement; or d) death.
Let me give you an example of a permanent injury. If you were in an accident, and a piece of glass or metal cuts into your arm, and that arm wound ultimately heals, and you have a major scar, then that would qualify as a permanent injury. Another example, let’s say that you were hit from behind, and you suffer a whiplash injury, and ultimately that whiplash caused a disk to herniate in your neck, and you had to have major surgery, like a fusion. There’s hardware put into your neck. Then, obviously, that’s something that you’re going to have to live with permanently, and that’s considered a permanent injury. On the other side, what is not a permanent injury? You may not have had a permanent injury if you had only soft tissue injuries, for example, and you ultimately healed 100% from those soft tissue injuries, and you have no more ongoing pain. Then, you do not have a permanent injury.
Why is this important? It’s really important because if you do not have a permanent injury, then you cannot bring a claim against the at-fault driver for pain and suffering. All of this is important, because if you have suffered a permanent injury, then you are deemed to have satisfied what is called the tort threshold under Florida law. Again, having that permanent injury means that you have passed the minimum threshold requirement under Florida no-fault law to qualify for non-economic damages.
What are non-economic damages? Those are things like pain and suffering and mental anguish. If you have suffered a permanent injury and therefore satisfied that tort threshold, then under Florida law, you’re allowed to recover damages for pain, suffering, mental anguish, and inconvenience because of bodily injury, sickness, or disease. This allows you to collect more than just your medical bills. It allows you to be compensated for having gone through all the pain and suffering from the accident. If you have not suffered a permanent injury, then the most you could collect is your outstanding medical bills that were not paid for out of your Personal Injury Protection under your own insurance, just medical bills that are outstanding.
If you’d like to talk to someone immediately then I encourage you to give our office a call at (888) 321-8131.