Words You Need To Know To Understand The Claims Process
Contingency fee-A fee for service only when a favorable outcome is reached. For personal injury attorneys, this means that they do not collect a fee from you unless you receive money in a settlement or a trial verdict. If an attorney takes your case on this basis, it means that they have confidence that your case is solid and winnable-otherwise they would be working hard with the possibility of never getting paid! Attorney Stoehr takes all of his cases on a contingency fee basis.
Attorney Stoehr will also advance your litigation costs for you. That is, doctors charge for copying your records, the court charges for filing fees, etc. You do not have to personally pay these costs while your claim is pending-Attorney Stoehr will pay these and he will be reimbursed from your settlement. If for some reason you do not win your case, you do not have to reimburse these costs to Attorney Stoehr, and there will be no fee.
Compensatory damages-Money awarded for pain, suffering, disfigurement, inconvenience and loss of life’s enjoyments. These are the most difficult type of damages to win in Pennsylvania for several reasons. Insurance companies are not easily persuaded to pay money for your pain. Likewise, jurors are often ultra-conservative. Nonetheless, DO NOT give up your claim. Call us and allow Attorney Stoehr to give you his legal opinion. The opinion is FREE and could result in your being compensated for what somebody else did to you.
Damages-The amount of money awarded to a plaintiff in a civil court case. This may include compensatory, economic, and punitive damages.
Defendant-The party in a civil court case that a claim was brought against. For personal injury, this is the person or organization responsible for the circumstances surrounding your injury, such as a negligent hospital, nursing home, automobile operator, or employer.
Economic damages-Here you are seeking reimbursement for your lost wages and medical bills. However, do not assume that the other party’s insurer willingly pays these damages-they are often discounted or denied by the insurance company.
First-party benefits-An insurance term that states which type of benefits may be paid out by your insurance policy during a claim. First-party benefits may include medical benefits, income loss benefits, accidental death, and funeral benefits.
Full tort-A type of automobile insurance coverage in Pennsylvania. If this type of insurance policy is chosen, you are legally permitted to make a claim for compensation for pain and suffering as a result of an automobile accident.
Liability-Liability simply means legal responsibility. Fault is a factor when evaluating liability.
Lien– When a personal injury settlement is being finalized, consideration must be given to resolving liens from insurance companies and the government. For example, liens are created by Highmark and other health insurers if they are ERISA health plans. There are also liens from Medicaid, Medicare, and the Pennsylvania workers’ compensation system. Finally, there may be a lien if your medical bills were paid by the Veterans Administration or the postal service or any other government entity. Typically the insurance company, Medicare or Medicaid is required to be repaid from the proceeds of the tort recovery and imposes a lien against the recovery. Attorney Stoehr can explain this process to you when he opens your claim. Fortunately Attorney Stoehr is typically successful in negotiating a reduction to the lien. However, the laws that govern liens are complex and you typically need an attorney to navigate this area for you. Please contact our office if you have a personal injury claim.
Limited tort- A type of automobile insurance coverage. If this type of insurance policy is chosen, you give up the right (in most instances) to receive compensation for pain and suffering caused by an automobile accident, whether you are a driver or a passenger in your car. It may also apply to traveling in other’s vehicles, or if injured as a pedestrian. We strongly recommend that you choose Full Tort coverage for future possible accidents. However, if you have limited tort and have been injured, do not give up your claim. Call Attorney Stoehr because there are some EXCEPTIONS to limited tort that their insurance company may not tell you.
Medical malpractice-Negligence or deviation from established medical practice by a physician or medical staff that results in improper patient care. Medical malpractice claims are very difficult to prove, and most people who think they have a claim learn that proving negligence is unlikely. However, Attorney Stoehr has settled various claims made against hospitals and nursing homes.
Negligence-A failure to act under societal and legal standards of conduct that result in harm to another person; a common and quick definition for negligence is “carelessness”. A person would be considered negligent, for example, if they served alcohol to a minor who later got into a car accident and injured another person.
Plaintiff-A person or party in civil law court that brings a claim against another party. In the case of personal injury, the injured and/or their family would be considered the plaintiff.
Punitive damages-Damages intended to punish the defendant and discourage future behavior; they do not involve compensation as a result of injury. This type of damages is only present in serious instances of misconduct. These damages may occur in addition to compensatory damages, but are not guaranteed in all verdicts or settlements.
Reimbursement-Repayment to another for expenses they had taken out. In legal terms, an injured victim may need to reimburse his health insurance company, or Medicare or Medicaid, if they paid your medical bills during the pendency of your claim. However, Attorney Stoehr can very often successfully negotiate a lower amount of reimbursement for you.
Statute of limitations-The period of time set forth by state law in which a plaintiff can file a lawsuit on a claim. After the statute of limitations passes, a plaintiff will never be able to file a lawsuit on that claim. Currently, the statute of limitations for personal injury in Pennsylvania is two years, with one year for libel or slander.
Subrogation-The concept of subrogation is related to the definition of reimbursement. Generally, a health insurance plan has a subrogation provision, which states that the health insurance company of the injured party is entitled to be paid back from the personal injury settlement. Typically Attorney Stoehr can negotiate a reduction in the subrogation claim made by your health insurer. Contact our office for free legal advice about this important area of the law.
Underinsured motor coverage (UIM)-A type of automobile insurance coverage that protects the policyholder if an accident occurs, caused by another party, which results in damages that are greater than the responsible party’s automobile coverage. In Pennsylvania, policyholders voluntarily purchase this coverage from their own insurance company. Attorney Stoehr highly recommends UIM coverage because defendant drivers OFTEN do not have enough insurance to fully compensate you for your losses. When this happens, you make a claim against your own insurer, after you exhaust the amount of coverage for the other vehicle.
Uninsured motor coverage (UM)-A type of automobile insurance coverage that protects the policyholder if they are involved in either a hit-and-run accident or an accident caused by a party that is uninsured. This type of coverage is voluntarily purchased from your own insurer similarly as UIM coverage.
Questions About Pennsylvania Auto Insurance Coverage?
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