The road to settlement for a Maryland personal injury claim can be long and treacherous. First there is the injury itself, whether its a car crash or some other injurious event. Unexpected, painful and fraught with potential unforseen problems, it is hard to express how disorienting and dispiriting these events can be.
Once you've left the scene of your injury, you are off into the great unknown. What medical care do you need and from whom and who will pay for it? What about work? Where is income going to come from if you are too hurt to work even temporarily? What about vehicle repair or replacement and rental cars?
Who will take care of payment and where can you get guidance on how best to handle things? The answer regarding guidance is find an experienced personal injury lawyer and that is an important first step.
With time and good representation, things can run more smoothly. Property damage gets fixed or replaced. Injuries are diagnosed and treated. Employers are read in on your medical prognosis and any physical limitations. Insurance companies are notified and available benefits are tapped.
A wildly stressful series of events can be made more manageable but of course the ultimate goal is for physical and psychological healing and of course fair compensation.
All of these objectives can be elusive. Some physical injuries are permanent and many victims suffer post-traumatic stress disorder. But time gives way to some level of acceptance of new circumstances and settlement of the underlying claim or claims becomes the primary focus.
Many articles are available on this website discoursing on the process of evaluating claimshttps://www.maryland-law.com/blog/ten-maryland-car-accident-case-evaluation-factors.cfm
The fact is that ultimately all cases either by dint of limited available liability insurance benefits or recovery from injuries. or the lapse of time, reach a point where they must be submitted for settlement or placed in litigation or both. In the modern era insurers routinely make settlement offers that are NOT calculated to settle the case in question see: https://www.maryland-law.com/blog/want-a-fair-offer-on-your-maryland-crash-claim-file-suit-.cfm
This leads to frustration both for the injured party and also their attorney. Often the best solution to expediting resolution is filing suit. With some insurance companies notably Geico, the confirmation of the existence of a lawsuit, shifts a claims file to a new " litigation" aduster.
Fairly regularly, the litigation adjuster has more settlement authority and a claim over which one has been haggling for months over a few thousand dollars, is promptly settled. Of course the disagreement over actual case value maybe be greater than can be bridged.by a few thousand dollars.
That leads into litigation and the so-called discovery process where the parties to the litigation exchange written information and often, conduct depositions. Depostions are opportunities for the attorneys of record in the case to ask direct questions of the parties and any witnesses and often help frame what issues need to be addressed at trial and clarify the strengths and weaknesses of each side's case.
Eventually, all cases in litigation reach some sort of court ordered mediation at which time a neutral party, often a retired judge, weighs in on what sort of outcome is likely at trial and pressures the parties and their lawyers to compromise and settle the case.
If this is unsuccessful actual trial decides who was right and wrong in settlement posturing. The bottom line : all cases reach a conclusion and if money is to be paid many forms of possible delay need to be borne in mind.
One would think that such matters could be worked out along the way but many potential delays don't come into full focus until the full compensation to be paid is realized.
The most common and multi-faceted stumbling block involves how any incurred medical expenses were paid or secured. While the following list is not comprehensive, it is extensive and each of the listed perils has been encountered and vanquished by the attorneys at Clark and Steinhorn, LLC.
1).Paying doctors who have not otherwise been paid by insurance. Many injured people don't have health insurance. Period. No Medicaid, no Medicare, No PIP or Medpay on their auto policy, literally no way to pay for medical care that is essential and is the direct result of some other negligent individual. These people are often in a position where their only hope is to locate a doctor who will agree to be paid out of any settlement or verdict.
Finding these doctors isn't necessarily easy and often is another reason to hire an experienced attorney that knows the medico-legal landscape and can help their clients get care that would otherwise be unaffordable. These doctors generally will not provide medical care absent an agreement in writing that secures their being paid out of settlement or verdict.
These agreements or authorizations and assignments, require the attorney's signature as well and consequently, attorneys make sure that they are honored. So, as one can imagine negotiating with these doctors get can be time-consuming and be a cause for delay. Fortunately, these healthcare providers have an appreciation that their business model only works when attorneys think they are being fair about what they require and so in the scheme of medically related delays agreement with these doctors may only delay matters a week or two.
The most obvious way to vanquish this issue is to make sure your lawyer is tuned in to what amounts are outstanding and are engaged in dialogue with these healthcare providers concerning what would be fair.
2). Workers comp liens. If you have received workers comp benefits of any kind associated with an incident where you are also bringing a third-party liability claim, you must repay the workers comp insurer or work out a settlement agreement with them that resolves the lien claim. Ordinarily this isn't a huge delay but increasingly workers comp insurers seem understaffed and routine actvities like paying an injured workers causally-related medical bills isn't taking place.
We presently have a case where the injured party received medical care in the spring of 2024 and missed several months of work. They were paid for the lost time and the workers comp attorney assumed that the medical bills were being paid when submitted in the summer of 2024.
So when the client inisisted that the underlying third-party auto accident case be settled immediately it was assumed that the extant workers comp lien could be arrived at promptly and the proceeds divided up. Unfortunately no adjuster was assigned to the case for more than six months and only recently has one been brought on to the claim with a goal of paying the medical bills and arriving at the lien.
This has delayed the injured victim's receiving his share and only has been moved forward by our firm taking over the workers comp case and forcing the issue.
3).Medicaid. It's simple. If your medical bills were paid by a Medicaid based health insurance, you have to resolve what they want to be repaid or risk losing future healthcare coverage. This can be more difficult than one might think. A recent firm case was resolved for $275,000.00 in February and the state of Virginia, which paid the medical bills through Medicaid, was unable to offer its lien and repayment terms for six months.
As one can imagine the injured client was astounded by the delay but with Medicaid there's no hurrying the process.
4). Medicare. This too is simple, contact CMS. The abbreviation for Center for Medicare and Medicaid services is not applicable to most state Medicaid services but is a model for how to promptly inform attorneys and their clients what needs to be repaid. One can even call (855) 798-2627 and speak to a live, helpful human being.
5). Tricare. Given our proximity to many military installations, we have had the privilege of representing numerous service members and their families in personal injury cases. Understandably they often choose the free medical care they receive on base or at an area military hospital.
The problem is that the military care system and its insurance entity, Tricare is not designed to generate traditional bills for services provided to its members in the way that a doctor's office would.
We have tracked down and established Tricare liens previously but presently have a two-year old case where the client has received extensive treatment that would cost tens of thousands of dollars if incurred in the private medical world and yet depsite pursuing the costs of services through numerous avenues, we have four hundred dollars in bills.
Under other circumstances this would be a boon but since the currency of case evaluation and settlement involves economic variables such as medical expenses and lost income, providing only $400.00 in medical bills hinders obtaining an offer of settlement commensurate with the value of the case.
An even larger problem is that some day Tricare will likely awaken and seek to be repaid a large sum of money. Thus, the Tricare problem here is a double edged sword. We need the bills to obtain fair compensation and also to enable us to honor their lien. How this one works out remains to be seen. Previously we have worked through various Judge Advocate General offices for the different service branches and arrived at both the billing amounts and the amount of lien. Hopefully that will take place here.
6). Private health insurers. Many people are fortunate enough to have private health insurance. Once Blue Cross or Aetna notice you are getting care associated with a car or truck accident, they routinely notify you that thet have a lien and want to be kept in the loop on your claim. Many private insurers including Kaiser use a company called Rawlings to keep an eye out that they are getting repaid.
Private health insurers despite their multi-billion dollar valuations are not always together on what they tnink they are entitled to, often sending out lien claim information that includes charges that are unrelated to the incident that underpins our representation. Thus we have to meticulously parse bills and cpt codes to ensure that our clients are not being asked to pay for care unrelated to their personal injuries.
Generally speaking Rawlings and the insurers are okay about reducing their liens to ensure the actual injured victim receives a fairer level of compensation. Having an attorney experienced with negotiating these reductions can be invaluable.
7). Union Health and Welfare programs. These operate rather in the manner of health and disablity insurers but often are self-insured entities and consequently have often proven to be less generous about lien compromises than private health insurers. It also seems like it takes inordinately long for their boards to review proposed lien reductions.
On the one hand one wants to be a bit careful about being real aggressive with one's union board on the other hand a little push can alter the landscape of union lien reduction.
8). Short and long-term disability insurers. Some of our clients have had the foresight to pay for either short or long-term disability coverage. Such coverage is a great boon to injured folks as it will often pay lost wages on a virtually immediate basis rather than having to seek lost income later at the time of trial or settlement.
The amount of such payments varies from policy to policy and person to person. What does not vary, is their desire to be repaid. Because each company that issues disability policies are unique the repayment terms are also sui generis. The policy must be read closely and one of the largest delays can be obtaining a copy of the specific policy that is applicable.
Once a copy of the policy is available and reviewed, areas for compromise can generally be identified and utilized. The outcomes of such negotiations are less predictable than what one work out with Medicare, Medicaid,and private health insurers.
9). Multitudinous other perils including spouses, ex-spouses, former attorneys and misguided liability insurers that seek to subrogate for PIP or Medpay benefits. Be aware of these possibilities and make sure your lawyer explains whether any of the above are potential roadblocks to getting your compensation
The bottom line is that your case may be settled, the check may be in and yet it may be months before you actually get paid and you are entitled to know the reasons for that and what is being done to move things along.
