Are you wondering why your friend got a $45,000 personal injury settlement, but you’re getting only a 25K to 30K offer or even less?
The facts and the insurance companies involved in the case differ – that’s why. Some insurance companies are liberal, and others set out to deny, delay, and defend every insurance claim that comes their way.
So what factors determine the value of your case? We consider your age, prior injury, and medical records. For instance, if you’re over 35 years old, you’re likely to have previous injuries, but that will not keep you from making a recovery. Sometimes it could even make your claim stronger. It depends on prior records and treatments.
A properly documented treatment timeline after an accident is another important factor. Unfortunately, some accident victims fail to get treatment weeks after the accident, which is one factor that undermines and devalues a case.
Inconsistent treatment timelines, filing a claim on your own, hiring the wrong lawyer, and ultimately not having uninsured/underinsured motorist coverage are other factors that undermine your claim. How do you avoid these missteps?
Listen to this David vs. Goliath podcast episode with elite personal injury lawyer Matt Dolman featuring Geoffery Pfeiffer, Esq. They talk about how to derive the value of a personal injury claim, what you can expect, increasing the value of a claim, and more.
In this episode:
- [00:55] Matt Dolman introduces his guest, Geoffery Pfeiffer, and the topic of the day: deriving the value of a personal injury claim
- [01:15] Why does my injury settlement offer differ from my friend’s?
- [02:54] What are the main factors when determining the value of a case? How do they play out?
- [08:10] Building your case: why getting medical treatment and showing up consistently for it is critical to the value of your case
- [11::25] What to do after an accident and how we determine who was at fault for the accident
- [23:07] From Pre-suit to litigation, how a case can gain or lose value
- [25:25] Understanding the role of the insurance carriers in determining the value of your case – and should your health insurance get involved?
- [30:24] The insurance carrier is entitled to an offset. What does that mean?
- [32:09] Your attorney matters to the value of your case, too. How to know if your lawyer has an exemplary reputation?
Welcome to the third edition of the Dolman Law group podcast. I’m Attorney Matthew Dolman, the Managing Partner of Dolman Law Group. And today I have a special guest, Geoffery Pfeiffer, the new associate at our firm. Geoffery , say hello.
How’s everybody doing?
Today we’re going to discuss values of a personal injury claim, how do we derive the value? What can you expect? How do you increase the value of a claim? And what are the actual components? What’s the criteria to determining the value of a claim?
Now, first off, and I’m often asked by current clients, my friend, Susie, down the block, was represented by a personal injury attorney and she got a $45,000 settlement, why am I only getting a 25K to 30K offer or even less?
And what I want to stress to my viewers and prospective personal injury clients is, not all cases are created the same. In fact, there’s so much criteria that goes into a personal injury claim. In fact, if I’m talking to the individual, the first thing I say is, “I don’t know who the insurance companies were that were involved.” Some insurance carriers tend to be a bit easier than others. Some tend to take the mantra that we’re going to litigate everything and we’re going to deny, delay, and defend every single insurance claim that comes our way. You’ve seen the same thing, Geoff?
Yeah, a lot of people that come into our office, they don’t quite understand that, like you said, every insurance company’s different, you’re dealing with different adjusters, and the facts of every case are different. So it all just depends.
Yeah, a claim evaluated by State Farm for $8,000 might be evaluated by the Hartford Insurance Company for $35,000, $40,000. And we see this often. This is consistent. It’s not an outlier. It’s not an exception to the rule. This is the rule in our office pretty much. There’s three or four carriers that evaluate claims the same way, State Farm, Geico, 21st Century, and I’d say Traveler’s. And then the other ones are a little bit more liberal in how they value the claim.
The first four insurance companies I mentioned, and I should have included Mercury, they tend to pay fairly when we get the case in litigation, but in a pre-suit mentality when we’re saying demand is based off the medical records, before we file a lawsuit, it tends to be very difficult. It’s very onerous. It’s like a war of attrition without filing a lawsuit itself.
Yeah, I would agree with that.
Okay. So what are the main factors when determining the value of a case? First, I want to know who is the client? Are they young or are they a bit older? And not every client, in fact, I rarely ever came across a client, in fact, I’ve never come across a client that comes from Central Casting as the 18-year-old that’s got hit by a Pepsi bottling truck. I’m waiting for that case to come through.
So many of our clients have claims that pre-existed or that injuries that pre-existed this current claim or had prior claims in prior automobile or motorcycle or slip and fall claims. And it’s rare that an individual over the age of 35 has a medical records that are devoid of any prior treatment. The question becomes, the crux of our practice is auto accidents. So we’re seeing a lot of neck and back injuries. And the question that we’re often faced with is, how do we determine if the injury’s acute or if it’s preexisting in nature? What have you seen so far?
During a lot of the intakes, I just get a lot of questions from potential clients as far as I was in a prior accident, maybe it was three, four, five years ago, maybe even 10 years ago, and I was injured, is that going to keep me from making a recovery in this case or how is that going to affect my case? And I just walk them through and just tell them that there’s a thing called exacerbation of your injuries and we can still work with it. It doesn’t mean that you don’t have a claim. And we go from there.
In fact, sometimes it makes the claim stronger. I’m able to actually show a timeline, if you will. I show the prior MRIs and compare it to the current MRIs, the diagnostic test as to the cervical, lumbar, or thoracic spine and pinpoint what injuries are new, what are old, especially if I have a prior MRI film where I can have an expert radiologist take a look at it.
If not, if we don’t have films from a prior accident or prior injury or prior, maybe it’s just prior maintenance treatment for having a kink in your neck or back and the insurance company has discovered that. We like to let the insurance company know of all records so they can ascertain and make an articulate determination what the value of a case is, we don’t have to hide anything.
But if we don’t have prior records, then sometimes the adjuster at least can determine by viewing the film if the injury is acute or based on the degeneration and dehydration of the disc, they can tell it’s old, a degenerative condition that pre-existed the day of this accident. And that helps us. In fact, sometimes seeing a prior preexisting injury makes the case a little bit easier, especially when they’re over the age of 35 to 40 to determine what is acute versus what is pre-existing.
Yeah, and if we can look at a prior film and we can see that there’s already an injury at that level and they’re complaining of an injury here at the same level, then we’ve already identified what the problem is and what the areas are that are being affected.
Correct. And going off my example from earlier, so the friend Susie down the block who was represented by a different lawyer, why is she getting more? I often want to know what was the prior medical records, what’d they look like, not just what the insurance companies that were involved, what were the prior medical records? What was there before this accident? And what do the current medical records look like?
It’s like you’re asking me a question, but it’s a snapshot in time. I don’t have this information available to me. You might say that your friend had back pain and neck pain and saw a surgeon and they got a recommendation. How come my recommendation’s not worth as much as their recommendation? But I don’t know what the MRIs look like. I don’t know what the treatment, I don’t know what the workup of the claim was like, let alone the insurance company, let alone the property damage. And there’s a number of issues and criteria that go into the case. How old was the client, what other prior claims do they have on the record, and so on and so forth.
Yeah, without looking at their prior record and determining the extent of the treatment that they went through or did they have injections, were they recommended for a surgery, it’s hard to really make any evaluation about somebody else’s claim without actually seeing the records.
And what we see from a lot of our peers in the field, and this is just a generalization, there’s some great attorneys, there’s some very average lawyers. There’s a whole mix of lawyers in Pinellas, Hillsborough, Pasco, Sarasota, Manatee County where we practice, but you’ll see a positive MRI result and they send the client right out to a surgeon to get a recommendation. A lot of times it’s volume shops, a lot of TV, advertising mills, if you will, that will send the client out just to get a positive or get a good recommendation from a spine surgeon and try to bluff the insurance company into paying a lot of money.
What I will want to ensure my clients understand is, yeah, that will move the needle a little bit. We might add maybe $2,000 to $3,000, maybe even $5,000, $10,000 in a pre-litigation case. Could be more depending on the facts of the case and every case is much different. But if the insurance company does not believe you’re actually having the surgery, they’re not going to pay. If the insurance companies were paying every single surgical recommendation I had in my office, I’d be long retired. So would most of the lawyers in Pinellas and Pasco County and Hillsborough. It doesn’t work that way. What the insurance company will look at it is if you’ve been recommended for procedures, surgery, even injections, and you have not done the injections, how serious could your injury be? How bad can the pain be if you’re not undergoing treatment?
Yeah, if you send somebody straight to a surgeon, the case hasn’t been worked up properly and there’s just no treatment between the time of the accident and the time that you’ve signed up and going straight to a surgeon, the insurance companies, they’re going to wonder what’s up. And it’s important along the way that you treat with a chiropractor so they can see that you’re continuing to treat, that you get in with a specialist, maybe get evaluated for injections. And those steps need to be established before you end up going to see a surgeon.
Correct. There’s a work up to a case. So the client will often ask, “Why am I seeing a chiropractor or physical therapist?” Well, I’m being very general here because we’re not talking about shoulder and knee injuries today. I’ll get into that, but the crux of our discussion is going to be about cervical, which is the neck, lumbar, lower back, and thoracic, upper back injuries. And in the majority of our cases where an individual has a neck or back issue component to the case, we’re asking ourselves, how is this case going to be worked up? And the client says, “Why am I going to see a chiropractor or physical therapist?” Well, sitting on your butt at home without objective medical documentation, without showing up consistently for treatment, you have undermined the value of your case. In fact, the value of your claim will be almost nil if you’re not seeking some type of conservative care.
And you need to establish conservative care before you try more provocative care like injection therapy, then move along the line to, if you inevitably need to see a surgeon, you have surgery, and most of my clients never see a surgeon unless they failed injection therapy. If they’ve tried injections or tried different nonsurgical procedures, it doesn’t warrant surgical intervention, absent they have drop foot because of a lower back injury where they’re dragging their foot, or they have cauda equina syndrome where they’re literally piddling themselves, where they lose control their bodily functions, or they have such serious radiculopathy, that’s a nerve injury, where they have grip strength loss or they’re dropping things and this is affecting their vocational skills, their ability to work, their ability to carry their children.
Some of my clients cannot carry a baby simply because they have such loss of grip strength, such loss of strength in their hands and their upper extremities due to a car accident, motorcycle accident, whatever have you. That’s why you need to start with conservative care, absent of those type of serious conditions, you’re not seeing a spine surgeon right off the bat.
Yeah, and after you’ve done conservative care and you’ve seen a specialist, maybe you’ve had some injections, another important issue that we often run into is the fact that a lot of clients don’t understand that after you’ve done this treatment and you go to see a spine surgeon, it doesn’t necessarily mean that you’re going to actually go through with a surgery. We like to get clients in to at least get them evaluated and see what a surgeon thinks, but it doesn’t automatically mean that you’re going to go through with a surgery.
Correct. But they have to have tried at least injection therapy and generally have tried it and have failed to alleviate the underlying condition that they have. Maybe it helped for a little bit of time. Most of these injections, they’re not necessarily therapeutic. They don’t really solve much, not all of them. There’s some procedures that do, but the majority of them are done for diagnostic purposes to pinpoint the disc level where the injury’s at or you coordinate, meaning do you feel pain at that level, or has the injection relieved the pain for a finite period of time, which tells them that’s the problematic disc area and that they are probably a candidate for something more serious.
Yeah, I agree. So I guess we can move into the next phase of some common questions that we usually get. When it comes down to the actual accident itself, it’s always important to look at what happened. What happened during the accident, during the moment of event impact? We can talk a little bit about the liability issues and just things that we commonly address with clients when they come in.
Sure. A huge issue right off the bat is, and I often instruct my clients and any prospective personal injury client in the state or anywhere in the United States, take pictures. We’re in the day and age of mobile phones, pretty much all of us have them. When you get out of the car, hopefully you’re okay. Obviously if you’re not, seek medical care immediately. EMS may be called to the scene.
But in your typical rear end, side impact action where the individual at least is cognizant and is able to get out of their car on their own, you want to take photos of the property damage. Pictures are worth a thousand words. That saying is so true and it’s so dear to our profession. Without the picture, without being able to illustrate the property damage, its very homogenous. They’ll claim it’s moderate property damage or nothing too significant.
It’s a whole different story when I’m able to blow up a picture of my client’s property damage in mediation, at trial, and sometimes in my demand letters to the insurance carrier to show them just how severe the property damage is. We can look at a $2,200 property damage claim, but it’s on 1989 car or a car from the early 90s, and perhaps that’s the value of the car and the car has been totaled out and you can see that the car has folded like an accordion.
Yeah, not only do you want to take pictures, but a lot of people when they’re first involved in an accident, even if it’s a minor accident, they think that they shouldn’t call the police, but it’s always important to at least call the authorities and get them on the scene to have an accident report so that we have somebody there who can document what happened.
Correct. And we talked about that actually in volume one, our first podcast where I had Alex Knapp with me, another attorney at the office. The purpose of calling the police is, at least there’s somebody take a recordation down of what happened according to the witnesses and according to the individuals that are involved, the parties in the accident.
It prevents the individual who’s in the accident later on saying that I wasn’t really at fault. The guy actually put his car in reverse and hit me at the light or the individual cut me off. They just change their story to give a self-serving version to prevent them from having their insurance rates jacked up. We see that time and time again. That’s why you want to have law enforcement out there.
Keep in mind that police reports are more often than not inadmissible at trial. They’re considered hearsay. And the likelihood that the police officer will be able to testify at trial two years later and have an accurate recollection of what occurred in that accident, absent of it being a death or an extremely serious car accident, is between likely and none. Slim and none, slim has left the room. So it’s not going to happen. These things rarely get in unless you have an attesting witness, which is the police officer who took down the report.
Yeah, and when a case first comes into the office, so it’s important to… We always review the accident report. If there happens to be a liability issue in the case, a liability issue means determining who was at fault for the accident, a lot of clients they’ll say that I was not at fault for the accident, but some insurance companies, you’ll find that they’ll value it 50-50, 50 for the defendant, 50 for the plaintiff.
Or a portion liability and some permutation of that, whether it’s 20-80, or whatever it is, they’ll portion some liability to our client.
Yeah, and we’ll pull up the accident report, see what happened and we can always get somebody out there to look at the scene and that helps us speak with the client about the liability issue and work with the insurance companies that way.
Yeah, and in those such cases where there’s a dispute, if we actually have an individual witness or from the pictures itself and viewing the accident scene, we believe that we can possibly overcome based on our client’s argument, we’ll retain an accident reconstructionist and sometimes even a biomechanical engineer.
The accident reconstructionist will help show and illustrate how the accident really took place based on timing sequences, based on the speed of the car. Oftentimes we will send out what’s called a spoliation letter, which prevents any destruction of evidence and the car is evidence. So we like to get the black box in the car and show what speed the car was traveling at the time or was the car idle. We like to get surveillance if it’s possible. Is there surveillance nearby any stores or the traffic light? Go out and also test the lights and see how often are they changing? What’s the sequence there, what’s the timing? What were the weather conditions like that day? And if we feel like we have a decent argument, a leg to stand on, we’ll spend the money and we’ll retain an accident reconstructionist to determine and illustrate what is the liability situation? What does it look like?
The biomechanical engineer will be able determine the force of the impact, which is a little bit different. That’s when the insurance carriers are claiming that it’s a minor impact or it’s a modern impact, how could your client be so injured? That’s when you hire the biomechanical engineer and through… Its science. Through mathematical computations, they are able to show what does the speed and how much speed went into that impact and how much energy transferred in that impact to the individual’s body?
Yeah, and oftentimes these experts, sometimes looking at a vehicle you can’t really tell what the total impact was or how this impact affected the vehicle, but a lot of people don’t realize that just because there’s cosmetic damage to the outside, there may also be frame damage. The actual frame of the vehicle may have been altered in some way and by hiring an expert, they can go look at the vehicle and they can give us an evaluation and explain to us how that worked.
Correct. That’s what we like to bring experts in. They’re going to bring their own experts in too. It’s not how they just accept it. Pre-suit and litigation are two different stories. So in litigation, the insurance carrier will always hire their own expert to counter yours. Sometimes they’ll bring in experts prior to bringing one in if there’s a dispute about liability.
Police reports don’t play a large role in litigation because, again, it’s considered hearsay, but they do play a huge role in the insurance adjusters evaluation of the claim. If all they have is a self-serving statement of their insured saying it wasn’t their fault and they don’t have anything else, there’s no eyewitnesses, and we’re able to show through an accident reconstructionist what really happened, that holds a lot of weight. The police report does hold a lot of weight for us.
Yeah, and you’ll see the adjuster usually change their position if all they have is a self-serving statement from their insured and we’re able to come back with some sort of accident expert report and ability to show that our client actually was not at fault for the accident.
Okay. Now, just going back a second, I know we’re running a little bit out of order here, but I feel like I rushed the first segment where we talked about injuries and why you’re seeing a chiropractor or a physical therapist before you go see somebody for injections, whether it’s a neurologist, a PM&R doctor, which is Physical Medicine and Rehabilitation, I want to really stress the fact that it’s important to get in and treat right away, to be evaluated at an emergency room or an urgent care center. Urgent care centers are usually quicker and cheaper, absent of very, very serious injury. You want to just get checked out. You got a little bit of a neck and back pain, maybe headaches, you’re feeling some discomfort, but it’s not something that warrants immediate medical attention as in you might need surgery right away. Go to an urgent care center. It’s going to be quicker. It’s going to be cheaper.
But the point of conservative care, the point of going to a chiropractor or physical therapist cannot be underestimated. There has to be a finite period of time where you try conservative care and it failed to alleviate the issues that you have. It failed to either completely alleviate it or the issues have not completely absolved itself within a four to six month period.
We see that span of time has gone by, four to six months, and the client still has the same issues, or they don’t have a complete relief, then it’s time to really work the case up. And generally, we’re sending our clients to a physiatrist, neurologist, somebody for interventional pain within the first four to six weeks in the case to start that workup, to have an MD or DO already on the case.
A lot of chiropractors are great and there’s some bad apples too. And that’s part of the argument of why some individuals want to get rid of PIP in the state, Personal Injury Protection. We’re in a no-fault state. Sometimes the chiropractors will run rough shadow over the first $10,000 and then you have an MD at least saying, “Slow down. Let’s pump the brakes.”
There’s no need to treat so aggressively three or four times a week. If we’re going to do three to four days of treatment a week, maybe you need to try an injection at this point. Maybe you need to try something a little bit more provocative to see how you’re going to react. Maybe we need to first start with trigger point injections, which is very minimal. Or is there a need, we already have an MRI and we can see that there’s a herniation or an anular tear in the herniation, do we need an epidural injection? Is it worth trying a rhizotomy or radiofrequency ablation because there’s some facet impingement, there’s issue with the facet, which is a procedure where it’s electricity going into the facet levels, which is basically the pain messenger to your brain. So is it worth giving that a shot?
We like to get our doctors involved very early in the case. These are ultimately going to be our experts if we have to try the case. And we like to develop a nice timeline to it. But at the same point, let’s assure our care continues. Unless it’s so serious the client needs to see a surgeon or begin procedures, whether it’s a PM&R doctor, neurologist, or anesthesiologist, they overlap and they do injections, unless they need that immediately and they need to stop chiropractic care because they feel like any adjustment could worsen the neck condition or the back condition, they’ll do both simultaneously. They’ll try the injections and go with the chiro care or physical therapist and continue the conservative care for a finite duration of time, which is usually, again, four to six months because you want to establish that baseline that the client has injuries.
Yeah, it’s important to get a good workup on the case as you said. I often have clients who they don’t quite understand the reasoning behind having to go to the hospital. Even if it’s just right after the accident and it’s just for an evaluation, it’s important to show that you were injured enough or you were in such pain that you felt the need to at least go in and get evaluated. And then when they show up here to get signed up, they don’t understand that chiropractic care is something that’s probably going to be needed. They don’t understand that in addition to chiropractic care, it’s important to have an MD on the case like you said.
Or DO. Yeah.
Or DO, yeah. So we always try to make sure that they understand this and that we show them this is what’s needed as far as medical side of things.
Yeah, and the MD/DO cannot be underestimated either or undervalued. The point of the MD/DO also is that chiropractic has a pejorative tone with insurance adjusters. It just does. And there’s a reason why they changed the PIP statute around three years ago was to punish… It was punitive against chiropractors that a medical doctor can declare an emergency medical condition, but a chiropractor cannot to limit PIP coverage.
And we can get into that on another episode. This is very convoluted and it’s not really germane to what we’re talking about today. But the insurance companies attempt to punish chiropractors. If all the client has ever seen is a chiropractor and done nothing else, it has the smell and stink of a personal injury lawyer running the medical treatment, which you never want to see.
You want to let the clients run their own medical treatment. You want to suggest that this is how this works out. If you do this, this is how you develop damages in a case. If you don’t, this is what is going to happen. But at the same point, if it’s not meritable, if you’re not really in pain, obviously you’re not going to go forth and treat for four to six months. We try to limit those cases and get them out of our office. You’ll see a lot of settlement mills out there, a lot of TV law firms will keep these cases on forever and just garbage and garbage on mentality. We try to put some quality work into our cases.
At the same time, though, you want to move the case along and you don’t want it just stuck in a perpetuity with a chiropractor. You want to move along and have the MD/DO involved. It just gives a lot more validity to the claim. Anything that the chiropractor’s claiming when the MD’s recommending more conservative care or recommending conservative care in the first place, it makes the case look stronger.
Yeah, and it’s not our goal to constantly push any client to treat. If they tell us that they’re feeling better with chiropractic care or with an injection, it’s always important that they understand that if you’re feeling better, listen, that’s the ultimate goal here and we’re not going to push you any further than what you’re comfortable with. And oftentimes, we’re fine with letting them direct their treatment. And if they’re telling us that they’re better, we can go ahead and move the case and try to wrap it up.
Correct. I think we pretty much covered medical treatment for the most part. I just wanted to, again, emphasize the fact that a recommendation, it helps, but if you’re not actually undergoing the procedure or surgery that’s recommended, absent, maybe there’s underlying circumstances like you’re pregnant, or you already have metal hardware in your body and you cannot undergo another surgical procedure, or you have some type of preexisting condition, which would jeopardize your health in undergoing a surgical procedure, a surgical intervention, if you’re not committing to the recommendation, if you’re not willing to at least attempt what is being recommended, the insurance company will always, it happens every single case, it’s very cookie cutter, they will always state how badly could your client be injured. How badly could this individual be injured if they’re not seeking anything further. That’s why recommendations don’t hold a whole lot of weight, absent of you actually undergoing the procedure or surgery that’s been recommended for you.
Yeah, being recommended for something and claiming that you may do it sometime in the future, insurance companies just don’t pay for that kind of thing.
Yeah. What makes it worse is, in a pre-suit mentality when we’re dealing with just the adjuster before a lawsuit has been filed, the recommendation may hold some weight, but then when you file a lawsuit and six to eight months have gone by before you get to mediation, some counties it takes even longer and how backlogged things are, but you get to mediation and a long period of time has passed, we’re looking at a timeline where you haven’t done anything more in six to eight months, and now you have a stale case, if you will, you have a claim where the individual did not do anything further. You have like a depreciating asset on your hand. It’s a case that’s not going to build value. In fact, it lost value. You’ve undermined your claim.
That’s the problem we’re seeing with a lot of cases that the client wants to file a lawsuit, they feel it’s an unfair offer, but at the same point, it’s hard bill damages once you’re filing your lawsuit, especially if the client is not committed to any further medical treatment.
The argument that how bad could your client be injured is only strengthened by the fact that we now have this gap of six months, a year, year and a half where there’s been no medical treatment. Maybe they saw the chiropractor a few more times. Maybe they went once every two weeks to the chiro, but they’ve hit baseline. There’s nothing worse about their injuries. They have not needed more provocative care, let alone surgery.
Yeah, without moving forward with any kind of recommendations, it’s like you said, it’s very difficult for us to just show the insurance company that there’s any future value to the case. So oftentimes during those situations, it’s best to just wrap it up.
Correct. And the last thing we want to talk about today is, who are the insurance carriers that are involved? Who is it? Is it on the bodily injury side? Who is the at-fault party, the other party that was in the car accident that caused the issue? Who is their insurance carrier? Who is your own insurance carrier? Do you have underinsured/uninsured motorist coverage, which is so very important and it’s not really that expensive?
Uninsured/underinsured motorist coverage means you have coverage in the event that the other party, the person that caused the accident, is uninsured, which a number of Floridians are, or their insurance policy is insufficient to cover your future medical damages. For example, let’s say they have a $10,000 bodily injury policy on the at fault party that caused the accident and the injuries amount to probably $25,000 to $30,000 in medical bills, and there’s ongoing medical treatment still continuing, and you clearly have a case that exceeds the $10,000 policy limits, who are you going to go after then? That’s what you have uninsured/underinsured motorist coverage for. That person is underinsured. So that’s what that coverage is there for. And so it’s pertinent, it’s necessary, it’s vital. I can’t understand why anyone would not have underinsured motors come or the amount of individuals who are driving around uninsured or if minimal coverage in the state, you need it.
Yeah, and unfortunately, people out there driving who don’t have underinsured motorists are basically relying on the fact that if they get into an accident, the person who hits them has bodily injury coverage. And in a lot of cases, we run into the situation where the person has no underinsured motorist and the person that hit them actually has no bodily injury coverage either. So we run into a situation where we have to explain to them, listen, there’s only so much we can do. If there’s no insurance in the case, then we’re limited by insurance. There’s no money to go ask.
Yeah, absent there being an asset check where the individual has significant liquid assets, assets that we can attach to or file against, it’s almost impossible to obtain a fruitful judgment. There are some lawyers in town have big jury verdict against pro se defense who didn’t show up at trial and who don’t have coverage, and it’s not forcible. So don’t also be impressed by virtue you see on websites. Some of them are against pro se defense on cases where they’re not collectible where there’s no insurance coverage at all. If you don’t have insurance coverage to go after, it’s almost certainly, it’s not always. There’s a couple of exceptions to the rule, but it’s a near certainty that you’re not going to have a fruitful case. There’s nothing to go after at that point.
Yeah. And also I also get questions from clients about their health insurance and how that affects their case. And I just tell them that it’s important to know that some of the bills actually may be paid through your health insurance.
We always recommend it. Use your health insurance, if and when possible, especially for injection therapy or surgical procedures. The health insurance company will pay the bill. What most clients don’t realize is there’s a process called subrogation. Absent you being in a car accident, you’re not going to have to pay your health insurance carrier back. But if you’re in a car accident, slip and fall injury, if there’s a personal injury claim going on, the health insurance carriers, Aetna, Cigna, UnitedHealthCare, they’re going to want to get paid back at the end, but they’re only going to want to get paid back a portion, penny’s on the dollar, sometimes 23 cents in a dollar of what they paid out, which is going to be a lot less than often a letter of protection, which is a term of art in the state.
And in many states where personal injuries practiced, a letter of protection is a document where you’re basically guaranteeing the medical provider that you’re going to earmark the settlement money and trust to pay their outstanding balance which that you’ll then to go when the case resolves. But what you’re going to pay off a letter of protection is, you’re going to be a lot more expensive than what you’re going to be paying off of health insurance, especially in a surgery.
So that’s why health insurance, it’s exceptional. When my clients have it, it makes things so much easier to work around. I know a lot of personal injury lawyers hate it because it feels like it’s another step and it takes a little bit longer to disperse the money and collect their money at the end of the case, but we’re not desperate to get to collect our money. We’d rather do a right job for our client and the client save so much more money when we have health insurance involved.
Yeah, and in addition to the BI and the UM, there’s also what we have known as PIP here in Florida. It’s important that clients understand that the first $10,000 typically of your covered or of your bills are usually paid through the PIP.
If there’s an emergency medical condition, within the first 14 days you have to treat in the State of Florida. If you have not commenced treatment in the first 14 days following your car accident, you will not have PIP available to you. Then more often than not, we’re going to require what’s called an emergency medical condition, which is a term of art created by the legislature, it’s not a real medical term, where they have to show, and it’s vernacular, it’s a lot of language that goes into this, to show there’s a substantial injury that meets the criteria of being called what’s an emergency medical condition.
Most doctors don’t know even understand what that means, but there’s enough doctors out there at EMC consults, which will determine whether an emergency medical condition exists. Absent of emergency medical condition, you’re limited $2,500 in coverage. That’s a change in a statute that occurred back in 2014. So it all depends on whether an EMC exists. an EMC exists, you have $10,000 available to you.
What I must state at this point is, and a client often don’t realize this, this is really what’s going to affect the value of your case too, the insurance carrier is entitled to an offset. So let’s say I get a case with minimal property damage, minor injuries, and we get a jury verdict for $14,000, just a small, small case. Okay. I can’t think of a very small case to taking the trial, but this is for example only. You get a $14,000 verdict. Only your actual verdict is downgraded to $4,000. That’s what the value you’re able to collect off the case is because you’re going to have a $10,000 offset. So as a collateral offset for PIP coverage, if PIP coverage is actually available in the case. If there’s no EMC in the case, there’s only $2,500 available for medical treatment, they’re still entitled to a $10,000 offset, which is insane. And it’s asinine. That’s how it works here in the State of Florida.
So remember, there is a collateral offset for PIP coverage. So when the at fault party, if you try this case, ultimately in Pinellas, Hillsborough, Pasco, Manatee, Sarasota, or in the State of Florida, they’re entitle to this offset, which adjusters are very well aware of. And they’ll often say, “Well, I understand you sent us a demand letter and we only value this case as being worth $18,000 in a letter, but we’re really valuing this case is worth $28,000 because it’s $10,000 of PIP garbage also that stands in front of our $18,000.” And clients often don’t realize that. That’s called an offset. That’s what the insurance company’s entitled to. It offsets their obligation under a jury verdict or their judgment.
Yeah. And with that being said, with the BI and of course, with the UM, it’s always important to make sure you just review your policies when you purchase your insurance and you look at the amount of coverages that you actually have in the case, just keep an eye on in the future. And just in case you happen to run into a situation where you’re going to need coverage in the future, it’s always important… The minimal coverage often severely limit your case and the more, the better
Correct. Last thing I’d like to touch on is and it’s vital when selecting your personal injury attorney and determining the value of a case is who is your lawyer? Who is the law firm that you’ve retained to represent you in your personal injury case? Do they have experience trying cases? Do they have a pattern of litigating successfully in the county in which the accident occurred in? Did they have a tracker with the insurance carriers for successful resolutions in litigation and at trial?
Absent of that type of reputation, the insurance companies are generally going to low ball the claim. All insurance carriers carry a database on what type of outcomes the lawyers had, and especially with their insurance carriers. There’s a lot of offshoot, smaller insurance carriers that might not keep such database, but they certainly know about the reputation of lawyer or law firm, they will research such.
But the bigger carriers like Allstate, State Farm, Geico and Mercury, Progressive, they’re at USA, they’re going to look at what are our prior resolutions with this law firm? What is our history? Have they obtained judgements against his verdicts in that specific county or anywhere in the State of Florida? Do they have trial lawyers of the firm? Like we have a board certified civil trial lawyer Dave Neiser and one that soon to be in Julia, my wife. And it depends on how good are the lawyers at the firm, how often they litigate?
The world’s worst trial attorney is still better than the guy down the block who’s never litigated a case, never tried a case. If there’s no bite behind the bark, if all you’re doing is barking, you don’t have the ability to actually effectuate the bite and actually go after them, then it really means nothing. It’s no different than an individual filing their own insurance claim and handling it themselves and not having a lawyer involved. There’s no threat. That’s why they treat individuals who do not have counsel, they don’t take them very seriously. And they give them these low, rinky-dink offers of 1,000 or $2,000 of the claim. We know full well, it’s worth over $15,000 to $20,000 because they know there’s no bite behind the bark. The claimant can sit there and pound their chest all they want, but they don’t have the ability to actually you effectuate anything. Cause they’re not going to be able to file a lawsuit.
Yeah, they keep the database just so that they have an idea of how far basically they can push the attorney before they’ll cave. They have a history of knowing how far they can go and what they can offer on cases and what that attorney typically will settle for and they use that to their advantage.
And does the law firm also try cases that a shoestring budget or they bring expensive experts in that can really help set up the case and illustrate to the jury, the damages, the causation of the actual injuries the person has, was it caused by the force, which is what a biomechanical engineer will show? Do you have an MRI that you can… A radiologist rather that can you retain a trial that can tell you what does the MRI show and just cipher, what is acute? Meaning what is caused by this accident versus what is preexisting?
Do you have a surgeon that can testify at trial to show you what they saw intraoperatively, which cannot… It’s really hard to rebut that because no one else was there during the surgery. And they can tell you what they saw at that this level when they’re operating on patient X, can you afford that? If the law firm is just doing case on a shoestring budget and not bringing the proper experts into trial, you get shoestring results.
So it’s very important to know the track record of the law firm. And do not be enthralled and excited by looking at jury verdicts that appear on a law firm’s website. I discourage you from doing that. You want to know if they have a history and the results help show that they least try cases and you can see verdicts versus settlements. Sometimes they’ll just post it as just numbers and you don’t know if they ever tried these cases or they’re just settlements. Did they bring in co-counsel or they do it themselves? And they’ll claim that they did it all themselves. They may have hired other lawyers to go do it for them.
It’s important to know if the lawyer has a reputation for trying cases that do you have a board certified civil trial lawyer at your law firm. That’s vital. There’s the insurance company, that’s somebody who can say they’re actually an expert in trying cases in the State of Florida, you can actually… The Florida bar allows you to make that designation because you have a history of trying cases and you have a board certification behind you. You are certified by State of Florida as an expert in trial advocacy as Dave Neiser is at our firm. And Julia soon will be. If you don’t have that, there’s not much a bite behind the bark.
Okay. It’s just important to make sure you do some research more than just the opening page on the website because it’s a business. They’re there to lure you in. And of course, they’re going to show you what you want to see.
Yeah, and I see so many jury verdicts and I can’t tell you how often we see us other law firm’s website, some very local firms here in Clearwater where they’re advertising five, 10 million jury verdicts, but they’re against pro se defendants who did not show up at trial knowing full well, it wasn’t enforceable. They’re just adding another verdict to tack on a wall like another notch on a belt, if you will. It’s not an actual enforceable verdict and they weren’t able to collect that money and they don’t tell them there. There’s no disclaimer in the website says we weren’t able to actually collect this money. It just shows nice big number and clients are enthused by that and they use that for advertising purposes. Truth be speaking is that there are a number of cases we could have taken all the way to trial where there was no potential for ever being able to collect. We do what’s best for the client in our case.
Yeah, those are just there to lure a consumer in because they know that most average consumers don’t understand the details behind it and they run with it from there.
And verdict results are also misleading just based on the simple fact that they’re showing you the good results. They’re not showing you the times they’ve been zipped the trial, which every lawyer has. No matter how good the lawyer is, you’re going to have trials that just do not work out well.
You’re putting in the hands of six lay people and you’re hoping that they value it, but it still craps you to an extent. It’s very tough to try cases, especially here up in Pinellas, Hillsborough, Pasco, Manatee, Sarasota. It’s a bit more conservative than Broward, Dane and Palm Beach County on the East Coast. You’re seeing west coast verdicts a bit lower. It’s a little tougher up here based on the population. And it’s just very difficult. So that’s why it’s misleading to look at the big verdicts. So you want to know how many cases the law firm tried and what’s their pattern of success because they’re not putting up the times they got a verdict that was much less in settlement offer before trial or a zero.
Yeah, and that also goes back to the situation where we try to compare two different cases to one another. Also, it depends on where the case was tried and who the attorneys were and what the jury comprised of, and whether it’s a liberal or conservative area.
Very true. Well, that wraps up our third episode of the Dolman Law Group podcast. I thank Geoffery Pfeiffer for joining us today and I wish you a pleasant day have a blessed one.
💡 Meet Your Host 💡
Title: Partner at Dolman Law Group Accident Injury Lawyers, PA
Specialty: Matt is a nationally recognized insurance and personal injury attorney and focuses much of his practice on the litigation of catastrophic injury and wrongful death cases throughout Florida.
💡 Featured Guest 💡
Title: Attorney with The Lopez Law Group
Bio: Geoffery graduated cum laude from Stetson University College of Law in 2016. Before his graduation, he clerked for the Dolman Law Group. Upon graduation, he worked at the Dolman Law Group as an associate attorney focused on personal injury actions.
🔑 Relevant Resources 🔑
- Lower Back Injury
- Cauda Equina Syndrome
- Serious Radiculopathy
- Epidural Injection
- What is Underinsured/Uninsured Motorist Coverage?
- Subrogation – How to Handle Your Medical Bills after a Car Accident
- Letter of Protection
- Emergency Medical Condition
The insights and views presented in “David vs. Goliath” are for general information purposes only and should not be taken as legal advice for any individual case or situation. The information presented is not a substitute for consulting with an attorney. Nor does tuning in to this podcast constitute an attorney-client relationship of any kind. Any case result information provided on any portion of this podcast should not be understood as a promise of any particular result in a future case. Dolman Law Group Accident Injury Lawyers: Big firm results, small firm personal attention.