How to Maximize the Value of Your Injury Claim

 

Available on Stitcher
Available on Audible
How to Maximize the Value of Your Injury Claim Cover
How to Maximize the Value of Your Injury Claim
1x 15s 30s
00:00:00 / 00:00:00
How to Maximize the Value of Your Injury Claim

If you're injured in an accident, don't be surprised your primary care doctor will not want to see you or may want to see you under a different arrangement and not your health insurance. 

That's because medical treatment for auto accident injuries is slightly different from your standard care. Many physicians don't want to do the extra work involved in treating you and not get paid.

How then do you get treatment? That's where your injury lawyer comes in. They need to issue a Letter of Protection to the doctor and make sure to add that medical bill to the value of your case as past medical bills. 

But what if the treatment reaches a point of maximum medical improvement and the accident leaves you with some form of permanent injury? You're going to want cover for your future medical needs. And that's your second value driver, but it requires, among other things, a life care planner to do the valuation for your future medical needs.  

And just like past medical bills, you can also expect damages for past wage loss. That is, what you've missed in work money from the past. It can be acute days out of work or time off. However, more complex cases require figures for a reduction in work-life expectancy and a reduction in earning capacity. 

That brings us to the next case value driver: expert witnesses who can speak to future injuries, future medical needs, and future wage loss. To get those, you need an attorney with the resources and willing to pay those experts on your behalf.  

Lastly, touchy-feely or non-economic damages constitute a significant value driver for your injury case. What are these non-economic damages, and how do you learn more about the other value drivers for your case? 

Learn more in this episode of the David vs. Goliath podcast with elite civil trial lawyers Matt Dolman and his partner, Stan Gipe. They discuss the five value drivers for personal injury cases, and how to shoot for those big verdicts! 

<iframe width="200" height="113" src="https://www.youtube.com/embed/MIPNVWCDL2I?feature=oembed" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" allowfullscreen title="How to Maximize the Value of Your Injury Claim"></iframe>

In this episode: 

  • [00:36] Stan Gipe introduces the topic of the day: value drivers and what makes your injury cases worth money
  • [01:05] Why medical treatment is different for injuries sustained from an auto accident, and why not every doctor can help 
  • [02:39] A letter of protection and past medical bills 
  • [04:27] Building up the value of your case: future medical needs matter 
  • [06:26] The art of boarding at trial
  • [07:22] When do you need a life care planner? 
  • [09:03] The before-and-after witness and mild traumatic brain injury
  • [10:47] Driving value using the past wage loss
  • [13:13] The cost of expert witnesses and why they matter to your case 
  • [17:47] Handling the bully that is your insurance company 
  • [18:29] Touchy-feely or the noneconomic damages
  • [21:11] Who pays the medical bills, and how are they paid after your case?

Transcript

Welcome to another episode of the David vs. Goliath podcast with the Dolman Law Group. I'm Matt Dolman. I'm with Stan Gipe, my partner-in-crime, board-certified civil trial lawyer extraordinaire. Stan.

Hey, I'm happy to be here. Glad to be on another edition of the Dolman Law Group podcast. And I think today we were going to talk a little bit about value drivers and really what it is that makes cases worth money. How do you get those big verdicts?

Yeah. How do you build the case up? But when we were off before off-camera, you brought up the best question. At least we think that consumers will want to hear the answer, too. How do we obtain medical treatment and who is paying those bills?

And it's true. Like you know Matt, in the auto accident arena, medical treatment ends up a little bit different than your standard care. There's some different elements and different things we need documented. And most of the time, the doctors that are working in this arena don't accept health insurances. If you find yourself injured in an accident and you go to your standard primary care doctor, most likely he's going to tell you he won't see you, or he won't see you under your health insurance because of the extra work involved in these claims.

Sure. Most physicians actually do not see personal injury claims.

Yeah, they won't. I mean they don't want to be involved in the whole thing at all. One part of the art is finding the doctor that will actually see the patient. The two's getting him to treat. And I think primarily, Matt, at least in my history, I've not used anything more than a letter of protection to get treatment for clients.

That's pretty much what I use. And now explain what is a letter of protection?

Letter of protection is simply an agreement. Now, one thing, it's not a promise to pay the doctor. Because what happens is our clients go in, a lot of times they need treatment. They need surgery, they need expensive procedures. And it's the responsibility of another party. We've got a lawsuit. Most people can't afford to pay $150,000 out of their pocket to pay for their treatment while the lawsuit's going on. Because of that, we've created a vehicle or a document called a letter of protection.

And a letter of protection, simply a document that gets signed by both the attorney and the client. And it's shipped over to the doctor's office and what it does, it tells the doctor, look, this client's got a lawsuit, and we can't promise you we're going to pay you. We don't know what's going to happen. At the end of the day, the bill is still the client's bill, win or lose the lawsuit the client's going to be on the hook for this money. But if we get a recovery, we promise we will take care of this bill out of the settlement proceeds before giving any money to the client.

Correct. It's basically a promise that we're going to earmark the settlement funds in our trust account. Our client trust account that's required by the Florida Bar and that we will hold that money in trust until we are able to resolve whatever the outstanding balance is and negotiate to what we believe is the proper price.

That's exactly it. We cannot disperse. We can't pay ourselves. We can't pay the client. We can't pay anybody till doctor agrees with us. So we've all kind of got sort of a system of checks and balances. The doctor's got the LOP. I've got my fee. My client's got to have a good net. And that's sort of the symbiotic relationship of... It has to work for everyone. And to do that and make it work for everyone, we've got to drive value to the case. We got to maximize it.

Now how do we do that? That's the art. That's what we do all day long, Stan. For those who are listening for the first time, or for those who are here to see multiple episodes, Stan is a board-certified civil trial lawyer. So, he's been designated by the Florida Bar as an expert in trying cases before juries. He's tried a number of cases in Pinellas, Hillsborough, and all throughout Florida and he's first chair meaning he's a lead trial attorney on numerous cases. Take me through, how do you build up the value to a case? What's the art?

There's several different stages to it. Now, I will tell you, the primary one that's somewhat common sense, but really not. It's one of these things like when someone has a bad injury, you blow out. I got a ski injury this last year. Okay. You have a bad injury, in someone's mind they know that's permanent. They know that they've got a limitation on their body that's going to be there forever. For me, I've shattered my collarbone. I had to get surgery to repair it. I know I've got a permanent limitation on my collarbone. If you were to ask me or any other normal person, "Well, how much is that going to cost you to deal with over the remainder of your life?" You can get a blank stare. But if this injury was caused by an accident, I'm entitled to collect the money that it's going to cost over my entire life to deal with this injury.

And sometimes you don't think about these things, whether it's the little bottles of Advil you're buying once a month, whether it's time you're taking off of work as you age, because your injuries flare-up and cause you not to be able to work as much or whether it's something else requiring treatment. Hey, as this injury degenerates in 20 years, you're going to require scanning. You may require another surgery, you may require more treatment. Future medical needs matter. A huge component of our claim. And they're typically not included in your standard doctor's report. If you think about your medical record, a doctor may reach out and say, hey, come back in five to six weeks. A doctor may reach out there and say, hey, follow up next year. Okay. Have you ever read one of your medical records and as you're treating, doctors say, " Well, here's what you're going to be dealing with for the rest of your life and how much it's going to cost."

Never.

No. And most of them are trained to do that.

But that's how Stan builds value at trial. That's how that's explain. What are you boarding at trial? When it means to board something? What does that take you through the whole art?

And Matt, just to bring the dream up, last Tuesday, our firm got a verdict for 6.7 million for a client. And most people when they're thinking it about these things think, oh, well, medical bills. And medical bills is just one component of a claim. When we throw this up in front of a jury, there are five boxes they can squeeze money into. Five boxes to put numbers in. Most people think of the first one. That's past medical bills. What were your medical bills that you needed to treat to get to this point to fix it as much as they could?

You're going to reach a point of maximum medical improvement. That means the doctor fixed everything they could. Most of the time, clients end up with some form of permanent injury from the accident. When they've got a permanent injury, well, you're also going to have future medical needs. Well, that's a function of the nature of the injury, the nature of the person and their life expectancy. How much time are you going to have to deal with this? Putting that all together real typically, requires a specialist we refer to as a life care planner.

Which we use on more egregious injuries. Those who require surgery. Or some type of procedure to obviously maintain their normal range of motion or get back to resolving a longstanding orthopedic issue.

Or even people who are going to require, let's say, a lifetime of pain management or like interventional pain procedures, radiofrequency, ablations, injections, things like that. Over time, they add up. So you get someone who's going to have to deal with what maybe seem like a relatively minor problem. Or when they deal with it for 20 years and it costs them 170,000, over those 20 years, someone's got to be there to give the jury a number to put in that box or give the insurance company a number to compensate. And in order to do that, that person's called a life care planner.

Saying you'll also from just past experience anecdotally, you can share for our listeners that, on a traumatic brain injury case, for instance, the person looks normal. They act and talk normal to a jury who was only getting a snapshot view of that individual. They don't understand what that person was like before and after, which is we use witnesses for that at the call before-and-after witnesses. Those are people who knew the individual and they can explain how they're different now but the life care planner helps illustrate what are the damages and what are the medical bills going forward? Not just medical bills. What is going to be the cost of living their normal life and all the needs they're going to have in terms of accommodations for the rest of their life?

You brought up a couple different things there. The before-and-after witness and mild traumatic brain injury, I want to get into that because you really brought that up. And when you say traumatic brain injury, a lot of people think scoop out of their brain, massive brain injuries. Most of what we're dealing with are mild traumatic brain injuries where if you met the person walking down the street, you wouldn't notice. And Matt, the most compelling case have dealt with ever on a before-and-after witness a mild traumatic brain injury, and really illustrates what you're saying. It's a dry cleaner.

Guy used to go in dry cleaner and it was, oh, Jim used to come in here all the time. He gave me the best stock tips and told me how money would grow and compounded interest and really explained basically financial markets to me. It says now he struggles to count as change. And that's the kind of thing that really brings it home. I can sit here and say, "Oh, I used to be great. Now I'm awful." But your loved ones can sit there and say it, but they're in the mix. They're dry cleaner. These sort of people that you deal with on a day-to-day basis don't have a dog in the fight, but have no reason to lie. You find those kind of people to really say, here's the change. Here's what's happened. Here's what I noticed. And here's what happened to Jim. Here's what I've seen from the accident.

Correct.

And if you don't know how to find those people, you don't know what to do, how to undig those people, what's really important for them to say, you really don't know how to drive the value to the claims and how to get what you need out on the table to get good verdicts.

And what are the other areas of damages? You said you got to check off five boxes. So we got past medical bills, future medical bills. Take me from there.

Future medical needs. The next one we got is past wage loss. And just like past medical bills, that one's pretty simple. Okay. What is it you've missed in work money from the past? That's typically acute days out of work or acute time off, pretty straightforward. Some injuries get a lot more complex. Obviously, someone's paralyzed. Well, that's not as complex. The number's big, but it's pretty simple because you pretty much can't work at that point for the most part where it gets really complex... So let's say we get someone with a herniated disc and a fusion. I've had a surgery, a herniated disc. They can go ahead and do, let's say their job as a driver. Well, they can do it. They can drive a car. They drive themselves to the store. They drive the airport. They can do it for a few hours.

But now if they're in the car for three or four hours at a time, they got to take breaks. They got to get done. And you know what, when they're having flare-ups, they really can't drive. So, this person can do the job. But on average, they're only going to be doing at about 35 hours a week for the rest of their life instead of 40. On average, they're going to have more time off than the other person. And we go through periods of unemployment throughout our life. It just happens. People change jobs.

When you're out there competing in the job market and you got a disability or an injury that's going to slow you down, you typically have longer periods of unemployment and are slightly less employable than someone who's wholly healthy. All of those things has to be taken together and put into one number so we can collect it. And that's all forward-looking. It's a combination of additional time out, shortened ability to work during the week and more days off. And then at the end of the day, you're likely to retire a little earlier. So all that's what's called a reduction in work-life expectancy and a reduction in earning capacity.

And we often use what...a vocational expert.

Exactly.

And often they go hand-in-hand with life care planners. Some of them do both.

Yeah. They're both forward-looking, man. We got someone who's going to tell us what it's going to cost to fix the injuries, deal with them in the future. And then we got someone who's going to be able to tell us what our likely wage loss is in the future.

Okay. What are the other damage factors?

Well, before we get to that, Matt, how cheap is it to get a life care plan or a vocational rehabilitation expert?

It's not cheap at all, usually we're spending upwards on these experts five grand just to get started. And sometimes for the report and taking us through the entire case, because that expert now has to deal with all the medical doctors, all the physicians and medical services that were procured for our client. And they got a conference with those doctors and figure out what is the game plan going forward, what is the likelihood or probability that the patient will need future medical care and what type of medical care will they need? So it's a pretty intricate process. And sometimes it'll cost us upwards of 10 to $15,000 just for that one expert, let alone, if we have to try the case, we got to pay another $10,000 fee just to have that individual come into the courthouse for a single day to give testimony.

And that's what I want to get at for case value drivers. A huge case value driver is these people that can talk about those future injuries, the future medical needs, future wage loss, in order to get those reports, it's going to cost you thousands, if not tens of thousands, of dollars to get them competently.

Sure.

If you don't have an attorney who's willing to lay out that money for you or an attorney with the resources to do that on the front-end, you're getting shortchanged. And that a huge value driver to the case is having an attorney with the resources to go out there and obtain the experts you need when it's necessary to document these things. Because the experts are out there, not every attorney's willing to spend the money to retain them.

And that's another issue. We're not unique in our practice. We're not the only guys in town that are willing to spend the money. There's some really good lawyers out there. The problem we have though is when we look at a lot of our peers, many of them are not willing to spend that money as you just said. And if you approach a case in a shoestring budget, you're generally going to get shoestring results. To really illustrate and drive home the damages that our client has suffered to an insurance company first, because our goal is to try to get the case settled. You only try a case. We you have no other option. Now we try plenty of cases. But the point is, we're not cowboys. We're not just going out there and seeking to try cases. The goal is to get the case done, path of least resistance possible for the best amount of money we can. But we can't get a fruitful recovery from the insurance company, we're willing to try the case. Correct?

Oh, the best resolution is a quick fat settlement for the client.

And the only way to do that with the insurance company is to hire the right experts.

Right. But if we can do that, it's fantastic, but you're right. If you are trying to hold off money on the front and if you're trying to save money, the insurance company isn't putting that value out there. If you don't have a doctor saying, hey, the future meds related to this claim are 270,000, in the insurance company's mind, the future meds are zero. Now you can negotiate a little above that but until you give them something, they can't do it. And then Matt, adjusters are normal people, little stingy, but they're normal people. They're trying to do a job. And they're worried about their boss looking over their shoulder. Most of them don't care. It's not their money. They're worried about documenting a file.

So if you send them a life care plan that shows a million dollars in future meds, if you send them the voc rehab report that shows 250,000 in wage loss, it gives them an excuse, a way to tender that $250,000 check. And when somebody comes back to look at it and their manager comes back to look at it, they can say, "Look I CYA, I've got these documents showing this claim's worth a million." Well, if you don't have those future reports and all you got is 50,000 and past meds and recommendation for surgery, when that file gets audited, someone's going... What are you? You some kind of wimp why'd you pay these people?

Matt Dolman:

I could have said it better myself. One more thing that I would add to that is, and I hate to call it's not a game. It's definitely not a game for the individual who's gone through the accident, who has sustained serious injuries, but there's gamesmanship between ourselves and defense lawyers and the insurance company itself, the handling adjuster. And part of it is posturing. If you're not retaining experts or you're not spending money, how serious are you about this case and how much do you believe in the case?

If you're going to say that you want high six figures or into the seven figures, you have a catastrophic or very egregious injury case. The only way to really show that is by posturing and hiring the right experts. Otherwise, does your attorney really believe in the case? They really spent the money to truly illustrate and document the injuries or we're just going to accept their word for it. It's a whole different process when you've hired experts. Even if they don't believe the expert, then if you're trying to go out of the loan... if a lawyer who was not really willing to spend the money, maybe bringing one expert, but not anyone special into the case.

It's right back to the schoolyard dynamics. The way I explain it to clients is this, we're all there. We're kind of walking around all the attorneys. The insurance companies are like the bullies in the schoolyard. They're the ones going to run around dictate to people how this is going to come out. Here's what I'm going to give you or what you going to do about it. Here's what I'm giving you for your claim or else. What are you going to do about it? They're the bullies. If you don't have the guy on your side that's punched the bully before, he's not getting the respect. If you don't have the guy that's willing to punch the bully, you're not getting the respect and your claim's not getting the value that it deserves.

Again. Couldn't have said it better myself. So, what final areas of damages?

Last box. Auto accidents. And then this is our Florida jury verdict form and auto accidents in Florida we have to show a permanent injury to get to the last box and other types of claims we do not. But that last box is the box people think about. I'll call them the touchy-feely or the noneconomic damages. This is the pain, suffering, mental anguish, loss of ability to enjoy life, embarrassment, all that kind of stuff. This is where you start to get into the psyche. The things that you don't always really think about. Certain things like this is where you get into the people in wheelchairs. You've gone through their medicals, you've gone through all this. And then you sit down and listen to a guy in a wheelchair testify.

And I've had this happen before that because one of the worst things about it is I don't interact with anybody normally. It's like they don't meet you and I and just say hello when they pass. It's like they look down. They don't interact. They look away. And then they think, oh crap, I just looked away. I look like I'm trying to avoid the guy in the wheelchair. Then they look back and it's an awkward eye meet. And they look away again. Because no one can just interact with me normal. I don't have conversations on the side of the street when I'm waiting for stuff. I don't interact with people like I used to. And that's where that pain, suffering, mental anguish, loss of ability to enjoy life. Because you can't put that number in any of those other boxes. That's not a medical bill. Because not a future medical need. That's not wages. That's quality of life, ability to enjoy yourself.

And you have to impress that upon a jury because that's what people deal with. For a lot of our claims, that's the real value driver. That's what's concerning patients. It's not my past meds. It's not the future meds. It's what happened to them. It's a lady that's in the wheelchair that goes, "One of my biggest fears is that there's going to be a fire at my house and my kids are going to die trying to rescue me." These are the kind of things that go through people's heads when they have significant injuries that you don't think about. The people are dealing with and these kind of sides... these value drivers on the claim, they need to be developed. They need to be pushed. Juries need to see this to understand what people are going through.

100%. To finish this off today, who pays the medical bills and how are the medical bills paid at the end of the case? And now we went over letters of protection. We went over the need. What a letter of protection is that, again, it's a guarantee that we're going to hold that money in our client trust account that's required by the Florida Bar until we get a reduction offer from the physician or we make an offer to them and finally negotiate out a price of what we're willing to pay them. But where does the money ultimately come from? It come from the settlement and explain how that works.

Okay. At the end of the day, the only money out there is the client money. When we get a settlement, when the insurance company pays the settlement, it is all the client's money. The client then pays us our fees. Pays the medical doctors their bills. And the client gets the leftovers. They're the last one to get paid. These medical bills... If someone's got a million dollars in medical bills and they get a $250,000 judgment, they lose a trial, they still owe the million of medical bills. They are the client's bills. So at the end of the day, the client pays the bills. Hopefully, we can get them the money from the settlement to do that. But if we're not successful, the client still pays the bills.

Which illustrates another reason why you should trust in your lawyer. We try to work with physicians that we've had relationships longstanding, not based on what they're going to say. We hope that they're plaintiff advocates, but they have to have understand that they rise or sink with the tide. Basically, if the case goes south, they go south with the medical bills. We don't want to work with physicians that are going to hold our clients' feet to the fire, so to speak if we do not get the result that we desire in the case... which is rare by the way.

It's rare. But it's one of those things you try to work with the doctor when it goes south, you reach out to the doctor and try to explain your client's financial position. I'm going to tell you. If I'm representing a guy in a $10 million house with a waterfront home, driving a Ferrari, millions in the bank, he's paying the bills no matter what because he's got the money. Most of our clients at the end of the day don't have the money to pay a 100,000 in bills or whatever. So it's our job to get in there, work out what we can with the doctors, but also the doctors don't benefit by chasing these people to the poor house. It's always in the doctor's best interest to make something work for everyone. And when the cases go south, when there's not a good recovery, it's just more work for you and I to get the doctors to see our side so that we do as much as we can for the patient.

Yeah. Another topic for another day. Because as we open up another can of worms is that we're taking a case to trial, before trial, we can actually obtain insurance against the resolution of the case. So if it's a defense verdict, the medical bills will still be covered. That's known as a Proposal for Settlement Insurance, PFS insurance. But that's another topic for another day. I don't want to confuse viewers, but understand that we're listeners rather, but in the 5,000 personal injury cases I've handled... and you probably handled a few more than I have, I have yet to have a case where the client has walked away in financial peril.

Yeah. I mean, that's the situation. They just typically don't. But you're right. If we're looking at a proposal for settlement and we're looking at triggering... And that is a whole nother issue for another day because there's like 10 different underlying issues here. But if we're looking at potentially getting deemed for attorney's fees on the other side, proposal for settlement insurance is something we can have the clients take out before we get to trial to sort of protect that exposure.

Right. I think we did a thorough job of covering this topic. Anything that can always come up that you want to discuss?

No, I think we managed to hit most of it here today.

If you have any questions, feel free to reach out to either of us. You could always reach me at [email protected] Our website is a vast resource for consumers and clients alike. It's dolmanlaw.com. D like in David, O-L-M-A-N law.com. Presently, it stands as second most search personal injury law firm website in the United States. You can reach us anytime toll-free E3355 crash. What's your email address, Stan?

Mine's [email protected] S-T-A-N. G-I-P-E. And I welcome any emails.

Stan's a busier trial lawyer. If you have a question, probably send the email to me first. I might take a little bit longer getting back to you only because he's a busy trial lawyer and again, congratulations on the 6.7 million verdict last week, but we are here for you throughout the country. Reach us anytime told free again, E3355 crash. This wraps up another episode of the David Vs. Goliath podcast. Thank you again, Stan, and have a great day.

Always enjoy it, Matt.

💡 Meet Your Hosts 💡

Name Matthew A. Dolman, Esq.

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. 

Connect: LinkedIn | Twitter | Instagram 

Name Stanley Gipe, Esq.

Title: Partner and Head of Litigation at Dolman Law Group Accident Injury Lawyers, PA

Specialty: Stan is a Florida Board Certified Civil Trial Lawyer. This distinction connotes expertise in the discipline of trial practice. He has served as lead counsel on over 1,000 Florida personal injury lawsuits.

🔑 Relevant Resources 🔑

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.