FAQs About Personal Injury Claims

       For informational purposes only. Always consult an attorney to obtain competent legal advice.

 
 
 
 
 

What is a Personal Injury Claim Worth?

  • Generally, a personal injury claim with a “closed period” of disability (meaning no permanent injury) can be evaluated by adding up the total charges for medical expenses, adding an amount for pain and suffering for each week or month of medical treatment, and adding any loss wages or other damages that can be proven.

Minor Personal Injury Claim:

  • A relatively minor personal injury, for example, a low impact, rear-end automobile collision in which the injured party suffered whiplash-type injuries that lasted for a few months. The injured party may have lost a few days from work immediately after the accident, and had an emergency room visit followed by follow-up medical treatments for a period of a few months before being discharged. Total medical expenses (whether or not covered by health insurance) could be $5,000; loss wages for weeks that the injured party was given a doctor's disability note could be a $1,000, and an allowance for pain and suffering during the treatment period could be $500 to $1000 per month. 

  • Generally, the more serious the symptoms, the longer the treatment period, and the greater the loss wages and benefits, the greater the claim value.

 

Major Personal Injury Claim:

  • An example of a major personal injury claim is where the victim sustained serious personal injuries, such as a brain injurypermanent lower back injury (for example, resulting from a high impact, rear-end car accident); loss of a limb; a permanent impairment; severe scarring; etc.

  • Other components of a major personal injury claim can include substantial loss wages, the cost of homecare workers, past and future medical treatments and medications. If properly proven, such a claim would be expected to result in a substantial settlement or award.

 

Wrongful Death Claim:

  • This is where the negligence of an at-fault party causes the death of a person. Evaluating such a claim involves retaining an expert to calculate the deceased person’s damages based upon expected lifetime income minus expected lifetime expenses

  • Other damages may be added as well, such as medical expenses, pain and suffering (if the death was not instantaneous) and loss of consortium if the decedent had a spouse and/or minor children.

  • Regardless of the amount calculated for any Wrongful Death claim, under Rhode Island law the minimum amount of damages for Wrongful Death is $250,000.

 

Catastrophic Injury Claim:

  • A catastrophic injury claim can result in even higher damages than a Wrongful Death case because victims of catastrophic injuries often require extraordinary lifetime medical care. In such a case, the cost of this care must be calculated by an expert. In addition, all other personal injury damages -- such as loss wages, pain and suffering, medical expenses, and loss of consortium  -- are added as well.

  • Medical malpractice claims are a major source of catastrophic injuries, as are automobile and motorcycle accidents, and work place accidents.

 

Permanent Injury Claim:

  • Personal injuries are deemed permanent when the injured person will suffer from the injuries for the remainder of his or her life. Therefore, even if the permanent injury is not great -- for example, a slight loss of use of a non-dominant hand -- the period of injury is for that person’s expected lifetime. Thus, permanent personal injuries, when properly established, can greatly increase the settlement or verdict value of any claim.  

What Do I Do if I Am Injured?

  • Obtain medical treatment and legal advice immediately. Often the shock of being in an accident will mask some or all of the pain at first. Don’t assume you haven’t been injured as the shock will soon wear off. The safest procedure is to be taken by rescue directly to an emergency room, or to go directly to a local emergency care facility.

  • Always speak to an attorney prior to speaking to any insurance company adjuster. Insurance company adjusters -- even the adjuster of your own insurance company -- work for the insurance company and are primarily trying to extract information that will reduce any future payout of benefits. The adjuster's role is to be friendly over the phone and encourage you to make statements. Those statements can be misconstrued and even used against you in the future. Thus, it is good practice to contact your attorney before making any statement to any insurance company representative

  • Delay in contacting a personal injury attorney can also result in important information about the accident and/or your injuries being lost or mishandled.

Steps of a Personal Injury Claim:

The typical process in which an attorney proves a personal injury claim includes: 

  • Obtaining Information:  Including accident report, statements, pictures of injuries and vehicle damage, contacting witnesses, etc.

  • Determining all insurance coverage: This requires not only investigation of the at-fault driver’s coverage, but also the coverage of any injured party -- whether driver, passenger, or pedestrian -- and even any coverage of persons living in the same household as the injured party. (Non-lawyers often underestimate the amount of insurance coverage available to pay a claim.)

  • Protect Client:  Send a letter of representation to all insurance companies involved, including the client’s insurance company. This ensures that client will not be contacted and questioned by any insurance company representative and/or the at-fault party at any time.

  • Obtain Medical Treatment History:  Keep track of all doctors and medical providers that treated the client for any injuries, obtain complete medical and billing records to prove all injuries, and obtain loss wage records from any employers.

  • Prepare Settlement Package:  When appropriate, advise the client as to the probable claim value and obtain permission from the client to make a settlement demand; prepare and send the settlement demand package; negotiate settlement of client’s claims; always notify client of any offers of settlement. Never settle a claim for any amount that was not approved by the client.

  • Resolve Medical Liens:  Negotiate amount of liens for client’s medical expenses that will need to be paid from the client’s settlement amount, so that the client keeps more of his or her settlement proceeds.

  • File Lawsuit to Protect Client's Interests:  If necessary, file personal injury lawsuit in the appropriate court within time allowed by law. Thereafter, prepare client and client’s claims for mediation or arbitration hearing and/or trial. 

Important Tips for a Victim of a Personal Injury:

  • Avoid providing the insurance company with reasons to withhold fair payment for your injuries. For example, avoid “gaps in treatment”. Keep going to treatments until your doctor(s) determine that you can be safely discharged from care. Do this even if your doctor is only monitoring your symptoms. This is important to protect your health and also to establish a complete medical record of your injuries.

  • Don’t cancel a doctor’s visit. If you can’t make the visit, reschedule the visit for the nearest date. Cancellations are red flags to insurance company adjusters.

  • Always be sure to fully explain your symptoms to your doctor and other medical providers, such as the severity, type and location of pain, limitations in movement, or limitations in activities that were caused by your injuries. Being totally clear with your doctor is the best way to ensure that you will receive proper medical care and to ensure that your medical records will contain a full description of your symptoms. When being treated by any medical provider, always remember that your medical records are what will ultimately determine the value of your claim for injuries.

  • To ensure that your medical records accurately reflect the symptoms of your injuries, be careful in how you state your symptoms to your doctors. For example, if you tell your doctor at a follow-up visit that you “feel better” without explaining that that you are still experiencing symptoms, your doctor may assume you are fully recovered and note this in your medical records. Always remember that what you tell your doctor can end up in your medical records and will eventually be reviewed by insurance company experts whose job it is to find any language that may be used to minimize a settlement amount. Words like “feels better” are ambiguous and can be taken to mean a complete recovery, even if not intended that way. Think carefully about what you will tell your doctor prior to your visit and always fully explain your ongoing symptoms.

  • A proven method of obtaining optimal medical care for your injuries is to keep a journal or notebook of your injury symptoms. You can include the date, the symptoms you experienced, the severity of the symptoms, any limitations in movement or activities caused by the symptoms, etc. You can then review your notes prior to each doctor visit so that you will remember what to tell your doctor. The more information you provide your treating physicians, the better your chances of receiving optimal care and treatment.

  • Always provide your doctor and other medical providers with accurate and complete information about your symptoms. The treatment they prescribe will be based upon what you tell them. 

Other Personal Injury FAQs:

Will I have to pay for medical treatments out of my own pocket?

  • There are usually sources available to an injured party to pay for necessary medical treatments resulting from an accident. Medical insurance is an obvious source. Also, if the injury was the result of an auto accident, the injured party usually has "Medical Payments" or "Personal Injury Protection" (PIP) coverage on their auto insurance policy.

  • Even in the event that such coverage is lacking, many doctors will render medical services without up-front payment as long as the patient signs a medical lien that authorizes the patient’s lawyer to pay the doctor out of any settlement proceeds. If you have an attorney, always have your attorney review any lien form before you sign it. In fact, it is best to have your doctor’s office contact your attorney directly so that the lien form can be sent via fax or email directly to your lawyer to avoid delay in treatment.

  • Also, in regard to medical liens, be aware that some doctors will not accept any reimbursement amount from your medical insurance as full payment for medical services, and will demand payment of the balance of charges not covered by medical insurance from your settlement proceeds. Most doctors do not engage in this “balance billing” practice but some do. If there is any question about the medical lien your doctor is asking you to sign, always consult with your attorney, even if you have already had one or more treatments with the doctor.

 

How are personal injury claims resolved?

  • Over 95% of all personal injury claims in Rhode Island will be resolved without a courtroom trial.

  • In fact, most personal injury claims will be settled without the filing of a lawsuit. Even if a lawsuit is filed, most claims will be resolved through either settlement, mediation or arbitration, prior to trial. 

 

What’s the difference between settlement, mediation, arbitration and trial?

  • In either case, your attorney must prepare the case by getting copies of all medical records, prescription drug records, reports, pictures, statements, loss wage records, and any other exhibits that will enhance the value of the client’s claim. Also, the attorney must arrange for any witness testimony. If need be, the attorney must also obtain the testimony of one or more doctors or expert witnesses.

  • Trials, on the other hand, are conducted in courtrooms, often in front of a jury, and can be time-consuming. In contrast, settlement does not require any hearing; and arbitration or mediation hearings are conducted in an attorney’s office at a prescribed date and time and without a jury. Thus, when settlement of a claim cannot be reached, mediation and arbitration have become the cost-effective way for both claimants and insurance companies to resolve most personal injury claims.

  • However, a jury trial is always an option to be considered as a last resort, especially if an insurance company is refusing to pay fair value for the claim.