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Understanding the Different Facets of Personal Injury

When you or a loved one have suffered from a personal injury, it is easy to feel overwhelmed and not to know where to turn for help. Oftentimes turning to friends or family members for answers to questions or assistance is a natural first response. However, because your legal rights may be impacted by the decisions made in the immediate aftermath of an injury, it is also important to speak to an attorney who specializes in personal injury. You may have questions such as:

  • Who will pay for my medical bills?
  • What type of doctor do I need to see?
  • How can I make sure all of the evidence related to my injury is preserved and not lost or destroyed?

At Michles & Booth, we specialize in helping individuals who have been injured due to the negligence of another. Whether your injury took place at work, on the road, or in the doctor’s office, we may be able to help.

What should I do first?

The first and most important thing to do when you have suffered a serious injury is to seek the medical evaluation and treatment you need. Depending on the type of injury, you may need to seek emergency treatment, therapeutic or rehabilitative treatment, or even evaluation with a surgeon.

Unfortunately, some physicians restrict what types of patients they will see. For example, in Florida many primary care physicians will not offer treatment to patients for injuries sustained in a motor vehicle accident because of the unique insurance billing and reimbursement requirements.

Who will pay for my medical treatment? 

One of the most common questions I receive from prospective and new clients is: “Who will pay for the medical treatment I need?” The answer, or course, depends on each individual’s situation. If you have been injured on the job, assuming your employer has worker’s compensation coverage, you will likely be able to receive treatment through that system, no matter who was at fault in causing the accident.

If you have been injured in a motor vehicle accident, your situation will be different. Assuming you have a Florida Auto Insurance Policy, your own Personal Injury Protection (PIP) coverage will be the initial primary payer. Even if you don’t have automobile insurance, you may be eligible to claim PIP benefits under someone else’s, such as a resident relative or the driver of the vehicle you were a passenger in.

PIP coverage, however, is limited and will only pay at a rate of 80% for up to $10,000 of treatment. This means you may be responsible for the remaining 20% as well as any deductible on your PIP coverage. Ultimately you may be entitled to recover compensation for those charges from either the at-fault party’s Bodily Injury policy or your own Uninsured Motorist policy.

If you have medical insurance, they may pay for medical treatment you receive after an injury as well. It comes as a surprise to most individuals that their health insurance company almost always has a right to be reimbursed for benefits paid out as the result of a third party’s negligence. This is called a right of subrogation. Depending on whether the health insurance is self-funded, qualified under ERISA, or a federally administered program can have important consequences on the negotiability of their rights. In other words, some plans are able to offer discounts on the amount to be repaid while others are not. Obtaining detailed information about the medical insurance plan is an important step in any personal injury case, as is not simply taking the plan’s word for a conclusion on their legal status.

Get answers to your questions.

At Michles & Booth we have successfully saved significant portions of our client’s net settlement proceeds from being paid to health insurance plans that improperly claim a designation that is more favorable to them without proper justification. If you or a loved one has questions after having been injured, please do not hesitate to contact our office for a complimentary consultation.

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