The minimum liability insurance required for large trucks in interstate commerce was set at $750,000 forty years ago in 1981 at the beginning of the Reagan Administration. Everything else has gotten more expensive in the past forty years. Nothing costs the same since then–not the truck, the repairs, the gas, or the tolls, so it is completely unrealistic for the truckers to have the same insurance as they did forty years ago.

If adjusted for the Consumer Price Index, it would be $2,203,415.84 today. People who are injured by trucking negligence need to pay their medical bills so trucking safety

Property insurance policies typically include provisions that the policyholder must cooperate in investigation and adjustment. This includes an examination under oath (EUO) — answering a lot of questions from the insurance company’s lawyer. Failure of the policyholder to submit to the examination may preclude even an innocent insured from any recovery under the insurance contract.

Policyholders who represent themselves against insurance company lawyers make fatal errors.

Generally insurance companies may impose almost any conditions upon their obligations so long as they are not inconsistent with public policy.  An insured cannot avoid the binding effect by neglecting to read the insurance

child carseatEvery summer there are far too many instances of children dying when left in a hot vehicle. One such tragedy involving a child care center without adequate insurance led to a claim against a city government for negligent licensing of the child care center.

Many child care centers in Georgia have no liability insurance because child care centers in Georgia are not required to carry any specific amount of liability insurance. The regulations governing Family Child Care Learning Homes require only “notification of the absence of a liability insurance policy sufficient to protect its clients,” though the amount of

Depositphotos_15861431_s-300x199Uninsured / Underinsured Motorist (UM/UIM) insurance coverage exists to cover your damages when you are injured due to the negligence of another motorist who has little or no insurance. Whenever we meet with a new client who was injured in a car wreck, we review all the auto insurance policies in the household to determine what UM/UIM coverages may be available.

Sometimes that is a big deal. For example, we had a case recently in which the at-fault driver only had the minimum $25,000 liability coverage but out client had $50,000 excess UM/UIM coverage on five vehicles covered under separate

If we have a nearly unique niche in our law practice it is the search for vastly more insurance for catastrophic truck crash cases where the visible insurance coverage is terribly inadequate. Other law firms — in Georgia and elsewhere — call us in to handle that part of a wrongful death or catastrophic personal injury case resulting from a tractor trailer crash.

Alchemist-Cropped

The approaches to finding significant additional insurance coverage are not really legal alchemy or voodoo.  But they do involve a critical knowledge of subtle complexity gathered over 38 years in law practice that does not appear in

hold hands

The “laying on of hands” can resonate powerfully. In my background, it has spiritual and theological implications as a ritual of blessing or of healing. Can this and other senses beyond sight and hearing also be part of legitimate trial advocacy in conveying truth to jurors?

The Georgia Court of Appeals recently said yes in the context of a case where two experts disagreed on whether there was a difference in temperature of the hands of a plaintiff who had a diagnosis of complex regional pain syndrome (also known as reflex sympathetic dystrophy), due to medical malpractice.

emergency room

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Clients who have been injured often express concern about their medical bills showing up on credit reports, harming prospects for major purchases, credit cards, employment and even security clearances in their work.

Anyone looking for a job, applying for a mortgage or car loan, renting an apartment, getting a cell phone, or seeking a new or renewed credit card can be affected. Those who work in sensitive roles in the financial services industry and in jobs requiring national security clearances have additional headaches when medical bills that remain unpaid pending a

Georgia law allows a plaintiff in a civil lawsuit one chance to dismiss without prejudice and refile. The renewal statute, OCGA § 9–2–61, allows a plaintiff who voluntarily dismisses a timely filed suit to file suit within six months, regardless of whether the statute of limitations has run.

However, a case decided by the Georgia Court of Appeals on May 26, 2012 reveals a trap door for the unwary in the exercise of this right. Cox v. Progressive Bayside Ins. Co., __ Ga. App. __, __ S.E.2d __, 2012 WL 1860704 (Ga.App., 2012).

In that case, Cox filed suit

One of the biggest headaches today in representing senior citizens in personal injury cases is the Medicare Secondary Payer Act.  Whenever Medicare has paid for treatment, or may in the future pay for any treatment even tangentially related, it may demand repayment out of a personal injury settlement. So far, so good, at least in abstract theory.
 
In practice, however, the system is absolutely riddled with inefficiency. While Medicare’s contract with its sole source recovery contractor, Chickasaw Nations Industries, calls for providing a "conditional payment letter" within 30 days after request, that does not happen. We have had cases where it took 6 to 12 months to get the "conditional payment" number from them, and even then it is not a reliable number.
 
Legislation now pending in Congress, HR 4796, the Medicare Secondary Payer Enhancement Act of 2010 would correct this problem by requiring the Center for Medicare Services (CMS) to respond to requests for their lien amount within 60 days. Self-funded by a $30 application fee, this bill costs the taxpayers nothing, and it has the broad support of coalitions in insurance, large businesses and plaintiffs’ trial lawyers, all of whom have been frustrated by the inefficiency of the current system. The bill may not be perfect, but it is a vast improvement over the current mess.
 
The Medicare Secondary Payer system at present makes it extremely difficult to reasonably settle cases and impairs access to justice by making it uneconomical for lawyers to represent seniors on Medicare in injury cases. HR 4796 should be passed.
 

Injury victims who are even close to being old enough to become Medicare beneficiaries are currently victims of a Kafkaesque nightmare than adds insult to injury and interminable bureaucratic delay to the delays already involved in the court system.

The Medicare Secondary Payer (MSP) system was intended to ensure that Medicare does not pay for health care services when a third party-for example, a group health or workers’ compensation plan-has primary responsibility. However, I cannot believe that anyone who ever spent a day litigating on either side of personal injury cases had any voice in designing the system.

The current MSP system is unwieldy and impossibly sluggish. It makes it difficult to obtain reliable verification of the amount of a Medicare lien and retains antiquated procedures for communicating with the Medicare bureaucracy, meaning delayed justice for plaintiffs and delayed payback of Medicare benefits to the government. Moreover, if a party responsible for repaying funds to Medicare disagrees with bureaucrat’s calculation, the appeals process is slow, arcane and obscure. (We won one of those administrative appeals last year, but it took forever.)

As a result, plaintiff lawyers sometimes must delay settlement negotiations and routinely hold settlement funds in escrow for many months and even years while attempting to verify and resolve Medicare liens. In some cases, Medicare has demanded additional reimbursement after a case has been settled and funds have been distributed.

Personally, I have cases where we have been waiting over a year after a liability settlement for Medicare to say how much a client must reimburse. In one case, we wrote to the Medicare office that handles the initial requests for information last December and still have not even received a response despite numerous phone calls in which we had to sit on hold for an hour or more before getting a nonresponsive clerk who could not tell us anything except to check back in a few weeks.

There has to be a better way.  The Medicare Advocacy Recovery Coalition (MARC) is working on legislation that would solve many of the recurring problems with the MSP system. MARC’s broad-based membership includes major insurers, large corporations, consumer advocates and trial lawyers.  This coalition is supporting the Medicare Secondary Payer Enhancement Act (MSPEA), which will streamline and expedite MSP procedures and provide some certainty that will benefit all involved in resolving third-party liability claims.

The MSPEA (H.R. 4796), which enjoys bipartisan sponsorship, would establish a workable procedure for parties to determine how much is owed to Medicare before a case is settled, create a right of appeal for parties who disagree with CMS’s calculation of the amount due, and establish a reasonable period of limitations. One notable feature: Plaintiffs may calculate the amount they believe is due, and Medicare will have 75 days to appeal that calculation. Or plaintiffs may request a final reimbursement amount, and CMS will have only 60 days to respond or lose its right to reimbursement.

This makes all kinds of sense. It would enable us to handle Medicare reimbursement essentially as we did prior to the past year and a half.  Even though it involved "coloring outside the lines" I would routinely calculate the amount owed to reimburse Medicare, and send them a letter with the calculation and a check. Six months later I would get a letter scolding me for not getting the official number from Medicare first, and a couple of years later I would get a second letter accepting my number. Now they say that if I don’t follow an incredibly slow bureaucratic procedure — by which time the client may be dead of old age — I am subject to draconian personal consequences.

On a related front, there remains considerable confusion and misinformation concerning set-aside requirements for third-party liability claims under §111 of the MSP Act. Many insurers and defendants erroneously require set-asides as a condition of payment. This misinformation has the effect of impossibly delaying settlements for senior citizens who are injured and have legitimate claims.