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Collateral Source Rule: Why Your Personal Injury Settlement is Not Valued on Co-Pays

Inevitably I will have clients that  make the poor decision to try and work things out with the at fault party’s insurance adjuster, thinking the at fault insurance company would “do the right thing.”

As I have written in the past on “How Do Insurance Companies Make Money?” & since copyrighted my favorite quote:

“Would you listen to the devil on how to get to Heaven? Then why do you listen to insurance companies on how to settle claims against them?” –Trey Mills

Having only practiced close to seven (7) years doing 100% personal injury,  it is hard not to be cynical and disbelieving of anything insurance companies do or say. As an attorney I am held to a higher standard legally and ethically but for some reason the insurance adjuster can dispense false “legal advice” with no consequences. Most times what you say, can not be proven. Always ask for what the insurance adjusters tell you in writing.

Therefore, when the insurance company offers to pay your medical bills at what you paid in co-pays or reduced costs because you are fortunate to have health or supplemental insurance THEY ARE TRYING TO TAKE ADVANTAGE OF YOU.

In South Carolina the law states: The collateral source rule provides “that compensation received by an injured party from a source wholly independent of the wrongdoer will not reduce the damages owed by the wrongdoer.” Citizens and S. Natl. Bank of South Carolina v. Gregory, 320 S.C. 90, 92, 463 S.E.2d 317, 318 (1995).  A tortfeasor (at fault party) cannot “take advantage of a contract between an injured party and a third person, no matter whether the source of the funds received is `an insurance company, an employer, a family member, or other source.’” Pustaver v. Gooden, 350 S.C. 409, 413, 566 S.E.2d 199, 201 (Ct.App.2002) (citations omitted).

Stop being scammed by the insurance companies and start seeking out legal advice from lawyers. It costs you nothing to sit down and talk with most personal injury lawyers about your issues. Yes, if they take the case it will most times be taken on a contingency fee basis whereby they receive a percentage of the settlement they achieve for you. It’s a symbiotic relationship.

Do yourself a favor and ask these two questions before you settle your insurance claim:

  1. Would you rather have someone working for you, ie attorney, or someone working against you, ie insuranceadjuster?
  2. Do you think the insurance adjuster gets paid a bonus and/or receives a raise at the end of the year for paying out more money on claims, or paying out less money in claims?

To ensure the value of your settlement is reasonable and commensurate with your losses and harms, or damages, please consult with a personal injury attorney. You can contact us or find out more about us on Facebook.

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Accidents Happen But Insurance Companies are Created

I have always enjoyed reading, watching, and listening to various recounts of historical information on a wide range of topics. Wikipedia is a scary resource given the ease of access and also in creating of the history online. However, for broad strokes and a general overview it has proven quite resourceful.

  • Did you know that insurance has been around in some form since humans have gathered together in communities, or societies?
  • The form of insurance as we know it culminated as a result of the mercantile trade along treacherous rivers and oceans where the chance of loss was great, thus if a merchant received a loan on the shipment they would pay the lender additional monies to cancel the loan if the shipment was lost or stolen.
  • Did you know the first insurance company in America was created here in CharlestonSouth Carolina?

I won’t bore you anymore with history but just as we have advanced as humans, so to have our societies (at least in most parts of the world), and thus our businesses, or economies.

As stated in one of many lessons learned in Sun Tzu’s, Art of War:

It is said that if you know your enemies and know yourself, you will not be imperilled in a hundred battles; if you do not know your enemies but do know yourself, you will win one and lose one; if you do not know your enemies nor yourself, you will be imperilled in every single battle.

Therefore, I try to learn as much as I can about insurance companies and convey that knowledge the best I can to clients that come in with questions.  Those questions mainly consist of:

  • trying to understand how their insurance company can treat them so poorly after they have religiously paid their premiums without ever having an insurance claim;
  • trying to understand how the insurance company of the negligent, ignorant, or omitting party, will not provide them a fair amount for the injuries, troubles, and ordeals they have experienced through no fault of their own; and/or
  • why the insurance company will not call them back or appreciate what they have had to experience and instead treats them disrespectfully or with disdain.

Well, it is very simple. It’s about money. The money insurance companies want to save by minimizing the payout on your injury, property, and/or life insurance claim. Simply stated insurance companies make money two ways:

  1. Through underwriting, the process by which insurers select the risks to insure and decide how much in premiums to charge for accepting those risks;
  2. By investingthe premiums they collect from insured parties.

The whole insurance business model is summed up succinctly as such:

 to collect more in premium and investment income than is paid out in losses

Your injury, or insurance, claim is the loss being referred to above. What the at fault party’s insurance company pays you cuts directly into their bottom line and therefore the less they can get out of paying your claim, the more they can invest in those really complicated structured asset backed securities, or CDO’s. You remember the recession was caused by ____? Greed.

And that greed can work both ways, on your extreme valuation or consideration of the fair amount to be paid and the insurance company’s extremely low valuation of your claim-regardless of facts.  Thankfully, advocates and plaintiffs’ attorneys exist to assist you in this eternal struggle of good vs evil. If you had to pay a plaintiff’s attorney the hourly wage the insurance company pays the defense attorneys, or advocates, I doubt you would ever be able to fight a fair battle.

Again we learn from Sun Tzu’s, Art of War:

Thus, what is of supreme importance in war is to attack the enemy’s strategy.

Please consider disrupting the strategy of insurance companies to make profit off of your injuries by low balling, denying, delaying, and defending against what you know is wrong. Just because insurance coverage has almost been made mandatory doesnt mean those same insurance companies have to make millions in profits off of your backs. Rise up and fight, now is your time!

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Workers Compensation Lawyers in Anderson, SC

Why Do You Need a Lawyer for a Workers’ Comp Case?

 

Nobody wants to get hurt while they’re at work. You’re just trying to make money to pay your bills, right? But work injuries do occur, and it’s important for you to know what to do if it happens to you. We at Trammell & Mills Law Firm remind you to remember these three things: report it, seek medical attention, and get legal help to file a workers’ compensation claim.

Work injuries can vary, but some of the most common ones are cuts or lacerations, ligament sprains, muscle or tendon strains, bruising or swelling contusions, burns, eye injuries, bone fractures, and cumulative or continuous trauma. Other work injuries might include slips and falls, vehicle collisions, toxic fumes, or exposure to loud noise. Any of these might cause you to miss work while recovering.

If your injury requires you to go to the hospital immediately, do that first.  Otherwise, you should report your injury to your employer right away, so there will be a record that it happened. Make sure you tell your boss or supervisor, because the word of a co-worker isn’t always enough to prove your case later. You need proper proof you were injured.

Your employer should give you the name of a recommended medical professional where you can get proper evaluation and treatment.  Even if you don’t think it’s that serious, don’t put it off! Failure to report an accident within 90 days may disqualify you from getting workers’ comp benefits.

Your employer should guide you on the paperwork you need to fill out to file for workers’ comp benefits. But be warned—not all employers want to do this. They may be afraid their insurance premiums will go up, or that filing one claim might lead to other employees making claims. You have a legal right to file your claim, so don’t let them drag their feet.

That’s where expert legal guidance from Trammell & Mills can make a difference. We’ll help you push through all the paperwork get authorization for proper medical treatment. And we will fight hard to make sure you get fair compensation for lost income, or for any permanent disability or disfigurement from your injury. We won’t let your employer push you around.

Most properly-filed workers’ comp claim disputes are resolved through an out-of-court settlement with the employer.  Less than 10% are denied.  And about 5% of claim disputes actually go to a court trial. But taking on the legal red tape by yourself can lead to big disappointment…and losing money. Our goal is to make sure you get your medical bills paid for any work injury, and to get any income you’ve lost due to missing work.

Be safe in your workplace, but make sure you know what to do if you get hurt on the job. Let the professionals at Trammell & Mills Law Firm guide you through the workers’ compensation process. We’re local, we’re experienced, and we’re ready to fight for your rights.

Give us a call at (864) 485-8585.

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Workers Compensation Lawyers in Anderson, SC

When Do I Hire an Attorney vs. Handling It Myself?

Through various avenues and referral sources, I often times get some interesting questions about “potential” cases. Lately, I have been looking over my shoulder for the hidden camera or wondering which one of my friends is playing a joke on me. I’m not sure it’s a result of our litigous nature, the dying art of customer service, or people just dont have time to properly deal with issues that arise.

 

So ask yourself these 3 questions to determine if you need a lawyer.

 

1) Are you dealing with an insurance company or adjuster?

YES, you need a lawyer. Insurance companies make money off of the money they don’t pay out in claims. You obviously have a claim and they want to minimize the payout to you regardless of how nice they may initially seem.

-Just ask yourself this: “Would you listen to the devil on how to get to Heaven? Then why would you listen to the insurance adjuster about how to settle a claim against them?”–Trey Mills

 

2) Are you dealing with a rude employee, disgruntled employee, or frontline of a company?

Probably Not. You need to make sure you document whatever the situation may be. Then reach out to the next level of management or ownership. If the wrong, or negligent act, that has been committed on you is not addressed by the next level of management or ownership then you need to determine the damages you have incurred.If those damages are simply hurt feelings and/or pride you don’t need a lawyer. If those damages are monetary and amount to more than a few thousand dollars then you may need a lawyer. If those damages are less than a few thousand dollars you may have alternative routes such as Magistrate Court, or Small Claims court. (Charleston County has online FAQs) You do not need a lawyer to represent you in Magistrate Court in South Carolina, or most states. Think Judge Judy but less dramatic, not on television, and not as timely.

 

3) Are you trying to pursue a wrong from a company or person that has no assets, money, or insurance because “it just ain’t right?” 

Probably not. You have certainly heard of the term, “You can’t get blood out of a turnip.” If not click on the previous link and don’t tell anyone you didnt know that. When I question the viability of a case or know that there is little to be gained from it, I request a retainer fee. That fee may very depending upon the case but it is usually at least $5,000.00. Are you willing to spend that much money to pursue your case? If not, then you don’t need a lawyer.

When you have performed this quick 3 step analysis and determined you need a lawyer, reach out to one. We don’t bite.

We represent clients  that have been injured at work, in wrecks, dog bites, slip and falls, nursing home abuse cases, and product liability claims arising out of South Carolina and Georgia.  Call us toll free at 1-800-483-0880, contact us on Facebook, Twitter, or just stop by. We offer free consultations to determine if we can assist with your legal needs.