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Double or Triple Recovery

On the page below you can find links to videos provided by Shapiro, Cooper Lewis & Appleton, P.C..

Hi my name is Emily Brannon and I am going to explain how you can make a double or triple recovery in your personal injury claim.  

Let’s go through a hypothetical.  Joe Smith is sitting at a stop light when another driver runs a red light and rear ends him.  In this case, the defendant is clearly at fault or to put it into legal terms, the defendant is clearly liable for the accident.  Liable means that the defendant is responsible for Joe’s bodily injury, wage loss, property damage and pain and suffering.  As long as the defendant driver has adequate liability insurance on his car, Joe will be able to recover from the policy.  This is avenue for recovery number one.

Now let’s go back.  When Joe went to the hospital and his various other health care providers, he used his health insurance card to pay for the visits.  Joe might have a copay or deductible but generally speaking, his health insurance covered the bill.  Remember, the defendant is responsible for Joe’s bills so now, Joe has recovered twice.  His bills have been paid by insurance and he still gets to recover from the defendant later.  Bear in mind that in Virginia like many other states, most health insurance plans do not qualify for repayment or “subrogation” rights.  In order for a health insurance plan to qualify for reimbursement, they must fall under the purview of a very tricky federal statute known as ERISA.  I won’t bore you with the details of ERISA.  Just know that you must meet certain criteria to qualify under ERISA and if the insurance company doesn’t, then they don’t get to recover.  This means that if you have a competent attorney she will confirm that you do not have to reimburse your health insurance company right off the bat.  When it comes time to settle your case, you get to claim the total amount of the charges, irregardless of insurance.  This is avenue 2 for recovery.

Lastly and possibly the least known is medical expense benefit coverage or “medpay”.  Back to our hypothetical, Joe the savvy consumer that he is, listened to a wise personal injury attorney who told him to make sure he carries med pay coverage on his own auto insurance policy.  Med pay is an additional coverage that you purchase on your automobile insurance policy.  The insurance companies don’t advertise med pay for one obvious reason, it’s a great benefit to you and not so great for them.  You can add it as easily as adding rental car coverage.  This coverage will provide reimbursement for medical expenses and wage loss up to the amount you purchase.  So in our scenario, Joe has $5,000 in med pay.  It’s also stackable so if Joe has three cars on his policy, he can collect up to $15,000 in med pay.  He goes to his various doctors and incurs medical bills as a result of the defendant’s negligence.  He uses his health insurance plan to cover the bills up front.  The bills get submitted to his med pay carrier and he receives a check in the amount of the bills.  Lastly, when he is finished treating, his attorney submits a demand package to the insurance company for the defendant and recovers Joe’s medical bills, wage loss, property damage and pain and suffering.  Alas, Joe has recovered three times for his injury, health insurance, med pay and defendant’s liability coverage.  
 

It is important to choose an attorney that knows to look for all possible means of recovery.  As I already told you, Joe is a savvy consumer.  He asks lots of questions and knows that there are certain things he doesn’t know how to handle.  That’s why he hires an attorney at Shapiro, Cooper, Lewis and Appleton.  

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