FREQUENTLY ASKED QUESTIONS
Our attorneys constantly review the law for changes.
A. A Personal Injury (PI) is any physical or mental injury to a person as a result of someone's negligence or harmful act. Many insurance companies refer to Personal Injury as Bodily Injury (BI).
A. No. Auto accidents are the most common type of Personal Injury recognized by the general public. Along with auto accidents, Personal Injury law also includes home accidents, boat accidents, airplane crashes, dog bites, defective products, failure to provide adequate security, and malpractice, including the failure to diagnose ?to name a few.
A. The most important thing is to get well - see your doctor & follow your doctor's orders.
Do not discuss the accident or give a statement to the insurance company or attorney for the "at-fault" driver. Remember: "What You Say Can and Will Be Used Against You!" Instruct them to call your insurance company or your attorney.
Call an attorney to discuss your claim. Most attorneys do not charge for an initial consultation in accident cases.
A. Do not speak with the adjuster. Refer the adjuster to your insurance company or attorney. Also, do not speak with the attorney for the "at-fault" driver.
A. Initially, the adjuster may tell you the reason for the call is to conduct a preliminary investigation. At that time, the adjuster may attempt to sound like your friend and even offer to pay your medical bills, which is an indication that the insurance company believes it is liable for an even larger payment to you. If this happens, the adjuster's real purpose is to convince you to settle your claim for a modest amount of money before you know how seriously you were injured. The insurance company may ask you to sign a Release. Unless you are ready to close your claim, DO NOT SIGN THE RELEASE.
A. Get the name and phone of the attorney. Report the attorney to the Bar Association or licensing authority in your state in your state. It is an ethical violation for an attorney to solicit accident victims. Click here for a list of state agencies.
A. Get the name and phone of the health care professional. Report that health care professional to his or her licensing association in your state.
A. Protect your rights. Call a lawyer. Get a professional opinion. You have nothing to lose. Most attorneys do not charge for an initial consultation in Personal Injury cases.
A. Most Personal Injury claims do not become lawsuits. After you are fully recovered from your injuries, your attorney will file a claim with the insurance company. In most cases your attorney (with your approval) and the adjuster negotiate a fair monetary settlement for your injuries.
A. Damages are any loses or expenses you incurred as a result of the accident.
A. Personal Injury Victims are entitled to recover money damages for all losses and expenses they incur as a result of an accident. The following is a partial list.
- Medical bills (doctor bills, hospital bills, surgery expenses, diagnostic charges, physical therapy, personal care nursing fees, prescription medicines, and others),
- Lost Wages, including overtime,
- Pain & Suffering,
- Physical Disability,
- Permanent Scars
- Emotional Trauma,
- Mental Anguish,
- Loss of Enjoyment,
- Loss of Love & Affection,
- Mental Disability,
- Property Damage,
- All out of pocket expenses (transportation charges, house cleaning, grass cutting, and others).
A. Whether a Personal Injury claim (a "tort") exists is a matter of law. There are four elements to a "tort" claim:
- The "at-fault" person is under a duty to do or not to do something,
- The "at-fault" person breaches that duty,
- You suffer Damages, and
- Your Damages are the result of the "at-fault" person's actions.
A. No. In fact, most Personal Injury claims are settled with the insurance carrier for the "at-fault" party.
A. No. It is your responsibility to handle your medical bills.
A. Depending on state law and the type of insurance coverage in your policy, your medical bills can be paid under your Personal Injury Protection (PIP) coverage, your Medical Payments coverage (MPC), your health insurance coverage, or your Worker's Compensation plan, if applicable. Although under most policies providing these types of coverage, the insurance company is entitled to reimbursement from the settlement funds of your Personal Injury claim for the medical expenses actually paid on your behalf. For people with no insurance and who are unable to pay for medical services, if prior arrangements are made, there are doctors, hospitals, and other medical facilities that will agree to be paid out of settlement. Generally, you will be required to sign a lien against your settlement funds.
A. No. Lost Wages are processed thru your No Fault claim.
A. Depending on state law and the type of insurance coverage in your policy, your Lost Wages may be covered under your Personal Injury Protection (PIP) coverage. Also, if you qualify, you may file a claim for short-term or long-term disability under your employer's disability coverage.
A. Remember: You are in shock and your adrenaline is doing its job by working to cover up the pain of your accident trauma. This is normal.
A. At the scene, you may not feel injured. Many people begin to feel the pain later. Although you may not believe that you were seriously injured, you may feel pain later, including significant pain, when the emergency is over. See a doctor for a complete examination and treatment as soon as possible.
A. If you are "sore", you are probably hurt. Consult your doctor. If you simply "tough-it-out" and do not see your doctor, you give the insurance company the ability to deny that you were injured in the accident.
A. You do not have to go to your primary care physician for treatment. You can go to a chiropractor, acupuncturist, or other health care professional.
A. Unfortunately there are adjusters who view chiropractors, acupuncturists, and other alternative health care professionals in a less favorable light than MD's. However, going to an MD is not a requirement for filing a valid Personal Injury claim. The most important factor is that you to go to the healing practitioner you believe will have the greatest success treating your injuries. Remember: Your job is to get well. The most important thing for you to do is recover from your injuries as quickly as possible so that you can return to your normal life.
A. In most Personal Injury cases, an attorney will accept a case on a contingent fee basis.
A. A fee is contingent when it is conditioned upon your attorney's successfully resolution of your case. And is often referred to as: "No fee unless you win." However, the client is generally responsible for the "out-of-pocket" costs of litigation. A Contingent Fee is paid as a percentage of your monetary recovery (either settlement or court award).
A. In Personal Injury cases the general fee is 33 1/3% if your case is settled Most state Bar Associations require that you and your attorney enter into a written Employment Agreement. The agreement must set forth the Contingent Fee percentage in your case in the event of settlement, trial, or appeal, whether litigation expenses are to be deducted from the settlement funds, and if the deduction so to be made before or after the contingent fee is computed. At the closing of your case, the attorney must give you a written Settlement Statement which sets forth the funds collected, the deductions from that amount and the net amount paid to the client.
A. Since rich people can afford to hire any attorney and since poor people have access to free attorneys, a long time ago, our society determined that Contingent Fee agreements provide a fair and just system in which middle Americans are able to hire competent attorneys to represent their interests in difficult legal matters. Contingent Fees insure that all Americans have equal access to our Justice System. Contingent Fees are advantageous to people who have a valid case but do not have the funds to hire an attorney. And Contingent Fees are especially beneficial if there is no recovery.
A. There is no set answer. All cases are different. The more complex the case is the longer it takes to settle. If you have substantial injuries, the longer it will take. The more money there is at stake for the insurance company, the longer it will take. In most cases, the settlement process starts when your doctor releases you from treatment. Assuming your attorney has all of your accident-related records, your claim could be filed with the insurance company in five to ten business days. It may take the adjuster two to four weeks to evaluate your claim and make an initial offer. At this point, it's a matter of both sides negotiating a dollar amount that is reasonable for your case and acceptable to you. If you receive medical treatment for two to four months, it is possible that your claim could be settled within six months.
A. Until all the information on your injuries is available and all the facts of your case are known, the value of your claim is unknown. Attorneys are prohibited by state Bar Association rules from promising that they will obtain a certain amount of money for you. If an Attorney promises you that he or she will win a certain amount of money, report the attorney to the Bar Association in your state. It is an ethical violation for an attorney to predict the outcome of a case as an inducement to you to become a client.
A. Once a settlement is reached, the adjuster is very motivated to close your file and get it off his or her desk. The adjuster will probably mail the Release to your Attorney within 24 hours of an agreement. Some insurance companies send the Release and settlement check at the same time. If this is the case, you can anticipate closing your claim within three to five business days after reaching a settlement agreement. Some insurance companies send the settlement check after the Release is signed and returned to the adjuster. In this case, you can anticipate closing your claim within five to ten business days after reaching a settlement agreement.
A. Call the Property Damage (PD) adjuster with the "at-fault" driver's insurance company who is handling your claim. Do not discuss anything with the adjuster except your Property Damage. Most insurance companies have separate adjusters for the Property Damage claim and the Personal Injury claim. Nevertheless, Remember: "What You Say Can and Will Be Used Against You!" If the adjuster does not have a copy of the Accident Report, fax or mail a copy to the adjuster. After the adjuster admits liability, make arrangements to have your car assessed. If for some reason the adjuster does not admit liability, you will need to file a claim under your policy's Collision coverage.
A. No. Although, it certainly seems very fair. After all, your car will never be the same again. Or, if it is "totaled", you will not be able to get as good a car with the money the insurance company is willing to pay for the value of your car.
A. The duty of the insurance company for the "at-fault" driver is put you back in the place you were in immediately before the accident. You are entitled to have your car repaired to its pre-accident condition or receive its "fair market value".
A. A car is considered a "total" loss if it will cost more to fix it than its "fair market value".
A. Most insurance companies use a service that maintains late model vehicle values. Like, Kelley Blue Book, or Edmunds. Establishing a value for your car is simply using one of the available formulas to compute the value of your car based upon the general condition of your car, its mileage, plus the options and equipment package on your car and other allowed factors.
A. If you've been offered a fair and reasonable price, accept it, find a new car and get on with your life. If you are not satisfied with the insurance company's offer, you must prove to the adjuster that your car deserves a higher valuation. You can get the prices of similar cars from your local newspaper. You can document the value of your car by researching your car's price in an appraisal guide or by checking the price of your car on the Internet At sites like, Kelley Blue Book, or Edmunds. Or you can hire an independent appraiser to value your car. If you and the adjuster are unable to agree upon the value of your car, you will have to sue the "at-fault" driver. However, with all the tools available to value cars, almost all Property Damage claims are settled.
A. You file your claim against your insurance company under your Uninsured Motorist (UM) coverage. For all practical purposes, your insurance company becomes the "at-fault" driver's liability carrier. At that time, think of your insurance company as the "at-fault" driver's company, because it will process your claim like it is the "at-fault" driver's company. Hopefully, you have UM coverage. In the case of a severely injured person who requires extended hospital care, his or her medical bills may be several times the liability limits on the "at-fault" driver's vehicle with average coverage. By some estimates, one in four drivers are uninsured. Everyone should have adequate UM coverage. If the uninsured "at-fault" driver hits a car in which you are the passenger, it is your UM coverage that will handle the claim. If your injuries are significant, it may be possible to "stack" insurance.
A. If you have a claim that is larger than the coverage on the "at-fault" driver's insurance policy, you file your claim against your insurance company under your Underinsured Motorist (UM or UIM) coverage. Hopefully, you have UM/UIM coverage. In the case of a severely injured person who requires extended hospital care, his or her medical bills may be several times the liability limits on the "at-fault" driver's vehicle with average coverage. By some estimates, most vehicles are underinsured. Everyone should have adequate UM/UIM coverage. If the underinsured "at-fault" driver hits a car in which you are the passenger, it is your UM/UIM coverage that will handle the claim. If your injuries are significant, it may be possible to "stack" insurance.
A. Depending on your insurance company's policy language, you may be able to collect insurance money from every family member's car who lives in the same residence with you.
A. Insurance companies spend a lot of money on friendly advertising asking you to think of them as a neighbor you can rely on to lend you a helping hand. The "at-fault" driver's insurance company is very experienced at handling auto accident claims. The adjuster's goal is to settle your claim as cheaply as possible. Unless you are an experienced claims processor, you should hire an Attorney to represent your interests (to be your Advocate).
A. You will be required to sign a GENERAL RELEASE which will state that your settlement is a COMPLETE, FINAL AND IRREVOCABLE SETTLEMENT AND DISPOSITION OF ANY AND ALL CLAIMS, RIGHTS OR DEMANDS OR CAUSES OF ACTION, KNOWN OR UNKNOWN, WHICH YOU MAY HAVE AS A RESULT OF YOUR ACCIDENT (NOTE: both SPOUSES ARE GENERALLY REQUIRES TO SIGN WHEN THE INJURED PARTY IS MARRIED). This means that you will no longer have any claim against the "at-fault" driver, or any potential defendant, or their insurance company as a result of this settlement.
A. The Settlement Check will be made payable to you, your spouse (if applicable) and your attorney. Your attorney will prepare a Settlement Statement. The Settlement Statement will set forth the amount of money collected. From the total collected, your attorney will deduct the agreed upon attorney fee, any unpaid medical bills, any insurance reimbursements (subrogation), and the expenses of litigation. After you sign the Settlement Statement, your attorney will issue a check to you from his or her Trust account in the "net" amount of your settlement.
A. A lot of people believe they have "full coverage" on their cars. Each one of them probably has a different understanding of what "full coverage" means. Generally, all states require that every vehicle on the road have a minimum amount of Liability coverage. Each state sets its own standard with minimum coverage generally beginning at 25/50/25. Some people only have "Liability" coverage, which they may incorrectly believe to be "full coverage" because their agent told them you are fully covered under the law. Other people assume that Liability coverage plus some additional coverage is "full coverage". To these people "full coverage" may mean having a little amount of each type of insurance coverage available. Other types of coverage include Collision, Comprehensive, Theft, Towing, Rental, Medical Payments, and Uninsured Motorist, to name a few. Whatever your definition, "full coverage" may not mean full protection.
A. All vehicles do not need all types of insurance coverage. If you have more than one car, you may not need Rental coverage. If you have good health insurance, you may not want Medical Payments coverage. If your car is very old and worth less than 10% of the Collision premium, it may not be a good value to purchase Collision coverage. It is important to get the coverage that is right for you in your circumstance. Talk to your agent. Learn what each coverage buys for you. The important thing is to understand your risk.
A. It means a maximum of $25,000 for any one person who is injured, a maximum or $50,000 for all the people who are injured, and $25,000 for damage to property.
A. As much as you can comfortable afford to buy.
A. It is a good idea to have a minimum of 100/300/50, which means a maximum of $100,000 for any one person who is injured, a maximum or $300,000 for all the people who are injured, and $50,000 for damage to property. If you can afford 250/500/100, it is probably a good buy. For example, if you are the "at-fault" driver in an accident, and you cause someone to be paralyzed for life or even kill someone, $25,000 is not very much coverage. If you are involved in a three-car accident and total a new Lexus and an "almost" new Mercedes, $50,000 property damage coverage may not be enough. Also, get the same amount of Uninsured Motorist (UM) coverage as your Liability coverage. Consider getting an Umbrella Insurance Policy.
A. Even though every state requires that all vehicles be insured, by some estimates, as many as 25% of all private passenger cars and small trucks are uninsured. If you are seriously injured by an uninsured driver, or by a driver with very low coverage, you will be able to make a claim against your own insurance company to take care of your injuries. You are not insuring the "at-fault" driver, you are insuring yourself and your loved ones. High matching UM coverage is a good buy for you and your family.
A. An Umbrella Policy is an insurance policy that provides additional liability coverage above the amount on your car and home (also, boats and airplanes). Generally you are required to carry the maximum amount of coverage available on your cars and home (boats and airplanes) before you can purchase an Umbrella Policy. With an Umbrella Policy you can get liability coverage of One Million Dollars or more. The cost for this additional coverage is modest.
A. "No-fault" insurance, also called Personal Injury Protection (PIP), provides immediate coverage of your medical bills and the medical bills of your passengers no matter who caused the accident. Because coverage is not dependent on who caused the accident, this coverage is called "no-fault". Also, under most "no-fault" or PIP coverage plans, another benefit is that a portion of your lost wages is covered.
A. In this case, you also have a Worker's Compensation claim. Under your Worker's Compensation coverage, your medical bills will be paid. Although under most Worker's Compensation plans, the insurance company is entitled to reimbursement from the settlement funds of your Personal Injury claim for the medical expenses actually paid on your behalf.
A. Yes. The fact that you have a "pre-existing condition" will not prohibit you from recovering from the "at-fault" driver. Your "pre-existing condition" is merely a factor to be considered in resolving your claim. The question is whether the "at-fault" driver aggravated your "pre-existing condition". The "at-fault" driver takes you in whatever condition you are at the time of the accident. The fact that someone else would not have been injured is irrelevant. A person in a weakened condition may actually recover more than an extremely fit person would recover in the same accident.
The hours after a construction accident can be hard to process. Along with serious pain and emotional trauma, you may be worrying about your family, whether or not you’ll be able to work, and how to make ends meet if you need to take time off.
You’ll probably also be faced by pressure from your boss. Your employer is already thinking about the possibility of a workers compensation claim, and whether their rates will rise after you file for benefits.
1. Get Immediate Medical Attention
While it may seem difficult, this is a time for level-headed decision making. Your health is the first priority, so seek medical attention immediately.
If your boss offers you on-site care, accept it graciously, and then go to your own doctor for an independent opinion.
2. Collect Documentation
No matter how you receive care, get copies of any and all documents that your doctors make. These are proof that you were injured, and may go to indicate how severely you were hurt.
In the long run, most successful claims for compensation are built on this sort of evidence.
If you can, collect statements from any witnesses that saw your accident. Write down their names and contact information so an attorney can follow up later.
Take photographs of the scene, if possible. Be sure to get pictures of the hazard that caused your accident, along with some showing the extent of your injuries.
3. Contact An Experienced Attorney
If you need medical attention or time off work to recover, your employer will want you to pay out-of-pocket. At best, they’ll want you to settle for workers comp benefits.
But what if another person’s negligence led to your injuries? You may be eligible to file a personal injury lawsuit. But you’ll never find out unless you contact an attorney.
The construction accident lawyers at IMPACTO LAW, Sheps Law Group, P.C. offer a free consultation to all injured workers in New York & New Jersey Just call (888) NY-LAW 44 or fill out our contact form to speak with an experienced attorney today about your situation. There’s no obligation and no charge. Just the answers you deserve.
4. Resist The Pressure
It is very likely that an insurer’s initial offer will be lower than that to which you are actually entitled.
You may be approached by your employer and their insurance company very quickly. If they offer you a settlement or ask you to sign any documents, contact your lawyer first.
New York State’s Workers’ Compensation Board requires all injured workers to report injuries to their employer within 30 days. If you don’t, you may lose the right to workers comp benefits.
Unfortunately, many workers feel an unjust pressure to bear the pain alone, and work injuries are chronically under-reported. In fact, the New York Times reports that an astounding 66% of all workplace accidents may go completely unreported.
Both Federal and State laws protect you from any and all employer retaliation. If your boss cuts your hours, wages or benefits, they are breaking the law and can be held accountable.
You have the right to legal representation. If your employer’s workers compensation insurance company contacts you, you should tell them that you wish to speak with an attorney first.
You are not legally required to describe your accident, or the events leading up to it, without a lawyer. Any statements you make can be used to reduce or deny your benefits.
Retaining an attorney is the only way to ensure that you receive the compensation and care you deserve.
In New York, every workers compensation policy is required to cover:
These cash benefits are calculated as two-thirds of your average weekly wage. That amount is then multiplied by a percentage representing how disabled you are.
If you are totally disabled, two-thirds of your weekly wage will be multiplied by 100%. If a doctor determines that you are only 50% disabled, you will receive half of that.
You will only receive these cash benefits if you are unable to work for longer than seven days. If you can’t work for longer than 14 days, you may (or may not) receive compensation for the first week.
Workers comp will cover all of the care that directly results from your workplace injury. This coverage includes surgical procedures, prescriptions and diagnostic tests (like X-rays and MRIs).
If you have to take a taxi or public transit to doctor’s appointments, your insurance company must cover the costs, but be sure to save the receipts.
In the event of a worker’s death, surviving dependents are entitled to a weekly cash benefit, equal to two-thirds of the decedent’s weekly wage.
Funeral expenses are also covered, to a maximum of $6,000 in New York City.
Have more questions about New York’s Workers Compensation system? Contact us.
If your employer has not purchased workers compensation insurance to cover the costs of your injury, you have the right to file a lawsuit.
This allows you to demand the full amount of your damages, rather than living under the arbitrary cap set by New York State’s Workers’ Compensation Board.
Workers compensation laws were designed to prevent you from suing your employer. In exchange for that right, all workers were guaranteed insurance coverage to pay for necessary expenses.
But New York is unique. Our labor laws include a statute usually called “the Scaffold Law.” This law gives workers the right to sue their employers for negligence after accidents that involve scaffolds, ladders and any other equipment that raises you above the ground. To learn more about the law, and whether or not you have a case covered by its legal protections, call us Today.
You may also be able to file a “third-party” personal injury lawsuit. Many accidents aren’t caused by an employer’s negligence, but the carelessness of someone else on the jobsite.
Architects, engineers, contractors, independent contractors, subcontractors, even equipment manufacturers can be held legally liable for a worker’s injuries under the right circumstances.
New York State uses a “comparative negligence” rule to determine fault in personal injury cases. In the event that a jury finds both plaintiff and defendant partially responsible for the plaintiff’s injuries, they’ll try to determine how responsible each party was.
If the court finds you 25% liable, and the defendant 75% liable, you will be awarded 75% of the damages you demanded.
New York State’s statute of limitations on personal injury lawsuits is three years after the date of your accident, or after the symptoms of an occupational illness first presented themselves.
After three years, it’s unlikely that a court would even hear your case.
Even successful workers comp claims provide minimal compensation. Necessary medical expenses will be covered, along with a fraction of what you could have made, but that’s about it.
A personal injury lawsuit, on the other hand, allows you to pursue a wider range of damages. The point is to make you “whole,” and return your quality of life to the days before your accident as much as possible. Rather than limping along, you’ll be building the bedrock for a successful future.
Past & Future Medical Expenses
Workers comp forces you to “pay as you go.” For most surgical procedures, you’ll need to seek your insurer’s authorization before hand, and you’ll always be at risk of a denial.
In a personal injury lawsuit, you can seek compensation not only for medical care you’ve already had, but also expenses in the future. With the help of your own, trusted doctors, you can estimate the cost of care for the days, months and years ahead.
These damages typically include procedures, prescriptions, rehabilitation services, along with the costs of living with a disability, like modifying your home to make it wheelchair-accessible.
Lost Wages & Earning Capacity
Workers comp will only reimburse you for a fraction of the wages you’ve lost by being unable to work. And even if you’re permanently disabled, New York only requires insurers to cover your lost earning potential for a maximum of 10 years.
In a civil lawsuit, you can demand the full amount you have lost due to your injury, without exceptions or arbitrary limits. If you are unable to work on an on-going basis, you can pursue compensation that will entirely make up for your lost earning capacity.
Pain & Suffering
Even though you feel it everyday, and it can make life miserable, physical pain doesn’t make it into an insurance company’s calculations.
The vast majority of plaintiffs in successful personal injury lawsuits are awarded damages for “pain and suffering,” which cover the sheer hardship of experiencing pain as well as the psychological effects of a serious accident.
Loss Of Consortium
If your spouse has been adversely affected by your injury, the court may award damages to compensate your loved one for the loss of a relationship’s pleasures and security.
Cases in which the negligence of a defendant is deemed particularly egregious may include “punitive” damages. These awards are meant to punish defendants, and deter similar behavior, rather than make up for a particular loss suffered by a plaintiff.
According to the Center for Justice & Democracy, 5% of all successful civil lawsuits result in the award of punitive damages.
Our construction accident attorneys offer a free initial consultation. After reviewing your case, we’ll help you begin making the best choice for your future.
The personal injury lawyers at IMPACTO Law, Sheps Law Group, P.C. work on a contingency-fee basis. If we win your case, our fees will be paid out of the damages secured in a settlement or verdict. If we don’t win, you pay us nothing.