Serious injury claims have unique issues and concerns. Here is a list of seven things you need to consider when dealing with a serious injury claim.
1. Medical Expenses
Oregon requires medical coverage in all automobile policies, known as Personal Injury Protection. Washington does not. Serious injuries require extensive medical care, and often times, the cost of the initial emergency room visit and transportation to the trauma center will exceed the Personal Injury Protection coverage. Health plans, if available are next in line to pay medical expenses, but absent coverage, obtaining the care you need may be an issue.
2. Lost Income
A serious injury often means a long road to recovery, and a long time off work. Like medical coverage, Oregon auto policies include a disability benefit. However, you must be off work for fourteen days in a row, and the benefit pays only 70% of your average weekley wage. Also, the maximum monthly wage benefit is capped, and may not be enough to meet your monthly personal overhead.
You are also looking at issues with a long term absence from work. The Family Medical Leave Act allows for unpaid time off work for a major medical issue, but the unpaid leave is limited.
3. Lost Earning Capacity
This is a different animal than the past or future lost income. Lost earning capacity refers to the permanent loss of ability to do certain kinds of work. A vocational expert can determine the value of this loss, which can be claimed as a loss.
4. Future Medical Treatment
Serious injuries often require future medical care, ranging from ongoing need for medications, to future surgeries, even home alterations to accomodate mobility. Including the cost of future medical care requires prove of specific needs, and their cost. We work wth physicians and life care planners to determine specific future medical needs to include these future costs as part of a claim.
5. Insurance Liability Limits
In auto injury claims, the repsonsible party will carry coverage for their liability to the injured person. The liability coverage, however, has monetary limits. In a serious injury claim, the policy limits of the responsible party may be insufficient to adequately compensate you for your loss. We look for all possible avenues of recovery, including underinsured motorist coverage in the auto injury claim, umbrella liability coverage, and even other responsible parties.
6. Liability or "Fault"
Establishing responsibility or fault is required to recover compensation for any loss. In many injuries involving serious injury, fault or negligence is not obvious, and early investigation is essential. This can involve documenting the conditions leading up to the injury, locating and interviewing witnesses, and having an expert, like an engineer, examine evidence in order to determine responsibility.
Liability may be shared between two or more parties, including the injured person. A person defending the claim may argue that the injured person was at fault. This is referred to as "comparative" or "contributory" fault. In Oregon, if a person is more than 50% at fault, he or she cannot recover any damages. In Washington, there is no cut off, but any damages (money for compensation) is reduced by the percentage of the injured party's fault.
A person may be at fault, or act carelessly, and another person may be injured, but in order for you to obtain any compensation for your losses, you have to show a connection between the careless conduct, and the harm. This is referred to as "causation." In some cases, it is obvious, but in many others, it is not. The need for certain medical care, like a surgery, for example, may be an issue. Often, expert opinions are required to make the connection between careless behavior, and resulting harm.