Atlanta Injury Attorney Blog

Many clients come to me after being injured in a car accident in Georgia and they complain that their health insurance company is refusing to pay their bills claiming that it is a car accident and therefore the money has to come from the other driver.This is a lie being spread by the health insurance companies. It is a complex issue,but it breaks down this way. Your Georgia health insurance is obligated to pay for your medical care after a car crash so long as you presented the bill within the time allowed under the policy and so long as there is no medical payments coverage. If there is no medical payments coverage, your health insurance is the first payor and they must pay. That’s it.

I do advise my client that they do need to provide them with information about the driver that caused the crash and the health insurer may claim a right of reimbursement if you make a recovery for bills that they paid, but they have to pay.

Do be careful though because some hospitals will lie to you and claim that they submitted the bill and that the health insurer refused to pay. I find the best practice is to submit the bill yourself to the health insurer the minute you get it and to send a certified letter to your medical providers with your health care information attached as well as a letter from your own insurance company confirming that there are no medical payments benefits (usually in the form of a copy of your declarations page)

As an attorney I see constant changes in the tactics used by hospitals and health insurers that are designed to put more money in the hospital and insurer’s pocket from the injured victims settlement and I have written about some of them previously. Today we will be talking specifically about two new situations my clients have experienced.

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Georgia Inadequate Security cases are complex and time consuming but rewarding in that I can help encourage property owners to behave responsibly. Inadequate security cases are grounded in general premises liability law and therefore the entire analysis begins and ends with superior knowledge. As I explained in my articles on what is the law in Georgia on slip and fall cases, the liability of the land owner stems from the fact that they know their property better than you do and have a duty to keep the property free from hazards through the exercise of ordinary care. On the left you will see what can happen to a client when an apartment complex fails to implement any security measures resulting in a car jacking and two rounds being fired into the his abdomen.
Prior Crimes Create a Duty to Take Reasonable Security Precautions

These same general principles also apply in third party criminal attack cases. Third party criminal attacks include rape at a Georgia apartment, assaults and murder. If the victim is an invitee(as opposed to a trespasser) then the first thing to analyze is the prior crime on the property. There must be sufficient prior crime on the property to put the property owner on notice that they need to take action. Once the owner is on notice, they have a duty to exercise ordinary care to safeguard the invitee from danger. That does not mean that every possible measure must be taken, but it does mean that industry customs must be followed and reasonable measures must be implemented.

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Wrongful death lawyers know that claims for the statutory claimants and the claim for the Estate of the deceased are separate and distinct claims and that suit must be filed within two years of the death, in most cases. There are a few exceptions and one of them is that where the Estate of the Deceased is not established (they died without a will and no one filed to appoint an administrator) then the statute of limitations will be tolled for up to 5 years. That means if you missed the two year statute of limitations for the Wrongful Death claim, if the person suffered before death, had substantial medical bills or had a punitive damages claim, then there may still be a suit that can be brought on behalf of the unrepresented Estate because it has been tolled by O.C.G.A. Sec. 9-3-32.

OCGA § 9-3-92 provides that “[t]he time between the death of a person and the commencement of representation upon his estate … shall not be counted against his estate in calculating any limitation applicable to the bringing of an action ….”

In Georgia, there is a two year statute of limitations within which your injury lawyer must file your lawsuit for injuries, with a few exceptions. Over the past few weeks a number of clients have called with the two anniversary fast approaching. Waiting until the last minute to file an injury claim is a very risky proposition. If your injury attorney has not filed suit yet I cannot emphasize enough how dangerous this is.

Now it is true that there are many good reasons to be patient in the pursuit of your injury case. If your medical care is continuing for instance, it would be foolish to attempt to try or settle your case in the middle of the care. However, as the first anniversary of the car accident passes you should have a talk with your lawyer to decide what the strategy is. If your medical care is at an end, the only thing you should have to wait for is the medical records. Once they are in, your attorney should be able to draft the demand within one week and the insurance carrier will usually respond within 45 days. The negotiations will take another 2 weeks, but at that point, you will have a good idea of whether the carrier is going to make a fair offer or if you will need to litigate the case to obtain the fair value.

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I see hundreds of cases a year and we are getting more and more Georgia notices of medical liens. This past week I noticed that we have received several Georgia Medical Lien notices filed by Feiler and Associates and Clinton Harkins on behalf of their medical provider clients against potential recoveries by my clients. There is nothing inherently wrong with that, but the problem is these clients all have health insurance! If you get notice of one of these liens being filed and you have health insurance, you need to call an Atlanta injury lawyer, immediately.

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When you are injured in a car accident in Georgia and there are serious medical bills and the at fault driver only has minimum insurance coverages, the availability of Georgia Uninsured and Underinsured Motorist Insurance is a major issue. As you may recall from my post a few weeks back, we were hopeful that the Court of Appeals would extend the logic of the Toomer and Thurman decisions to hold that having to pay off hospital liens in Georgia would have a positive effect on a persons ability to access their UM coverage. That has not happened.

As I explained earlier, for car crashes from before 1/1/2009 in Georgia, car accident lawyers are often faced with situations where their clients only have $25,000.00 in Georgia Underinsured motorist coverage and the at-fault party has $25,000.00 in liability coverage. Barring other insurance sources, the clients were left with having to settle for the available limits of $25,000.00 and no access to their UM. Georgia Appellate Courts held though in Toomer and Thurman that mandatory payment language in Federal Law for Medicare and Federal Worker’s Compensation claims would allow that same person to access their Underinsured coverage.

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Lawyers find that they have to file suit more often to obtain fair compensation for their clients than in years past. Years ago when I represented insurance carriers for injury claims in Georgia as a defense lawyer, I found that most of them had a fundamentally sound philosophy. They would pay for valid claims and they would fight exaggerated claims.Due to the success of the big three insurers with their deny, delay, defend philosophy, insurers that formerly operated in a reasonable manner seem to have adopted a “me too” approach. I am noticing that the adjusters handling cases prior to suit are less seasoned and more likely to make the standard silly arguments like “we reduced the bills because they are unreasonable” and “your client did not follow up until 3 weeks after the hospital.” Many of these arguments sound fine on the phone but the insurers know that in trial they just don’t fly.

So, the question becomes, what to do about getting fair value for my clients when they are seriously injured? The answer is that more often than not, we file suit. In a recent case I handled for a client in Dunwoody, Georgia he had a rear end collision with an insured where there was around $2300.00 in damage to his VW. He went to the hospital that day and was ultimately diagnosed with a herniated lumbar disc. As with any moderate damage case, the insurer blew off the demand letters from a prior lawyer and offered him $5,000.00 claiming that the injury pre-existed the crash and that the property damage was too low to cause a disc herniation.

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Georgians injured in a car crash have to be on their toes when it comes to hospital billing departments. Most hospitals code the intake so they know if the patient came in with a broken leg from a car accident or a broken arm from a trucking crash. Even where the patient has health insurance (which they are obligated to bill unless there is medpay insurance) the hospitals are trying to opt out and hiring a collections law firm to send out immediate lien notices. Why are they doing this to injured people in Georgia?

The answer is simple; if United Health insurance only allows $4,000.00 under their fee schedule for a set of procedures but the procedures are billed at $24,000.00, the hospital would rather get $24,000 instead of $4,000.00. By placing a medical lien on the file, they hope that they can tap into the injury settlement that the injured patient may be pursuing.

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Practicing law as an Injury attorney, I see a variety of serious injuries on a weekly basis and I spend hours talking to clients about the impact these injuries have on their lives. Serious car accidents frequently result in soft tissue injuries and many clients come to me after being told by the insurance company for the at fault driver that soft tissue injuries are not a big deal and they won’t pay much for them. This begs the question; what is a soft tissue injury and what is it worth in Georgia?

First, you have to draw a clear line of distinction between low impact cases where the majority of the medical care is chiropractic and moderate and high-impact cases. I do not accept low impact chiropractic cases and frankly the court system is overrun with claims that really have no business in the courts. Conversely, insurance carriers have a nasty habit of ignoring cases where the crash was serious but the MRIs and X-rays don’t show fractures or major disc herniations. I have written extensively about what an injury case is worth in Georgia, but this post will discuss soft tissue injuries specifically. Technically speaking, soft tissue injuries are those which affect anything besides the bones. This includes muscles, ligaments and tendons. A sprained ankle is a soft tissue injury as is a torn ACL. Just because the injury is to a soft tissue in the body does not mean it is insignificant.

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