I was injured at a franchised fast food restaurant with a head injury as a patron, The adjuster said to give my doctors his e-mail address but my PCP and Nuerologist stated they have had bad experience with that arrangement and I need to come up with several thousand cash or get an attorney since I do not have insurance. Should the adjuster come up with a solution , of course I want to use my medical professionals not the adjusters. What can I expect and what avenues are available to me ?
Unfortunately, your medical doctors may correct. I would contact an attorney who specializes in personal injury litigation. They may be able to best assist with you regarding any communication with your doctors. Further you should discontinue any communication with the insurance adjuster until you had your consultation with that attorney.
If you have head trauma, why would you consider attempting to handle this matter on your own? The insurance carrier and its adjusters are neither your friends nor your good neighbors. The sole goal of any insurance carrier is to pay you nothing or as little as possible on your claim.
You should obtain needed medical care and treatment immediately and follow the doctor's advice. Do not give any statement to the adverse party or insurance company nor grant them access to any medical records. Photograph the injuries and the damage done to any property. Contact a personal injury attorney in your area as soon as possible so that you can protect your rights. You may also find it helpful to review the Legal Guides I have published on Avvo.com dealing with many of the issues you are now facing.
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Mr. Lundeen is licensed to practice law in Florida and Vermont. The response herein is not legal advice and does not create an attorney/client relationship. The response is in the form of legal education and is intended to provide general information about the matter within the question. Oftentimes the question does not include significant and important facts and timelines that, if known, could significantly change the reply and make it unsuitable. Mr. Lundeen strongly advises the questioner to confer with an attorney in your state in order to ensure proper advice is received.
Unfortunately, the Texas Supreme Court has ruled against this very type of case for the past 15 years, making it increasingly harder to win a claim against a property owner. You may know that the entire court is composed of business-minded/conservative Republicans who believe it is better to insulate property owners from injury claims than allow persons who are injured at no fault of their own a meaningful manner in which to be compensated. Accordingly, in order to prevail on this type of claim the injured person has the burden of proof to establish that the property owner had prior knowledge of the unreasonable risk of harm (that is generally speaking the dangerous condition) and that despite that knowledge, the property owner failed to make it safe.
Given this fact, the injured person must find credible evidence to support the contention that the property owner had prior knowledge before there is any possibility of getting this case before a jury. Typically in my practice the injured person only gets to trial about 1/2 of the time. Then of the 1/2 that get to trial, around 1/2 get a jury verdict in their favor. As you can see the odds of winning this type of case are low, at best. Of course the adjuster knows this and he wants to use this to his advantage.
First, he is attempting to exploit you lack of knowledge of the claims adjusting process to delay your getting meaningful care. You must seek medical attention immediately!! Even if you must pay out of your own pocket. Failing to do this will result in the adjuster claiming a "gap in treatment." That is, you waited too long to go to the doctor therefore you are really not injured. Second, there is no duty on the part of the adjuster to pay for your medical care. In fact, in my experience it is exteremly rare in Texas for an adjuster to offer to pay for medical care on a pay as you go basis. Under Texas law your only right is to a trial by jury at which time, should you get to trial, the jury can award you a lump sum of damages, including past and future medical bills, should you present the credible evidence needed to win. In other words, there is no guarantee of any payment, only the right to ask the jury for money.
For these reasons, if you are hurt and you believe the negligence of the property owner caused the injury, please seek the immediate assistance of a qualified personal injury attorney.
Your doctors are concerned that they will not be paid. An attorney can ensure that this will happen. An attorney can sign a lien promising payment to the doctors from any settlement you receive.
Steven A. Schwartz
JOEL H. SCHWARTZ, P.C.
One Washington Mall, 16th floor
Boston, MA 02108
(617) 250-2072 fax