LEGAL GUIDE
Written by attorney Stephen R. Chesley | Sep 8, 2010

If i am in a car accident what am i entitled to

What Types of Injuries Am I Entitled to Be Compensated For?

Under New York State Law, one can not recover monies for bodily injuries unless they sustained a "serious injury." However, what you may consider a "serious injury" may not necessarily be what the law defines as a "serious injury". Section 5102(d) of the New York State Insurance Law defines a serious injury as follows:

5102(d) "Serious injury" means a personal injury which results in death; dismemberment; significant disfigurement; a fracture; loss of a fetus; permanent loss of use of a body organ, member function or system; permanent consequential limitation of use of a body organ or member; significant limitation of use of a body function or system; or a medically determined injury or impairment of a non-permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person's usual and customary daily activities for not less than ninety days during the one hundred eighty days immediately following the occurrence of the injury or impairment plain language, in order for you to recover money for your bodily injuries you must have sustained at least one of the following injuries:

Dismemberment (loss of arm, etc.) or significant disfigurement (a significant permanent scar); Death or Loss of a Fetus; Loss of a bodily function;

A non-permanent injury which keeps you from doing your normal and customary activities for a period greater than 90 days after the date of your accident.

The first two categories are self explanatory; however, the third and fourth categories are not. The third and fourth categories have been utilized by attorneys to allow compensation for those injuries commonly referred to "soft tissue" (Whiplash, Headaches, Backaches, etc.). "Soft tissue" injuries are the most common injuries sustained in automobile accidents. "Soft tissue" injuries, while severely limiting, are, more often than not, undetectable by the human eye. "Soft tissue" injuries can resolve themselves; however, "soft tissue" injuries may require a steady course of medical treatment as well as physical therapy. Due to the nature of "soft tissue" injuries, you may be required to see a Neurologist (Nerve doctor), an Orthopaedist (Bone doctor), Chiropractor (Back & Neck) or a Physical therapist.

During the course of your medical treatment, your doctors may refer you to other doctors for a number of tests such as X-rays, MRIs, CAT-SCANs, EMGs etc. Each time you are referred to a new doctor you should inform our office. What Is "No-fault" ?

"NO-FAULT" merely means that the expenses associated with your injuries will be covered by the insurance carrier of the car you are driving, passenger in or struck by. It does NOT mean that you are automatically entitled to money NOR does it mean that the property damage sustained by your motor vehicle will be paid for. "NO-FAULT" covers your medical expenses, lost earnings, transportation (to and from the doctor), housekeeping and other expenditures incurred as a result of your injuries.

Who Pays My Medical Bills? Medical expenses. Medical treatment will be covered up to $ 50,000.00 dollars or up until it has been medically determined by the NO-FAULT insurance company's doctor, NOT your own doctor's opinion, that you have recovered from your injuries or can no longer benefit from medical treatment. The NO-FAULT insurance company pays your doctor directly. Please note, that if NO-FAULT denies a portion of your doctor's fees, due to an excessive rate charge, you are NOT responsible for that portion deemed to be excessive.

Who Reimburses Me for My Lost Earnings? Lost Earnings. You are entitled to recover 80% of your lost earnings up to $ 2,000.00 per month. However, you must first file for disability and your doctor, not your attorney, must have made a determination that you are disabled. What Other Expenses Am I Entitled to Be Reimbursed For? Transportation and Housekeeping expenditures. You are allowed to be reimbursed for monies spent on Transportation and/or Housekeeping. Transportation and Housekeeping expenditures are reimbursable for a maximum of $25.00 per day. However, you may not recover for both transportation and housekeeping on the same day. Transportation will only be covered to and from the doctor. If you use a yellow cab ask for the receipt. If you use a "gypsy cab" have the driver write the amount on the back of the company card. If the driver states he does not have a card, buy a receipt book at Staples or any other stationary store and have him sign that.

Housekeeping. You will not be reimbursed for any housekeeping performed by a family member. Moreover, you must have receipts documenting your payment. Again, you may buy a simple receipt book from any stationary store. It is important to note, that you may not be immediately reimbursed for these expenses. It sometimes can take up to four months before you are reimbursed for any of the aforementioned expenditures.

It is necessary, if you own a car or a family member, in your household, owns a car, for you to forward a copy of that insurance policy to our office immediately. Your insurance rate is in NO way affected by mailing our office a copy. Who Pays to Fix or Replace My Car (Property Damage)?

There are a number of ways in which you may recover money for the damage caused to your car as a result of this accident. You, as the owner of the car, are in the best position to handle this. Of course, we will lend assistance. We merely request that you provide our firm with a copy of the release the insurance company may require before you sign it.

Collision Coverage. The fastest and most efficient way to have your car repaired or recover its monetary equivalent is through your own insurance policy. However, you must have purchased "collision" when you secured your car insurance; or Other Cars Policy. You may also recover your property damage from the other motor vehicle's insurance carrier. However, you will only be reimbursed the lesser of either the cost of repairs or the "blue-book" value minus your percentage of liability. In other words, if your car is worth $ 8,000.00 dollars and you are 50% responsible for the accident - you will only be reimbursed $ 4,000.00 dollars. Moreover, settling with the other cars insurance carrier may take some time.

If you are not the owner of the car we cannot pursue a settlement for the damage done to that motor vehicle.

AGAIN, RECEIPTS FOR NO-FAULT EXPENSES ARE TO BE SUBMITTED WITHIN 45 DAYS OF THE DATE OF THE BILL, BUT SHOULD BE SUBMITTED AS QUICKLY AS POSSIBLE.

How Long Before My Case Will Settle and How Much Will it Settle for? In the beginning, this question is next to impossible to answer as there are just too many factors to consider such as injury(ies), permanency of those injuries, liability (fault) and insurance coverage. Once your course of medical treatment has been completed and the diagnostic reports received by our office, then answers to these questions may be possible.

AGAIN, RECEIPTS FOR NO-FAULT EXPENSES ARE TO BE SUBMITTED WITHIN 45 DAYS OF THE DATE OF THE BILL, BUT SHOULD BE SUBMITTED AS QUICKLY AS POSSIBLE.

General Premises Liability Cases What Types of Injuries Am I Entitled to Be Compensated For Under New York State Law, when one is injured through the 'general liability' of another, they may be compensated for any injury sustained. While this sounds good on paper, issues such as cost/benefit analysis, insurance, and plain old practicality are significant issues considered when pursuing a 'general liability' personal injury case. Depending upon the type of injury you have sustained, your physicians may ask you to see a number of doctors with diverse specialties. This is especially the case when considering "Soft Tissue" injuries.

"Soft tissue" injuries are the most common injuries sustained in accidents. "Soft tissue" injuries, while severely limiting, are, more often than not, undetectable by the human eye. "Soft tissue" injuries can resolve themselves; however, "soft tissue" injuries may require a steady course of medical treatment as well as physical therapy. Due to the nature of "soft tissue" injuries, you may be required to see a Neurologist (Nerve doctor), an Orthopedist (Bone doctor), Chiropractor (Back & Neck) or a Physical therapist. During the course of your medical treatment, your doctors may refer you to other doctors for a number of tests such as X-rays, MRIs, CAT-SCANs, EMGs etc. Each time you are referred to a new doctor you should inform our office.

Who Pays My Medical Bills? Unlike an automobile accident, where "NO-FAULT" insurance pays your medical expenses, lost wages and expenses, a general liability case creates significant issues when considering the above question.

Medical Expenses: In the 'general liability' setting, medical expenses are most commonly paid for through the injured party's personal health insurance. The health insurance provider, in turn, will have a lien on any settlement for the benefits paid. This lien will be considered as a part of the damages when ultimately negotiating the case.

An alternative to personal health insurance in a 'general liability' case may be that the defendant's insurance company may provide for 'medical payment' coverage. Generally, this coverage may provide medical benefits to any individual who is injured on the defendant's premises, by their employees, etc. The insurance policy will have a certain limit on the amount of medical bills it will pay for, i.e., $5,000. (This, of course, is independent of the liability coverage which our office will pursue for your pain and suffering). The coverage is very policy specific. Therefore, it is handled on a case by case basis. If neither of the above coverages exist, our office will assist you in any way possible to arrange liens with treating physicians or secure other arrangements.

Who Reimburses Me for My Lost Earnings? Lost Earnings: Generally speaking, in a 'general liability' case, Lost Wages/Earnings are not collectable 'up front'. These damages, while very significant to you as well as your attorney, are usually calculated as out of pocket damages and are negotiated at the end of the case. Of course, to consider Lost Earnings, proof of the same must be supplied in documentary form.

What Other Expenses Am I Entitled to Be Reimbursed For? Other expenses, similarly to Lost Wages, are generally a matter left for negotiation at the end of the case. These expenses/damages also must be proven through documentary evidence.

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