After a loss or injury, the legal process can feel complex and overwhelming. This isn’t just your perception—the insurance companies have designed it that way. They know that the less knowledgeable and empowered you are, the easier it is for them to make a profit.

Over our 35 years of advocating for clients, some common questions have come up. We’ve compiled a list of the ones we get most often and our best answers to help make starting or considering the process of hiring an attorney as simple and straightforward as possible.

Hiring an attorney

The attorney and paralegal working on your case are a team and meet regularly to discuss the status and direction of your case. If your attorney is out of the office meeting with doctors, in court, or negotiating with insurance companies, your paralegal will be available to address your questions and assist you. If you have questions or concerns that your paralegal can’t answer, they’ll find out the answer for you, set up a conference call or schedule an in-office appointment with you and your attorney.

Once you’ve officially hired us, the insurance company is no longer permitted to contact you directly. If an insurance adjuster calls you, tell them that you’ve hired an attorney and give them our name and information.

Before you’ve hired us and while we’re informally consulting with you, we may ask you to send us a copy of any letters or other accident-related documents you receive. We can take a look and let you know what you should be doing with them.  As for your medical bills, if insurance is involved, your health care providers should bill the appropriate insurance company directly, and the insurance company may send you an “Explanation of Benefits” to explain what has been paid.

After you hire us, we‘ll be in charge of receiving most letters and bills. If you happen to get any, we’ll ask you to give us copies of any medical invoices so we can track your treatment and ensure your bills are getting paid.  If you ever have reason to believe the bills aren’t being paid, please let us know.

See below for more information on what to do if you don’t have insurance.

Yes. We understand that most people can’t afford to shell out a large sum of money from their own pocket for an attorney. That’s why we structure our fee on a contingency basis. A contingency fee agreement means we don’t get paid unless your case is completed and you get a settlement.  Our fee is typically 1/3 of the overall settlement.

Apart from the attorney fee, there can be additional costs associated with hiring an attorney. These costs are necessary to develop the evidence to support your claim, and include requesting medical records from your providers, collecting your employment records and police reports, conducting investigations on the facts of your case, copy charges, and meeting with your doctors. Your attorney should look to recover the costs of the case in the final result. Because there are costs involved in hiring an attorney, this is something we consider when advising you whether or not you need to hire one.  We’ll only recommend hiring an attorney if the potential benefits and costs of doing so make smart financial sense for you.

Our advice is always that if you’ve been hurt and someone else was at fault, you should consult with an attorney. That doesn’t necessarily mean you need to hire one, but a consultation is important because the world of insurance law is complex. It involves medical questions, legal questions, and questions of evidence and proof. There are so many unwritten rules that you may not know. Insurance companies have access to teams of attorneys anytime they want, and we think you should have access to the same.  When you consult with us, we can help you understand your rights, explain the insurance claim process, and work with you to explore whether or not you need an attorney. Your consultation is always free and you’ll never be pressured to hire us.

Insurance & Bills

Generally, your private health insurance company is required to pay for your medical treatment after your settlement. Under current state law, your health insurer can’t exclude pre-existing conditions. However, you may have a lengthy waiting period for payment of bills if you switch insurers and there is a break in coverage from one insurance company to the next.  If your coverage is through the Department of Labor and Industries or another governmental agency, different rules apply. You should discuss the circumstances of your case with your attorney.

Your insurance policy almost always has a process called “subrogation.” This means that if you receive a settlement for your injuries, the company has a right to be reimbursed for the bills they’ve paid, as this is (in theory) part of your settlement.

However, when you hire an attorney to help resolve your case, Washington law can require insurance companies to contribute toward your legal fees and costs in pursuing your claim for damages. For example, your PIP insurance company may accept a reduction in the amount of money they get back.  These rules may apply to your health insurance company as well, with some exceptions that your attorney can explain to you.

Some providers may agree to hold your bill while you’re being treated for your injuries. Sometimes they require a written guarantee that their bills will be paid out of your settlement proceeds at the end of your case. Not all providers will agree to hold your bills. In those instances, you should pay the providers directly or make payment arrangements so that you can continue to get the care you need.  If you aren’t improving with the recommended treatment, discuss this with your provider before making any changes to your treatment plan on your own. By discussing changes in care with your providers, you might protect yourself from insurance companies that claim that you weren’t trying hard to get better, or that you’ve recovered from your injuries when, in fact, you haven’t.

Typically, if you were in a car accident and there was Personal Injury Protection (“PIP”) or MedPay coverage on the car you were in at the time of the accident, your bills should be paid under that policy.  PIP also covers a limited amount of wage loss and household services for tasks you can’t perform due to your injuries. You should check your policy and be ready to discuss with us how much coverage you have available.

If you were involved in a car accident and didn’t have PIP or MedPay coverage at the time of the accident, or if your coverage has already been used up, you should submit your treatment bills to your health insurance company. Most health insurance companies will cover your accident-related treatment subject to the requirements of your policy dealing with referrals, deductibles, and co-payments. Your insurance company will usually claim to be entitled to reimbursement from your settlement for any bills they pay, but this is an area that an attorney can advise you on, or potentially negotiate for you.

If you were hurt in a way that didn’t involve a car accident, MedPay may still apply if it is available to help pay your bills. Your health insurance will also help pay your medical bills.

Ultimately, the at-fault party’s insurance company (also called the “third-party insurer” or the “liability insurer”) is responsible for paying for all medical treatment that your doctors connect to the injuries from your accident. However, the at-fault insurance company does not pay until the end of your case when you settle your entire claim. If you start discussing settlement with the at-fault insurance company, you might not be able to change how your case resolves. Once you settle with the insurance company, you can’t re-open your claim. That’s why we recommend you wait to settle until your care providers discharge you from treatment, or you have a good understanding from your doctors of how long-lasting your injuries may be.

Read the article(s) below for more information

Health Care Treatment Costs for Patient Injuries: Who’s Responsible, Attorney or Patient?

Injuries

Under Washington law, your right to a financial compensation for your injuries is balanced by certain duties you have. You must do whatever you reasonably can to get better from your injuries and regain your health, work life, and home life as closely as you can to how they were before the accident.  The good news is, you don’t have to figure this out on your own – your care team should help you along the way.

If your doctor is of the opinion that you have suffered a permanent injury, we will advise the insurance company of this fact when we enter settlement negotiations. A disability or impairment rating quantifying your level of permanent injury can only be done when your doctor is certain that no additional improvement can be expected. Often your doctor will only conclude you have a permanent injury after having explored all reasonable treatment options and waiting at least one year from the time of the injury.

Start by talking about it with your care team. They may be able to change your treatment or find different types of treatment that are more effective for you. You should also talk about the issue with us.

What if my condition is permanent?

If your doctor thinks that you’ve suffered a permanent injury, we’ll advise the insurance company of this fact when we enter settlement negotiations. A disability or impairment rating (that specifies your level of permanent injury) can only be done when your provider is certain that no additional improvement can be expected. Often, your doctor can only conclude you have a permanent injury after having explored all reasonable treatment options and waiting for a period of time after the injury.

Predicting recovery is difficult and depends on lots of factors including the nature of your injuries, access to good healthcare and your response to treatment. Your providers will give you the best answers. You can give yourself the best chance for recovery by following your doctors’ and providers’ treatment recommendations.

Settlement Process

Generally speaking, the answer is no. This is why we want to get an opinion from your doctor on any additional care you’ll probably require in the future and a written estimate of what that care will cost. This amount will be included in the amount of compensation we request when negotiations begin with the at-fault insurance company.

After all the important information is gathered and your health care providers determine that you’ve reached either “pre-injury condition” or “maximum recovery,” the settlement process can begin. A demand letter may be used to present the facts of the accident, your injuries, and how the accident has impacted your life to the at-fault insurance company. It will also request a monetary amount to settle the case. The majority of our claims settle at this stage. If, the insurance company refuses to compensate you fairly, a lawsuit may then be filed. This is done only with your approval and after discussing it with your legal team.

There are many important factors in determining what a case is worth, including our experience level as attorneys, and information about what juries and arbitrators tend to award in cases similar to yours. We regularly receive and review information that keeps us informed of case results. This allows us to advise you of the risks and benefits of accepting a settlement or pursuing your claim in a lawsuit.

We recommend you wait until you’ve been released from treatment, or your doctor says you have improved as much as possible, and that further treatment won’t improve your condition, before settling your case. Once your case is settled, the settlement is for all known and unknown injuries, even ones that may show up down the road. It’s best to wait until you and your doctor are reasonably sure that you understand the full extent of your injuries. We also recommend you talk to your attorney about the time limits you have under the law to resolve your claim, also called a “statute of limitations.”

Claim Values

Many factors affect the value of your claim, including your doctor’s opinion regarding your diagnosis, the nature and extent of your injuries, your prognosis, the amount of medical expenses, pre-existing conditions, future care needs, the amount of wage loss, whether or not you have a permanent disability or impairment and other factors.

Our experience level as attorneys and trends about what juries and arbitrators tend to award in cases similar to yours also come into play. We regularly receive and review information that keeps us informed of similar case results. This allows us to advise you of the risks and benefits of accepting a settlement or pursuing your claim in a lawsuit.

Starting a Lawsuit

A lawsuit may be necessary when all attempts to resolve your case through negotiations have been unsuccessful. Based on the circumstances of your case and individual needs, we’ll talk with you about whether or when a lawsuit would be filed. In Washington, most injured people have three years from the date of the accident (often called a “statute of limitations”) to settle a claim or file a lawsuit. A lawsuit begins when an attorney prepares legal documents and files them in court, with the intention to serve the defendant with notice of the lawsuit. If a lawsuit is filed, it doesn’t necessarily mean your case will go to court. Settlement negotiations often continue even after the lawsuit has been filed and your case can settle well before trial.

A lawsuit may be filed at the beginning of your case or when all attempts to resolve your case through negotiations have been unsuccessful. We will definitely discuss with you during our initial consultation whether and when a lawsuit would be filed based on the individual circumstances of your case and needs.  In Washington state, most injury victims generally have three years from the date of the accident to settle a claim or file a lawsuit. A lawsuit begins when an attorney prepares legal documents (the Summons and Complaint) and has them filed in the court and served on the responsible and/or carelessness party. Just because a lawsuit is filed, however, does not mean your case will go to court. Settlement negotiations often continue even though a lawsuit has been filed.

Read article(s) below for additional information on this subject
Dispute Resolution – Alternatives to Trial