Personal Injury Claim? It Pays to Get a Second Opinion

Marcus and Latoya Golden

When Latoya Golden’s 17-year-old son Marcus was injured in a car crash, she decided to use a TV lawyer to help her son with his case. After several months of not hearing any follow up, she finally got a call: the attorney wanted to simply settle the claim. “When he told me he was going to settle I was happy at first,” she said. “But then he told me how much would be left for Marcus after attorney fees and medical bills, and I felt it was just too low.” Over the next few weeks as the attorney continued pushing for a settlement, Latoya decided it was time for fresh advice.  She opted for a second opinion on her personal injury claim and took her son’s case to Mark Wolfe of Boteler Richardson Wolfe – Injury Lawyers. After the meeting with Mark, the case file was transferred to him.

“Marcus’ claim was interesting in that he had health insurance, but the hospital that treated his injuries opted not to bill it,” said Wolfe. “Instead, they filed a hospital lien against his insurance claim for the full balance of their service.”  Wolfe advises this is not uncommon in car crash cases, but often the lien can be negotiated down to the same amount as the health insurance provider would have paid.  In addition, Marcus had other damages that had not been previously documented when the other lawyer had presented the claim.  “When I took on the case, I felt confident we could get the hospital lien reduced and the overall settlement amount increased. Our fee was only charged against the additional benefit we won for Marcus.”

He was right. After several weeks of work, Mark was able to double the amount of money Marcus recovered from his accident.  Wolfe credits a team effort to pull together a great client result. “Our staff is used to navigating the technicalities of hospital liens and negotiating reductions for their repayment,” he said.  “When a firm like ours has years of litigation experience in car crash cases and a record of meaningful verdicts and settlements – insurance companies realize who they’re working with.  That experience helps to convince a claims adjustor to rethink… and up the offer on a settlement.

None of this was lost on Latoya, who was quite happy with the result for her son.  “Marcus can now afford a car to help him with transportation, and when he turns 19, he’ll get another check,” she said enthusiastically.  When asked about her experience with the two lawyers, she described the difference as night and day.  “Mr. Wolfe and his office kept us informed every step of the way. He told us what he was going to try and do and how he thought he could benefit Marcus. He was always available to answer my questions. I felt like the other lawyer just wanted to get my son’s claim over with as quickly as possible and wasn’t really concerned about helping Marcus.”

The Alabama Rules of Professional Conduct allow attorneys to provide second opinions about a legal matter. If you would like a second opinion about the value of your personal injury claim or case call Mark Wolfe today at 251 410-7761 to discuss the proper protocol and procedure to get a second opinion. 

Homeowner Insurance Claims: Six Things You Need to Know

Homeowner Insurance Claims: Six Things You Need to Know
You’ve notified your insurance company, what’s next?

Mark Wolfe, Attorney

“Many homeowner and commercial property insurance policies have a dispute resolution provision for valuation disputes. However, these provisions vary from policy to policy and often have legally binding requirements that must be complied with in order to resolve the dispute.”

As thousands of us along the Alabama and Florida Gulf Coast begin the recovery process after Hurricane Sally, many of us will be having to make insurance claims for damage to our homes and property. Here are some important things you need to know about your property damage and/or homeowner insurance claim. Keep in mind an insurance policy is a contract between you and your insurance company that details what each party must do related to a loss. Your failure to comply with these requirements can be grounds to void coverage! Also, when you are making an insurance claim it is your burden to prove the loss with proper documentation and credible evidence.

 

1. Notify Your Insurance Company Immediately. Most insurance policies require notification of a potential claim as soon as possible. A delay in notifying the insurance company of a potential claim could result in a denial of coverage.

2. Document & Mitigate Your Damages. There is no such thing as too many photographs or videos of your damage. Also, your policy requires you to undertake reasonable steps to help minimize the loss. This may mean putting a tarp over roof damage to prevent more damage or putting plywood over broken windows. Failure to mitigate your damages can result in the denial of benefits or reduced benefits. If you can not get to your property to assess and/or mitigate your damages because of government restrictions, make sure to print or screen shot the restriction.

3. Review Your Policy. There are several important things to know about your policy and the coverage it provides. While there is no “uniform” homeowner policy, most contain the following sections and parts. The starting point in your review is the Declarations Page. This tells you the amount of coverage available for the various losses and should document what real property is covered by the policy. It should also document the deductible for each claim. The Terms and Definition sections defines a “covered loss” and any exclusions as well as all the other relevant terms used in the policy. The Property Damage section of your policy outlines the what real property and personal property will be covered under the policy and it usually explains the loss of use coverage. The Personal Liability portion of the policy explains the personal protection afforded to you for liability claims made against you or a member of your household for negligence or careless actions. The Additional Terms & Conditions section of the policy may contain legal provisions such as assignment of benefits, subrogation and dispute resolution procedures.

4. Be Careful in Your Conversation with the Insurance Company. Always be truthful but only provide facts you know to be true. After a storm, insurance adjusters are working hard and moving quickly. Often when reporting your damage the insurance company will ask about other damage. If you assume you have no other reportable or claimable damages and say you have no other damage then the adjuster may not give your house a full inspection when he or she comes to adjust your loss and write an estimate. Always ask that the adjuster give your home or property a full and complete inspection. They are trained to identify damage and they may see storm damage that you did not realize.

5. What to do if  You and the Insurance Company Don’t Agree. Generally, there will be two potential areas for disagreement: coverage and valuation of the loss. If your insurance company is denying coverage for the damage then you have a right to have the denial in writing. Generally, you should ask for a written explanation of the denial and ask for a specific reference to the policy provision that supports the denial. E.g., A policy may exclude flood or rising water damage. Have the written denial letter and the policy reviewed by an experienced insurance claims attorney as soon as possible. If you disagree on the valuation of the loss, e.g., repair vs. replace, then you may want to consult with an experienced insurance attorney. Many homeowner and commercial property insurance policies have a dispute resolution provision for valuation disputes. This allows for a resolution without having to file a lawsuit! However, these provisions vary from policy to policy and often have legally binding requirements that must be complied with in order to resolve the dispute. Some States even allow for the recovery of attorney fees if you are successful

6. Consultations are Free! Almost all lawyers who represent people who have a dispute or disagreement with an insurance company provide free consultations. Many of these lawyers will represent a claimant under a contingency fee contract; that is, no money recovered for you, no fee owed. However, the percentage charged can vary greatly from law firm to law firm. Some may charge 15% of the total recovery while others may charge 25% of the amount in dispute. Also, some lawyers may advance the expenses related to the matter while others may require you to pay those expenses directly and as incurred. If you hire an attorney to assist you with your claim, you should know exactly how the fee will be calculated and how expenses will be handled. You should always get a copy of the representation agreement. If you don’t get a copy of the agreement at least send a written confirmation of your understanding as to how fees and expenses will be handled.

If you are an Alabama or Florida Gulf Coast resident and you have a question about your insurance claim, please contact Boteler Richardson Wolfe – Attorneys at 251 433-7766. We’ve been helping Gulf Coast residents with insurance claims since 1987. Offices in Mobile, AL  and Foley, AL

 

REQUIRED DISCLAIMERS: Alabama Rule of Professional Conduct 7.2: No representation is made that the quality of legal service to be performed is greater than the services provided by other lawyers. The Mississippi Supreme Court advises that a decision on legal services is important and should not be based solely on advertisements. Free background information is available upon request to a Mississippi attorney. The listing of any area of practice by a Mississippi attorney does not indicate any certification of expertise therein. See Mississippi Rules of Professional Conduct Rule 7.2(d), Rule 7.4(a), Rule 7.6(a) (1997). Statement in compliance with Florida Bar Advertising Rules: “The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask us to send you free written information about our qualifications and experience. [Florida Rule 4-7.2(d)]. General Disclaimer: This information is posted for general information purposes to help those interested parties or persons with potential civil claims better understand their rights and potential causes of action. If readers are currently represented by an attorney on the subject matter of this post then they are encouraged to continue with said representation. No attorney-client relationship is established by this post.