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Are You Covered?
2003 Vol. 2

   
 
Recent Articles:
  Are You Covered?
  Junk Lawsuits
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  Health Care Issues
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WHAT'S NEW WITH THE FIRM?

We have recently completed a physical expansion of the firm. Construction is now complete on an addition to the real estate division and parking lot.

DID YOU KNOW?

About 43,000 Americans are killed in automobile wrecks every year. A 1999 study by the Institute of Medicine found that about the same number of people die in U.S. hospitals every year, not from their illness or injury, but from medical errors or mistakes. A study recently released by the U.S. Government Agency for Healthcare Research, published in the October 2003 Journal of the American Medical Association, found that the same problems and about the same number of deaths still exist, four years later. What will it take to change this? Do you really think limiting recovery for such cases will help?

In September 2003, state inspectors in Chicago, Illinois found that 9 out of 12 of the "basic life support" vehicles used by EMS crews for the city fire department were either "filthy" or "poorly stocked." Some of the personnel staffing the vehicles lacked fundamental lifesaving skills and did not know how to use some of the standard life saving equipment on the vehicle. Is that what you expect when you call "911" in a medical emergency?

Weiss Ratings, an independent insurance statistical analysis firm, recently completed a study of data for the 12-year period from 1991 to 2002. During that time, malpractice insurance premiums for doctors and hospitals went up an average of 4% per year in states that have "capped" the damages for injury or death, and 3% per year in states that have no such caps. So much for the idea that legislative "caps" reduce premiums. By the way, the cost of medical care (including doctors’ salaries) during that same period went up an average of 6.25% per year.

We are not "down" on doctors, hospitals and healthcare professionals. Most of them are honest, competent and hard-working. However, it is not right for politicians, paid insurance lobbyists, and a minority of people to twist the facts to gain support for "tort reform." Find out the truth! Stand up for your freedom to have a jury of your peers and fellow citizens (not an insurance company or a politician) decide who is responsible for an injury and what amount of compensation is fair and just. If you do not fight for your freedom, it will be lost.

WORKERS’ COMPENSATION OR THIRD PARTY ACTION: MUST I CHOOSE BETWEEN THEM?

Absolutely not. If you are injured by a third party while you are on the job, you are not required to choose between receiving workers’ compensation benefits from your employer and pursing a claim against the third party who was responsible for your injury. Typically, this situation may exist where a person who is working is involved in a car wreck with a third party who is at fault, but other situations may arise as well. Often, your employer may suggest that because it was someone else’s fault, you can recover from them directly, rather than seeking workers’ compensation benefits. While this is certainly true, it is somewhat misleading. Employees frequently believe that they are either 1) not entitled to workers’ compensation benefits because they were injured through a third party’s negligence, or 2) must choose between the third party or the workers’ compensation benefits. Fortunately, this is simply not the case.

If you are injured on the job you are most likely entitled to workers’ compensation benefits. You may also be entitled to seek recovery from the party who is responsible for your injuries. If your employer’s workers’ compensation insurance carrier has paid out anything on your behalf (i.e. medical bills, lost wages, compensation for permanent impairment, etc.), they will want to be reimbursed for these expenses, provided you recover money from the third party who was at fault. They want to be able to "step into" your shoes. This is called subrogation, and South Carolina does not prohibit the carrier from attempting to be compensated. In some ways, this makes sense. After all, the purpose of the court in allowing you to pursue both remedies is not to allow you to "double recover", but rather to "make you whole" from your injuries.

However, this does not mean that it is better simply to go after the third party, for a number of reasons. First, workers’ compensation benefits will often enable you to receive immediate necessary medical treatment with no cost to you, whereas medical treatment will generally not be provided at no cost to you by the third party who is at fault. Similarly, lost wages are seldom paid up front by a third party, but are often routinely paid as a workers’ compensation benefit. Finally, workers’ compensation benefits are seldom reimbursed dollar-for-dollar when there is a recovery made against a third party.

The amount of workers’ compensation benefits to be reimbursed is often negotiable. Having a lawyer involved in the claims may result in the carrier agreeing to accept a reduced amount, thereby enabling you to retain more of the money you received from the third party. Of course, some carriers are aware of this and, as a result, suggest that you pursue the at-fault third party directly, without seeking benefits. Just remember, if you are hurt by a third party while on the job, you can seek both workers’ compensation benefits and recovery from the third party.

ARE YOU COVERED?

One of the frequent problems our firm faces in representing our clients who have been injured in automobile accidents is the fact that many of the people who are at fault are uninsured and therefore cannot pay damages for our client’s injuries and medical expenses. What is an "uninsured motorist"? An uninsured motorist is a motorist who either does not carry any liability coverage applicable to his motor vehicle or who carries liability coverage with limits less than those required by state law. South Carolina has mandated by statute that insurance companies provide as a minimum $15,000 in uninsured coverage on every automobile liability insurance policy that is written and sold. This amount, however, is frequently insufficient to cover the damages that our clients sustain in car wrecks because hospital and medical expenses continue to increase dramatically, often more rapidly than any other expense our clients face.

WHY DO I NEED UNINSURED COVERAGE?

If you are in a wreck with an individual who is driving an uninsured vehicle, you will need to file a claim with you own insurance carrier under the uninsured provisions of the policy that covers your vehicle. It is not only important to carry coverage. It is also important that the amount you carry be sufficient to compensate you for your injuries and medical expenses, which, even if covered by a health insurance policy through your employer or your own private policy, may have to be reimbursed.

Fifteen thousand dollars ($15,000) is often not nearly enough to cover these losses. That is why South Carolina law requires insurance companies that sell auto policies to offer, at the option of the insured, additional coverage over and above the basic $15,000 dollar minimum and up to the limits of your liability coverage. For example, if you have purchased an auto policy with liability limits of $50,000 dollars, your insurance agent or company must offer uninsured benefits up to the $50,000 limits you purchased in liability coverage. We strongly encourage all of our clients to purchase much more than $15,000 dollars in liability coverage.

Uninsured motorist coverage also covers accidents when a hit-and-run driver or unknown motorist is responsible for an accident in certain circumstances, such as when there is physical damage done to your car or it can be proven by an independent witness, other that the owner or operator, that the accident was indeed caused by an unknown driver. You must, however, comply with certain legal requirements, which include reporting the accident to an "appropriate police authority" within a reasonable time and you must not be negligent in failing to determine the identity of the other vehicle and its driver at the time of the accident.

Automobile insurance policies and their legal requirements can be very complex, and we urge all our clients to retain legal counsel in any serious automobile accident in which an injury occurs.

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Disclaimer of Liability: The information on this website is presented as a service to the public. While the information on this site is about legal issues, it is not legal advice; nor does it create an attorney-client relationship. Actual legal advice is dependent upon consultation with an attorney, acceptance of representation, and review of the specific facts of a given situation. Also, because of the quickly changing decisions of courts and legislatures, as well as our reliance in part on information provided by others, we make no warranty or guaranty concerning the accuracy or reliability of the content at this site, other than the specific information about the firm and its attorneys.


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301 Gibson Rd, Lexington • South Carolina 29072

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