"I was injured in a car accident. Who pays my medical bills?"

scott@grossmanjustice.com (Scott Grossman) — Tue, 13 Mar 2007 21:44:54 -0500

Here’s something interesting I’d like to share with you. Over the past decade, I have observed that most, if not all of my motor vehicle accident clients had no idea who (or more accurately, whose insurance company) was financially responsible for the medical treatment of the injuries they sustained. There is a common misconception that it is the automobile insurance carrier of the “at fault" driver that is responsible for paying the medical bills.

]]>While that is the case in many states, New Jersey operates under a “no fault” system, meaning that who is to blame for causing the accident is irrelevant when determining which insurance company must pay for one's medical treatment. Your automobile insurance has something called Personal Injury Protection or PIP Benefits. So if you were injured in an accident, regardless of fault, your medical treatment would be paid for by your own automobile insurance carrier’s PIP Benefits. Another way to look at it is that the PIP Benefits follow the person, and not the vehicle. Take this example: let’s say you are in an automobile accident, but as a passenger in a friend’s car, again it is your own automobile insurance policy’s PIP coverage that pays for your medical treatment.

What if, in the passenger example, you did not have automobile insurance? Well, the law in New Jersey requires that the injured person next turn to any "insured resident relative" who must provide the PIP benefits to you. If neither you nor a "resident relative" insure a motor vehicle, then you would look to the "host" vehicle's insurance policy (the owner of the vehicle you were in at the time of your injury) for PIP benefits.

It is important to note that this information is not legal advice. I must stress this because this area of law has become so complex in recent years that now only attorneys that concentrate their practice in the area of personal injury practice or NJ auto insurance law should be consulted to determine an auto accident victim's PIP eligibility and rights associated with automobile insurance.

Auto insurance companies adopt "Delay, Deny, Defend" to maximize profits at consumers expense

scott@grossmanjustice.com (Scott Grossman) — Sun, 04 Mar 2007 20:57:01 -0500

"Delay, deny, defend" is the battle cry for the auto insurance industry to protect their multi-billion dollar empire. In a recent report filed by CNN's Drew Griffin, he uncovered that this practice is rampant among the nation's auto insurance companies when people are injured in what insurance representatives consider a "minor impact" auto accident. New Jersey attorneys representing persons who have suffered injuries in auto accidents have long experienced first hand these tactics of the nation's largest insurance companies. Throughout the past decade I have represented many individuals that were involved in what the insurance company deemed a "minor impact" and as a result of the accident they suffered serious permanent injuries such as a herniated disc. Many times the injuries were so debilitating that after multiple steroid injections, extensive narcotics usage, physical therapy and chiropractic care, spinal surgery became the only option. The suffering was very real.

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The auto insurance companies do not want the public to understand the most important of Newton's Laws on Physics. Energy does not dissapear, it is transmitted to the impacted vehicle and hence to the occupants. Often times at trial, after years of delays from the insurance company, defense counsel will blow up a photo of the impacted vehicle that does not show significant property damage. A strategy frequently successful in having jurors draw an inference that the injuries claimed by the plaintiff are either untrue or if true they must have been from some other cause unrelated to the auto accident. The CNN news story referenced above did an excellent job exposing the tip of the iceberg when it comes to insurance companies doing whatever it takes to put corporate profits above the interests of those very individuals they are supposed to help.

In New Jersey when you are involved in a motor vehicle accident, your medical bills are supposed to paid for through the PIP, Personal Injury Protection benefits of the injured persons' insurance company without regard to who caused the accident. So in New Jersey, the medical benefits through PIP coverage follows the person and not the vehicle. However, the policy of denial often times happens through the issuance of a medical treatment cut-off or denial letter on the basis that the patient has reached MMI or maximum medical improvement. This frequently occurs without consulting the treating physician or without even examining the patient. Often the denial will be on the reccomendation of a physician advisor review. This means that a physician of like specialty will review some of your medical records and decide for your insurance company, while being paid by that insurance company if you should be cut-of from further treatment regardless of what you may be feeling. The system is driven to maximize profits by minimizing costs of medical care to insurance companies own insureds. To add insult to injury, these corporate profits aren't even passed onto the consumer in the form of auto insurance rate reductions. The PR spin shall continue........Blame the lawyers for your exorbitant auto insurance rates. It works each year after year along with the deeply ingrained favorite phrase of the insurance corporate elite ..."TORT REFORM".

Please read the CNN article linked above and I invite all who are interested or who have personal stories to tell to respond to this post.

New jersey PIP - New Jersey Accident and Injury Law Blog

"I was injured in a car accident. Who pays my medical bills?"

Auto insurance companies adopt "Delay, Deny, Defend" to maximize profits at consumers expense