Badly Needed Victory for Injured Texans.
The Texas Supreme Court has ruled in favor of an uninsured woman who challenged her whopping hospital bill of $11,000.
The opinion written by Debra Lehrmann, formerly a district court judge in Fort Worth, held that hospitals must disclose the lower rates that are given to people covered by health insurance or government assistance.
You probably think that the driver who rears-ends another car or truck is automatically at fault.
Since there are a shocking 1.7 million rear-end collisions each year in the U.S. which take the lives of 1,700 people and injure 500,000 others, they are serious problems that need to be prevented.
But juries and courts have eased up on the quality and quantity of the evidence required to defeat these cases.
A new decision from the Fort Worth Court of Appeals, Lee v. Carmona, appears to make it harder to win rear-end lawsuits.
How does someone recover damages when they are hit by an uninsured driver? This is unfortunately a common question since here in Texas, 20% of drivers don’t have a liability policy, and from my personal experience, this number is much higher.
That means there are at least four million uninsured drivers on our roads. Yikes!
And that doesn’t even count the huge number of highly restricted “junk policies” our state legislators allow to be sold where the driver has been excluded from coverage by the owner.
A good personal injury lawyer will chase down these subprime companies, their insureds, and drivers and demand proof that there is no insurance. We have been successful at making some of them change their coverage decisions and pay claims, and when this doesn’t happen, sue the driver (and by extension his company) for our client’s damages and collect money that way.
Usually the other driver will have liability insurance coverage, but probably in the minimum amount of $30,000 for any one person’s injuries, $60,000 for all people he injured, and $25,000 for all vehicle damage.
Of course, this is often insufficient, especially if there are serious injuries with large medical bills and lost wages and/or multiple vehicles involved in the highway chain-reactions we see far too often on the highways in the Dallas-Fort Worth area.
In this case, if you and your attorney can negotiate a successful settlement with his liability adjuster or you have to file suit and either settle at a later stage of the litigation (which happens 99% of the time) or go to a trial, you will be paid this amount.
But what happens if and when he or she didn’t have insurance — or didn’t have enough? If you file a lawsuit and take a judgment, how will you collect your damages?
This is a serious problem that Texas drivers often have to deal with.
An arbitration clause is the new normal in health care provider contracts that patients must sign. Why? They usually favor the big hospital over the little consumer and remove the possibility of a lawsuit.
But what happens when a patient is better off trying to resolve a billing dispute in front of a jury of his peers, not a panel of businessmen?
On Monday an all-too-rare appellate decision allowed that to happen when it sided with an injured Texan in Cardon v. Goldberg.
Why did hospital file a lien against patient’s settlement?
Susan Goldberg received treatment at the Seton Healthcare Services emergency room in Austin for injuries she sustained in an automobile collision. Ms. Goldberg incurred $7,800 in charges which were billed to her health insurer, Blue Cross Blue Shield of Texas. BCBS had the standard reduction contract with the hospital and the bill was reduced to $6,503.
BCBS agreed to pay its share of $4,600 and Ms. Goldberg was billed the remaining $1,903. She forwarded that to her own automobile insurance provider, Nationwide Mutual Insurance Company. So far, so good.
However, instead of just paying that lower amount, Nationwide somehow paid the full $5,000 available under her personal injury protection (PIP) policy.
You might think this situation could be easily corrected. After all, the hospital was paid in excess of the original bill, let alone the adjusted bill as negotiated by BCBS, and could simply refund the difference. Ms. Goldberg never agreed that all $5,000 of her PIP proceeds was to paid to the ER and had other medical bills and lost wages that she presumably wanted to pay with those funds.
But nothing is straightforward in the often Upside Down world of insurance (“Stranger Things” fans will quickly agree).
Does the State of Texas have a duty to warn drivers about a dangerous road condition? Last week’s decision by a Texas appellate court ruling said that it did.The Dallas court affirmed a jury’s verdict in favor of a motorcyclist who crashed when his wheels hit a large crack in the highway. The trial court capped the $1,200,000 verdict at $250,000, the maximum damages allowed under the Texas Tort Claims Act, and the state appealed.
Brian Milton was traveling on FM Road 148 in Kaufman in 2012 at night. He couldn’t see the deep cracks in the road pictured here until he hit one and crashed his bike into a ditch. Milton had never driven on this road before. He was severely injured.
Testimony from state employees and other evidence showed that the TxDOT clearly knew about the problem before the crash. The responding officer noted the “big cracks” in the roadway.
A few days later, Milton’s wife took this photo of the severely eroded highway. And just one month earlier, a TxDOT worker had taken pictures of the poor road conditions and ordered signs to warn drivers about the failing road but the signs weren’t placed in the correct location.
In addition, the agency had begun roadwork nearby but had not yet made its way to the area of the crash where work orders were in place.
Judicial nominee Matthew Petersen had to withdraw today from consideration for the U.S. District Court after muddling through a dismal interview before the Senate Judiciary Committee. Thank goodness.
Peterson squirmed when Senator John Kennedy, a Republican from Louisiana, asked him to define such basic legal terms as motions in limine. They are submitted just before a trial begins and limit what evidence can be considered. Senator Kennedy also asked Petersen about the well-known Daubert test and the abstention doctrine and again the potential federal judge had no clue.
Peterson admitted that he had never tried any cases in court. Instead, he had held desk jobs working for the Republican National Committee and the Federal Energy Commission. Of all possible trial lawyers who already know the complicated litigation process, how did he ever get nominated?
As Senator Kennedy said, “You can’t just walk into a federal courthouse for the very first time and say “Here I am, I think I wanna be a judge.” It just doesn’t work that way.”
What’s worse is that federal judges are given life tenure to the bench. Firing an incompetent or unethical judge is nearly impossible.
Third Involving Girl Is On Tuesday. Why So Many?
This week I was in court finalizing two cases where small children were hit by big vehicles. And I will be in court on Tuesday where the young front seat passenger was seriously injured when her driver started ingesting drugs and crashed into the concrete median.
What in the world is going out there?
Fortunately all three young ladies have recovered from their injuries. I don’t know why we have so many pedestrian injuries. But a lot of good questions were asked by the parents about the legal process so I wanted to discuss how the personal injury case of a child differs from an adult’s.
For an example, today’s hearing involved a two year old who was walking next to her mother holding her hand in a crosswalk next to I-20 last year. They had the “walk” sign. Suddenly a young woman ran into them with her SUV. Then after apologizing, the woman fled the scene and could not be found.
I went to the scene and located several eyewitnesses. I then tracked down the driver and made her admit fault. I worked with the mother to get her daughter the medical, dental, and psychological help she needed, paying for some of this treatment up front so the mother didn’t have to. She was also badly injured and I assisted her in every way possible with her case.
I later negotiated with several adjusters and attorneys and collected the entire insurance limits from three different policies for both the mother and her daughter. To put more money into the four year old’s recovery, I reduced my attorney’s fee, waived expenses, slashed medical bills, and shopped for the best annuity plan which will allow the girl to attend college. The mother was thrilled — her very kind review is here.
Wednesday’s case successfully resolved the case where a seven year old girl was crashed into by a truck driver who refused to stop for her school bus on the side of the road with its red lights flashing. She broke her leg and required surgery. I again maxed out the driver’s large liability insurance policy, reduced my client’s medical bills, cut my fees, didn’t charge expenses, and set up a favorable annuity for her college tuition. I also made the driver’s insurance company pay a large sum for the emotional distress of the girl’s brother who was standing next to her and could have also been hit. My client was also very happy with the outcome.
Two 14-year-old twins were passengers being driven to school last year when their van was rear-ended by a pick up truck. The van was propelled through the walls of the Los Zarapes restaurant on the North Side of Fort Worth. Thankfully no one was inside eating.
The young women were rushed by ambulance to the hospital where their injuries and lacerations were treated. Each student attended physical therapy for the next month. I’m glad they quickly recovered from their injuries.
Their medical bills were reduced significantly by my law firm and Medicaid. That was of course good for the family, but bad for the verdict potential of the lawsuit in court. That’s because under a confusing law first passed by the Texas Legislature in 2008 and recodified in 2013 after the landmark Texas Supreme Court ruling in Haygood v. De Escabedo, their medical bills that could be used in court were reduced by $30,000.
I’m happy to report the maximum $50,000.00 available under the at-fault driver’s policy was recovered for one student and $30,000.00 for the other. The driver also sustained personal injuries and her injury lawyer recovered the remaining $20,000.00 for her, maxing out the policy.
I then set up a favorable four year payment plan starting with their 18th birthdays so they can attend college. One young lady will have approximately $17,000.00 and her sister will have $9,000.00 invested in an annuity. I am a huge proponent of these structured settlements, especially when young people are hurt.
I attended a hearing yesterday to finalize their settlements. Their mother was thrilled, said that her daughters could now go on to college, and that this would change their lives. That’s always so great to hear.
Good news for policyholders! Insurance companies must now pay for deceptive practices under a Texas Supreme Court ruling released this week.
The opinion hinged on whether the policyholder was entitled to benefits. If so, the policyholder could recover damages for the insurance company’s wrongdoing, even if there was no breach of the insurance policy.
USAA Texas Lloyd’s v. Menchaca involved a claim for damages caused by Hurricane Ike on the Gulf Coast in 2008. Gail Menchaca filed a claim with her homeowner’s insurance for damage to her home. The adjuster for the USAA Texas Lloyds insurance company determined that the estimated repair costs were less than Ms. Menchaca’s deductible so he declined to pay her anything for the damage. A second adjuster also estimated only minimal damage from the storm.
The policyholder sued USAA for breach of her homeowner’s policy and for the company’s violation of the Texas Insurance code that governs fair settlement practices. She argued that the company’s failure to properly investigate her claim resulted in her loss of insurance benefits.
The jury found that the company did not breach the policy but did violate the insurance regulations and awarded her the damages the company should have paid on her hurricane claim. The company appealed, arguing that since it did not breach the policy, no damages for bad faith could be awarded. However the court ruled in favor of the consumer and established five new ways to determine how these cases should be decided.