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Articles Posted in Insurance

Surprise balance bills can be a financial catastrophe.

After being in a car accident, you smartly checked your health insurance policy and only went to an in-network hospital and doctor so that you would only have to pay a small copay. They assured you at the front desk that they would bill your Aetna plan.

Then a few weeks later you may have started screaming when you opened the mail and read whopping medical bills for thousands of dollars. It happens every day to people who are injured in collisions in Fort Worth and North Texas. Medical bills cause a staggering 643,000 Americans to file bankruptcy each year.

Here’s what causes enormous medical bills to happen:

  • Even if you are even covered by Blue Cross, not every hospital and doctor is your plan’s network,
  • Or you haven’t met your annual deductible yet, especially now at the beginning of the year,
  • Or you may have a large deductible, say $5,000.00, and never meet it each year,
  • Or the ambulance, hospital, doctor, or MRI facility refuses to file with the plan,
  • Or the hospital files a lien and demands payment in full from you and your recovery from the other driver,
  • Or the plan refuses to accept any claims, falsely claiming it is not required to do so,
  • Or the plan slowly pays some of the bills and then bills you for the enormous balance still due and/
  • Or the plan pays bills and demands subrogation (repayment) when you receive funds from the at-fault driver’s liability policy or another source.

This financial roulette is a catastrophe. Medical bills can be astronomical even if health insurance steps up and pays the bills in full. This process is unfair to Texans for so many reasons and must be reformed.

You can’t guarantee that every medical provider you saw and will see is in your network.The ambulance that showed up at the scene drove you to the nearest available hospital. By sheer luck, the ambulance and hospital might have been in-network, but the separate company’s emergency room doctor often is not. Even if you knew this (which isn’t likely unless you searched your plan documents first) you weren’t exactly in a position to demand to be transferred to a different hospital that was in-network. It’s a dangerous game of financial roulette and it can be ruinous to your bank account.

Why does it matter if the hospital is out of network? Because it will charge whatever it wants, many times higher than the negotiated insurance rate of your in-network one. So a $1,000.00 bill that should have only been $200.00 in the first place can be billed at $5,000.00 or more.

Guess who pays the difference — you. That is, unless you hire a good personal injury lawyer.

I regularly negotiate for the maximum possible damages as well as getting the lowest possible reductions for the medical bills of my clients. Success on both of these fronts is crucial for a successful outcome. After all, it doesn’t matter if you get more money from the other driver’s insurance policy if you have to hand all of your proceeds to hospitals and doctors. This is especially true if you had health insurance and should have been covered to begin with.

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Insurance adjusters are carefully trained to pay out injured people as little money as possible — if any. At the same time, they spend billions of dollars convincing you that they are your “good neighbor” (State Farm), “you are in good hands” (Allstate), or that “Liberty stands with you.” What nonsense.

These companies often use tricky, even sleazy, tactics to minimize claim and lawsuit amounts. That’s why you need a personal injury lawyer to fight for you.

How do you know when an insurance company is trying to cheat you? It’s easy. You’ll know it when you see that they

1. Pretend to be your friend. Don’t believe it. The adjusters are reading scripts and asking questions right off their computer screens. They will call back wanting to know if you are getting better but want to later be able to refer to the day you said you were feeling “better.” What they want to do is to gain your trust so you’ll accept a low settlement offer.

2. Pressure you to give them a recorded statement. Don’t even think about it. You are not legally required to. And anything you say can and will be used against you in settlement negotiations or at your trial, if one becomes necessary if and when they don’t offer you a good amount of money.

As soon as possible after the crash, the adjuster wants to  catch you off guard. You will probably be on pain medications, scared, and not had enough time to consult with an attorney. I’ve refused almost every

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What are your options if you should be involved in a car or truck accident while driving to a sales meeting or making a delivery? Who pays to repair or total your car or truck and for your lost wages and medical bills? Your case can get complicated very quickly.

There are multiple sources you can pursue to collect compensation for your damages. In addition to filing on the at-fault driver’s or vehicle owner’s liability insurance policy and your automobile insurance benefits, should you consider filing on your company’s workers’ compensation policy?

How will workers’ compensation affect your claim?

You may have been told that you cannot file against or sue your employer for damages if you were injured on the job. You may be able to but it’s not always a good idea. Here’s why.

Workers’ compensation insurance covers your medical treatment and lost wages without you having to prove fault. In return for the guarantee of a substantially limited pay check, you waive your right to sue your company — even if it were negligent. But what if your service department failed to properly maintain the company truck’s brakes, causing you to crash and get seriously injured?

There are other drawbacks as well. You usually receive less quality medical care. Most “good” doctors refuse to file on “comp” since payments are drastically curtailed and the paperwork and red tape can be onerous.

Further, you will have to reimburse the money you receive for your lost wages and medical bills. This is a legal concept called subrogation authorized in the Texas Labor Code. That means that you will have to pay back the comp carrier for what it paid you up front. So if your net settlement proceeds are $20,000 but the comp company has already paid you $20,000, your “new money” will be zero. Not good, since your initial payments will have already been spent by you or paid to hospitals and doctors.

A good injury lawyer will fight to get that subrogation amount that you owe reduced. We are in the process of finalizing the severe injury case of the man pictured above who was driving his truck for his company when another vehicle failed to yield the right of way. He’s had three surgeries to date. We successfully obtained a huge cut of what he owed to comp after getting him the maximum available under the large insurance policy available.

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With freezing temperatures and wet roads forecast in North Texas, I was concerned this weekend would be particularly dangerous and it was. A toxic mixture of drunk drivers and slippery highways led to hundreds of car crashes.

170 auto accidents, including 26 rollovers, happened in Fort Worth on NYE before 9:00 PM — before prime drunk driving hours had even begun.

Later four people tragically died in these car accidents:

  • 12:33 AM – a wrong way driver crashed head-on into another vehicle on I-35 south of Dallas, killing both drivers.
  • 5:20 AM – a motorist died when a car he stole from a strip club caught fire after hitting a curb and crashed into a light pole on Irving Boulevard.
  • 5:25 AM -two good Samaritans stopped to help a driver who had collided with the median wall on LBJ Freeway. Another vehicle slammed into the accident scene, killing the driver and injuring one of the good Samaritans. The other good Samaritan, an off-duty Garland firefighter, escaped injury by jumping over the median when he saw the vehicle barreling down on them.

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Study finds hospitals charge people an outrageous 340% too much for ER care.

Johns Hopkins Medicine researchers have analyzed the records of over 12,000 emergency rooms in all 50 states and discovered that prices for the same procedures varied wildly between different hospitals. Rubbing more salt on the wound, the most vulnerable, least insured, and poorest patients were often charged the highest prices.

The researchers then compared the prices charged to the amount listed by Medicare. On average, patients were billed 340 percent more for their services than the Medicare listing price.

The researchers aptly referred to the practice as “price gouging.” This has got to stop. Car wrecks are not profit centers to support the rest of the hospital. Continue reading

ER clinics must now give patients billing information up front.

You will need prompt medical care after you are injured in a car crash. But you don’t necessarily need to be taken by an expensive ambulance (the typical cost in Fort Worth is $1,600.00) to a huge level one trauma center and have to pay the hospital, emergency room, and radiology company $5,000.00 or more.

This is where freestanding ERs can fill the gap. But they can also sometimes come with an enormous price that is shocking.

After years of complaints about excessive bills for minor emergency clinics, the Texas legislature stepped in. A new Texas law will hopefully alleviate these surprise bills.

As of September 1st, freestanding emergency clinics must post which insurance companies cover their services.

I just discussed a similar problem about how air ambulance companies gouge people after auto collisions here and what you can do about it. Continue reading

Air ambulance bills are sky high

When 17-year Colton Lightfoot crashed his motorcycle, his parents didn’t hesitate when doctors suggested that he rushed to the emergency room by air ambulance. At that alarming moment, they didn’t think to ask questions like how much that would cost or whether their insurance covered it in full or at all.  Naturally all they cared about was their son’s recovery.

But nothing could prepare the East Texas family for the enormity of the bill for that flight — $58,000. After their health insurance carrier only paid $15,000, they were stuck with a whopping $43,000 bill. And many of these carriers refuse to pay all medical bills when they find out that they were the result of a car wreck.

Their story is typical and I’ve seen the victims of car accidents grapple with this serious problem. Continue reading

Almost every adult in the Houston area owns a car. Now hundreds of thousands of vehicles have been ruined by the torrential rainfall. This, added to the loss of life and staggering property and commercial damage, has become the worse natural disaster in the history of the United States.

Insurance companies have received more than 100,000 Harvey-related auto insurance claims. That number is expected to reach 500,000.

As car owners begin to review their policies, some might get an unwelcome surprise. Policies that seemed just fine at the time they were signed might actually exclude the types of damages caused by Harvey.

Unfortunately many car owners figured flooding was highly unlikely and opted for lower premiums instead of comprehensive coverage.

The thing about insurance is you have to predict what you might need and decide whether paying higher premiums is worthwhile. You could potentially pay premiums for a lifetime and never file a claim. Or, as with Harvey, your insurance might be a financial lifesaver. In many ways, it’s a gamble. But usually choosing the better coverage pays off. Continue reading

Our High Rate Of Uninsured And Underinsured Motorists Is A Serious Problem

Last week local drivers started being stopped by police to see if they had licenses and liability insurance. It’s about time. I hope other police departments in the Dallas Fort Worth area start doing this. It’s for our own protection.

At just one checkpoint, police wrote 36 citations and ticketed 24 uninsured drivers on Bardin Road in Arlington in just a 1½-hour period.

With 1.6 million uninsured drivers, Texas was in the top five states last year. While our officials estimate that 13 percent of drivers in the state do not have car insurance, as a personal injury lawyer I have seen that this number is much higher. The Dallas News estimated the number of uninsured drivers in Dallas County at 16%.

But that doesn’t count the drivers who officially have insurance and the policy expired or is fraudulent, or the driver has been excluded from coverage, hits and runs, disappears, denies responsibility, or fails to cooperate with his insurance carrier.

The checkpoints have exposed important information about the high number of uninsured drivers driving in North Texas . What happens if you are hit by one of these drivers? Who will pay your damages?

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Why you are smart to hire a personal injury attorney

Some of the important questions you need answered if you have been injured in a car wreck are

  • how much money can I get from the other driver and his insurance company?
  • will they pay me as much money as I want? 
  • will a lawyer charge me so much that I should just represent myself?

I’ve been asked them countless times over the past 37 years as an injury lawyer in Fort Worth.

I’ll give you answers that will help you make a good decision about what to do after your car wreck case.

I’ve discussed this topic on my web site, in a book for injury attorneys, and at a presentation to the Texas Trial Lawyers Association.

A personal injury lawyer wants to get the most compensation for his clients and sooner, not later. Continue reading

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