Length of Time for Settlements

“How long does it takes to get an insurance company settlement?”

There is no one answer for every case.  Cases in certain counties tend to move more quickly than cases in other counties. This is true for both New York as well as New Jersey.

The common types of personal injury cases like car accidents and trip and fall accidents tend to move the quickest. The less common cases like contruction accidents or medical malpractice claims usually take longer.

We tell our clients that most car accidents cases and trip and fall claims brought in Supreme Court, Richmond County settle in between two to three years.  Some cases settle more quickly, some take longer. But there are so many different factors that determine how long litigation takes until a trial or settlement, that it is not fair to give a specific length of time for litigation, especially without knowing the particulars of your case.

Worker’s Compensation claimants may receive no settlement at all. Such settlements only occur when the claimant’s medical conditions have stabilized and the doctor submits a report commenting on disability. There is no set time how long a medical condition takes to stabilize. Furthermore, unlike cases brought in Supreme Court, there are formulas that the Componsation Board uses to calculate the amount of a settlement. (The amount of the settlement is computed on a case by case basis.)

Insurance Policy Limits

“Do Insurance Companies settle cases within their policy limits to avoid trial?”

Yes, but that is only part of the answer that Insurance Companies offer to settle cases within their policy limits.  First, Insurance Companies are obligated by law to try to settle legitimate claims against their insured. Insurance Companies also are obligated to defend their insured by paying lawyers to defend their insured’s interests in Court. Thus, if an insurance company has determined that the claim is legitimate and the claim is larger than the amount of the insured’s policy limits, then the carrier will offer to settle within the policy limits to avoid the costs of defense and jeopardizing a judgment against their insured.

But insurance companies do NOT offer their insured’s the policy limits to settle all claims. Insurance companies make money by collecting premiums and minimizing the amount they pay in claims. Thus, insurance companies are constantly evaluating the potential defense costs and exposure of their insured before paying a settlement. Some Insurance Companies use sophisticated statistical models to predict settlements like baseball teams use metrics to hire players for a team.

 

Liens on Accident Claims

If my medical bills were paid by insurance, do I have to pay back the insurance company from my personal injury settlement?”

There is no short answer to this question.  When someone is injured in an accident, they need immediate medical trereatment.  There is no time to wait for a personal injury case settlement which coulkd take years. Medical providers like to be paid for their services rendered. So in almost all accident cases, there is some insurance entity paying the bills for medical treatment. The question really is, will that entity that paid for medical treatment have to be repaid for those medical billls it paid?

Generally, for car accident cases, there would be no lien (but there are certain cases where you do have to pay back medical bills paid by insurance).

For many claims involving innuries on the job, the Worker’s Compensation Carrier who paid the bills would have to be repaid. The amount of that lien would be reduced by proportional amount of legal fee and disbursements. (This would mean the reduction of the lien would be at least one-third of the total lien. (But there are certain types of Worker’s Compensation liens could be waived entirely, but that depends on the type of accident.)

For those accidents covered by Medicare, there is a lien and Medicare would have to be repaid for medical bills covered. But, just like Worker’s Compensation Carriers, Medicare will reduce its lien based on the amount of legal fee and disbursments.

For many other cases, there is no lien. It is difficult to understand the lien reductions without specific facts. But the best answer to the original question would be that there could be a medical lien reduction or waiver, but it really depends on the specific facts of your case.

Monetary Value of Personal Injuries

“How does a judge determine the amount of money to award in a personal injury lawsuit?”

A Court awards “fair and reasonable” compensation for the injuries sustained. This does not really seem like an answer, but the question is too vague to give a better answer. The best I can really do is to briefly explain the process that a court uses to determine monetary damages.

Although a judge can make awards for personal injuries, most cases are decided by juries. In New York, six people decide the amount of the award and only five have to actually agree on a number. The jury listens to testimony, reviews photographs, looks at medical records, and listens to doctors testify about the injuries. After attorneys present all of the evidence, the trial judge reads a set of jury instructions. Jurors go to private room where they talk amongst themselves to discus the evidence and the jury instructions.

The judge instructs the jury to use their common sense to award “fair and just” compensation. There is no magic formula, no schedule of injuries to guide a jury explaining what to award based on the body part or severity of injuries.

Judges have the power to over rule juries to lower outrageous verdicts (called remittitur) or to raise unconscionably low verdicts (called additur).  Appeals courts can also raise or lower verdicts based on prior cases of similar injuries.

This is far from inexact science. That is why many times parties end up settling cases at a figure both sides can live with.