Legal Question in Personal Injury in California
Hello,
Last year I was injured at a Days Inn, and I ended in emergency with a concussion, broken arm and one broken tooth. We waited a couple of weeks for the respective/responsible risk management insurance company to get a hold of us, and it took a couple of months. So by then I had seen several doctors, and my arm mended, and my headaches stopped, but not after I had taken some serious x-rays to verify all was okay. The whole case took about 8 months, and then the insurance requested all the appropriate medical expense paperwork, story of event and like that, but then they sat on my case for several more months. When I finally called them on it--they said "Oh, yes we were getting the settlement paperwork ready", and I was told this amount, and I said well that sounds too little, and so they added a couple more beans to the amount.
Now, my coverage insurance company has contacted me and basically wanted to know whether I had suit for settlement, and my reply would be NO, because I kept it out of court, and basically got reimbursed for basic Co-payments to my doctors, and mileage and days skipped from work (all about $1,600.00), not some great amount. My question is: Is there a certain amount that Medical/Kaiser is allowed to ask for in my case? If so why would they want that money if it barely covers the above (of which they CO-pay is paid already-to them), and the other payments are basic charges, can they really expect me to pay for all the coverage or do they just want what I got from the Days In Insurance Company. I should add that I was not able to get 3 attorney's to take my case/they did not consider it lucrative enough --I guess. So that is why we basically settled for basic fees and stress.
Last question, can we go after the Risk Management Insurance Company if they mislead us.
Sincerely,
Victor R. Esparza
2 Answers from Attorneys
Victor with all of your facts you failed to state how you were injured. My firm handles PI all over the State of California. Call me for a free consultation at 800-816-1529 x. 1.
Norm
I handle PI cases as well and I can tell you that Kaiser will expect back what it paid unless you are represented by legal counsel. More recently, Kaiser has retained an outside agency to recover the value of its services to its Kaiser members. Nontheless I believe that involving an attorney still can help reduce Kaiser's lien amount. Where an attorney is involved (and depending upon the severity of the injury/damages incurred verses the settlement amount recovered) the amount has been reduced by 25%-331/3% and perhaps a litttle more (with no guarantees) reduction. By the way, it sounds like the insurance company is giving you the "run around", which, unfortunately, can happen with self representation. I hope this helps you.
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