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Some common insurance questions, answered

Do you have the right coverage on your insurance?For all of my friends who are looking to insure or are insuring an automobile or motorcycle here are a few answers to questions you may have regarding what type of insurance to buy and why:

Q: Should I buy personal injury protection (PIP)?
A: Yes, every time, always, yes. Why? Many reasons, first, because you can select coverage anywhere from $2,500 up to $10,000. If you do not have health insurance, this will provide you reimbursement, dollar for dollar for any medical care you receive relating to the crash. If you do have health insurance this coverage will provide you dollar for dollar coverage and things your insurance coverage may not cover, for example, x-rays, dental, professional nursing, even funeral expenses. This coverage may even cover a percentage of lost income due to disability resulting from injuries, and costs for services to maintain the household. Each insurance company has different coverages and these are meant to provide examples.

Some people elect to only get the medical payments/med pay when electing coverage on their policy. Med Pay only covers medical expenses, as you can see, PIP can cover much more. Generally, you will not be allowed to elect both Med Pay and PIP coverages since Med Pay is duplicative of the medical payments portion of the PIP.

Q: Should I get Uninsured/Underinsured Motorists Bodily Injury Protection (UMBI) and Uninsured/Underinsured Motorist Property Damage Protection (UMPD)?

A: Yes, every time, always, yes. Why? The most reckless drivers historically do not have insurance. They have the least to lose and can cause a lot of damage. Drunk drivers can cause more harm than they have coverage for, if they have coverage at all.

By getting protection under these policies you are covering yourself in the event a driver has no coverage or causes more harm than their policy will cover. For instance, you are injured by a drunk driver and hospitalized. Most hospitalizations cost more than the Texas state mandatory minimum of $30,000 coverage. So, if you have underinsured motorist benefits for bodily injury, your own policy will cover you up to the amount of coverage you have elected.

The additional coverage will cost you a lot less than what you stand to lose if hit and injured by a reckless driver.

An Example of Insurance Company Tactics – Tackling Colossus

Tackling ColossusAt Shefman Law, home of Austin personal injury motorcycle accident attorneys, we constantly see insurance companies attempting to utilize psychological games to get clients to accept settlements. One thing that differentiates Shefman Law from other motorcycle accident lawyers is that we’re experienced personal injury trial attorneys, and we’re always prepared to take your case as far as we have to in order to ensure fair compensation for your injury. When we saw a recent attempt by an insurance company to encourage a victim of injury to settle using a dubious technique we’ve come to recognize, we knew we had to bring attention to it. This is the story of Colossus, and how insurance companies use it to get victims to settle their claims.

What Is Colossus?

Often times when a victim has been involved in a motorcycle crash and has sustained injuries, they will receive a letter from the insurance company that is managing their claim. As motorcycle accident attorneys, we constantly see letters stating something along these lines: “We’re writing you to let you know that among other tools, our computer program Colossus, which is a sophisticated program that calculates claims to an incredibly accurate level, has made a recommendation as to the value of your injury.”

Colossus is a program that came about in the 1990’s, and is used by most major insurance companies. Essentially, it standardizes the claims process in order to expedite settlement while often reducing the payout made for an injury. The letter mentioned above typically goes on to give a litany of reasons why Colossus is as precise as possible, and furthermore why its deliberation is a fair representation of the value of your claim.

Any experienced motorcycle injury lawyer will tell you to take this information with a grain of salt, and there’s a good reason for that. When you’ve been involved in a motorcycle accident that has resulted in significant injuries, the insurance company that is handling your claim is in the business of preventing as many losses as possible. Whereas a motorcycle accident attorney such as those found at Austin’s Shefman Law will make sure to take your claim as far as it will go, insurance companies are hoping to prolong the process while settling for the smallest amount possible. Referencing the authority of a program like Colossus is meant to discourage you from moving forward with your claim.

How We’re Different

Whereas the insurance companies will be attempting to limit the damages paid out due to negligence or other culpability, the motorcycle accident personal injury lawyers at Shefman Law will always take your claim as far as need be to get the compensation you deserve. If you’ve been injured in a motorcycle crash, don’t let the insurance companies bully you around with psychological warfare such as Colossus; instead, call Shefman Law where you’ll find a personal injury attorney that will fight for you. You’ve got a bike? We’ve got your back.

Sample Personal Injury Demand Letter

Attorney Shefman on her Iron 883 Motorcycle

Attorney Shefman on her Iron 883 Motorcycle

This is meant to be a tool for those folks who choose to represent themselves following a minor crash where they are seeking personal injury or bodily injury losses in the Texas Justice of the Peace Courts in an amount under $10,000. As Austin personal injury attorneys, we’ve noticed that often folks will choose not to hire an attorney, perhaps liability is clear they just need some help writing a letter to the insurance company. If you are not sure what to include, this sample letter will provide an idea of how to structure your letter and what to include. There are many ways to do this, this is a simple outline that we hope is useful and easy to follow. If for any reason you do need a motorcycle accident attorney or car accident injury attorney, make sure to contact Shefman Law. We fight, and we win.

REMEMBER, YOU ONLY HAVE TWO YEARS, IN TEXAS, FROM THE DATE OF YOUR CRASH, TO FILE A CLAIM AGAINST AN INDIVIDUAL OR CORPORATION THAT HAS HARMED YOU IN A PERSONAL INJURY CASE.

IF YOU HAVE BEEN HARMED AS A RESULT OF A MUNICIPALITY OR STATE ENTITY (GOVERNMENT) YOU SHOULD SEEK LEGAL COUNSEL FOR THE LIMITATION ON WHEN YOU CAN BRING A CLAIM.

Sample Demand Letter for Pro Per (Self Representation) where you are seeking $10,000 and under (Justice of the Peace Cases):

Introduction

This is where you provide a short statement of who you are, your age, your occupation, (a snapshot of who you are in your own words).
Include a picture of yourself. Mention that this is an offer for early resolution of your claim.

Facts Establishing Liability

Write about the crash. Where you were coming from. What the other driver did just before the crash. What you did. How the crash occurred. Be careful not to get too specific about time and distances if you are uncertain and can’t be exact. Discuss the choices the other driver made when they hit you that make the incident the other party’s fault. Liability has either been established –If it has not been established by a police report or admission of party that hit you, then state why they are at fault, for example did they violate your right-of-way? Did they run a red light? Were they talking on the phone?

How do you know they are at fault? List your observations, the other driver, witness or passenger statements. Put all of that information in this section to establish your arguments why the other person is at fault. Whatever evidence you have to support your argument, include it as an attachment and reference it in this section. Any good car accident injury attorney will want this information as well in case you do end up seeking legal assistance.

If it is a violation of a right-of-way, or a failure to stop at a red light, speeding, inattention of the other driver (driving while distracted), not keeping a safe distance provide the code section for that law and copy that law into your paragraph. For instance, most of these code sections can be found through google, but you can also look directly at this site: http://www.statutes.legis.state.tx.us/Docs/TN/htm/TN.545.htm. Then state, the law “Sec. 545.152. VEHICLE TURNING LEFT. To turn left at an intersection or into an alley or private road or driveway, an operator shall yield the right-of-way to a vehicle that is approaching from the opposite direction and that is in the intersection or in such proximity to the intersection as to be an immediate hazard.” When Mr. Defendant Driver made the left hand turn directly into my lane of oncoming traffic, there was no time, reflexive or deliberate to avoid a collision. Therefore, Mr. Defendant Driver is liable for the resulting injuries.

(Include photos of crash or car)

Injuries Related to the Crash

What happened to you, immediate harms, treatment you received, physical losses, emotional losses (harms and losses) things you were unable to do. What were your pain scales 1-10 and list out in table format.

Provide a pain scale of 1-10 for the parts of your body injured immediately following the crash, three days after crash, one week, two weeks, three weeks, one month, etc.
1st Day 3d Day 1 Week 2 Weeks 3 Weeks 1 Month
Head: 3 5 4
Neck:
Low Back:
Shoulders:
Right Ankle:

For each treatment provider, list the date of treatment, the physician or therapist, then list what the record states in summary. Do this for each treatment date, and for each treatment provider.

Describe how these injuries affected your life and what setbacks, if any, the injuries caused you. List in as much detail with as many descriptor words as you can, what these injuries prevented you from doing and why. For instance, if you hurt your neck and were diagnosed with whiplash perhaps you could not drive for a period of several days. Maybe you are a new dad or mom and you could not lift your child? Describe what you were unable to do as a result of your pain.

Damages

These are the financial losses you have as a result of the crash. List every economic loss you have, this will include wages lost, medical costs, co-pays, ambulance bills, repair and replace costs of clothing you may have been wearing that was soiled or property damage. If you broke a watch for instance, provide the receipt and a photo. If you have no receipt or photo look it up on amazon and get the cost to repair and/or replace the watch. For your motorcycle, bike, or other vehicle, send the estimate to repair or replace with photos of the damage. Again, you’ll want to detail this information even if you wind up seeking the assistance of a motorcycle accident attorney or personal injury lawyer here in Austin.

For medical treatment, provide records for every item listed. Reference the record and bill and attach it to the letter in order it is mentioned in the letter or embed it into the demand with a readable snapsnot.

Treatment provider Cost of treatment
1. seton Hospital $1,100.00
2. CVS Pharmacy $17.00
3. Primary M.D. $135.00
Total: $1252.00

Conclusion

This section is a short recap of what happened, why liability is clear, why you are entitled to payment for reimbursement and also all of the harms and losses you suffered including lost wages, and emotional and physical pain both past and future. List your demand. Some people list demand amounts to include pain and suffering and emotional distress as a multiplier of the amount of bills they have. $1500 X2 or X3. This is a subjective number and only you know the value of your loss. If there is no egregious behavior involved and it is simple crash from simple negligence x 2 or x 3 is maybe a fair number. Remember you want to be reasonable so you can resolve the claim with the insurance company.

If writing the demand is unsuccessful you will have to pursue your claim in small claims or justice of the peace court.

Include as attachments or embedded in your document to be sent to the insurance adjuster for the defendant (not your insurance company) all documentary evidence, photos of your damaged property, your injuries, reports, bills, wage loss letter from your employer or a paycheck stub (insurance company will probably ask for a letter) etc.

Remember, you may want to give yourself time after you feel healed to make sure nothing else comes up as a result of the crash. Once you resolve the claim with the insurance company, you cannot reopen your case and ask for anything else. Your case will be resolved for all times. As Austin car accident injury lawyers, we recommend this to most clients.

THIS IS NOT MEANT AS LEGAL ADVICE OR TO SUBSTITUTE FOR LEGAL ADVICE FROM AN ATTORNEY. THIS IS ONLY A SAMPLE PRE-LITIGATION DEMAND LETTER MEANT TO ASSIST THOSE WHO HAVE ELECTED TO REPRESENT THEMSELVES IN A PERSONAL INJURY CASE WHERE THE MAXIMUM VALUE OF THE CASE DOES NOT EXCEED (TEN THOUSAND) $10,000.00 DOLLARS

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