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Catastrophic Injuries, Finding the Policy to Cover The Costs of All of the Harms and Losses

When a client of ours suffers a catastrophic injury there is always a search for insurance coverage to manage the extensive harms and losses experienced by the injured and their loved ones. A tree of inquiry is to be followed and it naturally begins with the driver’s insurance policies. Texas has a glut of uninsured drivers—the Department of Transportation shows as of 2014, 1 in 6 drivers is using our roads without maintaining financial responsibility.

Inadequate coverage by the owner or driver leads to an inquiry of the injured party—did they have uninsured motorist or underinsured motorist coverage (UIM)? Many people overlook the importance of purchasing this additional bit of insurance. To every driver we recommend purchasing this layer of insurance.

Sometimes there are third-party policies that may provide coverage in a catastrophic injury cases. In Texas, these policies are referred to as Umbrella Policies and usually only exist when the primary policy exceeds $300,000.00. These policies are on top of regular auto policies and must be separately searched for using databases built to find this specific layer of insurance. These excess or umbrella policies are usually meant to cover events that are not typically covered by standard policies and the policies must be read to verify applicability.

The next query is to seek the possibility of other negligent parties such as employer liability for cases involving commercial vehicles such as delivery trucks, semi trucks, 18 wheelers, construction vehicles and vehicles driven for the benefit of an employer, or in the course and scope of employment. Commercial policies, often referred to as CGL (commercial general liability), are specifically for vicarious liability issues. Knowing how to read the policies for exclusions and coverage is key to knowing what money is on the table to cover the catastrophic losses.

Trucking accidents can have layered coverage for the driver, owner, operator, and company. Typically there are layers of insurance that cover separately the owner, operator, and the company, depending on the way the driver is employed. The Motor Carrier Safety Act sets standards for insurance and endorsements on drivers and big rigs.

If you have suffered a catastrophic injury and are trying to dig through the layers of coverage and/or find coverage for your harms and losses, let us help navigate the claim so you and your family can focus on gaining quality of life and living back.

Common Slip and Fall Causes, and How To Avoid Them

Slip and Fall Accident

Shefman Law, Austin personal injury attorneys, handles all different kinds of personal injury lawsuits, from motorcycle accident cases to swimming pool injuries. One of the most common types of personal injury suits we see revolves around what is known as slip and fall accidents. Slip and fall accident attorneys are all sadly aware of the fact that not only can slip and fall injuries often create distressing situations for our clients, they also tend to be incredibly avoidable. Most slip and fall accidents that are the result of negligence could be prevented with a bit of foresight and care, and as Austin personal injury attorneys we believe in doing everything we can to make the situation safer for our community. Here are a few common slip and fall situations, as well as ways to avoid creating them.

Damage or Change to a Property

 One of the reoccurring themes in slip and fall injury cases is a lack of property owners to properly address a change in their physical property. Whether it’s damage to a floor that creates an obstacle or a remodeling project that isn’t yet completed, failure to properly handle and address dangerous property damage is something that every slip and fall accident lawyer continually sees in cases.  If you are a property owner, you’ll want to not only avoid these types of situations, you’ll also want to always properly document and mark any area that could potentially prove unsafe for guests.

Unsafe Cleaning Practices

 At Shefman Law, Austin slip and fall personal injury attorneys, we’re surprised that all property owners are yet to understand the implications of not handling cleaning and maintenance with the utmost care. From recently mopped floors to areas that have been over-polished, maintaining a safe walking surface is a requirement for any space and liability can and will fall on property owners who fail to provide it. In the legal field, we utilize a coefficient of friction measuring system to determine if a floor is too slippery. Although not every property owner can maintain such a precise system, make sure to always err towards a floor that is as safe as possible in order to avoid unnecessary slip and fall accidents.

Failure To Address Weather Conditions

 Even if a property owner stays up to the task of maintaining the general safety of a surface are while also avoiding dangerous cleaning practices, a slip and fall accident can still occur if weather conditions aren’t properly responded to. As slip and fall injury lawyers, we’ve seen countless cases that occur due to rain, snow, and ice, and it is up to a property owner to combat these unsafe walking conditions with effective protocol. Whether it’s salting any and all icy areas or placing rubber mats in needed areas, if you don’t maintain safe surfaces during difficult weather conditions, you may just find yourself getting a call from a slip and fall accident attorney.

Although this is in no way an exhaustive list, it should illustrate just how essential it is for any business or property owner to attentively focus on providing a safe and manageable space for all of their guests. If you’ve been in a slip and fall accident, contact the Austin personal injury attorneys at Shefman Law to find out what options might be available for you.

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

Telling the Truth at Trial….Well, Sort of …

Preparing for trial is always the lead in to what it is all trial lawyers crave: the high emotions, the low emotions, the insane and crazy strategic gamesmanship that can be found in no other game. Litigation is like chess – only, the players are real people.

Plaintiffs are real people. Defendants, they are, well…. sort of, real people. Let me explain.

Given that it takes nearly two, three, sometimes four to five years to get the case to trial generally gives you an idea of how hard fought the case has been. In a personal injury trial situation, someone has been harmed, suffered losses and is seeking compensation for those losses, those major setbacks in their life, from the party that harmed them.

The reality is, the person that caused the harm is typically represented by an insurance defense attorney. The attorney for the insurance company and the claims representative are calling the shots. They are deciding if the case will settle, if the case will go to trial. They are playing a numbers game. Plaintiff is living his or her life. Defendants are trying to maintain their insurance policy and have to do what the insurance company tells them to do. It is a risk/reward numbers game for the defense. There is a cost benefit analysis. A rolling of the business dice. An effort to maintain a bottom line.

That is a significant fact a truth that never gets told. We have selective justice in our civil jurisprudence. Insurance lobbies are powerful and prevent jurors from hearing that there is insurance involved… though we all suspect it, it is never spoken about in a courtroom. The theory is that if jurors know there is insurance they will be more likely to apply a verdict that will make whole the plaintiff for the harms caused. If the jurors think it is coming from the pocket of the defendant, then the verdict will reflect sympathy for their fellow man and his or her bank account.

In a nationwide effort to further reduce the cost to insurance companies, medical bills – often used to evaluate how “harmed” a plaintiff was, or is – are not fully allowed to be seen by a jury. Let me explain how this has come to work in the past two years. In both CA and TX, companion cases decided near the same time, 2011, held that only the amount of medical bills actually paid by an insurance company would be presented to a jury. In other words, we all know how astronomical the cost of medical care is in the US. If jurors hear that a person claiming to be seriously injured only suffered FIVE THOUSAND ($5,000.00) DOLLARS in medical care costs, you would not assume that was very serious. What you may not hear, depending on the judge’s ruling pre-trial, is that the billed amount for medical services to the injured person was actually FIFTY THOUSAND ($50,000.00) DOLLARS. Blue Cross, Blue Shield, Aetna, Travelers, Healthnet, etc., all have agreements with the medical providers to pay set rates for various services/procedures. That reduction by contract between the insurance company and the healthcare provider/hospital, a separate agreement having nothing to do with the crash, the harms, the surgery, the pain, is the only information that will get before some juries. When that happens, the juries won’t know the actual amount billed, and more likely than not, the verdict will be anchored to the amount of bills to determine the extent of harm when deciding non-economic (pain and suffering) damages.

As I prepare for trial, I think of all the ways in which I have to word my opening, my direct examinations, my cross-examinations, my closing argument, and every other piece of evidence with insurance information on it, has to be redacted. I think about how truth in this “truth-telling” forum can only partially be told. I think about how one day, hopefully I will be preparing for a trial where I will be able to present to that jury, the WHOLE truth.

Until then, I am left to work around, strategically present my case so that the burden on the plaintiff is not so burdensomely felt. My goal: fix what can be fixed, help what can be helped, make up for what cannot be fixed or helped. I do this for the little guy, the underdog, the one fighting to make sure the bills s/he owes due to someone harming him/her don’t cost him/her his or her apartment or throw him/her out on the street, cause him/her to miss a child support payment or go so deep into debt that there is no coming out. It is a fight involving human lives. It is not about numbers and cost benefit analysis. For the plaintiff, it is about winning justice in a system that only allows the telling of half-truths. For the defendant, it is only about protecting a swollen and deeply weighted bottom line.

Depositions-Don’t Go In Unprepared

A deposition occurs in litigation. Witnesses, named parties (plaintiffs and defendants), experts (doctors, engineers, people with special knowledge) are all likely to have their depositions taken prior to a mediation, arbitration or trial in a lawsuit. The deposition is in effect an interrogation. That is frightening. The opposing party’s attorney will have a chance to ask you anything that is reasonably calculated to lead to admissible evidence. That is a vast possibility of questions for the non-lawyer, anything “reasonably calculated”.

As an attorney, I have an obligation to provide my client the tools necessary to understand and succeed in deposition against a seasoned law expert, opposing counsel. We call this preparing the witness.
An attorney’s client should never go into a deposition with fears they don’t know how to handle. Client’s should clearly understand how to answer the types of questions lawyers will ask. Depositions are not customary environments where typical conversation occurs. Attorneys talk funny, and they may ask you questions in a way you are unfamiliar. An attorney that properly prepares their client may have a client that is still afraid of being deposed but the client will also have enough tools and knowledge to understand the issues, questions, language, and dialogue and how to ask clarifying questions of the attorney interrogating them.
When an attorney fails to properly prepare their client (a process that in our practice can take no less than five hours and sometimes days) is an attorney who is failing their client and ultimately the merits of the case may suffer. The preparation for deposition should begin days in advance of the client’s deposition to allow the client to ask questions about the process and their participation. The days between meeting with the client and the actual deposition taking place give the client time to digest and develop questions that their attorney can then help them with prior to the day of the deposition.
The more difficult the case, the severity of injuries involved, the complexity of the law and or the facts, will often require more preparation time with the client and never less than 3-5 hours. In bike and motorcycle crash cases the facts can often be difficult and are often highly disputed. Anytime serious injuries are involved and the client has been hurt physically and especially emotionally, be prepared to spend hours preparing with your attorney for your upcoming deposition.
Don’t go in unprepared. Don’t survive the crash to get killed in deposition or at trial. Preparation is key.

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