Dallas Man Left for Dead by Lime Scooter Lunatic

Angel Reyes III Insurance Law, Personal Injury

DALLAS—A local Dallas musician was recently the victim of a hit and run while he was walking on a Downtown Dallas sidewalk, leaving him a trip to the emergency room, injuries to the face and the financial burden of paying for injuries caused by no fault of his own.

The vehicle was a rental scooter traveling at full speed.

Cody Daniels, 31, is likely the city’s first hit-and-run victim via rental scooter.

Daniels was leaving his job in Downtown Dallas near the aquarium when he said he was blindsided by a man riding a Lime rental scooter.

“I Stepped onto the sidewalk and then he hit me from this side, straight to the ground,” Daniels said. “He hit me faster than I could turn my head really to look.”

Daniels said his co-workers treated him with first aid before he left to visit an urgent care. There, he received 7 stitches over his right eye.

Worst of it all, Daniels said that the rider who hit him just fled the scene.

Because the rider took off, Daniels will be paying off his urgent care bill on his own, which he said will probably cost upwards around $400.

Daniels said he has health insurance but isn’t sure if the amount meets his deductible. Plus, Daniels said the rider was on the sidewalk. A big no-no in downtown Dallas.

This unfortunate incident raises some very important questions:

    • Does the victim have the option to file a claim with his motor vehicle insurance?
    • Is the rental scooter recognized as a motor vehicle?
    • In this case, can the victim seek compensation from the rider?
    • Can the person who fled the seen be faced with criminal charges?
    • Can the person be fined for riding on the sidewalk after the fact?

According to Lime`s website, riders are responsible for accidents and injuries, and each scooter company encourages driving safely.

Late last month, the city agreed to a 6-month trial run with electric rental scooters. They travel up to 15 mph after the rider pays a fee.

You can’t ride on sidewalks in the Central Business District (which includes Deep Ellum and Downtown Dallas), and you can’t ride in a street where the speed limit is over 35 mph.

Failure to do so could get you a fine up to $500 – enforced by…who, exactly?

In light of these details, Mr. Daniels may indeed have a case.

With more and more patrons taking to the Dallas rental scooters, it is important for pedestrians to know their rights, and options, if they find themselves in a similar situation. Call the attorneys at Reyes Browne Reilley today for a free consultation.

What to Do if Your Pet is Injured in a Car Crash

Angel Reyes III Insurance Law

bigstock-Small-dog-maltese-in-a-car-wit-136098791-300x200Only 16 percent of dog and cat owners say they use safety restraints when driving. Using proper safety restraints can protect your furry friends as well as you and any passengers in the vehicle.

According to the Center for Pet Safety (CPS), some types of pet restraints performed terribly during vehicle crash tests and are not very reliable. The worst products are plastic pet crates because the plastic tends to splinter into sharp pieces during a collision. During crash tests, dummy pets in plastic crates were ejected through the crate’s flimsy walls.

During a car accident, a dog or cat that is unrestrained can be flung forward and may injure fellow passengers or even go through the windshield of a vehicle. There are ways to help make your pets feel comfortable when traveling while also keeping them safely restrained. A pet with appropriate protection will not be a distraction for a driver while on the road.

Common Pet Restraints

When picking out a pet restraint, the type of device that is appropriate depends on the size and weight of the animal. What might be appropriate for a small cat may be unsuitable for a 70-pound dog.

Pet Carriers and Crates – Pet crates work best for cats and small dogs that weigh less than 15 lbs. They should be made of a material other than plastic. A carrier that attaches to any car seat belt during your ride will restrain your pet safely. You can also attach the harness or collar to the carrier’s inside for additional security.

Dog Booster Seats – These booster seats take the form of a comfy box, which is positioned above the car seat by arranging the seat belt. The booster seat will elevate the dog so that he or she can see out the window without leaning out the window. To keep the dog from jumping out, you can also attach a harness.

Harnesses – These restraints are designed to fit around the pet’s neck and chest, which spreads out the force of a potential impact. Harnesses have tethering straps that anchor them into the car’s seat belt points. A three-point fixing system that holds all parts of your pet’s body is ideal since this type of harness will secure the pet to the seat. For larger dogs, a harness that attaches to the back seat is recommended.

Barriers – Barriers can range from mesh that is secured with loops to metal grill barriers. Metal grills that secure the dog in the back of the car or SUV are more effective.

Car Safety Tips for Pet Owners

The following tips can help pet owners keep their beloved pets safer during trips:

  • Take your pet on shorter drives to avoid unnecessary stress and anxiety and help the animal get used to car travel before taking them on an extended vacation.
  • Be sure that all ID tags and microchip information have your current contact information, in case you and your pet become separated or injured.
  • Always properly restrain or crate your pets inside of your vehicle while driving.
  • Never allow pets to sit on your lap or stay in the front seat while you drive. This may be illegal in some states.
  • Never allow pets to stick their heads or bodies out of the car. Most dogs love to stick their heads out open windows, but wind and debris can seriously injure your pet, not to mention what would happen if you are in a car accident.
  • Pets should not be allowed in the bed of a pickup truck. The animal may be ejected if the truck crashes. Several pets die in crashes each year because they were riding in truck beds and not restrained.
  • Do not leash your pet inside of the bed of a truck. The hot sun can heat the floor of a truck bed enough to burn your pet or expose them to heatstroke.
  • Don’t leash your pet to the inside of the car as a restraint. They could strangle themselves in the vehicle, either when unattended or in a collision.
  • Never leave pets unattended inside a parked vehicle, even for a short time. Even with the windows cracked, the temperatures inside a car heat up fast during the summer month and cause an animal to suffer heat stroke.

What to Do If Your Pet Is with You or Injured in a Car Crash

If you have been in a car accident that has injured or killed your pet, a loss like this can be considered part of an insurance claim. Your pet’s injury can be viewed as property damage. If a negligent driver caused your accident, you could seek compensation for your own medical costs and for your injured pet’s vet expenses.

If your pet is killed, you can receive compensation equal to what would be required to replace your pet. If your pet was a prize-winning show animal, you could seek compensation through an accident claim. The loss of a service animal would also qualify for additional compensation.

If you are a victim in a car accident and another driver had a pet in his or her vehicle, you need to investigate whether the driver’s pet was a distraction and caused the accident. In some states, it is illegal for a pet to be unrestrained in a vehicle.

Contact Our Lawyers Now

If you and your pet have been injured in an accident caused by another motorist, you need a personal injury attorney who can make a strong case to get you the compensation you deserve. Contact an experienced attorney at Reyes Browne Reilley for a free consultation about your injury claim.

How Can I Reduce the Cost of Having a Teenage Driver on My Policy?

Angel Reyes III Insurance, Insurance Law

Teen_Driver_2-731735-editedThe financial shock of adding a teenager to a family auto insurance policy is getting less shocking… kind of.

An annual analysis by insuranceQuotes.com found that adding a teenager still increased annual premiums substantially, but the magnitude of the increase has been falling over the past few years.

Adding a single teenager to a policy caused annual premiums to increase an average of 78 percent, or $671. But rate increases have been decreasing since 2013, when the average increase was 85 percent.

Laura Adams, senior insurance analyst with insuranceQuotes, said that factors in the trend may include safer automobile technology, a dip in the number of teenagers getting driver’s licenses and the continued impact of “graduated” driving programs, which place restrictions on new drivers until they gain more experience on the road.

But the impact of adding teenagers to a policy is still a jolt to families, especially those adding boys. Putting a male teenager on your insurance policy increased rates an average of 89 percent, compared with 66 percent for a female teenager, the analysis found.

Ms. Adams said premiums increased when a teenager was added because, statistically, younger drivers — particularly boys — have more accidents than older, more experienced drivers, and file more insurance claims.

Nearly 1,900 drivers aged 15 to 20 died in car crashes in 2015, according to the National Highway Traffic Safety Administration, up 9 percent from 2014.

Motor vehicle crashes are the leading cause of death among teenagers, according to the Centers for Disease Control and Prevention.

As with most insurance costs, the impact of adding a teenager varies by state. Adding a teenager in Rhode Island bumps up premiums by more than 150 percent, while parents in Hawaii get about an 8 percent increase.

For the analysis, insuranceQuotes.com hired Quadrant Information Services, an insurance data firm, to calculate the price increase of adding a driver aged 16 to 19 to a family’s auto insurance policy. The averages are based on a hypothetical couple — a man and a woman, both 45 years old, married and employed — who each drive 12,000 miles each year and have good credit and driving records. The policy tested included $100,000 for injury liability, $300,000 for all injuries, a $500 deductible on collision and comprehensive coverage, and uninsured motorist coverage.

Here are some questions and answers about teenagers and auto insurance:

How can I reduce the cost of having a teenage driver on my policy?

Kathy Bernstein Harris, senior manager for teenage driving initiatives at the National Safety Council, a nonprofit, said that some insurers offered discounts for students who get good grades (even though it’s not necessarily clear that being a good student correlates with safer driving). Discounts are also often available for new drivers who take driver’s education classes.

Ms. Harris said the best way to reduce claims and hold costs down — and keep your child safe — was to set rules and spend time driving with teenagers and coaching them along, even after they pass their driver’s license tests. “Just getting a piece of plastic doesn’t mean they are totally prepared for the open road,” she said. “The first year of independent driving is the riskiest.”

Many state programs set restrictions on teenage drivers, such as curfews for night driving and limiting the number of other people, particularly other teenagers, who can ride in the car with them. Ms. Harris urges parents to follow such rules. “With every teen passenger you put in the car,” she said, the risk of a crash increases.

The council’s DriveitHome website offers resources for parents and teenage drivers, including interactive safety tests.

Are some cars safer than others for teenagers to drive?

The Insurance Institute for Highway Safety each year publishes a list of safe, affordable cars for teenagers. In general, larger, heavier vehicles are best.

Ms. Harris suggests that parents not buy a new car specifically for their new teenage driver — or, if they do, that they make it clear that the car is the family’s car, rather than the teenage driver’s personal vehicle. By making the car a “family” car, she said, parents can better set rules for its use and talk about where their child is headed and who is expected to go along.

Also, she advises getting teenagers involved in researching the safety and price of a new car, as a way of teaching them lessons about budgeting, and emphasizing the need for safe driving habits.

Are there apps that can help reduce distracted driving?

Technology is emerging that can disable texting and social media on cellphones while the car is in motion. One system, Cellcontrol, recently was favorably reviewed by Consumer Reports.

The organization also offers other tips for reducing distracted driving and increasing safety for teenage drivers on its website.

Why You Need UM/UIM & PIP Insurance Coverage

Angel Reyes III Auto Accidents, Insurance Law, Safe Driving



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Why You Need UM/UIM & PIP Insurance Coverage

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bigstock-Two-Car-Crash-1522381-300x240Most drivers believe they can make it by with just the minimum required coverage. When you only purchase the minimum required insurance coverage to avoid a traffic violation, you and your family are exposed to potentially devastating financial hardships resulting from an accident.

Most minimum coverage plans leave out some of the most important aspects of insurance coverage, primarily Personal Injury Protection (PIP), Uninsured Motorist (UM), and Under-Insured Motorist (UIM). Auto Insurance is designed to protect you and your family in the event of an accident – not just avoid a ticket in a traffic stop.

Why You Need UM/UIM & PIP Insurance Coverage

Having the right insurance can make all the difference in what you pay after an auto accident, and how your claim is handled. The State of Texas only requires drivers to have liability insurance coverage, which helps the other person in the event of an accident. Liability coverage protects you from the risk of liabilities by lawsuits or other claims from other parties, but it doesn’t fully cover you.

Liability insurance does not include collision or comprehensive coverage to fix your car, towing, rental car, or the other guy being uninsured/under-insured. You might think that everyone has liability coverage because it’s the law, but over half the accident victims who call our law firm have at least one party in the accident who was uninsured! Assuming the other guy has it covered, and skipping the proper coverages to save a few bucks can and will hurt you financially if you are injured, or your car is too damaged to drive (or both). The resulting domino effect can be catastrophic when you can’t work, can’t get to work, and potentially lose your job, home, and your credit rating due to unpaid medical bills. Below are some insurance terms you should get to know. Many people do not know whether they have the following ‘extra’ coverage items:

Personal Injury Protection

PIP‘ covers you and the passengers of your car in the event of an accident. PIP covers medical and related expenses, lost wages and collateral costs after an accident. Collateral costs can include child care, lawn maintenance, and even travel expense to receive medical care. PIP covers you even if you are at fault for the accident, making it that much more important to consider when purchasing auto insurance. If you have a good health care plan, comprehensive PIP may not be necessary, but as we all know – health insurance doesn’t cover everything. For this reason, it is always important to go over all of your coverage options for each type of insurance so you know exactly what you are covered for and under which policies. PIP coverage is also valuable is when it covers your passengers. Pip covers non-immediate family members to help alleviate medical cost from both you and them. This is most important when you regularly have passengers in your car, such as a carpool. Your health insurance plan won’t help them, but PIP coverage will.

Uninsured Motorist

UM‘ coverage helps drivers involved in a crash with an uninsured driver. A surprising amount of drivers are not complying with State minimum requirement laws. UM covers you and your vehicle from damages caused by an uninsured driver in an accident. Additionally, this will cover you and your passengers for medical expenses, pain and suffering, and lost wages. UM coverage is valuable in the event of a hit and run accident as well. Since in that circumstance you are unable to confront the responsible party, UM will give you the same coverage and protection. UM coverage, as with any type of coverage, has different restrictions and limits in each state and with each different insurance company. Check with your agent for details.

Under-Insured Motorist

UIM‘ Coverage is similar to UM coverage in that it covers you when the other driver’s limited coverage cannot. UIM helps take care of the financial burden that happens when you are in an accident with a driver who decided it was better to save a few bucks on their quote, and doesn’t have enough coverage to pay for your injuries or property damage. This type of coverage is usually put into two different types of UIM coverage; bodily injury and property damage coverage. Bodily injury coverage is the more popular type of UIM coverage, and covers your medical expenses when you sustain an injury after an accident with an under-insured driver. Property damage coverage only applies when the other driver is at fault and they do not have adequate coverage. This coverage will help pay whatever the at-fault driver’s insurance plan will not cover. UIM property damage coverage can go beyond just automobile damage to also help recover damages to valuable property such as cell phones and laptops.

The more insurance coverage you have – the better off you will be in the event of an accident, but you need to find coverage that fits your budget. When getting that insurance quote, please take a moment and think about the devastating effects that high medical bills and time missed from work would mean to your budget and your family. PIP, UM and UIM coverage are not required by many state minimum coverage plans, and therefore many people neglect to purchase them. These three types of coverage can and will make it easier for you to recover physically and financially if you are in an accident.

If you or a loved one has been injured in a car wreck due to someone else’s negligence contact the attorneys at Reyes Browne Reilley for a free case review today!

Just a Question can Raise Your Insurance Premiums

Angel Reyes III In The News, Insurance Law

bigstock-meeting-6825017-1024x694We are all familiar with the normal ways in which insurance companies try to get us to pay more for coverage. There are fees for 24-hour service, fees for adding another car to your plan, and fees for just about anything.

According to a new law, if you happen to call your insurance agent with a question about a potential claim on your automobile policy in Texas, you could face an increase in your premium when your policy is renewed. This fun bit of Texas legislature makes it easier for the insurance companies to take more money out of your pocket, even if you don’t end up filing a claim. Texas Legislature passed a law that made it illegal for insurance companies to charge Texas insurance customers who ask questions about their homeowners policy, but insurance lobbyist pressured legislators to remove the part that protects your automobile policy.

State Senator Kirk Watson, Austin D, had originally written the bill to protect Texas insurance customers. However, he knew if he did not remove the part including automobile insurance, the entire bill would not have passed. During the proceedings to pass the bill, the insurance industry kept their opposition quiet in order to keep customers from discovering the bill. According to the legislative record, the insurance industry claimed, “Limiting the types of information that insurance companies can take into account could hinder operations and unfairly shift premium costs among policyholders.”

Many Texans are unaware of this “quirk” in the system. If the insurance company gathers enough information from your inquiry, they can register it as a claim, even if no money is ever exchanged. Most insurance companies will say they do not penalize customers who ask questions about their automobile policy. But since it is allowed under the current law, there is nothing to stop insurance companies form finding a way to benefit from their customers’ curiosity.

Certainly, not all insurers use innocent inquiries as an excuse to raise rates. But it’s among the tricks of the trade detailed in a report by the American Association for Justice, an advocacy group of lawyers who often represent policyholders in disputes with insurance companies.

The Insurance Industry Institute, the industry’s trade group, has said most companies only submit a loss-history report if a claim is opened, so inquiries usually don’t count. However, some companies treat all inquiries as reportable because from their perspective, you typically don’t call with a hypothetical question.

The best way to sidestep this trap is to not call your insurer’s toll-free number at all. If you have an insurance agent, you should ask that commissioned rep any policy questions. The agent will want to keep your business and is less likely to automatically assign a claim number than an unknown employee at insurance company headquarters. Policyholders without agents should first pull out their policy documents and see whether their question is answered there.

But if you must phone the toll-free number, know that your call is likely being recorded and anything you say may be used against you. Repeatedly say that you are “calling with a hypothetical question — and not to file a claim.”

It’s also a good idea to tape the call — though in several states you are legally required to have the other person’s consent — and to keep the recording for possible later use. 

In subsequent weeks, watch for a letter from your insurer. And get a copy of your CLUE (comprehensive loss underwriting exchange) report. Available for free once a year to consumers, it comes from an industry-wide database that details home and auto insurance claims listed under your name over the past seven years.

If your call was interpreted as a claim, you should see a notation of that on your report.

If your premium rises or you suspect it might, first write a letter to your insurer, detailing the specifics of your call, This should include the questions asked to whom, when and why, the answers received, and how you expect the company to correct your record.

Mail copies to the rep with whom you spoke and the company’s homeowner claims office, and copy your state’s insurance commissioner and the Better Business Bureau. You may also be able to file an online complaint with your insurance commissioner.

Follow up until the company does what you want. Don’t assume it will automatically happen.

The insurance industry has always been good at finding loopholes that allow them to add more charges to their customers. That’s why it is always important to have an experienced attorney who can help you when your curiosity kills your premium. An attorney with experience dealing with insurance companies will know what it takes to get your insurance company to remove any unnecessary charges or increases on your premium.

In most cases, our insurance policies do help protect us from wrong doing by other drivers. However, in a world where insurance companies will raise your rates just for asking a simple question, having an experienced attorney to represent you can help show the insurance industry that they can’t get away with this unfair treatment of their customers.

6 Things You Need to Know About Auto Insurance

Angel Reyes III Auto Accidents, Insurance Law

bigstock-Automobile-Insurance-816463-300x193

Acquiring car insurance can often seem overwhelming or a flat out burden. However, it is very important.

We obtain car insurance because it’s a financial safeguard against damage to your car or injury to you or others, and mainly because it happens to be legally required in some form in the state of Texas. Car insurance is complicated, and drivers often don’t know what to expect from the process.

Let’s break down the basics so you’re better able to find the right coverage for you. Here are six things you need to know, originally written by Neil Richard of Credit.com.

1. What is car insurance

As a licensed insurance agent, I find that many people I talk to don’t quite understand what insurance is or why they need it. I get it. After all, insurance is rather abstract — it’s not a physical object you buy at a store. Further, if all goes well for you, you won’t ever have to use the coverage you paid for. So it’s often hard for people to see the value.

In the simplest terms, insurance is a promise from an insurance company to support you financially in the event that something unfortunate occurs and causes you financial loss or other damage. You pay an insurance company money (your premium) for a policy that details your coverage (who/what is protected and to what dollar amount), and the insurance company is responsible for paying if something happens and you incur a loss (damage to your car, a broken leg, etc.). Insurance companies do this by pooling risk among all the people they insure, collecting premiums from everyone and using those funds to pay claims for those who need it.

Of course, there are many other details that go into the whole system, but we’re keeping it simple.

2. What different insurance types cover

The type and amount of coverage each person needs varies, but these are the coverage basics you should know.

Liability coverage is legally required for drivers in almost every state. It covers the other driver in a crash you cause, and it includes injury and property damage. If you see numbers like 25/50/10 or 30/60/25, that shows the liability coverage limits for (1) bodily injury per person, (2) bodily injury per accident, and (3) property damage — each in thousands of dollars. For example, 25/50/10 means your coverage will extend up to $25,000 per individual injured in an accident, $50,000 for all persons injured in an accident, and $10,000 for property damage.

In no-fault states, you are required to carry coverage (normally personal injury protection or PIP) for your injuries regardless of who caused the accident.

Collision coverage, which covers damage caused in a crash, and comprehensive coverage, which covers damage from other events including weather (fire, flooding, etc.) as well as theft, are often collectively called full coverage.

Other coverages include uninsured motorist coverage, which protects you and your vehicle from damage caused by people who don’t have insurance, and medical payments coverage, which covers select costs for injuries you and your passengers sustain in a collision.

3. How to get car insurance

You can easily go online, call a company or two, or even walk into a local insurance agent’s office to talk to them about getting coverage. But how do you know which company to contact?

Insurance companies spend billions of dollars every year on advertising, so you could probably rattle off a few big car insurance brands you’re familiar with. But it’s important for consumers to know that not all insurance companies are the same — in fact, they all have different ways of pricing policies, and many look for certain types of customers with certain risk profiles to do business with.

This is why it’s more important than ever to compare car insurance quotes from as many companies as possible. Getting multiple opinions and understanding the market will help you find the best rate around.

4. Why you pay what you do

Insurance companies determine what you pay for insurance based on dozens of “rating factors”—all having to do with who you are, where you live, what you drive, and other details of your history, both on and off the road. Everything is about statistics, and insurance companies assign certain levels of risk to each of these factors to gauge the likelihood that you will file a claim.

For example, teens are considered high-risk drivers because they have so little experience behind the wheel and are statistically likelier to be in an accident — and thus file more claims — than older drivers, so they often pay much more for their premiums.

Other risk indicators include some obvious ones (like your driving record) and some less-obvious ones (like your ZIP code). There are also certain factors, like your credit score, which only some states allow to be used in determining your rate (it’s prohibited in California, Hawaii and Massachusetts).

5. How to lower your risk and your rates in the future

You can’t change certain insurance rating factors, like your age, but you can make a few changes to reduce your risk in other areas. Here are a few tips:

  • Drive safely and maintain a clean driving record.
  • Consider sharing a policy with someone you live with.
  • Bundle your renters or homeowners policy if you can.
  • Pay your premium in full at the start of your policy or sign up for auto-pay.
  • Maintain insurance coverage with no lapse between policies (even for a day).

6. When to get insurance

The obvious time to get car insurance is when you’re getting a car, but it’s critical that you don’t have a lapse in coverage between insurance policy terms. I highly recommend shopping around for car insurance before you begin the car-buying process. Shopping early also allows you to account for your premium in your car-related expense budget.

Other times to switch insurance could be if you get married, move, or have another big event in your life; if your rates increase for no apparent reason; or if you need to add a new teen driver to your policy.

Additionally, it’s important to compare rates every six months to make sure you’re staying up to date on any changes that might occur if you move, get a speeding ticket, or even have a birthday.

Once you’re ready to start your insurance search, you can use a comparison tool to get a car insurance quote and compare rates.

 

Professional Liability Insurance Best Practices

Angel Reyes III Insurance, Insurance Law

 

professional_liability_crop_09Professional liability insurance safeguards your business. It is specifically beneficial to those who operate their own business, provide medical or dental services or provide other high-level professional service. It is also known as E & O (errors and omissions) insurance. This coverage helps to minimize the costs associated with claims made against your organization or you personally regarding the service, advice, consultation or other expert information you’ve provided. From IT workers to business consultants, it pays to have this coverage in place.

We recently came across the below article that not only explains the importance of Professional Liability Insurance, but suggests best practices as well.

by: Michael Downey and Paige Tungate

“After dealing with an upset client or realizing a mistake was made, lawyers often ask, “Should I tell my insurer?” Usually this leads to concerns about making a problem worse or facing increasing professional liability insurance premiums. Procrastination and worry take over, leading to inaction.

This response – or non-response – is generally unfortunate. Often the better choice is to give notice to the insurer. This column explains why, and how to give notice.

Professional liability insurance is “claims made” insurance. Most people are familiar with “occurrence” coverage, because most homeowner, automotive, and other insurance are occurrence policies. Occurrence coverage is triggered when the act or omission giving rise to the claim occurs. Thus, if you have a car accident in 2016, and you have automotive insurance at the time of the accident, you have coverage for the accident – even if you first learn of a claim in 2017, after you have stopped paying for insurance.

Professional liability policies – including lawyers’ professional liability insurance policies – provide “claims-made” coverage. If a lawyer commits malpractice in 2016 (for example, not suing a correct party or missing a filing deadline), but does not learn about the claim until 2017, the key focus will be whether the lawyer had insurance at the time the claim was made (in 2017) and not when the malpractice occurred. A lawyer who had insurance in 2016 but then learned of a claim in 2017, after dropping insurance, would be “bare” or lack coverage.

For claims made policies, the key date is the date when a claim is first made against the insured or the date the insured first becomes aware of facts or circumstances that might reasonably be expected to be the basis of a claim. Claims-made policies define what a “claim” is. Normally the definition focuses on learning of or receiving communications about potential malpractice liability. Courts then often supplement the policy language defining a claim with a “reasonableness” standard to determine whether the lawyer should know of a claim: “not whether or not the plaintiffs actually committed malpractice, or whether they subjectively believe there was no conduct which could give rise to a claim, but whether a reasonable attorney would have expected a malpractice claim under circumstances.”[1]

Also, malpractice insurance policies require the insured to notify the insurer (a) during the policy period and (b) within a certain amount of time after learning about a claim. The notice also needs to be given during the policy period. Sometimes the policy language requires notice “as soon as practicable.” Courts have defined “as soon as practicable” to mean “prompt and reasonable under the circumstances.”[2]

Lawyers can learn of potential claims in many ways. A lawyer can become informed of events that might give rise to an eventual claim in many ways. You might discover an error on your own, or you might receive a complaint or lawsuit from a client. Contrary to what many lawyers believe, the best rule is better to be safe (and report) than to be sorry. So when in doubt, a report ordinarily should be made.

Complaints from clients can vary in tone and severity. While a little grumbling is normal, significant criticisms – particularly when accompanied by a demand for the client’s file and disgorgement of substantial attorney fees – should probably be reported to the broker. Again, the broker will help evaluate whether a claim has been made, and help provide notice to the insurer.

Why report such potential claims? It may seem like a hassle or overkill to report any instance where you think you made a mistake that might materially impact a client, or any instance when a client’s complaints seem more significant than ordinary grumbling. This is actually smart practice.

The reporting of such a pre-claim – often referred to as a “circumstance” – attaches that incident to the professional liability policy then in place. Thus, if you learn about a potential claim in 2016, and give notice to your insurer at that time, the claim will be covered even if the actual lawsuit or demand is not filed until 2017, even if your professional liability policy has expired by 2017. Meanwhile, if it turns out what you knew in 2016 did constitute a “claim,” your failure to report it at that time might prevent you from having insurance coverage due to the delay in reporting.

Also, such early notice may give you access to resources that your insurer can provide to help prevent the circumstance from growing into an actual claim. Insurers can often help remedy a situation before it requires litigation or an expensive settlement. This helps everyone keep the costs down.

Legal malpractice insurers appreciate insureds who are on top of their business and trying to head off potential claims before those claims grow into expensive problems. Everyone in the lawyers’ professional liability world recognizes that sometimes mistakes occur, or that sometimes clients get angry, for good or bad reasons. Insurers recognize that quick action often heads off bigger and more expensive problems. Also, a law firm that is aware of and seeks guidance on its problems can adopt corrective measures before similar circumstances are repeated. The insurance company’s sole job is to assist its insureds, whether that assistance involves defending or resolving claims, or by utilizing other resources to avoid liability.

Therefore, in my experience, prompt reporting of pre-claim circumstances almost never results in an increase in insurance premiums or denial of renewal, at least when the firm generally operates in a safe manner and is attentive to reducing malpractice liability risks.

Provide notice when renewing. Law firms are asked on the application to list any circumstances that may give rise to liability when seeking to renew their professional liability insurance. The law firm should be careful to gather all available information on potential claims, and to report those circumstances directly to the carrier for the existing policy (to attach those claims to the policy the firm has already purchased) and on the renewal application. The old insurer will only cover reported claims, and the new insurer will generally refuse to cover claims the firm should have identified during a prior policy period. Failure to report a circumstance or claim might therefore create a gap in coverage, where neither insurer is willing to cover a claim.

The basics of notice.

What is required to provide notice? Policies may include specific requirements, but normally a short, plain writing (often an email) that states the identity of the client, the lawyers handling the file, and the situation that may result in the claim should suffice to give notice to an insurer. Normally the firm provides this information to broker or risk management counsel, who reviews the notice and insures it provides an adequate description of the relevant circumstances.

Conclusion.

There are many pros and often zero cons to providing prompt notice of claims and potential claims to your professional liability insurer. Once you provide notice, you will likely then only need to keep them informed of any changes in the situation. This is far less painful and annoying than learning that you had purchased professional liability insurance, but still are going to be uncovered on a claim because you did not report the claim in a timely manner.”

 

This article was prepared by Michael Downey and Paige Tungate. Michael Downey is the founder of Downey Law Group, LLC., a St. Louis law firm devoted to legal ethics and the law of lawyering. He has also taught legal ethics and law firm practice at Washington University and St. Louis University, and testified as an expert on legal ethics and law practice matters in Missouri, Illinois, Kansas, Oklahoma, Pennsylvania, and the District of Columbia.

Paige is also a lawyer at Downey Law Group, LLC. (She was admitted in September 2015).

Car Insurance Coverage: PIP or MedPay?

Angel Reyes III Insurance, Insurance Law

Car Insurance Coverage - Reyes Browne Reilley Law Firm

Injuries are an unfortunate outcome for many motor accidents, and as such, car insurance comes with ways to make sure you can pay for medical costs. The three parts of car insurance concerned with health are bodily injury liability (BI), medical payments and personal injury protection (PIP).

In Texas, PIP and BI are mandatory, however you cannot have PIP and Medical Payments on the same policy.

So what’s the difference between the two?

Med Pay Coverage

If you are involved in an accident, Med Pay may cover your expenses for medical, surgical, dental and chiropractic treatments that are considered necessary and reasonable. Some of these services include ambulance transportation, hospitalization, X-rays, nursing care, prosthetics and funeral expenses. If you already have health insurance or HMO coverage, you may not need to add Med Pay coverage to your insurance.

Med Pay is not a substitute for regular health insurance; it covers you only in the event of an accident. Some companies offer $25,000 or more in Med Pay coverage. Keep this in mind when it comes to your insurance needs.

PIP Coverage

Personal injury protection also provides coverage for medical expenses as the result of an accident. However, PIP insurance covers more than Med Pay. Additional expense coverage includes physical and occupational therapy and rehabilitation costs, psychiatric expenses and other professional health services. PIP also offers insurance coverage for wages lost from work, other reasonable non-medical or work related losses and a death benefit.

You need to check your policy for the exact benefits included in your PIP plan. In some states, PIP coverage is mandatory. In other states, you must either accept or reject the coverage. You cannot be covered by both Med Pay and PIP insurance; you must select one of the two plans if you are interested in the protection.

Under Texas Law:

Personal Injury Protection is coverage you purchase with your auto insurance policy that covers medical expenses and lost wages as a result of injuries sustained in a car accident.

PIP is required under Texas law.  The Texas Insurance Code provides that all policies of automobile insurance issued in Texas must provide for PIP coverage for a minimum of $2,500 per person, unless rejected in writing by the insured. If you choose not to carry PIP coverage, then the insurance company is required to obtain your signed rejection of the PIP coverage.  Therefore, unless you rejected PIP, then you would be entitled to the minimum coverage even if you were never charged a premium for it.

Minimum Coverage.  Texas law requires that PIP coverage be provided at a minimum of $2,500 per person.  You may carry more coverage if you like.

What if I’m at fault in the accident?  PIP provides “no-fault” coverage.  This means that you are entitled to PIP benefits regardless of fault in the accident.

Does PIP cover medical bills and lost wages?  PIP covers reasonable and necessary medical bills and 80% of your lost wages.

Do I have to re-pay my PIP benefits if I get a settlement?  No.  Texas provides that PIP has not right or subrogation or reimbursement in the event you get a settlement for your personal injuries.  That means that you can collect medical benefits on your PIP coverage and also submit those very same bills as part of your injury claim.  “Subrogation” is explained in more detail below….

What if I’m at fault in the accident?  PIP provides coverage to you even if the accident was your fault.  This is called “no-fault” coverage.

Medical Payments Coverage (Med-Pay) operates differently than PIP.  Med-Pay is not mandated by Texas law.  Additionally, Med-Pay coverage may be issued in any amount:  $500, $1,000, $2,000, etc.  There is no state mandated minimum.  Although Med-Pay also provides no-fault coverage, it only covers medical bills and does not cover lost wages.

However, there is one major difference between PIP and Med-Pay that can make a big difference in your case.  Unlike PIP, Med-Pay coverage is entitled to subrogation and reimbursement rights.

Subrogation (http://www.dmv.org/insurance/subrogation.php) refers to the right of an insurance company to get reimbursed in the event you make a settlement with a liable third party.

Consider this example:

Let’s say you are injured in a car accident and have $5,000 in medical expenses.  You also carry $2,500 in PIP coverage on your auto policy. Once you are done treating and are released from your doctor’s care, your lawyer will submit your case to the other driver’s insurance company as well as your own for PIP benefits.  If you settle your case for $7,500 with the other driver’s insurance company, you can also expect to get another $2,500 from your policy under the PIP coverage.  Likewise, your total recovery is $10,000.

However, if you had Med-Pay coverage, then your insurance company would be entitled to reimbursement of the $2,500 in Med-Pay benefits.  In the example above, if you collect the Med-Pay benefits of $2,500 and also enter into a settlement for $7,500 with the other driver’s insurance company, you would not have $10,000 in total funds to work with.  You would have to account for reimbursement of the Med-Pay benefits, thereby leaving you with a total recovery of $7,500.  In the end, you just paid premiums for Med-Pay coverage and received no real benefits from it at all.  This is the most important part of Med-Pay coverage that your agent may not clearly explain to you.

If you find yourself in an accident and have questions about your coverage, call us to learn more about how we can help you or to set up a free consultation.

Reyes Browne Reilley is a Dallas, Texas, based Martindale-Hubbell AV-Rated personal injury law firm. Our Dallas personal injury lawyers have a nearly combined 100 years experience representing plaintiffs in personal injury, business, and dangerous prescription drug & device litigation.

Is Arbitration a Legitimate Threat to Our Justice System?

Angel Reyes III Aside, In The News, Insurance Law

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Arbitration clauses are becoming an effective tool for employers and certain litigation-prone professions like medical doctors, hospitals, nursing homes and automobile manufacturers to bypass the legal system. The vast majority of people who sign an employment contract, service agreement, or purchase contract have no idea that they are signing away their right to take the company or person to court should a dispute arise.

People who are injured in accidents, suffer medical malpractice, or are sexually harassed or otherwise wrongfully terminated from their job are shocked when they file legitimate civil claims suing their doctors, employers and manufacturing companies and have their cases thrown out of court, not being heard by a judge that cites the arbitration clause present in the contract.

The NY Times lists several cases where legitimate civil claims were forced into the arbitration process instead of being heard by a judge in court:

  • A 94-year old women who died of a festering head wound was forced into arbitration rather than a malpractice lawsuit.
  • A women in Alabama who sustained injuries when the brakes failed on her car was barred from suing Honda.
  • A women who sued her obstetrician for negligence when her baby was born with serious deformities had her case thrown out of court and forced into arbitration instead.

And the list of abuses in arbitration continues from there.

  • Arbitration officials can be a lawyers and not a judges.
  • There is nothing prohibiting the lawyer from having pre-existing or on-going relationships with the defendant.
  • The appeals process is non-existent.
  • Witnesses can be paid for their testimony by companies.
  • Employees can be threatened with termination for not testifying in favor of the company.

And the cost of arbitration can be prohibitively expensive. The Times article cites arbitration cases running as much as $150,000 for a six-hour session and if that wasn’t enough to discourage one from pursuing their case, the arbitration hearings are often held in the offices of the lawyer that represents the defendant!

Arbitration is fast becoming an alternative justice system and is denying people many of the rights that the legal system affords them. Lawyers feel that there is an alarming and growing trend for the current legal system to be bypassed in favor of arbitration. What’s to prevent every company from shielding themselves from their legal responsibilities by adding a simple arbitration clause to all their employment contracts and purchase agreements?