Once a plaintiff has established damages, negligence, and causation, there still remains the job of finding a source of payment.  In most cases, the defendant’s automobile liability policy is the first source of coverage. If a defendant has no coverage or minimal coverage, the next step is often the plaintiff’s own Uninsured/Underinsured motorist coverage. If the insurance coverage available from all sources is insufficient to pay the plaintiff’s damages, then we look to the defendant’s personal assets for payment.

Even if there is adequate coverage available, a plaintiff may not be able to actually keep all of what they receive as a result of an accident. Certain employer-funded health plans, Medicare, and Medicaid are entitled to repayment for medical treatment, and may assert a lien on the plaintiff’s recovery to ensure repayment.

Determining the amount of insurance coverage available and the amount of the potential liens and other claims to be deducted from any recovery is one of the most complicated things we do.  When you study the rules governing insurance coverage, you will usually find that they make sense, but the rules are far from intuitive.  It is important in each case to go back to fundamental principles to make sure that no stone is left unturned in the search for sources of compensation.

Case Studies

Case Study: Maximizing Insurance Compensation

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Unraveling the Complexities of Multiple Coverage Fred and Mary were longtime residents of Northern Virginia who were getting ready to retire full-time to Florida. They had fixed up their Reston home to sell and had bought a house on the Gulf Coast, their favorite vacation and bird-watching locale. On the day of the accident Fred and Mary were headed out to pick up moving supplies. Mary was driving her station wagon with Fred in the front passenger seat. They were... Read More >

Nov 20, 2014 @ 3:51 pm

Compensation for Life

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CASE FACTS This case concerned the inappropriate use of the anticonvulsant drug Dilantin by the defendant neurosurgeon, Dr. John Smith, M.D., causing a severe allergic reaction to his patient, Jane Jones. The reaction, called Stevens-Johnson Syndrome, led to scarring of the corneas and lids of Ms. Jones’ eyes so severe that she became legally blind. The central facts of the case were undisputed. On a mid summer Friday, 13 year-old Jane Jones fell off a ladder and hit her head.... Read More >

May 02, 2014 @ 8:18 pm

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