Don Speaks Candidly About Auto Insurance, Part III Don Speaks Candidly About Auto Insurance, Part III Transcripts:
Interviewer: You know, with these automobile accidents, or vehicle accidents that people are in, your own personal medical insurance - I'm trying to understand, does the medical insurance cover, say for instance if that person was in the hospital, or is it going to have to be the automobile insurance that picks up the tab for the hospitalization?
DK: That's an interesting question. Because frequently when people are in an auto accident, they go into a hospital, and in the emergency room they ask you, what is your insurance. If you are in an accident, the medical provider has got the first billing, no fault. So they may ask you for that information but really pertinent information for them to obtain is what is your insurance company, what is your policy number, what is the address, who can be contacted. So until you've exhausted your own no-fault coverage, it's a non-issue. All the bills should go in to cover your medical, your hospital, your lost wages. If you find yourself where that coverage is insufficient, then you can always go make a claim against your personal insurance company. But again, you've got to come to the point where you've exhausted your no-fault coverage. A more familiar, or usual, occurrence in complication with the no-fault insurance is where you are injured in an accident and you haven't fully recovered, but the insurance company doesn't want to pay anymore, surprise, surprise. So they send you to a physician who they refer to as an independent medical examiner. They're not independent. They're there to make certain that they represent the insurance company's interests. If you wanted to be more jaundiced, you could say they're there to make sure the insurance company doesn't pay you anymore.
Interviewer: Exactly.
DK: So, in that instance they send you for a medical examination. Inevitably, unless you are very seriously injured, they're going to come back and say you've reached the maximum benefit from your treatment. Therefore we're not going to pay you anymore. If you then choose to have your own coverage, what are your options? Well, you can always make the claim to your own insurance company. And, there are other ways go as well. So you may have a situation where your insurance company decides not to pay because you haven't exhausted the coverage, you find yourself in the middle. Because they're saying, well, your injury is from an auto accident, make your claim against the no-fault company. You're saying, well, they've decided I've reached the maximum benefit, so now I'm coming to you. You have alternatives. What you can do is you can bring an arbitration claim against the no-fault company, and basically what you're saying is that this was not a just determination, that I am still injured and that I should still have coverage, and that you should still pay my medical bills. Unfortunately, if you bring an arbitration claim like that, it can have an adverse effect on any third-party suit that you might bring against the tortfeasor who caused the accident. And you don't want the issue of whether or not you're permanently injured to be resolved by an arbitration.
Interviewer: How much of your business here at Kiley, Kiley & Kiley is automobile accident?
DK: Well, I wouldn't just cut it up and say, well, this is our automobile insurance, this is the percentage of the time we spend in auto cases. We represent people who are injured in many different ways. We had a case for one woman whose daughter was bitten by bed bugs. We have a lot of cases for people who are injured in a slip and fall. We handle medical malpractice cases, dog bites. Anytime someone is injured, they may bring a claim for personal injury. In any negligence case is one where you might recoup for your pain and suffering, for an economic loss you have, lost wages, permanent injury. So, we represent plaintiffs in all those fields, and that is a major, major part of our business. We do other work as well, but that certainly is a field of our expertise.
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