Considerations in hiring a physician (chiropractor, medical doctor, orthopedist, neurologist, neurosurgeon)

There are many considerations in hiring a physician after you have been in an accident. The Boca Raton personal injury lawyer (also Coral Springs accident attorney, Tamarac injury lawyer, Pembroke Pines accident lawyer, Miramar injury attorney, Plantation personal injury lawyer, Weston accidetn attorney, Coral springs injury attorney, Parkland accident lawyer, Fort Lauderdale, accident attorney, Lauderhille injury lawyer, North lauderdale accident lawyer, Oakland Park injury attorney, Wilton Manors accident attorney, Pompano personal injury attorney) regularly gets questions about how to hire a doctor and which one and in this blog entry I am going to discuss some of those considerations.

The first primary consideration would deal with getting the physician paid.  Thus, does the doctor accept your health insurance or is he or she a contracted provider on your health insurance plan.  Not all doctors are on every insurance plan.  So clearly this is one consideration. 

If not, will the doctor accept a letter of protection.  A letter of protection is an agreement where the doctor agrees to forgo collection of the bill for an agreement where the doctor will get paid from the proceeds of the injury settlement, if any.  Many doctors accept these agreement but many do not.

Another important consideration is the proximity to your work or house.  In many injuries, a patient is required to go on therapy or to see the doctor on a regular basis and sometimes this may be three or more times per week for a prolonged period of time.  Thus, getting a doctor 30 miles away where you have to go 3 times per week is going to make the treatment very difficult to go to.  I generally recommend going to a doctor whose office is fairly close to your work or house.

A recommendation from a friend tends to generally be a good basis for going to a doctor.   If you have had a friend that has had a positive experience with both their injury and the result of an injury case at a certain doctor’s office, that certainly would be a persuasive basis to go to a physician.

A recommendation from your lawyer also would be a good basis for going to a doctor.  The injury lawyer tends to have more information about different doctor offices as the lawyer likely has dealt with the doctor in the past and would have a lot of information in making the recommendation. 

Clearly the type of injury will play some part in which doctor you go to.  If you are complaining pain from a broken arm, then you clearly would want to see an orthopedic surgeon, a physician that specializes in bones, muscles and joints.  Similarly, if you are complaining of neck or back pain, you would want to see a chiropractor, an orthopedist, an neurologist, or a neurosurgeon.  Someone with a unique foot injury likely would want to see a podiatrist or an orthopedic surgeon that specializes in feet.  This is an important consideration in choosing a doctors office.

Every case is different and must be judged on its merits. It is a good start to get a complementary consultation regarding an accident case in case this happens to you. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so please call a licensed Florida attorney, like the lawyer at Drucker Law Offices, to determine if and how Florida law applies to your case.

While all of these considerations needs to be taken into account when you choosing a physican, if you have any questions regarding this topic or any other topic, please call the accident lawyer in Boca Raton (injury attorney in Delray, accident attorney in Wellington, personal injury lawyer in Boynton Beach, injury attorney in Lake Park, accident lawyer in West Palm Beach, accident attorney in Riviera Beach, injury lawyer in Royal Palm Beach, injury attorney in Loxahatchee, personal injury attorney in North Palm Beach, accident lawyer in Forrest Hill) for a free consultation regarding your accident case.  The phone number is 561-483-9199.

Different types of automobile insurance coverage under Florida law per the injury and accident lawyer

People are constantly asking the injury lawyer from Boca (also accident lawyer from Delray, personal injury lawyer from Boynton Beach, injury attorney from Wellington, accident lawyer from Miami, injury attorney in Fort Lauderdale) about the different types of car insurance that are offered and which are required by law.

Generally, in Florida, owners of vehicles are required to have PIP coverage and property damage insurance.   PIP coverage pays for 80 percent of your medical bills in an accident and 60 percent of lost wages, regardless of fault.  This coverage generally caps at $10,000.00. 

Property damage insurance pays to fix the other person’s car if you cause an accident.  The law requires you to carry $10,000.00 of this coverage although you obviously can purchase additional coverage.

Bodily injury is not required, although if you drive without it and cause an accident you are required to do certain things like posting money or else your license will be suspended as well as other administrative penalties.   The smallest bodily injury police is for $10,000.00 per person and $20,000.00 per accident and this coverage pays the other person for medical bills that are unpaid, lost wages over and above what PIP pays, as well as pain and suffering if certain proof is made.  This is generally indemnity insurance which means the insurance company indemnifies its insured, up to the coverage limits, against a judgment for bodily injury entered by someone who was injured as the result of the negligence of the insured or someone driving the insured vehicle.  Indeed, the reason that indemnity insurance companies “settle” or resolve cases is that when a case resolves, the insurance company requires a release to be signed by the injured person and the release states that the injured person cannot sue the insured.  Thus, this process is the proverbial “nipping in the bud” by preventing the injured person from suing in exchange for the monetary settlement.

Collision coverage is also not required although if you lease or purchase a car by loan, those companies likely will require you to have this coverage.   Collision coverage fixes your car when you are in an accident, regardless of fault.  It usually has a deductible so if it costs $5,000.00 to fix your car and you have a $500 deductible, then your insurance company pays $4500.00 towards your repair.

Comprehensive coverage basically fixes your car when it is damages by anything other than a car accident.  Thus, it would fix your car if damage by hurricane, theft, vandalism, and so forth.  This coverage, like collision, is not required by law but commonly required by contract (lease, loan, etc.).  This also usually has a deductible.

Uninsured motorist is also not required.  Uninsured motorist coverage, which is also underinsured motorist coverage, pays you money when you are injured in an accident that is not your fault and the other person does not have any insurance, does not have bodily injury coverage, does not have enough bodily injury coverage, or in a hit and run situation.  This pays, like bodily injury coverage to for the other person but when they do not have that coverage.  Interestingly, if someone purchases bodily injury coverage the law requires the insurance company to offer you the uninsured motorist coverage and if you choose to reject it, you are to sign a rejection form stating that you are not electing this coverage and that you understand you are giving up important coverage.  If the insurance company does not explain to you what you are giving up and you do not sign that form, then in the event of an accident, the insurance company may have to provide you with that coverage, even though you did not purchase it.

There is a lot of information here.  Obviously, before you purchase insurance you should speak with your agent and/or lawyer to make sure you understand in full the insurance that you are purchasing and the insurance that you are not purchasing.  You should get as much insurance and as large of policy limits as you can affort but we are in tough economic times and many people are limiting the coverage that they purchase.  So long as you have an understanding of what you are getting, you can make an educated decision for you and your family.

It is important to remember that these insurance coverages are covered by contract and there could be exclusions in the policy and further there could be differences in coverage between insurance companies depending on the wording of the contract/policy.

Every case is different and must be judged on its merits. It is a good start to get a free consultation regarding an accident case in case this happens to you. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so please call a licensed Florida attorney, like the lawyer at Drucker Law Offices, to determine if and how Florida law applies to your injury case.

At Drucker Law Offices, clients are helped when they are in an automobile accidents.  One of the first things the lawyer does is obtain the insurance policies, so that clients can get their cars fixed/totaled out and so that the lawyer can advise the clients of the applicable insurances.  The lawyer also answers questions from clients about their insurance coverage so they can make educated decisions about what insurance to get.  If you have been in an accident, feel free to call the accident lawyer in Boca Raton (Miramar injury lawyer, Pembroke Pines personal injury lawyer, Weston accident attorney, Plantation accident lawyer, Coral Springs personal injury lawyer, Tamara injury attorney) for a free consultation.  The phone number is 561-483-9199 in Boca Raton (principal office), 954-755-2120 in Coral Springs (satellite office) and 305-981-1561 in Miami (satellite office).

What are a driver’s rights in an accident – both the at fault driver and the driver who is not at fault

Common questions are about what rights someone has when they are in an accident.  Sometimes drivers are at fault and sometimes drivers are not at fault.  Please accept this blog post as a brief summary of this issue, but of course every case has to be based on the specific facts of that case.

At Drucker law offices, the personal injury lawyer in Boca Raton (also, Miami accident lawyer, North Miami injury attorney, Pembroke Pines accident attorney, Miramar injury lawyer, Plantation lawyer, Tamarac injury lawyer, Coral Springs attorney, Fort Lauderdale injury attorney), helps clients who were involved in an accident.  If you have question, please call the Boca office – 561-483-9199 (principal office); Coral Springs office (954-755-2120) or the Miami office 305-981-1561.

Here is an example.  Mary and Joseph are in an accident.  Mary is stopped at a red light. Joseph crashes into her car from behind.  Joseph acknowledges fault.  Joseph receives a ticket.  They both go to the hospital.   They both miss a week of work.  They both go to doctors and are found to have sustained permanent injuries (required by law to be entitled to pain and suffering per earlier blogs). What are their rights and what are the differences between them?

As to the car, Mary can make a claim against Joseph’s property damage coverage.  Since Joseph is at fault, his insurance company should fix Mary’s car.  There would be no deductible and Mary would not owe anything out of pocket through Joseph’s insurance.  Joseph on the other hand cannot get his car fixed through Mary’s insurance.  If Joseph has collision coverage, then he could get his car fixed through his own insurance but there likely would be a deductible, somewhere between $250 and $1,000. If Joseph does not have collision coverage, then he would have to fix his car and pay for it in full.

In Florida, PIP pays for 80 percent of medical bills and 60 percent of lost wages to a total of $10,000.00, without regard for fault.  Therefore, Mary and Joseph’s rights in terms of the PIP coverage are the same in that 80 percent of their medical bills and 60 percent of the time they missed from work will be the same.  However, Mary will have a claim against Joseph for the 20 percent out of pocket expenses and the 40 percent wages.  Joseph will not be able to make that claim against Mary or her insurance company.  If Joseph has health insurance, he can seek to have unpaid medical bills paid through his health insurance.  If Joseph has some for short term disability insurance like sick leave, then he can get additional monies from that source.

The last issue that would remain would be the issue of pain and suffering.   In Mary’s case, she would have a claim for pain and suffering to extent that she has permanent injury (or death; or permanent  disfigurement; or significiant scarring).  Joseph would not have a claim for pain and suffering.

Every case is different and must be judged on its merits and on the specific facts of the particular matter. It is a good start to get a consultation regarding an accident or injury case in case this happens to you. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so please call a licensed Florida attorney, like the lawyer at the law offices of Gary J. Drucker, to determine if and how Florida law applies to your case.

As you can see, while the person who was at fault does have some rights, there are much more rights for someone who was not at fault.  The lawyer helps those people who are not at fault in an accident. A free consultation is offered, and the number is 561-483-9199 (principal office Boca Raton) or 954-755-2120 (Coral Springs satellite office or 305-981-1561 (Miami).

Accidents where a car is speeding

As written about in prior posts, Florida is an at fault state when it comes to fixing the cars that are damaged in an accident, and payment of monies for injuries (other than for certain medical bills and wages that are covered by the no-fault personal injury protection insurance).

And while there are general fault rules that go along with the rules of the road, there are also comparative laws.  Comparative fault basically means that while it is possible that only one car is at fault, it is also possible that two cars can be at fault, even in a two car accident.

There are many accidents in Florida where, after a jury hears the facts and reviews the evidence, they find both cars partly at fault in an accident.  The way this would work is that they jury would have to apportion fault, i.e. 20 percent to one car and 80 percent to the other, or 50 percent to one car and 50 percent to the other; they key of course is that the total fault has to total 100 percent. 

It is also important to understand that in Florida if you are suing the other person and if the jury finds you to be 50 percent at fault and the other car is 50 percent at fault, then you recover 50 percent of your damages from the at fault car.

What happens when an accident is caused in full or in part due to the speed of another car?  This would play into comparative fault.  If for example, a car is stopped at a stop sign and then proceeds forward and the other car is speeding but has the right of way, then the jury would have to decide whether the speed of the other car is fully or partly or not the cause of the accident.

This scenario is something that is seen a lot, where one person is wrong due to the rules of the road (failing to yield like above, etc.) and yet the car claims that the other car caused the accident due to excessive speeding.

Proving that the other car was speeding is usually a difficult thing to prove.  If there is some independent witness that will say the other car was going well in excess of the speed limit and otherwise traveing in a negligent way, that would really help the case.  If it is just the person who failed to yeild saying that the other car was going too fast, that clearly would be self-serving and more difficult to convince a jury of.

Other things could help to prove the speed, like the damages to the car.  If the accident took place in a low speed zone and yet the damages to the car are severe, then that could be evidence to show the car was traveling at excessive speed.

Every case is different and must be judged on its merits. It is a good start to get a complementary consultation regarding an accident case in case this happens to you. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so pelase call a licensed Florida attorney, like the lawyer at Drucker Law Offices, to determine if and how Florida law applies to your case.

If you have been in an accident, please feel free to call Drucker Law Offices for a free consultation. The number is 561-483-9199.  The Boca Raton accident lawyer (also Boynton Beach injury lawyer, Delray Beach accident attorey, Wellington, injury attorney, Deerfield Beach accident lawyer, POmpano Beach, injury lawyer, Lake Wroth injury attorney, Loxahatchee accident attorney) only charges lawyer fees and costs if money is recovered for you.

Who pays for wages in a motor vehicle accident

In Florida, owners of cars are required to carry some amount of car insurance – Personal Injury Protection (PIP) and Property damage coverage.   PIP pays 80 percent of medical bills and 60 percent of wages to a total of $10,000.00.  Some people have a PIP deductible of up to $1,000.00.

Wages claims are generally presented as follows.  The injured person needs to get a disability note from their treating doctor stating they could not work for the pertinent period as a result of the accident.  The injured person needs to have their employer fill out a wage verifiation form showing the time they missed from work and showing the earning history for the last 13 weeks.  Once these documents are forwarded to the PIP insurance company, the insurance company has 30 days to pay the wages.

The timing of the presentation of the wage claim can be important.  If the wage claim is presented at the very beginning and if the person has a deductible, then the wages may not get paid as they might be applied to the deductible.  Similarly, if the wage claim is presented too late, then the PIP benefits may exhaust if the medical bills are large enough to exhaust the $10,000.00 of PIP benefits.

Every case is different and must be judged on its merits. It is a good start to get a complementary consultation regarding an accident case in case this happens to you. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so pelase call a licensed Florida attorney, like the lawyer at Drucker Law Offices, to determine if and how Florida law applies to your case.

If you have been in an accident, please feel free to conact Drucker Law Offices regarding your wage claim to discuss how to best present same.  Clients are helped to process their wage claims, medical claims and claims for pain an suffering.  The injury lawyer is in Boca Raton (accident lawyer in Boynton Beach, injury attorney in Delray Beach, accident lawyer in Deerfield Beach, injury lawyer in Pompano Beach). Please call 561-483-9199.

How do you get liability insurance information when you are injured in an accident in Florida

When someone is injured, Florida law has rules about providing liability insurance policy information.

Basically, Florida Statute 627.4137 requires disclosure of an insurance policy as well as disclosure of other information regarding the insurance policy.  The law requires disclosure of this information from the insurer, the insurance agent or the insured within 30 days of request.

Commonly, in car accident cases, clients come in with the accident report and that accident report would list the insurance companies and policies.  In other types of cases, however, there is little to no information regarding the insurance.  For example, when someone slips and falls at a property, it is not possible, other than requesting the policy from the property owner or the property management company, to get that insurance information.  Similarly, when someone is injured at a neighbor’s house, this statute is used to request the insurance policy of the homeowner.

Every case is different and must be judged on its merits. A good start is to get a complementary consultation regarding your accident case. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so please call a licensed Florida attorney, like the lawyer at Drucker Law Offices, to determine if and how Florida law applies to your case.

At Drucker Law Offices, Attorney Drucker endeavors to help all clients with with injury cases, which includes the prompt disclosure of insurance information.  A proper statutory letter seeking insurance information allows the retrieval of this critical information for our clients. Fortunately, due to Florida Statute 627.4137, the insurance information is available for the client.  If you have been injured in an accident, call Drucker Law Offices for a free consultation regarding your injuries at 561-483-9199. 

627.4137  Disclosure of certain information required.

(1)  Each insurer which does or may provide liability insurance coverage to pay all or a portion of any claim which might be made shall provide, within 30 days of the written request of the claimant, a statement, under oath, of a corporate officer or the insurer’s claims manager or superintendent setting forth the following information with regard to each known policy of insurance, including excess or umbrella insurance:

(a)  The name of the insurer.

(b)  The name of each insured.

(c)  The limits of the liability coverage.

(d)  A statement of any policy or coverage defense which such insurer reasonably believes is available to such insurer at the time of filing such statement.

(e)  A copy of the policy.

In addition, the insured, or her or his insurance agent, upon written request of the claimant or the claimant’s attorney, shall disclose the name and coverage of each known insurer to the claimant and shall forward such request for information as required by this subsection to all affected insurers. The insurer shall then supply the information required in this subsection to the claimant within 30 days of receipt of such request.

(2)  The statement required by subsection (1) shall be amended immediately upon discovery of facts calling for an amendment to such statement.

316.062 Duty to give information and render aid.—(1) The driver of any vehicle involved in a crash resulting in injury to or death of any person or damage to any vehicle or other property which is driven or attended by any person shall give his or her name, address, and the registration number of the vehicle he or she is driving, and shall upon request and if available exhibit his or her license or permit to drive, to any person injured in such crash or to the driver or occupant of or person attending any vehicle or other property damaged in the crash and shall give such information and, upon request, exhibit such license or permit to any police officer at the scene of the crash or who is investigating the crash and shall render to any person injured in the crash reasonable assistance, including the carrying, or the making of arrangements for the carrying, of such person to a physician, surgeon, or hospital for medical or surgical treatment if it is apparent that treatment is necessary, or if such carrying is requested by the injured person.
(2) In the event none of the persons specified are in condition to receive the information to which they otherwise would be entitled under subsection (1), and no police officer is present, the driver of any vehicle involved in such crash, after fulfilling all other requirements of s. 316.027 and subsection (1), insofar as possible on his or her part to be performed, shall forthwith report the crash to the nearest office of a duly authorized police authority and submit thereto the information specified in subsection (1).
(3) The statutory duty of a person to make a report or give information to a law enforcement officer making a written report relating to a crash shall not be construed as extending to information which would violate the privilege of such person against self-incrimination.
(4) A violation of this section is a noncriminal traffic infraction, punishable as a nonmoving violation as provided in chapter 318.
History.—s. 1, ch. 71-135; s. 13, ch. 91-255; s. 297, ch. 95-148; s. 84, ch. 99-248.

Rear end collision accidents – who is at fault?

At the law offices, there are so many questions about rear end collisions.  Who is at fault?  Is the Car from behind always at fault?  Can the fault be divided between the cars?

First, it is important to understand that every case is different and that ultimately, if the parties cannot agree as to fault, a judge or jury would have to decide, after listening to the facts from all the interested parties and the witnesses.

In Florida, there is a presumption in the law that the car from behind is at fault.  This presumption is rebuttable.  I will go over some common examples.

A car driven by Mary is stopped at a red light waiting for it to turn green.  Scott, driving a car, is not paying attention and accidentally slams into the rear of Mary’s car.  This case would likely present the scenario where Scott would agree that he was at fault.  Fault likely would be determined at 100 percent against Scott.  Again, every case is different.

Let’s try another scenario.  Mary is stopped at a light.  The light turns green but Mary is texting on her phone and is not paying attention.  She is sitting there for more than 30 second.  Scott is coming behind her and sees the light has turned green and assumes that Mary has started to drive forwawrd.  Unfortunately, before he realizes that she is stoped, he slams into the rear of Mary’s car.  Here Scott very well may argue that Mary was negligent for being stopped at a green light.  Mary of course will argue that Scott should have payed closer attention and the accident could have been prevented.  It is possible that the parties here, or their insurance companies, will not be able to agree on the fault issues.  It is possible that a judge or jury finds Scott fully or significantly at fault but it is also possible that a judge or jury find Mary significantly or partly at fault. 

While the presumption suggests fault from the car in the back, there are some scenarios where the car in front may be party or fully at fault.  In the next blog entries, I will discuss more scenarios where fault is not quite so clear.

Every case is different and must be judged on its merits. It is a good start to get a complementary consultation regarding an accident case in case this happens to you. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so please call a licensed Florida attorney, like the lawyer at Drucker Law Offices, to determine if and how Florida law applies to your case.

If you have any questions for the injury lawyer at Drucker Law Offices, please call 561-483-9199.

Do I have to prove a permanent injury to recover pain and suffering in a car accident in Florida?

People assume that in an accident if they have pain and if they suffer, they are entitled to pain and suffering when involved in an accident in Florida.  This is one of the more common questions that the accident attorney in Boca Raton (injury attorney in West Palm Beach, injury lawyer in Wellington, accident lawyer in North Palm Beach, accident attorney in Loxahatchee, personal injury lawyer in Palm Beach, accident lawyer in Delray Beach, injury attorney in Boynton Beach, injury lawyer in Greenacres, accident attorney in Lake Worth) at Drucker Law Offices gets. Generally, in Florida, in order to recover pain and suffering in a car accident you must prove:  1) death, 2) significant scarring 3) permanent disfigurement or 4) permanent injury.  Most people believe the important issues are how the accident happened and how much medical bills and treatment in the case but while these are also important issues, the other critical issue in an automobile accident case is whether the claimant suffered a permanent injury within a reasonable degree of medical probability.

In 1973, the Florida Legislature passed the comprehensive Motor Vehicle Act and created Personal Injury Protection (PIP) insurance, making such coverage mandatory in Florida.  PIP coverage provides their insureds with medical and employment disability insurance coverage for any injuries caused by a car crash, whether significant or not, and regardless of fault.  The concept of providing insureds with easy access to medical coverage following accidents was designed to reduce liability claims for minor injury accidents. 

This PIP requirement came with a trade-off, however, which is found in §627.737(2), Florida Statutes, which states: 

(2)  In any action of tort brought against the owner, registrant, operator, or occupant of a motor vehicle with respect to which security has been provided as required by ss. 627.730-627.7405, or against any person or organization legally responsible for her or his acts or omissions, a plaintiff may recover damages in tort for pain, suffering, mental anguish, and inconvenience because of bodily injury, sickness, or disease arising out of the ownership, maintenance, operation, or use of such motor vehicle only in the event that the injury or disease consists in whole or in part of:

(a)  Significant and permanent loss of an important bodily function.

(b)  Permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement.

(c)  Significant and permanent scarring or disfigurement.

(d)  Death.

Under this law, if a claimant is able to show that the other vehicle was at fault and caused the plaintiff’s injuries, they will be able to recover any out of pocket medical bills incurred (the monies owing after the PIP pays; usually PIP pays at 80 percent), any future medical bills, any lost wages, the loss of ability to earn money in the future, as well as any other out-of-pocket expenses legally shown.

The primary limitation of the law is that  pain and suffering can only be recovered if the injured person can prove death, significant scarring, permanent disfigurement or permanent injury.  Death, significant scarring and permanent disfigurement findings are obviously rare, so the most common way to seek pain and suffering damages in a car accident case is by a showing of permanent injury.  Indeed, in the industry, the permanent injury finding is called the permanent injury threshold, as unless the injured person breaches the permanent injury threshold, they are not entitled to pain and suffering.  Said another way, if the injured person has pain and suffers due to the negligence of another in a car accident, but the injury is not permanent, they cannot recover monies for the pain and suffering.

What is a permanent injury?  Obviously, it is an injury that is permanent but there must be more to it.  In court, a permanent injury is generally proven by expert testimony of the treating doctor or doctors.  If the treating doctor testifies to a permanent injury, then the plaintiff has made a prima facie case for pain and suffering but this could be rebutted by an expert for the defense.  In litigation, the defense lawyers are entitled to sending the injured person to a physician of their choice for a compulsory medical examination.  That doctor would render a decision of whether he or she believes the injured victim has a permanent injury.  If the treating doctor finds a permanent injury and the defense doctor finds that there is no permanent injury, then the jury ultimately would have to decide that issue, and they would only be allowed to award pain and suffering if they find that the injury is permanent.

Every case is different and must be judged on its merits. It is a good start to get a complementary consultation regarding an accident case in case this happens to you. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so pelase call a licensed Florida attorney, like the lawyer at Drucker Law Offices, to determine if and how Florida law applies to your case.

A person injured in a car accident may want to consider hiring a lawyer that is experienced in handling the issue of permanent in an injury case and have familiarity with the medical issue of these cases.  At Drucker Law Offices, the accident attorney in Boca Raton (permanent injury lawyer in Cutler Ridge, injury attorney in Homestead, accident lawyer in Westchester, accident attorney in Doral, injury lawyer in Miami, injury attorney in Coral Gables, personal injury lawyer in Aventura, accident attorney in North Miami Beach, injury attorney Kendall, personal injury attorney in Miami Beach) handles car wreck cases and offers a free consultation to accident victims.  Please call the satellite office in Miami 305-981-1561; the satellite office in Coral Springs 954-755-2120; the satellite office in Boynton Beach 561-265-1976; the satellite office in West Palm Beach 561-686-7070; or the main office in Boca Raton 561-483-9199.

Can I sue the Florida State government if one of its employees injures me in a car accident, a slip and fall case or a general negligence case?

I receive a lot of calls seeking advise on car accidents, slip and falls or general negligence against the State of Florida or one of its subdivisions.  As a personal injury lawyer in Boca Raton (accident attorney in Miami, injury attorney in Kendall, injury lawyer in Westchester, accident lawyer in Coral Gables, personal injury attorney in Cutler Ridge, accident attorney in Aventura, accident lawyer in Miami Beach, injury lawyer in North Bay Village, personal injury attorney Hialeah), I handle many governmental cases and I write this blog entry as a very general summary of this particular area of law.  I encourage any specific questions regarding this topic via a phone call or email and I would be glad to answer any questions on this or any injury topic. 

Florida has adopted many parts of the common law (common law is the law from England).  One of these laws that were adopted is sovereign immunity, although it has been adopted in a limited fashion.  Sovereign immunity, generally speaking, is the doctrine that the sovereign or state cannot commit a legal wrong and is immune from civil suit or criminal prosecution hence the saying, “the king (or queen) can do no wrong.”  In Florida, some suits are allowed and some are disallowed, hence it is limited sovereign immunity.  Florida does not generally allow suits for general negligence, like cases against the State for car accidents, slip and falls cases and general negligence.  There are some other limitations which I discuss below.

Generally, there is a cap on what can be recovered from the sovereign in Florida.  From 1981 to date, that cap was for $100,000.00 per person and a total of $200,000.00 per occurrence.  The statute dealing with this law is section 768.28 of the Florida Statutes and I have pasted certain parts of the statute below.  Interestingly, recently in what is a victory for personal injury victims the legislature agreed to raise the sovereign immunity limits of compensation from $100,000.00 to $200,000.00 per person and from $200,000.00 to $300,000.00 per occurrence. In order to recover an amount greater than these statutory sovereign immunity limits, it is required that the victim convince the legislature to pass a “claims bill,” a process which places an undue burden, with little chance of success, upon the injured victim.  Interestingly, the law limits what a plaintiff personal injury attorney can charge for governmental cases to 25 percent whether the matter is resolved pre-suit or in litigation.

Please note that all cases are different and one single fact difference can make a significant difference is any case evaluation.  Please call Drucker Law Offices or another licensed Florida lawyer if you have questions regarding any case that happened to you or a loved one.

Every case is different and must be judged on its merits. It is a good start to get a complementary consultation regarding an accident case in case this happens to you. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so pelase call a licensed Florida attorney, like the lawyer at Drucker Law Offices, to determine if and how Florida law applies to your case.

At Drucker Law Offices, the accident attorney in Boca Raton (injury lawyer in Hallandale, accident lawyer in Hollywood, personal injury attorney in Pembroke Pines, injury lawyer in Miramar, injury attorney in Plantation, accident attorney in Weston, accident lawyer in Tamarac, personal injury lawyer in Coral Springs, personal injury attorney in Parkland, accident attorney in Margate, accident lawyer in Lauderhill, injury lawyer in Deerfield, injury attorney in Pompano, personal injury lawyer in Ft. Lauderdale) handles governmental injury cases against the State of Florida and other municipalities and governmental bodies.  If you have been injured in an accident feel free to call the principal office in Boca Raton 561-483-9199, satellite office in Miami 305-981-1561, satellite office in Coral Springs 954-755-2120, satellite office in West Palm Beach 561-686-7070 or the satellite office in Boynton Beach 561-265-1976.

768.28  Waiver of sovereign immunity in tort actions; recovery limits; limitation on attorney fees; statute of limitations; exclusions; indemnification; risk management programs.

(1)  In accordance with s. 13, Art. X of the State Constitution, the state, for itself and for its agencies or subdivisions, hereby waives sovereign immunity for liability for torts, but only to the extent specified in this act. Actions at law against the state or any of its agencies or subdivisions to recover damages in tort for money damages against the state or its agencies or subdivisions for injury or loss of property, personal injury, or death caused by the negligent or wrongful act or omission of any employee of the agency or subdivision while acting within the scope of the employee’s office or employment under circumstances in which the state or such agency or subdivision, if a private person, would be liable to the claimant, in accordance with the general laws of this state, may be prosecuted subject to the limitations specified in this act. Any such action may be brought in the county where the property in litigation is located or, if the affected agency or subdivision has an office in such county for the transaction of its customary business, where the cause of action accrued. However, any such action against a state university board of trustees shall be brought in the county in which that university’s main campus is located or in the county in which the cause of action accrued if the university maintains therein a substantial presence for the transaction of its customary business.

(2)  As used in this act, “state agencies or subdivisions” include the executive departments, the Legislature, the judicial branch (including public defenders), and the independent establishments of the state, including state university boards of trustees; counties and municipalities; and corporations primarily acting as instrumentalities or agencies of the state, counties, or municipalities, including the Florida Space Authority.

(3)  Except for a municipality and the Florida Space Authority, the affected agency or subdivision may, at its discretion, request the assistance of the Department of Financial Services in the consideration, adjustment, and settlement of any claim under this act.

(4)  Subject to the provisions of this section, any state agency or subdivision shall have the right to appeal any award, compromise, settlement, or determination to the court of appropriate jurisdiction.

(5)  The state and its agencies and subdivisions shall be liable for tort claims in the same manner and to the same extent as a private individual under like circumstances, but liability shall not include punitive damages or interest for the period before judgment. Neither the state nor its agencies or subdivisions shall be liable to pay a claim or a judgment by any one person which exceeds the sum of $100,000 or any claim or judgment, or portions thereof, which, when totaled with all other claims or judgments paid by the state or its agencies or subdivisions arising out of the same incident or occurrence, exceeds the sum of $200,000. However, a judgment or judgments may be claimed and rendered in excess of these amounts and may be settled and paid pursuant to this act up to $100,000 or $200,000, as the case may be; and that portion of the judgment that exceeds these amounts may be reported to the Legislature, but may be paid in part or in whole only by further act of the Legislature. Notwithstanding the limited waiver of sovereign immunity provided herein, the state or an agency or subdivision thereof may agree, within the limits of insurance coverage provided, to settle a claim made or a judgment rendered against it without further action by the Legislature, but the state or agency or subdivision thereof shall not be deemed to have waived any defense of sovereign immunity or to have increased the limits of its liability as a result of its obtaining insurance coverage for tortious acts in excess of the $100,000 or $200,000 waiver provided above. The limitations of liability set forth in this subsection shall apply to the state and its agencies and subdivisions whether or not the state or its agencies or subdivisions possessed sovereign immunity before July 1, 1974.

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(8)  No attorney may charge, demand, receive, or collect, for services rendered, fees in excess of 25 percent of any judgment or settlement.

(9)(a)  No officer, employee, or agent of the state or of any of its subdivisions shall be held personally liable in tort or named as a party defendant in any action for any injury or damage suffered as a result of any act, event, or omission of action in the scope of her or his employment or function, unless such officer, employee, or agent acted in bad faith or with malicious purpose or in a manner exhibiting wanton and willful disregard of human rights, safety, or property. However, such officer, employee, or agent shall be considered an adverse witness in a tort action for any injury or damage suffered as a result of any act, event, or omission of action in the scope of her or his employment or function. The exclusive remedy for injury or damage suffered as a result of an act, event, or omission of an officer, employee, or agent of the state or any of its subdivisions or constitutional officers shall be by action against the governmental entity, or the head of such entity in her or his official capacity, or the constitutional officer of which the officer, employee, or agent is an employee, unless such act or omission was committed in bad faith or with malicious purpose or in a manner exhibiting wanton and willful disregard of human rights, safety, or property. The state or its subdivisions shall not be liable in tort for the acts or omissions of an officer, employee, or agent committed while acting outside the course and scope of her or his employment or committed in bad faith or with malicious purpose or in a manner exhibiting wanton and willful disregard of human rights, safety, or property.

How do medical bills get paid in a car accident case?

At Drucker Law Offices, I get a lot of questions about the cost of medical treatment when my clients are in car accidents.  People see explanations of benefits showing “allowable charges” from their car insurance and they are unclear as to how much treatment they are entitled to under PIP’s $10,000.00 coverage.  The accident attorney in Boca (accident lawyer in Miami, personal injury lawyer in Miami Gardens, accident attorney in North Miami Beach, injury lawyer in North Bay Village, injury attorney in Kendall, injury lawyer in Downtown Miami, accident lawyer in Aventura) will try to answer some common questions about the cost of medical treatment following a car accident. 

Generally, in a car accident case, medical bills are paid through the appropriate automobile insurance carrier.  As discussed in the last blog entry, in a Florida car accident, your own car insurance generally pays your medical bills, regardless of fault and regardless of whether you are in your car, another car or even if you are hit by a motor vehicle as a pedestrian or on a bicycle.  If you do not own a car, then if you live with a relative that owns a car, then that relative’s automobile insurance, regardless of fault and regardless of whether you were in that relative’s car or even if you were hit by a car while on a bicycle or as a pedestrian.  If you do not own a car nor live with a relative that owns a car, then you generally would qualify for PIP benefits through the car that you were in or from the car that hits you if you are on a bicycle or on foot.

The statute pertaining to the cost for treatment under Florida’s No-fault PIP laws is discussed in 627.736(5), a copy of that statute is pasted below.  Understanding the history of the bill might prove somewhat insightful.  Prior to January 1, 2008, there were no PIP fee schedules for doctors, which basically means that the doctors and hospitals could charge “usual and customary” charges.  These charges had to be reasonable and necessary and also had to be causally related to the accident but otherwise there were no fixed charges for most medical treatment (prior to 2008, a fee schedule for MRIs were already part of the statute. 

Under the current laws (post January 1, 2008), hospital charges are allowed to be at 75 percent of the usual and customary charges and then they are paid at 80 percent.  Thus, generally, if a hospital charges are $1,000.00 and the bill is submitted to an automobile PIP carrier, the bill is reduced to $750.00 and paid at 80 percent or $600.00.  Under the statute, the hospital is not allowed to charge the patient for the difference, i.e. the $250 reduction is a write off and thus after the payment of $600.00, the balance owed would be $150.00 not $400.00.  Ancillary hospital bills (emergency room physician, hospital radiology and ambulance charges) are allowed under the statute at usual and customary and thus there generally would not be a reduction for those bills. 

After the hospital, if the injured person goes to a private physician (chiropractor, primary care physician, orthopedist, neurologist, medical doctor, etc.), the charges are limited to 200 percent of the medicare fee schedule and then paid at 80 percent.  Thus if an initial visit to the doctor is charged at $500.00 (this is the doctor’s usual and customary charge), the PIP carrier would review the fee schedule and if the medicare fee schedule pays $150.00 for that particular coded visit, then the PIP carrier is allowed to reduce that charge to $300.00 (double the medicare of $150.00) and it gets paid at 80 percent or $240.00.  The balance owed would be $60.00 and not $260.00 as the $200 reduction per the fee schedule is generally not allowed to be charged against the patient per the statute.  If the PIP benefits are exhausted, i.e. the $10,000.00 has already been paid back, then the fee schedule no longer applies and the whole charge is due and owing. 

While generally it takes $12,500.00 to exhaust PIP benefits (presuming a no deductible, $10,000.00 PIP policy paying at 80 percent), you can see that it is not so easy to figure out when PIP benefits have exhausted in a case.  Many automobile insurance companies will send explanation of benefits to their insureds, and from this the patient can see approximately where there benefits are at certain points of treatment but again it is not so easy as the doctors do not necessarily bill right after each treatment.  There are even companies that will allow people with online access to check their available PIP benefits but again with delayed billing, this is not necessary updated with all billing to that moment. 

Every case is different and must be judged on its merits. It is a good start to get a free consultation regarding an accident case in case this happens to you. The advice contained in this blog is intended to be of general matter and not as to a specific situation, so please call a licensed Florida attorney, like the lawyer at Drucker Law Offices, to determine if and how Florida law applies to your case.

It is difficult to analyze available PIP benefits in a case but at Drucker Law Offices, the accident attorney from Boca (injury lawyer in Delray Beach, personal accident attorney in Northlake, injury attorney in Loxahatchee, injury lawyer in Royal Palm Beach, accident attorney in Wellington, accident lawyer in Boynton Beach, personal injury attorney in Lake Worth, injury lawyer in Lake Park, injury attorney in West Palm Beach, accident attorney in the Acreage, accident lawyer in Palm Beach) helps client with these issues and offers a free consultation to people that have been involved in any sort of accident where they believe someone else caused the accident.  Please call with any questions at the principal office in Boca Raton 561-483-9199, satellite office in Miami 305-981-1561, satellite office in Coral Springs 954-755-2120, satellite office in Boynton Beach 561-265-1976 or the satellite office in West Palm Beach 561-686-7070.

(5)  CHARGES FOR TREATMENT OF INJURED PERSONS.–

(a)  Any physician, hospital, clinic, or other person or institution lawfully rendering treatment to an injured person for a bodily injury covered by personal injury protection insurance may charge the insurer and injured party only a reasonable amount pursuant to this section for the services and supplies rendered, and the insurer providing such coverage may pay for such charges directly to such person or institution lawfully rendering such treatment, if the insured receiving such treatment or his or her guardian has countersigned the properly completed invoice, bill, or claim form approved by the office upon which such charges are to be paid for as having actually been rendered, to the best knowledge of the insured or his or her guardian. In no event, however, may such a charge be in excess of the amount the person or institution customarily charges for like services or supplies. With respect to a determination of whether a charge for a particular service, treatment, or otherwise is reasonable, consideration may be given to evidence of usual and customary charges and payments accepted by the provider involved in the dispute, and reimbursement levels in the community and various federal and state medical fee schedules applicable to automobile and other insurance coverages, and other information relevant to the reasonableness of the reimbursement for the service, treatment, or supply.

(b)1.  An insurer or insured is not required to pay a claim or charges:

a.  Made by a broker or by a person making a claim on behalf of a broker;

b.  For any service or treatment that was not lawful at the time rendered;

c.  To any person who knowingly submits a false or misleading statement relating to the claim or charges;

d.  With respect to a bill or statement that does not substantially meet the applicable requirements of paragraph (d);

e.  For any treatment or service that is upcoded, or that is unbundled when such treatment or services should be bundled, in accordance with paragraph (d). To facilitate prompt payment of lawful services, an insurer may change codes that it determines to have been improperly or incorrectly upcoded or unbundled, and may make payment based on the changed codes, without affecting the right of the provider to dispute the change by the insurer, provided that before doing so, the insurer must contact the health care provider and discuss the reasons for the insurer’s change and the health care provider’s reason for the coding, or make a reasonable good faith effort to do so, as documented in the insurer’s file; and

f.  For medical services or treatment billed by a physician and not provided in a hospital unless such services are rendered by the physician or are incident to his or her professional services and are included on the physician’s bill, including documentation verifying that the physician is responsible for the medical services that were rendered and billed.

2.  Charges for medically necessary cephalic thermograms, peripheral thermograms, spinal ultrasounds, extremity ultrasounds, video fluoroscopy, and surface electromyography shall not exceed the maximum reimbursement allowance for such procedures as set forth in the applicable fee schedule or other payment methodology established pursuant to s. 440.13.

3.  Allowable amounts that may be charged to a personal injury protection insurance insurer and insured for medically necessary nerve conduction testing when done in conjunction with a needle electromyography procedure and both are performed and billed solely by a physician licensed under chapter 458, chapter 459, chapter 460, or chapter 461 who is also certified by the American Board of Electrodiagnostic Medicine or by a board recognized by the American Board of Medical Specialties or the American Osteopathic Association or who holds diplomate status with the American Chiropractic Neurology Board or its predecessors shall not exceed 200 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001, for the area in which the treatment was rendered, adjusted annually on August 1 to reflect the prior calendar year’s changes in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor.

4.  Allowable amounts that may be charged to a personal injury protection insurance insurer and insured for medically necessary nerve conduction testing that does not meet the requirements of subparagraph 3. shall not exceed the applicable fee schedule or other payment methodology established pursuant to s. 440.13.

5.  Effective upon this act becoming a law and before November 1, 2001, allowable amounts that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services shall not exceed 200 percent of the allowable amount under Medicare Part B for year 2001, for the area in which the treatment was rendered. Beginning November 1, 2001, allowable amounts that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services shall not exceed 175 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001, for the area in which the treatment was rendered, adjusted annually on August 1 to reflect the prior calendar year’s changes in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor for the 12-month period ending June 30 of that year, except that allowable amounts that may be charged to a personal injury protection insurance insurer and insured for magnetic resonance imaging services provided in facilities accredited by the Accreditation Association for Ambulatory Health Care, the American College of Radiology, or the Joint Commission on Accreditation of Healthcare Organizations shall not exceed 200 percent of the allowable amount under the participating physician fee schedule of Medicare Part B for year 2001, for the area in which the treatment was rendered, adjusted annually on August 1 to reflect the prior calendar year’s changes in the annual Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor for the 12-month period ending June 30 of that year. This paragraph does not apply to charges for magnetic resonance imaging services and nerve conduction testing for inpatients and emergency services and care as defined in chapter 395 rendered by facilities licensed under chapter 395.