Jim Dodson: Hey, it's Jim Dodson, The Florida Bike Guy, so welcome to our live stream. Today I wanna talk about the topic of when you should consider settling an auto, or a bike case on your own. We get this question pretty regularly. I'm gonna give you four topics I'd like to cover today. The first would be, an area, number one, where you definitely could consider settling an auto or bike crash on your own. I'll talk about the areas, those types of cases, where in my view you definitely need an attorney. I'll talk about some of the, there's a pitfall for the unwary in terms of dealing with health insurance or Medicare. And then finally I wanna talk about number four, some of the advantages you have when you talk to an attorney, or when you're represented by a lawyer.
So, what are the cases that you should definitely consider maybe settling a case on your own? You know, and in my view they are the type of case where you're only using the PIP, or the medical insurance that comes on the auto. Remember if you're involved, if you're on your bicycle and you're injured by a car, or you're in a car crash as a driver or a passenger, there is mandatory medical insurance in Florida under what we call the Personal Injury Protection of your own auto policy, and that's up to $10,000. So that is not a benefit that you have to repay out of the settlement of your case. It's available to you, regardless of fault, and it covers up to the first $10,000 of your medical treatment, okay?
So if you have a case where only the PIP is involved, in other words, your medical treatment doesn't go over 10,000, there is no surgery, there's no nerve injury, there's no significant and permanent scarring, and it's a situation where you feel like you've pretty well recovered in the first few weeks. Definitely a case that I would talk to you about settling on your own. And I think sometimes people have a question about it, and I'd be happy to talk to you about the circumstances of a case and tell you. I'm the first to tell you if you can do just as well on your own, I'll even tell you what to do in order to make that happen.
Now, number two is, what are those cases where, in my view, and in my experience, having done this for 30 years, when you should definitely consider and hire an attorney? First would be, if you have an injury that requires surgery, or one that involves a nerve injury. We have significant nerve injuries that can cause limitations and permanent paralysis in people. And finally, where you have an injury that might involve permanent and significant scarring, okay?
The other would be, if Medicare is involved in paying for your healthcare, or your health insurance, because of some issues related to reimbursing them. Also, a case in which you have suffered an injury that's gonna lead to permanent limitations in your activities, your quality of life going forward, or one in which the doctors are already telling you you're gonna have future medical treatment, the need for future medical treatment. In any of these situations, in my view, you definitely need to consult with an attorney, and in most of these situations, definitely need to have an attorney on your side, doing what lawyers do, in order for you to receive the compensation that you should be entitled to.
Now, there is a real trap for people who are unaware of something we call health insurance, or Medicare subrogation. That means that when you have health insurance, particularly if you have Medicare, and the Medicare or health insurance pays the medical expenses that you incur because of a bike crash, or you were involved in an auto accident. They are entitled to subrogate, or stand in your shoes, and collect what they paid out on your behalf out of your settlement. A lot of people don't understand why, you know, I paid for the health insurance, I paid for Medicare, it's a benefit that I have, but I understand your reaction when I tell you that, but I can just tell you that having done this all these years, that's not a winning argument. They are entitled to be reimbursed. Florida law is very clear. National/Federal law is very clear, Medicare is entitled to be reimbursed. And there are penalties associated with not handling that correctly. Medicare is particularly treacherous to deal with. I've had people that have called us and explained, "Well, I settled my case." I said, "Did you have Medicare?" "Yes." "Well did you pay them back?" "Well I didn't know I had to pay Medicare back." You know, that's a big problem, because if you don't handle the Medicare lien correctly, they will actually have the right to set-off your future benefits for what they did not receive from you from the settlement. So, in that situation, you definitely need the advice of an attorney.
So, I think a lot of people, talking about what are the advantages of working with a lawyer. I think the best, the biggest advantage that I recognize having talked to so many people and met with them in their home, met with them in a hospital, even meeting with them in our office, is this relief that people have when you've been injured, your world has been turned upside-down, you don't know which way to turn, it's that simple relief of turning all of these issues over to an experienced lawyer who's definitely on your side. I always tell people, "You have a life, "and you have a case. "We'll take care of your case, "I want you to focus on your life." That's a real comfort to people, that I don't have to worry about the next phone call. What am I gonna say, and what's the explanation? Am I gonna say something that could hurt my case?
There's also the issue of billing. You know, I've already alluded to the Medicare trap, and the reimbursement subrogation trap. The billing issue takes quite a bit of time. One of the biggest responsibilities that my assistant, Judi, has, and she's worked for me for 30 years, with me as a team for 30 years, is pulling together all the billing issues, or the doctor's billing. Have they been paid? How much is the medical lien? Has it been submitted? Have we received notification from a health insurance company, or from Medicare about what the lien is? Have they added things to the lien that are unrelated to the injury that we're representing the client for? That happens a lot. Mistaken additions to the lien that we can get reduced. So, not being responsible for those billing issues is a huge relief to the vast majority of people who we encounter in our practice.
Knowing when and how to conduct an investigation after a crash has occurred. You know, we don't have to have an investigator in every case, but in a lot of cases, we do. And they do things from scene investigation, to tracking down witnesses, there's a lot of things we do. We have engineers to get involved. In bike cases, engineer gets involved frequently to download the data on the Garmin, the GPS locations. Where was everybody at the time? There's a lot of things that investigators do to facilitate the investigation of a bike crash.
But you know, beyond that, we also use life care planners. In many cases, someone's ability to earn money in the future has been affected, or the need for future medical care in the future has been a part of the case, and we may need the assistance of a life care planner to kind of project out what those costs are. And when you start calculating taking one medication that costs you $150 a month, over a 20 year life expectancy, that becomes a huge number that many times people fail to recognize when they even consider the value of their own case.
So we have doctor issues, you know. Who's the brain injury doctor to see? Who's the concussion doctor you need to see? Who's the neuropsychologist you need to see? There's just a lot of things that we can do to enhance a person's ability to diagnose the case and get a recovery.
The other thing, a claims adjuster understands when we deal with a lawyer, that the lawyer can file suit if the case isn't settled within what is viewed to be a fair and reasonable amount. If you're handling a case on your own, you don't have that implicit threat. We don't, in our practice, it's not our practice to simply file suit in every case. We file suit when it's necessary, in order to protect our client and get the full value. We are very successful in, quite frankly, working a case up to not necessarily having to file suit, not necessarily having to increase the attorney's fees, but allow our client to get a larger net recovery because we're not in litigation and don't have a larger attorney's fee to deal with. So, but we have that implicit threat if the insurance company doesn't handle the case properly that that's exactly what we can do.
And I would add another thing. You know, when you're injured in a crash, whether in a passenger in a car, or riding your bike, you have an injury. Unless you've been in the claims business in the past, it's just impossible to have any concept of what an injury might be worth. Many times, a client's value, or view of the value of an injury has nothing to do with the actual case value. Many times clients kind of get it confused with what they need in their life. I need a roof for the house, I need a car, I need to buy a new car. Well that doesn't really have a direct bearing on the value of your case, so we have to deal with what's the value of the case? You know, I've done this 30 years. My assistant, Judi, has worked with me for 30 years, and in our practice, we have a claims adjuster, Mark, who works in our office. He's retired as a major case handler, from a major insurance company. He's worked with us for several years. Mark brings all of that experience of 30 years, evaluating how defendants look at the case, what they need in order to get the case value established, and then placing the proper value on a client's injury. So trying to do that on your own is just impossible. You have no frame of reference. A lot of people are under the mistaken belief that, "Hey, there's just a formula. "You look at the medical bills, "and it's three times the medical records." Well clearly there's a relationship, of a case that has $100,000 in medical bills is worth more than a case that has 10, but it's not simply a matter of use two or three times what the medical bills are, it's much more nuanced than that.
I think it's interesting, some people just can't get past the fact that while a lawyer's gonna take, maybe, a third of your settlement, and I understand that feeling sometimes. I'll give you an example. Somebody called us here and said in conversation, "I got my case settled for $30,000," and in their view, they've saved $10,000 if the lawyer charged a third, but in conversation, listening to what the injury is, and what the medical records were, and how it was worked up, you know, the case is worth $90,000 in my view. Client got it settled for 30, they saved 10, but they lost 60 because they didn't understand the implications of their injury, and the full value of what's involved.
The other thing to consider, when you consider the attorney's fees, we are going to save money, in virtually every case, on getting the medical lien. So we talked about Medicare has a right of reimbursement, health insurance has a right of reimbursement. Typically, like in the Medicare situation, they are going to give us a credit for, basically, collecting that lien for them. So using an example, if the Medicare bill is $45,000 and they send us a notice that they're looking for reimbursement of $45,000 from the settlement, when the settlement is done, they're going to reduce that lien, their subrogation right, by a third, if that's the percentage of the fee, recognize we've collected that for them. It's a much more complicated formula than that, but in essence it works out that that $45,000 lien would turn into a $30,000 actual payment, and yes, you're gonna pay a percentage to the lawyer, but when you calculate how much savings you're actually receiving, the lawyer, typically, is gonna earn, get a higher settlement, you're gonna pay a fee on that, but the lawyer's then gonna knock off, if the Medicare lien is, you could save 15,000 on the Medicare lien, well that offsets a great deal of what the attorney's fees are in terms of the net effect for the client in their pocket.
But again, I think at the end of the day, most clients are just so relieved and comforted knowing that someone that they know and trust is making decisions to help them, giving them the alternatives to make intelligent, reasonable choices for their lives, giving them a sense of control in a situation where they didn't feel they had any control, and they're relieved to move through this process knowing they've got someone in their corner that cares about them, and is looking out for their best interest.
So, you know, those are my thoughts on when you should consider hiring a lawyer, and when maybe you should consider representing yourself in a minor case. I wanna remind you that we represent cyclists across Florida, whether you've been involved in a car crash, or a bike crash. We welcome your referrals. You, or the person you refer, will be well taken care of by me, and by this amazing team that we've assembled here at Jim Dodson Law. So if we can help you, just call, let us know.
We have an offer for you today. You know, I love this, our phone case. This is a waterproof phone case. It comes with some branded information inside. It's shamelessly logoed. I always tell people that it comes with a lifetime guarantee. If it breaks, or cracks, or fails in any way, we'll give you another one. So, this is the offer, get it. You can go to the bit.ly link, and get one of these sent to you. If I can help you in any way, let us know. I'm Jim Dodson, The Florida Bike Guy, we'll see you on the road, be safe, bye.
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