Personal Injury and Wrongful Death FAQ

WHY SHOULD I HIRE AN ATTORNEY? CAN’T I SAVE MONEY BY HANDLING MY OWN CLAIM?

It is true that with many auto accident claims with minor injuries, a claimant may save time and money by handling the matter without an attorney. The claimant should always understand, however, that he is at a disadvantage in his negotiations with an insurance company. Unlike the insurance company, the claimant generally has no experience or training in handling claims and negotiating settlements.

The insurance industry employs highly trained and experienced professional adjusters whose primary job is to minimize the amount his company has to pay for a claim. Even if he saves only a few dollars on your auto accident claim, multiply that times thousands of claims made nationwide every year, and the adjuster has saved the industry hundreds of millions of dollars.

In auto accident claims involving minor injury, or where the claimant is not sure how bad his injuries may become, the attorneys at Hefferon & Hefferon advise you to at least consult with an experienced personal injury attorney before communicating in any manner with the adverse insurance company. A good adjuster will start minimizing your claim from the initial phone call. Don’t let him. Contact or call Hefferon & Hefferon at (704) 243-9444.

With auto accident and other claims involving serious injury, a claimant should always retain an experienced personal injury lawyer who limits his or her practice to the representation of the seriously injured. You would not hire a criminal lawyer to handle your tax matters, or a family doctor to perform brain surgery. Likewise, if you or a family member has been seriously injured, you should choose an experienced personal injury attorney who has dedicated his professional life to the handling of complex injury claims and lawsuits.

WHY SHOULD I RETAIN Hefferon & Hefferon?

Experience. Resources. Resolve. Results.

Today’s personal injury claims and lawsuits tend to be highly technical in nature. In addition, insurance companies are fighting claims more vigorously than ever before. They have the resources and staff to quickly investigate and gather evidence favorable to their side. They have access to the finest legal counsel in virtually unlimited numbers.

To offset the formidable powers arrayed against you, and maximize your recovery, you will need an experienced personal injury attorney who is competent to handle large and complex cases and who will fight for your rights. Tom Hefferon and Paul Hefferon have over 60 years combined experience and are highly respected by their peers. They have recovered millions of dollars for their clients. Contact or call Hefferon & Hefferon at (704) 243-9444.

HOW DOES THE PERSONAL INJURY CLAIM PROCESS WORK?

Under the civil law of most states, when a person carelessly causes personal injury or damage to another, that person is liable for all costs related to the injury caused. If the person at fault has an insurance policy providing coverage for the loss, the insurance will pay the loss on behalf of its insured up to the monetary limits chosen by the policyholder (“policy limits”).

A person with a claim against his own insurance company (as for a loss caused by a break-in at home) is called a “first-party claimant.” A person with a claim against the insurance company of another individual (as with an auto accident) is a “third-party claimant.”

Both first-party and third-party claimants must first give the insurance company a “Notice of Claim.” This is often done by providing basic information over the phone.

Once the insurance company has notice of a claim, a “claims file” is opened and the file is assigned to an “adjuster.” The adjuster typically must make two initial determinations:

  1. Does the insurance policy provide coverage for the loss claimed? (“coverage”). This includes whether the insured has paid his premiums to keep the policy in effect; and

  2. In a third party claim, if coverage exists under the policy, is the insured person liable for the loss? (“liability”). Where liability is not obvious, the adjuster will investigate the facts and circumstances of the claim, and has a wide variety of resources, such as auto accident reconstruction experts, to help in make this determination.

If coverage and liability are established, the adjuster will then request documentation of the loss. In an auto accident, he will require auto damage estimates (or his own appraisal of the loss), and receipts for incidental losses, such as rental vehicles and broken personal property (eyeglasses, cell phones, etc.). If an injury has occurred, he will require the claimant to produce medical bills, all relevant medical records, and adequate documentation of lost income. If there is a permanent injury or scars, the adjuster will require documentation or photos of those losses as well. Large, complex claims involving serious injuries often require very sophisticated documentation (or proof) in order to recover for future losses.

While an injured person is recuperating, or while he or she remains under the care of medical providers, the claim remains in limbo. Documentation is provided as it becomes available but resolution of the claim must wait until all losses and damages are capable of itemization and documentation. This process can take days, weeks, or even years, depending on the severity of the injuries.

At some point, however, an adjuster will determine that he has sufficient documentation in the claims file to attempt to negotiate a settlement. Negotiation will either resolve the claim, or reach an impasse. If the claim is settled to the satisfaction of the claimant, the adjuster will require the execution of a “Release of Claims” before he will issue payment. Generally, by signing a Release, the claimant discharges his entire claim, no matter what the circumstances. A General Release releases all claims of whatsoever kind, known or unknown, past, present or future, from the beginning to the end of time.

If a settlement cannot be reached, the claimant must file a lawsuit. The insurance company is under no obligation to pursue a resolution of the claim after settlement negotiations fail. The ball is in the claimant’s court and he must take action within a certain time limit or lose his claim entirely. A claim can be settled at any time, even after a lawsuit is filed. In fact, the great majority of claims involving lawsuits are eventually settled before trial and verdict.

However, if the claim and lawsuit cannot be settled, eventually (the length of time depends on how crowded the civil court dockets are in any particular jurisdiction) the lawsuit will go to trial. After all the evidence is presented, the judge will instruct the jury on the law, and the jury will then deliberate. The jury may be asked to determine questions regarding the fault of not only the other party, but the claimant as well; and the amount of damages the claimant should receive.

If you have questions about the claims process, contact or call Hefferon & Hefferon at (704) 243-9444.

WHAT IS MY PERSONAL INJURY CLAIM WORTH?

Every claim is different, no matter how much it resembles other claims. There are countless variables that go into an analysis and evaluation of a personal injury claim, including but not limited to the relative fault of the various parties, the type and severity of the injuries, whether the injured person has pre-existing medical conditions, whether the injured person has a history of making personal injury or workers compensation claims, the amount of time it takes to recuperate, the amount of income lost while unable to return to work, the amount of medical expenses and whether those medical expenses have been paid by other sources, the amount of all insurance coverage available to compensate injured persons, whether the at-fault person is guilty of bad conduct (drunk driving, reckless driving, etc.), and on and on and on.

An experienced personal injury attorney should never tell a prospective client what his claim is worth without first having a solid understanding of all the facts and circumstances affecting the value of a claim. If you have an attorney who makes such promises, beware. If you wish to consult with an experienced personal injury attorney, with a reputation for straight talk and honest answers, contact or call Hefferon & Hefferon at (704) 243-9444.

HOW LONG DOES IT TAKE TO RESOLVE A CLAIM FOR PERSONAL INJURY

The amount of time between the injury and ultimate resolution of a claim depends on the facts and circumstances of each claim. The claims process can take a few months to many years. There is no way to evaluate the time involved without a detailed evaluation of all the facts and circumstances. However, it is safe to state that the claimant should always be patient, and should not expect a quick resolution. If you would like an evaluation of your claim by experienced personal injury lawyers, contact or call Hefferon & Hefferon at (704) 243-9444.

WILL I HAVE TO GO TO COURT?

Most personal injury claims are settled without court action. However, there are cases where you and your attorney simply do not agree with the adverse insurance company about the value of your personal injury claim. An experienced personal injury lawyer will “build” your claim and make powerful and persuasive arguments on your behalf, but he or she cannot force the insurance company pay a fair amount. Sometimes, you have to file a lawsuit.

The best way to maximize the value of your claim and stay out of court is to hire an experienced personal injury lawyer with a reputation for trying jury trials in court. The insurance companies know which personal injury attorneys try cases and which don’t. Experienced trial attorneys typically obtain higher settlements values.

Tom Hefferon and Paul Hefferon have over 200 jury trials under their belts. They try cases when necessary. They follow the maxim: “First negotiate, but when all else fails, litigate.”

I WAS IN AN AUTO ACCIDENT AND THOUGHT I HAD ONLY SLIGHT INJURIES, SO I DID NOT SEEK ANY MEDICAL TREATMENT. NOW MY INJURIES ARE GETTING WORSE. WHAT SHOULD I DO?

When you are involved in an auto accident in which you receive even slight injury, you should seek an immediate medical examination. Your health should always be your first priority. You can worry about the legal ramifications later. It is better to have good health than a good claim. If you have been examined following an accident, and your injuries do not clear up, you will have a documented medical record that you received some injury in the accident in question and received some treatment. This makes it much easier at a later date to persuade a claims adjuster that your injuries are genuinely related to the accident. We invite you to contact Hefferon & Hefferon or give us a call at (704) 243-9444 to discuss your particular situation.

THE OTHER DRIVER’S INSURANCE COMPANY SAYS THE AUTO ACCIDENT WAS MY FAULT AND THEY ARE REFUSING TO ACCEPT RESPONSIBILITY. IT WAS NOT MY FAULT. WHAT SHOULD I DO?

An insurance company has a legal right to deny liability for a personal injury claim, and you cannot force them to accept responsibility except through legal action. When an auto liability insurer denies your claim, you have two choices: Accept it and move on, or hire am experienced personal injury lawyer and fight it. Contact Hefferon & Hefferon or call us at 704-243-9444 for advice as to your best option.

THE OTHER DRIVER’S INSURANCE COMPANY WANTS ME TO GIVE THEM A RECORDED STATEMENT. WHAT SHOULD I DO?

Never provide a recorded statement to an insurance company without first speaking with an experienced personal injury attorney. You are not required to give a recorded statement, and you have the right to seek legal counsel first. You should always keep in mind that the adjuster is not taking a recorded statement for your benefit. He wants your recorded statement because the first rule of insurance adjusting is to minimize your claim. He will use your own words against you any way he can. If an insurance adjuster asks you for a recorded statement, first contact or call Hefferon & Hefferon at (704) 243-9444 and we will be happy to discuss this with you.

THE OTHER DRIVER’S INSURANCE COMPANY HAS CALLED WITHIN DAYS AFTER THE AUTO ACCIDENT AND OFFERED ME A SETTLEMENT. WHAT SHOULD I DO?

When you settle with an insurance company, they will insist that you sign a full Release Of Claim before they will cut you a check. When you sign a full Release, your claim is gone – over, extinguished, dead – no matter what happens to you in the future. You should never sign a Release without first seeking the advice of an experienced personal injury lawyer. If you have any questions or concerns, contact or call Hefferon & Hefferon at (704) 243-9444 before you sign anything.

THE OTHER DRIVER’S INSURANCE COMPANY HAS WRITTEN ME A LETTER SUGGESTING THAT I DO NOT NEED TO HIRE A PERSONAL INJURY LAWYER, THAT THEY WILL TREAT ME FAIRLY. WHAT SHOULD I DO?

If you believe that, we’ve got a bridge in Brooklyn we’d like to sell you. Seriously, the decision to consult with an experienced personal injury attorney is your decision, and an insurance adjuster is the last person in the world that should have any input into that decision. They dearly hope you won’t consult an attorney because they know they’ll save money if you take their advice. If you receive such a letter, contact or call Hefferon & Hefferon at (704) 243-9444 concerning your legal rights and options.

WHY SHOULD I USE MY MEDICAL INSURANCE WHEN THE ACCIDENT WAS NOT MY FAULT?

Whether you have a private health insurance policy, employer-provided health insurance, or Medicare/Medicaid, go ahead and submit your medical expenses to the medical insurer just as you would any other medical treatment. Submitting medical expenses to your insurer has no direct effect on your or your employer’s premiums. The injury claims process can take time and you do not want your creditworthiness affected by medical expenses that remain unpaid for a long period of time. Be prepared upon settlement, however, to reimburse your medical insurer, or Medicare/Medicaid, for accident-related medical expenses it paid. At Hefferon & Hefferon, we will guide you through this process. Contact us or give us a call at (704) 243-9444.

I DO NOT HAVE ANY MEDICAL INSURANCE. WILL THE ADVERSE AUTO INSURANCE COMPANY PAY MY MEDICAL EXPENSES AS I INCUR THEM?

In the majority of claims, most auto insurance companies will not pay your medical expenses as you incur them. Ultimately, if the claim settles, and as a part of the settlement, the auto insurer will pay the amount necessary to satisfy all medical expenses. But there is no “pay as you go.” At Hefferon & Hefferon we will help you consider all your insurance options, we will attempt to work with the medical provider to delay payment without affecting your credit, and we will advise you as to the different resources that might be available to you while you await the resolution of your claim. Contact us or give us a call at (704) 243-9444.

IF THE AUTO INSURER WON’T “PAY AS I GO” HOW WILL I GET THE MEDICAL TREATMENT I NEED?

Public hospitals cannot turn you away, or turn you out, when you have life-threatening injuries or if you are in unstable medical condition. They can bill you later, and they will. However, after you are medically stabilized, no medical provider has a legal obligation to provide medical treatment without being paid. This can be a real problem for uninsured claimants who have sustained non-emergency traumatic injuries for which surgery is indicated, such as a ruptured vertebral disc or a torn rotator cuff in the shoulder. At Hefferon & Hefferon, we will help you consider all your options, we will attempt to work with medical providers to provide critical treatment and delay payment, and we will advise you as to the different resources that might be available to you while you to get the treatment you need. Contact us or give us a call at (704) 243-9444.

WHAT IS UNINSURED/UNDERINSURED (UM/UIM) MOTORIST INSURANCE COVERAGE?

Uninsured Motorist Insurance (UM) is insurance you purchase as a part of your auto policy. It provides insurance coverage to you if you are injured or damaged in an auto accident caused by a driver who has no insurance. Your own insurance company steps in and evaluates and pays your claim. After your claim is resolved, the insurance company will seek reimbursement or a judgment from the uninsured driver. You should always purchase UM coverage. It is relatively inexpensive, and you never know whether the guy that just ran into you forgot to pay his insurance premiums.

Underinsured Motorist Insurance (UIM) is also additional coverage you purchase with your auto policy. It provides coverage to you if you sustain injuries and damages reasonable compensation for which exceeds the insurance limits of the at-fault driver. UIM coverage is a good idea because many drivers are minimally insured and therefore underinsured. In North Carolina, you can purchase UIM limits from $50,000 to $1,000,000.00, and the premiums are relatively inexpensive. It’s a good bargain, it protects you, and we at Hefferon & Hefferon always recommend that you to purchase UM/UIM coverage If you have any questions about insurance coverage, contact us or call us at (704) 243-9444.

WHAT IS MEDICAL PAYMENTS COVERAGE, AND SHOULD I BUY IT?

Many states allow auto insurance companies to offer optional coverage for payment of reasonable and necessary medical expenses incurred as a result of an auto accident. In most instances, “med pay” coverage is limited, but is available without regard to whether you were at fault in the auto accident in which you were injured. In North Carolina, if you purchase medical payments coverage, you can collect your “med pay” from your auto insurer even if the auto insurer for the other driver, or your own health insurer, pays your medical expenses. At Hefferon & Hefferon, we recommend that our clients purchase medical payments coverage.

WHO IS GOING TO REPAIR MY CAR AND WHAT WILL I DRIVE IN THE MEANTIME?

There are three possibilities when you have been in an auto accident:

  1. There is no dispute that it is the other driver is at fault.

    In this case, the adverse insurance company will pay to either repair your car, or pay its fair market value (FMV) if your car is a total loss. If the cost of repair exceeds 75% of FMV, the insurer must declare the car a total loss and pay FMV. FMV is not what you think your car is worth. Even if your deceased granddaddy gave you that “classic” for your 21 st birthday, the car is only worth what “a willing buyer would pay and what a willing seller would accept in an arms length transaction when neither is compelled to buy or sell”. In understandable terms, if you put an ad in your local paper the week before the accident, what could you realistically expect to sell your car for to a stranger answering the ad? That’s FMV.

    The adverse insurer will also pay for a replacement rental vehicle for a “reasonable period” while your car is being repaired, or while a determination is made whether your car is a total loss. WARNING: The adverse insurer decides where you rent your car, and also decides what is a “reasonable period.” The insurer will refuse to pay for a rental if you rent one without their approval, and will cut off payment of a rental car on their schedule, not yours. If your car is totaled, start looking for a replacement vehicle immediately.

    If the other driver is uninsured, your insurance company will step in and pay for the repair of your vehicle, even if you do not have collision coverage. However, they do not have to provide you with a rental vehicle unless you have rental coverage.

  2. There is a dispute over fault and the adverse insurer refuses to repair my car.

    The adverse insurer has a legal right to deny liability and refuse to pay your claim. If you have “collision coverage” you will have no choice but to have your auto insurer pay to repair your car. And yes, it may lead to increased premiums or even cancellation of your policy. Your collision insurer is under no obligation to provide you with a rental vehicle unless you also purchase optional rental coverage. If you have no collision coverage or no rental coverage, you will be stuck with the cost of repairing your vehicle and/or the cost of renting a vehicle.

  3. The accident is clearly your fault.

    The adverse insurer has no responsibility to you at all. If you have no collision insurance or rental coverage, you must bear your own losses. If you have collision coverage, contact your insurance agent. Prepare for an increase in insurance premiums and possibly cancellation of your auto coverage.


(DISCLAIMER – The following information is provided for educational and illustrative purposes only. There is no representation that the information is complete or up-to-date. Nor is there any representation that the information provided herein has any relevance or applicability to jurisdictions outside states where our attorneys are licensed. You should not substitute the information and opinions provided herein for direct legal advice from a qualified attorney concerning your legal problem. You are invited to contact Hefferon & Hefferon to discuss your legal problem directly.)