Filing a Lawsuit2018-08-29T12:13:56+00:00
Queens Personal Injury Attorney - Answers to Your Questions

DO YOU HAVE A CASE? LET WITTENSTEIN & WITTENSTEIN HELP YOU DECIDE

When you are thinking about filing a lawsuit, you have lots of factors to consider. There is the money, the time, the energy, and of course, the case itself. How can you determine whether you have a legitimate lawsuit on your hands? Wittenstein & Wittenstein, with our highly qualified attorneys and years of experience, can help you decide whether filing a suit is the right choice for you to make.

Here are a few things to consider before deciding to file a lawsuit:

  • Many people are under the impression that trials are only about determining guilt vs. innocence. This is not always the case. Lawsuits are not about differentiating the good guy from the bad guy; they are about determining what has been lost and what if any compensation is deserved for these losses.
  • When an incident occurs, there may be a dispute between the parties involved. This is where litigation comes in: Lawsuits are a way to get an impartial assessment of damages and fault.
  • Lawsuits are often lengthy. Wittenstein & Wittenstein is confident we have the patience and experience to see you through. Make sure this is something you, too, are willing to commit to.
  • Lawsuits filed through Wittenstein & Wittenstein are done on a contingency fee basis.
  • You do not need to be a citizen [link to filing w/green card, visa, etc] to file a lawsuit.
  • Wittenstein & Wittenstein will always prepare for the full trial, but keep in mind that 99% of all lawsuits we have dealt with have ended in a settlement and have not gone to trial.

If you believe you may be eligible to file a lawsuit, we hope you will contact us at 718-261-8114 or law@wittenstein.com so that we can assist you in determining your options and taking the next step.

THINKING ABOUT FILING A LAWSUIT IN NEW YORK?

LET WITTENSTEIN & WITTENSTEIN HELP YOU DECIDE

When you are thinking about filing a lawsuit, you have lots of factors to consider. There is the money, the time, the energy, and of course, the case itself. How can you determine whether you have a legitimate lawsuit on your hands? Wittenstein & Wittenstein, with our highly qualified attorneys and years of experience, can help you decide whether filing a suit is the right choice for you to make.

Here are a few things to consider before deciding to file a lawsuit:

  • Many people are under the impression that trials are only about determining guilt vs. innocence. This is not always the case. Lawsuits are not about differentiating the good guy from the bad guy; they are about determining what has been lost and what if any compensation is deserved for these losses.
  • When an incident occurs, there may be a dispute between the parties involved. This is where litigation comes in: Lawsuits are a way to get an impartial assessment of damages and fault.
  • Lawsuits are often lengthy. Wittenstein & Wittenstein is confident we have the patience and experience to see you through. Make sure this is something you, too, are willing to commit to.
  • Lawsuits filed through Wittenstein & Wittenstein are done on a contingency [link to contingency fee page] basis.
  • You do not need to be a citizen [link to filing w/green card, visa, etc] to file a lawsuit.
  • Wittenstein & Wittenstein will always prepare for the full trial, but keep in mind that 99% of all lawsuits we have dealt with have ended in a settlement and have not gone to trial.

If you believe you may be eligible to file a lawsuit, we hope you will contact us at 718-261-8114 or law@wittenstein.com so that we can assist you in determining your options and taking the next step.

Knowing that most cases are settled with insurance companies without litigation, people wonder whether they really need to hire a personal injury lawyer.  In some cases, it might not be necessary.  For example, if you are hit in the rear by another vehicle, and have a police report that indicates that the accident was completely the other driver’s fault, you could probably settle the claim for your property damage on your own.  All you would need to do is send an estimate for the damages to the driver’s insurance company and they will likely pay your claim without much hassle.  They might want to inspect your car, but that’s no big deal either.  The advantage of doing this yourself is that you get to keep all the money and don’t have to share it with a lawyer.

Sometimes it’s trickier, even with a simple car accident.    You saw the other driver blazing through a solid red light while texting, but when the police arrive, he tells them that YOU went through the light.  There are no witnesses and the police did not observe the accident, so they have no choice but to say that both drivers accuse the other of going through the light.  Now, if you send the estimate for your car to the insurance company with the police report, they will tell you that they will only pay you for 50% of the damage, or, even worse, that they are sticking by “their insured’s” version and will not offer to pay you anything.  Hopefully, you have full-coverage on your car in case this happens!

In the scenarios above there are “no injuries,” but already it’s complicated.  If you are injured, not only will the insurance company not be willing to pay the full value based on the conflicting stories, but they will also discount the value of your injuries.   You need an attorney to prove that the accident was the other driver’s fault.

Let’s say now that the police report gives all the fault to the other driver, and the insurance company pays you in full for the damage to your car, but you are injured.   When you finish with your treatment, you send your medical reports to the insurance company and they assign a claims representative to your case.  You send the medical reports to the claims representative, who reviews them and tells you that they are not paying you anything because you don’t have a “serious injury.”  You need an attorney.

What may seem simple in theory is much more complicated in practice.  They are filing deadlines, and statutory limitations, as well as a host of regulations that personal injury lawyers know how to handle, so the value added by a good attorney is well worth the fee,  especially if you have severe injuries or have lost time from work.

SEVERE INJURIES

If your injuries are severe and you have lost time from work, this is something to take very seriously.  It might not be possible at the onset to know how long it will take to heal or when you will be able to return to work.  In such cases, it is important to ensure that your claim is being handled properly from the very beginning.   An experienced personal injury attorney will be able to negotiate with the insurance companies to get you the services you need for a complete recovery and to make sure that you get the maximum compensation down the line.

MEDICAL MALPRACTICE

This is the kind of case that it is virtually impossible for an indiviaul to handle on their own.  The cost of prosecuting a malpractice case is enormous as doctors must be hired to testify, and spending that kind of money without knowing what you are doing (and risking the case getting dismissed,) makes no sense at all.  Malpractice insurance carriers never settle cases in the early stages, so it’s not like you can just pick up a phone.  Litigation will be necessary.

WHEN THE INSURANCE COMPANY REFUSES TO PAY OR LOWBALLS YOUR CLAIM

Some insurance companies are easier to settle with than others.  There are insurance companies that will not settle claims at all unless there is some litigation done.  Personal injury attorneys know the insurance companies and what has to be done with each one to maximize a claim.  A good lawyer will make a jury case to a jury if necessary.

WHEN YOU DON’T KNOW THE VALUE OF YOUR CASE

It is difficult to make a decision to settle your case if you don’t understand it’s value.  Personal injury attorneys have seen similar sets of facts before and have a good sense of what a case is worth.  You may think you case is worth $100,000, but it’s really only worth $50,000.  You may have a $200,000 and settle for only $10,000.  You need a legal expert to guide you in these decisions.

NO WIN, NO FEE: WHAT YOU NEED TO KNOW ABOUT CONTINGENCY FEES WHEN FILING A LAWSUIT

Like anyone with financial concerns, you may be wondering if it is even worth it to file a lawsuit. You may be worried that it is too costly to try to fight for your rights, even if you think you likely have a strong case. It seems unfair: How can you try to take a stand when it costs so much money? How will you come up with the finances to file a civil litigation? What if you lose the case and can’t pay the attorney fees? When you choose to work with Wittenstein & Wittenstein, you need not be concerned about such things, because we work on contingency.

Contingency is an agreement between the attorney and the client wherein the former agrees to be paid only if the client is awarded a sum. If the client gets a favorable verdict or a settlement, then the lawyer will take a normal fee. However, if no money is granted to the plaintiff, then the attorney does not get money, either. By working on contingency, Wittenstein & Wittenstein puts itself at financial risk in order to help you seek justice.

If you believe you have a case and are worried about the financial implications of taking legal action, contact us at 718-261-8114 or law@wittenstein.com so we can help you discuss your options and figure out the next best step.

The first thing to do is get your child medical care.  Once the injuries are being addressed, its time to consider whether the injuries were preventable had proper care been taken.  Consider whether the child was injured in:

  1. A Traffic Accident – pedestrian, passenger or bicyclist
  2. Using an unsafe product – a dangerous toy, a harsh soap, etc.
  3. An unsafe condition – poor lighting, a crack in the sidewalk, a swimming pool with no lifeguard or a poorly trained guard.
  4. Other types of negligence

The best way to know for sure if you can sue to recover damages for your child’s injuries is to call an experienced personal injury lawyer and discuss the facts of the case.   When a child is involved, things that seem like the child’s fault may actually be something an adult should be responsible for preventing.  For example, New York Law requires a four-foot fence around pools.  If a homeowner doesn’t have a fence the law calls this an “attractive nuisance,” and the owner is responsible if a child trespasses on their property and hurts themselves in their pool.  Another example is a child crossing the street between cars on their way to school, (along with 100 other kids going to that school at that time.)  A driver would be expected to notice that the streets a full of kids and take extra care.

Please feel free to call us for a FREE CONSULTATION to find out if you have a case for injuries to your child.  Call 718-261-8114 for an appointment.

KNOW WHEN YOUR RIGHTS RUN OUT: LEARN ABOUT THE STATUTE OF LIMITATIONS WHEN FILING A LAWSUIT

It is not a wise decision to wait when you think you have a case: Act now!

Unfortunately, the law does not have infinite patience. Lawsuits cannot be filed whenever it is most convenient to the litigant (you). According to the law, suits must be filed within a certain amount of time after the date of the incident in question. The statute of limitations is a guideline that determines whether your case is still valid or if you have waited too long to file. Its purpose is to set a calendar deadline for litigation based on a given event.
The start date for the statute of limitations is almost always the date when the incident occurred. There are two exceptions:

  • Date of Discovery: When a person could not have known they were injured, like if a surgical instrument was left inside them after surgery and was not discovered until complications arose, it would be unfair to use the date of the surgery (when the accident took place) as the start date for the statute of limitations. In these cases, the start date is the date of discovery.
  • Delaying (“Tolling”): When the person who incurred the loss is unable to file suit right away because they are (most commonly) a minor, mentally incompetent, or bankrupt, then the statute of limitations is delayed or “tolled.” To cite a common example, if the litigant was a minor on the date of loss and the statute of limitations is two years, then the statute of limitations is delayed until that person can file as an adult. The start date for the two years will then be the day he or she turns eighteen.

In New York State, the statute of limitations laws are as follows:

  • Defective Products or Devices: An action must be brought within 3 years of the date the injury occurred.
  • Personal Injury & Negligence: An action must be brought within 3 years.
    • Toxic substance exposure is counted under Date of Discovery.
  • Personal Property Damage: An action must be brought within 3 years of date of incident.
  • Professional Malpractice: An action must be brought within 2 ½ years.
    • This statute is delayed when there is a foreign object that may have been left in someone’s body or if there was continuous treatment of the plaintiff. The statute of limitations runs from the time when the foreign object is discovered (up to 1 year) or the last date of the continuous treatment.
    • If it is discovered that the medical practitioner withheld the truth about the malpractice, the statute of limitations runs for 6 years from the date when the fraud occurred or should have been discovered.
    • If an infant is the victim of malpractice, the statute of limitations can be extended by up to 10 years from the date of the act or omission that caused the injury.
  • Wrongful Death: An action must be brought within 2 years of date of death.

Those whose death came as a result of complications from involvement on September 11th have 2 ½ years from date of death.

As indicated above, the statute of limitations varies depending on the type of case you have. This is why it is of the utmost importance to pursue litigation as soon as possible after you have incurred a loss of any kind. If you have any questions regarding this matter or believe you may have a case that may expire under the statute of limitations, please feel free to contact us at 718-261-8114 or law@wittenstein.com. We are ready to help you figure out your best options and take the next step.

Wittenstein & Wittenstein knows from extensive legal experience that life-changing injuries can happen in a split second.  Our Personal Injury Attorneys at our Queens office are experts at helping victims of negligence.  An experienced Personal Injury Lawyer can get you the compensation you deserve, and a Personal Injury Attorney that knows the turf can get even better results.  Wittenstein & Wittenstein has been handling negligence cases in Queens, Brooklyn, Manhattan, The Bronx, Staten Island and Nassau County for over 60 years.  The grandchildren of our clients come to us because we get them great verdicts and settlements, and also because they know we really care.

Here’s an example of negligence, and there are many more.  Jane lives in an apartment where steam heat pipes are used to warm the building in the winter. These pipes are placed in every room of the apartment in lieu of regular radiators. However, this type of steam heat piping – which can reach scalding temperatures and cannot be controlled by the tenants – is often justify uncovered by property managers. On this particular morning, Jane stepped out of the shower and put on a towel just like she does every day. But this time she had the misfortune of grazing her arm against the pipe as she wrapped the towel around her to dry off, and the pipe instantaneously justify a large second-degree burn near her elbow that is both disfiguring and painful, so much so that the range of motion in her arm is limited until it heals. But still after it heals, it will scar, leaving behind an ugly blemish that will last the rest of her life. And she realizes that no, the property manager did not push her into the pipe, nor did he intentionally hold Jane’s arm against it. However, the property manager is still at fault for neglecting to do his job by preventing these kinds of horrible and completely avoidable accidents from happening. This pipe needed only to have an inexpensive protective cover to have saved Jane from suffering.

And this is only a mild example of the kinds of neglect that cause serious harm to people. If you believe you or someone you love has incurred an injury as a result of someone else’s negligence, you may be entitled to compensation, and Wittenstein & Wittenstein wants to come to the rescue. While we do regret your loss, we also hope you will call us at 718-261-8114 to find out what your options are and figure out the best next step in seeking justice.

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TOURISTS AND IMMIGRANTS CAN TAKE A STAND, TOO!

Are you a tourist or an immigrant, and in need of legal assistance in the United States? Do not be afraid to fight for your rights! Wittenstein & Wittenstein can help you seek compensation for any injustices done to you.

Many non-native residents in the United States are hesitant to file lawsuits because they are afraid they do not have the same rights as citizens. But you need not feel fear: let an experienced and highly qualified attorney from Wittenstein & Wittenstein decide the merits of your case. We understand that immigrants face special challenges when filing a lawsuit in the United States. The laws of your home country may not be the same as the laws here. You may not speak English very well, so the idea of sorting through legal jargon—which is difficult even for Americans to understand—is scary. But Wittenstein & Wittenstein is dedicated to helping. With our small size, we are able to give you the individual attention you need to feel comfortable with your litigation. Additionally, we are prepared with translators on staff to assist you in making decisions. This kind of special attention cannot be found at a large firm, which is why Wittenstein & Wittenstein takes pride in its size.

It is not true that you must be a citizen to file a lawsuit in the United States. Common examples of people who are eligible to file suit are:

  • Students on Student Visas
  • Workers with Work Visas
  • Green Card holders
  • Non-citizen residents
  • Illegal aliens

If you are not from the United States but believe you have a case to file in this country, please call Wittenstein & Wittenstein at 718-261-8114 or email at law@wittenstein.com so we can help you determine what your options are and help you take the next step.

personal injury lawyer (sometimes called an accident attorney) is a lawyer who represents people that claim to have been injured, physically or psychologically, from the negligence or fault of a person, a company, a government agency. Even though personal injury lawyers are trained and licensed to practice virtually any field of law (as all lawyers are,) they choose to specialize in cases that fall under “tort law” including work injuries, automobile and other accidents, defective products, medical mistakes, and slip and fall accidents.

The expression “trial lawyers” can refer to personal injury lawyers, because even though most cases handled by personal injury lawyers settle rather than going to trial, personal injury attorneys pursue litigation to position their cases for settlement, whereas some other types of lawyers never step foot in court.  Personal Injury/Accident lawyer have various duties in serving his or her clients. These obligations include professional and ethical rules put forward by state bar associations where the attorneys are authorized.  Once they are authorized by their state bar association, legal advisors are legitimately allowed to offer counselling and guidance and to file lawsuit on behalf of their clients in state courts.  Personal Injury attorneys can also be licensed to handle matters for clients in Federal Court.

Sometimes personal injury lawyer called Plaintiff’s Attorneys, even though there are also attorneys that do defense work, representing those that are sued for personal injuries.  Those attorneys usually work for insurance companies.  Many personal injury attorneys will offer a free consultation to decide whether or not they want to take on a new matter.  Most personal injury attorneys work on a “contingency retainer,” which means that the client pays nothing unless money is collected.  This is, of course a risk for the attorney who might end up investing cash and resources for a case and will have a loss if nothing can be collected.  That’s why a smart personal injury lawyer will be very selective about what they take on.  Personal injury lawyers must follow strict ethical rules.  The guidelines do vary from State to State, but what is always paramount is that lawyers owe a duty of loyalty and confidentiality and must zealously prosecute cases for their clients.

In order to practice personal injury/accident law in the United State, a lawyer must sit for and pass at least one State Bar Examination.  Most States also require four years of college and three years of law school.  There are also graduate degrees in various legal specialities that some personal injury/accident attorneys might also have obtained.  Ask your personal injury/accident attorney about his or her qualifications.  Sometimes personal injury/accident attorney will have very narrow specialities such as a malpractice attorney that focuses their practice on a specific disease.  Other examples of narrow personal injury/accident attorney specialities include maritime law (laws of the sea), railroad or aviation accidents.

If you are injured in an accident or in some other way by the fault of another, it is always in your best interests to consult with a personal injury.  Ask the lawyer how much of their practice is devoted to personal injury and accident law.  You wouldn’t want your gynaecologist doing your root canal, so probably you don’t want a divorce lawyer to handle your accident cases.

Call Wittenstein & Wittenstein 718-261-8114, experienced professional personal injury and accident lawyers if you have any questions.  Always remember JUSTICE IS SWEET.

Women attorneys are more sensitive to your needs.  They are also less belligerent, making them superior negotiators.  See our articles:

Why Woman Attorneys are Better for Sexual Harassment and Personal Injury Cases

Alyce B. Wittenstein, Esq – Outstanding Woman Attorney

Statement of Client’s Rights
Section 1210.1 of the Joint Rules of the Appellate Division amended April 15, 2013
(22 NYCRR §1210.1)

1. You are entitled to be treated with courtesy and consideration at all times by your lawyer and the other lawyers and nonlawyer personnel in your lawyer’s office.

2. You are entitled to have your attorney handle your legal matter competently and diligently, in accordance with the highest standards of the profession. If you are not satisfied with how your matter is being handled, you have the right to discharge your attorney and terminate the attorney‐client relationship at any time. (Court approval may be required in some matters, and your attorney may have a claim against you for the value of services rendered to you up to the point of discharge.)

3. You are entitled to your lawyer’s independent professional judgment and undivided loyalty uncompromised by conflicts of interest.

4. You are entitled to be charged reasonable fees and expenses and to have your lawyer explain before or within a reasonable time after commencement of the representation how the fees and expenses will be computed and the manner and frequency of billing. You are entitled to request and receive a written
itemized bill from your attorney at reasonable intervals. You may refuse to enter into any arrangement for fees and expenses that you find unsatisfactory. In the event of a fee dispute, you may have the right to seek arbitration; your attorney will provide you with the necessary information regarding arbitration
in the event of a fee dispute, or upon your request.

5. You are entitled to have your questions and concerns addressed promptly and to receive a prompt reply to your letters, telephone calls, emails, faxes, and other communications.

6. You are entitled to be kept reasonably informed as to the status of your matter and are entitled to have your attorney promptly comply with your reasonable requests for information, including your requests for copies of papers relevant to the matter. You are entitled to sufficient information to allow you to participate meaningfully in the development of your matter and make informed decisions regarding the representation.

7. You are entitled to have your legitimate objectives respected by your attorney. In particular, the decision of whether to settle your matter is yours and not your lawyer’s. (Court approval of a settlement is required in some matters.)

8. You have the right to privacy in your communications with your lawyer and to have your confidential information preserved by your lawyer to the extent required by law.

9. You are entitled to have your attorney conduct himself or herself ethically in accordance with the New York Rules of Professional Conduct.

10. You may not be refused representation on the basis of race, creed, color, religion, sex, sexual orientation, age, national origin or disability.

“No-Fault” is a “statutory scheme” that pays for medical bills and other expenses resulting from types of vehicle accidents in New York.  Below is the link to our blog article and the entire statute.

“Everything You’ve Ever Wanted to Know About No-Fault”

Article 51 of the New York Insurance Law a/k/a “The No-Fault Law”

Section 5101. Title.

5102. Definitions.

5103. Entitlement to first party benefits; additional financial security required.

5104. Causes of action for personal injury.

5105. Settlement between insurers.

5106. Fair claims settlement.

5107. Coverage for non-resident motorists.

5108. Limit on charges by providers of health services.

5109. Unauthorized providers of health services.

5101. Title.

This article shall be known and may be cited as the “Comprehensive Motor Vehicle Insurance Reparations Act”.

5102. Definitions. In this chapter:

(a) “Basic economic loss” means, up to fifty thousand dollars per person of the following combined items, subject to the limitations of section five thousand one hundred eight of this article:

(1) All necessary expenses incurred for:

(i) medical, hospital (including services rendered in compliance with article forty-one of the public health law, whether or not such services are rendered directly by a hospital), surgical, nursing, dental, ambulance, x-ray, prescription drug and prosthetic services;

(ii) psychiatric, physical and occupational therapy and rehabilitation*;

*NOTE*: Section 5102(a)(1)(ii) of the New York Insurance Law has been amended, effective November 23, 2006, to read as follows:

(ii) psychiatric, physical therapy (provided that treatment is rendered pursuant to a referral) and occupational therapy and rehabilitation;

(iii) any non-medical remedial care and treatment rendered in accordance with a religious method of healing recognized by the laws of this state; and

(iv) any other professional health services; all without limitation as to time, provided that within one year after the date of the accident causing the injury it is ascertainable that further expenses may be incurred as a result of the injury. For the purpose of determining basic economic loss, the expenses incurred under this paragraph shall be in accordance with the limitations of section five thousand one hundred eight of this article.

(2) Loss of earnings from work which the person would have performed had he not been injured, and reasonable and necessary expenses incurred by such person in obtaining services in lieu of those that he would have performed for income, up to two thousand dollars per month for not more than three years from the date of the accident causing the injury. An employee who is entitled to receive monetary payments, pursuant to statute or contract with the employer, or who receives voluntary monetary benefits paid for by the employer, by reason of the employee’s inability to work because of personal injury arising out of the use or operation of a motor vehicle, is not entitled to receive first party benefits for “loss of earnings from work” to the extent that such monetary payments or benefits from the employer do not result in the employee suffering a reduction in income or a reduction in the employee’s level of future benefits arising from a subsequent illness or injury.

(3) All other reasonable and necessary expenses incurred, up to twenty-five dollars per day for not more than one year from the date of the accident causing the injury.

(4) “Basic economic loss” shall not include any loss incurred on account of death; subject, however, to the provisions of paragraph four of subsection (a) of section five thousand one hundred three of this article.

(5) “Basic economic loss” shall also include an additional option to purchase, for an additional premium, an additional twenty-five thousand dollars of coverage which the insured or his legal representative may specify will be applied to loss of earnings from work and/or psychiatric, physical or occupational therapy and rehabilitation after the initial fifty thousand dollars of basic economic loss has been exhausted. This optional additional coverage shall be made available and notice with explanation of such coverage shall be provided by an insurer at the first policy renewal after the effective date of this paragraph, or at the time of application.

(b) “First party benefits” means payments to reimburse a person for basic economic loss on account of personal injury arising out of the use or operation of a motor vehicle, less:

(1) Twenty percent of lost earnings computed pursuant to paragraph two of subsection (a) of this section.

(2) Amounts recovered or recoverable on account of such injury under state or federal laws providing social security disability benefits, or workers’ compensation benefits, or disability benefits under article nine of the workers’ compensation law, or Medicare benefits, other than lifetime reserve days and provided further that the Medicare benefits utilized herein do not result in a reduction of such person’s Medicare benefits for a subsequent illness or injury.

(3) Amounts deductible under the applicable insurance policy.

(c) “Non-economic loss” means pain and suffering and similar non-monetary detriment.

(d) “Serious injury” means a personal injury which results in death; dismemberment; significant disfigurement; a fracture; loss of a fetus; permanent loss of use of a body organ, member, function or system; permanent consequential limitation of use of a body organ or member; significant limitation of use of a body function or system; or a medically determined injury or impairment of a non-permanent nature which prevents the injured person from performing substantially all of the material acts which constitute such person’s usual and customary daily activities for not less than ninety days during the one hundred eighty days immediately following the occurrence of the injury or impairment.

(e) “Owner” means an owner as defined in section one hundred twenty-eight of the vehicle and traffic law.

(f) “Motor vehicle” means a motor vehicle as defined in section three hundred eleven of the vehicle and traffic law and also includes fire and police vehicles. It shall not include any motor vehicle not required to carry financial security pursuant to article six, eight or forty-eight-A of the vehicle and traffic law or a motorcycle, as defined in subsection (m) hereof.

(g) “Insurer” means the insurance company or self-insurer, as the case may be, which provides the financial security required by article six or eight of the vehicle and traffic law.

(h) “Member of his household” means a spouse, child or relative of the named insured who regularly resides in his household.

(i) “Uninsured motor vehicle” means a motor vehicle, the owner of which is (i) a financially irresponsible motorist as defined in subsection (j) of section five thousand two hundred two of this chapter or (ii) unknown and whose identity is unascertainable.

(j) “Covered person” means any pedestrian injured through the use or operation of, or any owner, operator or occupant of, a motor vehicle which has in effect the financial security required by article six or eight of the vehicle and traffic law or which is referred to in subdivision two of section three hundred twenty-one of such law; or any other person entitled to first party benefits.

(k) “Bus” means both a bus and a school bus as defined in sections one hundred four and one hundred forty-two of the vehicle and traffic law.

(l) “Compensation provider” means the state insurance fund, or the person, association, corporation or insurance carrier or statutory fund liable under state or federal laws for the payment of workers’ compensation benefits or disability benefits under article nine of the workers’ compensation law.

(m) “Motorcycle” means any motorcycle, as defined in section one hundred twenty-three of the vehicle and traffic law, and which is required to carry financial security pursuant to article six, eight or forty-eight-A of the vehicle and traffic law.

5103. Entitlement to first party benefits; additional financial security required.

(a) Every owner’s policy of liability insurance issued on a motor vehicle in satisfaction of the requirements of article six or eight of the vehicle and traffic law shall also provide for; every owner who maintains another form of financial security on a motor vehicle in satisfaction of the requirements of such articles shall be liable for; and every owner of a motor vehicle required to be subject to the provisions of this article by subdivision two of section three hundred twenty-one of the vehicle and traffic law shall be liable for; the payment of first party benefits to:

(1) Persons, other than occupants of another motor vehicle or a motorcycle, for loss arising out of the use or operation in this state of such motor vehicle. In the case of occupants of a bus other than operators, owners, and employees of the owner or operator of the bus, the coverage for first party benefits shall be afforded under the policy or policies, if any, providing first party benefits to the injured person and members of his household for loss arising out of the use or operation of any motor vehicle of such household. In the event there is no such policy, first party benefits shall be provided by the insurer of such bus.

(2) The named insured and members of his household, other than occupants of a motorcycle, for loss arising out of the use or operation of (i) an uninsured motor vehicle or motorcycle, within the United States, its territories or possessions, or Canada; and (ii) an insured motor vehicle or motorcycle outside of this state and within the United States, its territories or possessions, or Canada.

(3) Any New York resident who is neither the owner of a motor vehicle with respect to which coverage for first party benefits is required by this article nor, as a member of a household, is entitled to first party benefits under paragraph two of this subsection, for loss arising out of the use or operation of the insured or self-insured motor vehicle outside of this state and within the United States, its territories or possessions, or Canada.

(4) The estate of any covered person, other than an occupant of another motor vehicle or a motorcycle, a death benefit in the amount of two thousand dollars for the death of such person arising out of the use or operation of such motor vehicle which is in addition to any first party benefits for basic economic loss.

(b) An insurer may exclude from coverage required by subsection (a) hereof a person who:

(1) Intentionally causes his own injury.

(2) Is injured as a result of operating a motor vehicle while in an intoxicated condition or while his ability to operate such vehicle is impaired by the use of a drug within the meaning of section eleven hundred ninety-two of the vehicle and traffic law.

(3) Is injured while he is:

(i) committing an act which would constitute a felony, or seeking to avoid lawful apprehension or arrest by a law enforcement officer, or

(ii) operating a motor vehicle in a race or speed test, or

(iii) operating or occupying a motor vehicle known to him to be stolen, or

(iv) operating or occupying any motor vehicle owned by such injured person with respect to which the coverage required by subsection (a) hereof is not in effect, or

(v) a pedestrian, through being struck by any motor vehicle owned by such injured pedestrian with respect to which the coverage required by subsection (a) hereof is not in effect, or

(vi) repairing, servicing or otherwise maintaining a motor vehicle if such conduct is within the course of a business of repairing, servicing or otherwise maintaining a motor vehicle and the injury occurs on the business premises.

(c) Insurance offered by any company to satisfy the requirements of subsection (a) hereof shall be offered (i) without a deductible and (ii) with a family deductible of up to two hundred dollars (which deductible shall apply only to the loss of the named insured and members of his household). The superintendent may approve a higher deductible in the case of insurance policies providing additional benefits or pursuant to a plan designed and implemented to coordinate first party benefits with other benefits.

(d) Insurance policy forms for insurance to satisfy the requirements of subsection (a) hereof shall be subject to approval pursuant to article twenty-three of this chapter. Minimum benefit standards for such policies and for self-insurers, and rights of subrogation, examination and other such matters, shall be established by regulation pursuant to section three hundred one of this chapter.

(e) Every owner’s policy of liability insurance issued in satisfaction of article six or eight of the vehicle and traffic law shall also provide, when a motor vehicle covered by such policy is used or operated in any other state or in any Canadian province, insurance coverage for such motor vehicle at least in the minimum amount required by the laws of that state or province.

(f) Every owner’s policy of liability insurance issued on a motorcycle or an all terrain vehicle in satisfaction of the requirements of article six or eight of the vehicle and traffic law or section twenty-four hundred seven of such law shall also provide for; every owner who maintains another form of financial security on a motorcycle or an all terrain vehicle in satisfaction of the requirements of such articles or section shall be liable for; and every owner of a motorcycle or an all terrain vehicle required to be subject to the provisions of this article by subdivision two of section three hundred twenty-one of such law shall be liable for; the payment of first party benefits to persons, other than the occupants of such motorcycle or all terrain vehicle, another motorcycle or all terrain vehicle, or any motor vehicle, for loss arising out of the use or operation of the motorcycle or all terrain vehicle within this state. Every insurer and self-insurer may exclude from the coverage required by this subsection a person who intentionally causes his own injury or is injured while committing an act which would constitute a felony or while seeking to avoid lawful apprehension or arrest by a law enforcement officer.

(g) A company authorized to provide the insurance specified in paragraph three of subsection (a) of section one thousand one hundred thirteen of this chapter or a corporation organized pursuant to article forty-three of this chapter may, individually or jointly, with the approval of the superintendent upon a showing that the company or corporation is qualified to provide for all of the items of basic economic loss specified in paragraph one of subsection (a) of section five thousand one hundred two of this article, provide coverage for such items of basic economic loss to the extent that an insurer would be required to provide under this article. Where a policyholder elects to be covered under such an arrangement the insurer providing coverage for the automobile shall be furnished with the names of all persons covered by the company or corporation under the arrangement and such persons shall not be entitled to benefits for any of the items of basic economic loss specified in such paragraph. The premium for the automobile insurance policy shall be appropriately reduced to reflect the elimination of coverage for such items of basic economic loss. Coverage by the automobile insurer of such eliminated items shall be effected or restored upon request by the insured and payment of the premium for such coverage. All companies and corporations providing coverage for items of basic economic loss pursuant to the authorization of this subsection shall have only those rights and obligations which are applicable to an insurer subject to this article.

(h) Any policy of insurance obtained to satisfy the financial security requirements of article six or eight of the vehicle and traffic law which does not contain provisions complying with the requirements of this article, shall be construed as if such provisions were embodied therein.

5104. Causes of action for personal injury.

(a) Notwithstanding any other law, in any action by or on behalf of a covered person against another covered person for personal injuries arising out of negligence in the use or operation of a motor vehicle in this state, there shall be no right of recovery for non-economic loss, except in the case of a serious injury, or for basic economic loss. The owner, operator or occupant of a motorcycle which has in effect the financial security required by article six or eight of the vehicle and traffic law, or which is referred to in subdivision two of section three hundred twenty-one of such law, shall not be subject to an action by or on behalf of a covered person for recovery for non-economic loss, except in the case of a serious injury, or for basic economic loss.

(b) In any action by or on behalf of a covered person, against a non- covered person, where damages for personal injuries arising out of the use or operation of a motor vehicle or a motorcycle may be recovered, an insurer which paid or is liable for first party benefits on account of such injuries has a lien against any recovery to the extent of benefits paid or payable by it to the covered person. No such action may be compromised by the covered person except with the written consent of the insurer, or with the approval of the court, or where the amount of such settlement exceeds fifty thousand dollars. The failure of such person to commence such action within two years after accrual gives the insurer a cause of action for the amount of first party benefits paid or payable against any person who may be liable to the covered person for his personal injuries. The insurer’s cause of action shall be in addition to the cause of action of the covered person except that in any action subsequently commenced by the covered person for such injuries, the amount of his basic economic loss shall not be recoverable.

(c) Where there is no right of recovery for basic economic loss, such loss may nevertheless be pleaded and proved to the extent that it is relevant to the proof of non-economic loss.

5105. Settlement between insurers.

(a) Any insurer liable for the payment of first party benefits to or on behalf of a covered person and any compensation provider paying benefits in lieu of first party benefits which another insurer would otherwise be obligated to pay pursuant to subsection (a) of section five thousand one hundred three of this article or section five thousand two hundred twenty-one of this chapter has the right to recover the amount paid from the insurer of any other covered person to the extent that such other covered person would have been liable, but for the provisions of this article, to pay damages in an action at law. In any case, the right to recover exists only if at least one of the motor vehicles involved is a motor vehicle weighing more than six thousand five hundred pounds unloaded or is a motor vehicle used principally for the transportation of persons or property for hire. However, in the case of occupants of a bus other than operators, owners, and employees of the owner or operator of the bus, an insurer which, pursuant to paragraph one of subsection (a) of section five thousand one hundred three of this article, provides coverage for first party benefits for such occupants under a policy providing first party benefits to the injured person and members of his household for loss arising out of the use or operation of any vehicle of such household, shall have no right to recover the amount of such benefits from the insurer of such bus.

(b) The sole remedy of any insurer or compensation provider to recover on a claim arising pursuant to subsection (a) hereof, shall be the submission of the controversy to mandatory arbitration pursuant to procedures promulgated or approved by the superintendent. Such procedures shall also be utilized to resolve all disputes arising between insurers concerning their responsibility for the payment of first party benefits.

(c) The liability of an insurer imposed by this section shall not affect or diminish its obligations under any policy of bodily injury liability insurance.

5106. Fair claims settlement.

(a) Payments of first party benefits and additional first party benefits shall be made as the loss is incurred. Such benefits are overdue if not paid within thirty days after the claimant supplies proof of the fact and amount of loss sustained. If proof is not supplied as to the entire claim, the amount which is supported by proof is overdue if not paid within thirty days after such proof is supplied. All overdue payments shall bear interest at the rate of two percent per month. If a valid claim or portion was overdue, the claimant shall also be entitled to recover his attorney’s reasonable fee, for services necessarily performed in connection with securing payment of the overdue claim, subject to limitations promulgated by the superintendent in regulations.

(b) Every insurer shall provide a claimant with the option of submitting any dispute involving the insurer’s liability to pay first party benefits, or additional first party benefits, the amount thereof or any other matter which may arise pursuant to subsection (a) hereof to arbitration pursuant to simplified procedures to be promulgated or approved by the superintendent.

(c) An award by an arbitrator shall be binding except where vacated or modified by a master arbitrator in accordance with simplified procedures to be promulgated or approved by the superintendent. The grounds for vacating or modifying an arbitrator’s award by a master arbitrator shall not be limited to those grounds for review set forth in article seventy-five of the civil practice law and rules. The award of a master arbitrator shall be binding except for the grounds for review set forth in article seventy-five of the civil practice law and rules, and provided further that where the amount of such master arbitrator’s award is five thousand dollars or greater, exclusive of interest and attorney’s fees, the insurer or the claimant may institute a court action to adjudicate the dispute de novo.

5107. Coverage for non-resident motorists.

(a) Every insurer authorized to transact or transacting business in this state, or controlling or controlled by or under common control by or with such an insurer, which sells a policy providing motor vehicle liability insurance coverage or any similar coverage in any state or Canadian province, shall include in each such policy coverage to satisfy the financial security requirements of article six or eight of the vehicle and traffic law and to provide for the payment of first party benefits pursuant to subsection (a) of section five thousand one hundred three of this article when a motor vehicle covered by such policy is used or operated in this state.

(b) Every policy described in subsection (a) hereof shall be construed as having the coverage required by subsection (a) of section five thousand one hundred three of this article.

5108. Limit on charges by providers of health services.

(a) The charges for services specified in paragraph one of subsection (a) of section five thousand one hundred two of this article and any further health service charges which are incurred as a result of the injury and which are in excess of basic economic loss, shall not exceed the charges permissible under the schedules prepared and established by the chairman of the workers’ compensation board for industrial accidents, except where the insurer or arbitrator determines that unusual procedures or unique circumstances justify the excess charge.

(b) The superintendent, after consulting with the chairman of the workers’ compensation board and the commissioner of health, shall promulgate rules and regulations implementing and coordinating the provisions of this article and the workers’ compensation law with respect to charges for the professional health services specified in paragraph one of subsection (a) of section five thousand one hundred two of this article, including the establishment of schedules for all such services for which schedules have not been prepared and established by the chairman of the workers’ compensation board.

(c) No provider of health services specified in paragraph one of subsection (a) of section five thousand one hundred two of this article may demand or request any payment in addition to the charges authorized pursuant to this section. Every insurer shall report to the commissioner of health any patterns of overcharging, excessive treatment or other improper actions by a health provider within thirty days after such insurer has knowledge of such pattern.

5109. Unauthorized   providers   of  health  services.

(a)  The superintendent, in consultation with the commissioner of health and  the   commissioner of education, shall by regulation, promulgate standards and   procedures  for  investigating and suspending or removing  the   authorization for providers of health  services  to  demand  or  request   payment  for health services as specified in paragraph one of subsection   (a) of section five thousand  one hundred  two  of  this  article  upon   findings  reached  after  investigation pursuant to this section. Such   regulations shall ensure the same or  greater  due  process  provisions,   including  notice  and  opportunity  to  be  heard,  as  those  afforded   physicians investigated under article two of the workers’ compensation   law and shall include provision for notice to all providers of health   services of the provisions of this section and  regulations  promulgated   thereunder at least ninety days in advance of the effective date of such   regulations.

(b) The commissioner of health and the commissioner of education shall   provide  a list of the names of all providers of health services who the   commissioner of health and the commissioner  of  education  shall  deem,   after  reasonable investigation, not authorized to demand or request any   payment for medical services in connection with  any  claim  under  this   article because such provider of health services:

(1)   has   been   guilty  of  professional  or  other  misconduct  or   incompetency in connection with medical  services  rendered  under  this   article; or

(2)  has  exceeded the limits of his or her professional competence in   rendering medical care under this article or has knowingly made a  false   statement  or representation as to a material fact in any medical report   made in connection with any claim under this article; or

(3) solicited, or has employed  another  to  solicit  for  himself  or   herself  or  for another, professional treatment, examination or care of   an injured person in connection with any claim under this article; or

(4) has refused to appear before, or to answer upon  request  of,  the   commissioner  of  health,  the  superintendent,  or  any duly authorized   officer of the state, any legal question, or  to  produce  any  relevant   information  concerning  his or her conduct in connection with rendering   medical services under this article; or

(5) has engaged in patterns of billing for  services  which  were  not   provided.

(c)  Providers  of  health  services  shall  refrain from subsequently   treating for remuneration, as a  private  patient,  any  person  seeking   medical  treatment  under this article if such provider pursuant to this   section has been prohibited from demanding or requesting any payment for   medical services under this article. An injured claimant so  treated  or   examined  may raise this as a defense in any action by such provider for   payment for treatment rendered at any time after such provider has  been   prohibited  from demanding or requesting payment for medical services in   connection with any claim under this article.

(d) The commissioner of health and the commissioner of education shall   maintain and regularly update a database containing a list of  providers   of  health  services  prohibited  by  this  section  from  demanding  or   requesting any payment for health services connected to  a  claim  under   this  article and shall make such information available to the public by   means of a website and by a toll free number.

(e) Nothing in this section shall be  construed  as  limiting  in  any   respect   the   powers   and  duties  of  the  commissioner  of  health,   commissioner of education or the superintendent to investigate instances   of misconduct by a health care provider and, after a  hearing  and  upon   written  notice  to  the provider, to temporarily prohibit a provider of   health services under such investigation from  demanding  or  requesting   any  payment  for  medical  services under this article for up to ninety   days from the date of such notice.

Everybody wants to know how long their case is going to take to settle.  I’d say the average is about a year, it depends on so many things:

  1. Insurance Coverage
  2. Length of Treatment
  3. Policies of the Insurance Company
  4. Liability
  5. Quality of Medical Reports
  6. Seriousness of Injuries
  7. Type of Case
  8. Intangibles

INSURANCE COVERAGE

The minimum policy limits for automobile liability insurance coverage in New York are 25/50.  This means that the most that can be paid out is $25,000 per person and $50,000 per incident. So if you were seriously injured, the only person injured in the accident and it was clearly the fault of the other car, your case can be settled very quickly. The insurance company will likely “tender” their policy to you, which means that they will pay out their entire policy.  Under the circumstances, it would be “bad faith” if they did not. Unfortunately, although your case is settled quickly, you will not be able to get very much money.

Let’s say you had the same serious injuries and good liability, but the other vehicle was a truck with $1,000,000 in coverage.  Here’s where you don’t want to rush. Sure, you COULD settle this case quickly, but that wouldn’t be the best way to handle it. With only $25,000 to collect, the case can be settled before you are even finished with treatment, but with more money to collect, it wouldn’t make sense to even try to settle the case before treatment is complete, as medical treatment is “damages” that increase the value of your case.  Here’s where we want to hold out for a good settlement and litigate if one is not offered. This is going to make the case take much longer, but it’s well worth it.

LENGTH OF TREATMENT

More serious injuries usually mean lengthier treatment.  Client’s sometimes ask why their case is not settled when they are actively getting medical treatment or they are still unable to work.  It’s not possible to know the value of the case until treatment is complete, and trying to settle a case at that point would be selling it short.  For example, if injuries cause you to be out of work for a year and half, your case can’t be settled for at least a year and a half (assuming there is ample insurance coverage.)  On the other hand, a case with minor injuries that requires little treatment can be settled sooner, but will not yield as high a settlement. The important thing to ask an attorney is the reason why the case is taking whatever time it’s taking – you should be sure it’s not just sitting in the file cabinet because they are too busy with other cases.

POLICIES OF THE INSURANCE COMPANY

Some insurance companies have a policy of wanting to make fair settlements quickly.  They have a team of claims representatives that follow up on their caseloads and answer calls from attorneys.  You can send them a medical package which they will review in a timely manner and then they will make an offer in a reasonable amount of time.  If the offer is not acceptable, a lawsuit can be commenced. There actually are companies this good – one of the best has some funny animal commercials.

Other insurance companies don’t want to settle cases.  They have few claims reps and they don’t bother to return calls.  They ask for 60 days to review medical records. They make lousy offers to settle cases.  Attorneys know which companies these are and know that lengthy litigation is going to be necessary.  Some attorneys won’t even accept cases if they know they are with certain insurance companies! If you case takes a long time because it’s with against an insurance company that doesn’t actively settle cases, it’s not your attorney’s fault.  It doesn’t matter is your Aunt Jean got a lot of money really quickly with a case against a “good” insurance company.

LIABILITY

If you have a police report that shows says you were hit in the rear by a drunk driver that was texting, there will likely be no dispute about liability.  This speeds up the case as the only discussion is damages. On the other hand, if the other guy went through a light, but is claiming that you went through the light, it might be necessary to litigate the case through depositions before being able to settle it.  This is frustrating when you saw the other guy go through the light, but that’s what courts and judges are for. Depositions cannot be held until both sides have exchanged documents and after several conferences in court. This case is not going to be quick to get full value.

QUALITY OF THE MEDICAL REPORTS

If you treat with high quality medical providers that are knowledgeable about how to produce reports for accident cases this is helpful for a faster settlement.  Medical reports that are scribbled and not comprehensive give claims adjusters little to “hang their hats” on when asking for “authority” to put money on your claim.  That’s when an insurance company may want extensive litigation if you are looking for a large settlement. They will want to hear your testify in a deposition and send you to their doctors for an examination.  Good quality medical reports will speed up a settlement.

SERIOUSNESS OF INJURIES

Assuming there is coverage, it will take time to build up to an excellent settlement amount on a serious case.  This is the type of case where lengthy litigation can improve the final settlement. You want the insurance company to know that you are willing to go to trial if they don’t come up with enough money.  Even though most cases are eventually settled, with very serious injuries you want to prepare the case for trial, even settle on the eve of trial. This can take years, but it’s worth it.

TYPE OF CASE

Auto accident cases have a “serious injury threshold” that must be met.  With smaller cases, it’s important that there is at least enough treatment to meet this threshold, which often means treatment for a minimum of three months.  Other types of cases do not have this threshold. For example, if you fall in a supermarket and go to the doctor and have a sprained ankle that heals quickly, your case might be settled very quickly.  A food poisoning case could be quick because there is little treatment once the problem subsides. Product liability and malpractice cases will always take a long time as experts must be hired and complicated investigations must be carried out.

INTANGIBLES

The insurance company denies payment for your surgery as not “medically necessary,” and the doctor arbitrates this denial.  It can take over a year to get a decision. It is prudent to wait for the decision as the surgery is an important part of the damages in your case and having an arbitration decision that it was indeed medically necessary is important for your case.

The insurance company transfers your claim to a new claims rep who must now review your entire file from scratch.  This can add months to the time it takes to settle the case. The insurance adjuster goes on an extended vacation or family leave and there is nobody to discuss your claim.  Of course, the litigation can continue, but the case cannot be settled unless there is a claims rep to discuss it with.

There are many reasons why cases take the time they do to settle.  The most important thing to remember is that it is your attorneys job to explain why YOUR case is taking the time it’s taking.  If you are in the dark, you don’t have the right attorney.