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What You Should Do If Your Auto Insurance Carrier Refuses to Pay for Your Medical Treatment With PIP Benefits

Posted on Monday, July 6th, 2015 at 11:11 am    

stretcherThis post discusses the PIP benefits that are available on all Kentucky automobile insurance policies for people who live in Kentucky at the time they take out insurance.  If you have an Ohio motor vehicle policy or lived in Ohio when you got car insurance, you can check this page of our blog to find out more about Ohio’s no-fault benefit, Med Pay.

Kentucky passed the Motor Vehicle Reparations Act (MVRA) in 1974. Among other things, the MVRA requires all Kentucky drivers to have liability auto insurance, and requires all such auto insurance to have no-fault benefits, which is often called Personal Injury Protection (PIP). PIP benefits must be at least $10,000.00 per person covered by the policy, and can go to pay any medical treatment related to an automobile accident or lost wages related to the automobile accident up to $200 per week. If you look at the itemization of your auto insurance premium, you will see that part of your premium goes to support your PIP benefits.

Kentucky’s main purpose for passing the MVRA law was to make sure Kentuckians injured in car wrecks got prompt medical treatment and rehabilitation by ensuring that money was set aside to pay for whatever treatment was necessary. Although $10,000 does not stretch nearly as far today as it did in 1974 – especially where skyrocketing medical bills are concerned – PIP payments are still a crucial first link in a long chain of medical payments for most car accident victims in Kentucky.

How Does Your Medical Treatment Get Denied By The PIP Carrier?

Northern Kentucky residents have started seeing more and more denials of PIP benefits in recent years. Where car accidents are concerned, Lawrence & Associates mostly represents victims in Boone, Kenton, Campbell, Grant, and Gallatin counties, and in those counties we have mostly observed Allstate and Geico challenging treating doctors by refusing to pay PIP.

Typically, Allstate or Geico will challenge the treating doctor by sending medical records off to a “peer review” or a “utilization review.” These are both bogus terms for “hiring a doctor who has never treated you to second guess your doctor.” The insurance company will send you a formal letter that typically does not address you by name, advising you that your treatment cannot be approved until the “peer reviewer” has given a decision. To make matters worse, your health insurance company will often refuse to cover the bills because, by law, the PIP insurance company is “primary” which means the PIP carrier has the duty to pay before the health carrier does. For this reason, your medical treatment stops entirely, even if you are in pain or getting worse.

Your PIP carrier then sends a “review,” which is the peer reviewers report. It will either accept the treatment as being necessary and related to the car accident, deny the treatment, or recommend an “independent medical exam” (IME). An IME means you have to allow the insurance company to pick a doctor for you and go see that doctor. The trick of an IME is that IME doctors are not truly independent; they are paid by the insurance company and nearly always claim that future treatment is unnecessary. (If they cost the insurance company money, why would the insurance company continue hiring them?) Regardless of whether the treatment is accepted, denied, or referred to an IME, it is rare for the PIP carrier to put the review letter in language that a layperson will understand.

The end result? You pay premiums for PIP coverage and never see the PIP money that you paid for. In the meantime, your untreated injury keeps hurting and keeps getting worse.

How Can An Attorney Help Make Your Auto Insurance PIP Benefits Pay For Your Medical Treatment?

The worst thing about the process above is that the MVRA doesn’t allow it. The MVRA states that a PIP carrier like Geico or Allstate must file a claim in court if it wants to deny PIP payments for your medical treatment. These insurance companies can’t ship all your medical records off to some hidden doctor in a backroom, with no transparency as to why medical treatment is being denied! Rather, the law requires the insurance companies to challenge a treating doctor (and you!) in open court, with full transparency. Auto insurance PIP carriers only get away with this because the average person in Northern Kentucky doesn’t know the rights that come with their auto insurance premiums.

If a PIP carrier wrongfully denies you the payment of your PIP benefits, you are allowed to sue that company in court and get 18% interest on all overdue payments. Further, if the PIP carrier didn’t have a “reasonable foundation” for denying your PIP benefits, you can force the insurance company to pay for your attorney’s fees. However, forcing the PIP carrier to relinquish your insurance benefits to you will necessarily involve filing the case in court and proving the insurance carrier is wrong. The insurance carrier will hire attorneys to represent it. That means you’ll need an attorney to represent you too.

Don’t Give Up On Your Right to Kentucky PIP Benefits

At Lawrence & Associates, we are Working Hard for the Working Class. We take great pride in representing Northern Kentucky residents who have been injured in car accidents. We can’t fix broken bones or heal cuts, but we can make sure no one takes advantage of you while you are hurt. PIP carriers that ignore the law to line their pockets with your money should be brought to justice. We can help. Call us today.


Can a Kentucky Doctor Tell the Person That Hurt You About Your Medical Treatment?

Posted on Tuesday, June 16th, 2015 at 12:57 pm    

If you’ve been injured due to someone else’s negligence, such as in a car accident, Kentucky law now gives the person that hurt you the right to contact your doctor about your medical treatment. The question is whether your doctor is required to talk to the person that hurt you, and what your doctor is allowed to tell that person.

In Caldwell v. Castro, the Kentucky Supreme Court just decided that Kentucky law does allow someone else to contact your doctor without you or your attorney present, and without being in a courtroom or without a licensed court reporter present. That person is then allowed to ask the doctor all kinds of questions about your personal medical treatment, both before and after the accident that hurt you, even if that person is the one that hurt you in the first place. Talk about an invasion of your privacy!

doctor-patientHowever, there is always fine print to read and this fine print is very important. The Kentucky Supreme Court said that HIPAA is a factor here. HIPAA is the law that makes all your medical information private. Even though another person is allowed to contact your doctor and ask all kinds of personal questions about you without getting in trouble, that doesn’t mean your doctor is required to answer those questions. On the contrary, both HIPAA and the Kentucky Medical Licensure Board’s code of ethics requires a doctor to keep a patient’s information confidential. Thus, before a doctor can release your medical information to the opposing party in a lawsuit, the doctor must have either a) an authorization signed by you, or b) an order from the Court specifically requiring the doctor to disclose protected medical information.

The Caldwell opinion is probably going to create a problem: people liable for injuries but desperate to get out of their duty to pay for their bad actions are going to call the injured person’s doctors looking for something to give them a get-out-of-jail free card. Doctors need to know that they are not allowed to give this information away freely! Make sure you tell your doctor that you do not feel comfortable with him or her discussing your medical history with someone else, and specifically instruct them not to do so without your permission. That is your right, and it should be protected.

At Lawrence & Associates, we represent Kentucky and Ohio clients in all forms of personal injury claims, from car accidents to product liability claims. We’re Working Hard for the Working Class, and we’d be proud to represent you. Call today!


What is the Statute of Limitations for Car Accident Cases in Northern Kentucky?

Posted on Tuesday, March 17th, 2015 at 4:26 pm    

Gavel and old clockMany people understand the importance of seeking an attorney after they have been involved in a car accident. One of the reasons for this is due to the fact that a licensed attorney will be able to tell a person exactly how much time they have to file or settle their accident related claim. This is known as the Statute of Limitations, and if a claim is not filed within the allowed time frame, then in most situations, it will not be heard by the Kentucky Courts.

2 Years From the Date of the Accident or No-Fault Medical Payment

The Statute of Limitations in Kentucky for car accident cases is two years from the date of the accident, or two years from the date the last no-fault medical payment (or no-fault PIP payment) was paid by your car insurance company. However, the maximum time allowed is four years from the date of the accident, regardless of the date of the last no-fault medical payment.

Statutes of Limitation Vary From State to State

Statute of Limitations can even vary depending on the type of accident a person was in or who the lawsuit is being brought against. In Kentucky, the Statute of Limitations is different for different types of claims. The Statute of Limitations for an auto defects or product liability claims is one year, as opposed to the Statute of Limitations for a contract, which can be up to 15 years (depending upon the type of contract).

When Does the Statue Begin to Run

There can also be a question as to when the statute begins to run. For example, the Statute of Limitations for filing a professional malpractice claim, including medical malpractice, must be commenced within one year of the date of the act or omission giving rise to the claimant’s injury. If the malpractice cannot reasonably be discovered within that time, the lawsuit may be filed at a later time not to exceed five years after the date of the act or omission giving rise to the injury.

If you were in a car accident but are afraid that your Statute of Limitations has already run or is about to expire, contact an attorney Northern Kentucky Personal Injury Attorney. Lawrence & Associates will be able to tell you with certainty whether or not you may still file a claim in Kentucky.

Contact Us at (513) 351-5997 for a Free Consultation


Lawrence & Associates Helps a Client in a Car Accident Get a Settlement For His Surgery, Time Off Work, and Pain and Suffering!

Posted on Wednesday, September 3rd, 2014 at 3:31 pm    

personal injury settlementAt the firm of Lawrence & Associates in Fort Mitchell, Kentucky, we fight for the rights of people who have suffered serious injuries and the families of fatal accident victims. We work tirelessly to help our clients get compensation and deal with the medical, financial and emotional effects of serious accidents. We want to share with you the results of a case we oversaw in September of 2011. We will supply as many details as possible while still respecting our clients need for privacy.

The Situation

Our client was in a motor vehicle accident in November 2011. The other driver failed to yield the right of way and hit the left rear of of our client’s vehicle.

The Injury

A few days after the accident, our client developed numbness and tingling in his arm and severe jaw pain. He was 58 years old at the time of the accident and had been diagnosed with rheumatoid arthritis. Our client’s numbness was diagnosed as carpal tunnel syndrome, which his doctor thought came from clenching the steering wheel when the collision occurred. The doctor also said the jaw pain was related to the impact.

The Result

Our client initially came to Lawrence & Associates because he had no way to get the medical treatment he needed. Lawrence & Associates was able to get him the surgery his doctor recommended, which was fully paid for by the other driver’s insurance company. Our client  also got paid for his time off work and for his pain and suffering.


Lawrence & Associates Help a Client Get a Settlement That Contains Extra Money For a Future Surgery

Posted on Friday, August 22nd, 2014 at 3:18 pm    

settlementAt the firm of Lawrence & Associates in Fort Mitchell, Kentucky, we fight for the rights of people who have suffered serious injuries and the families of fatal accident victims. We work tirelessly to help our clients get compensation and deal with the medical, financial and emotional effects of serious accidents. We want to share with you the results of a case we oversaw in September of 2011. We will supply as many details as possible while still respecting our clients need for privacy.

The Situation

Our client was in a motor vehicle accident in September 2011 when another driver ran a stop sign and T-boned her vehicle.

The Injury

Our client suffered low back pain and her doctor recommended surgery that our client was unable to go through because of her work schedule. She went to physical therapy instead but knew she was going to need surgery at some point in the future. The insurance company wouldn’t pay for a surgery that hadn’t happened yet, and our client needed help.

The Result

Lawrence & Associates got our client a settlement that not only paid for the physical therapy medical bills, but also contained extra money to be used for the future surgery. The other driver’s carrier was forced to compensate our client without hiding behind frivolous defenses.

Contact Us at (513) 351-5997 for a Free Consultation


Lawrence & Associates Help a Client Who Was Hurt on a Bus Trip Passing Through Northern Kentucky

Posted on Friday, July 25th, 2014 at 2:24 pm    

Bus WreckAt the firm of Lawrence & Associates in Fort Mitchell, Kentucky, we fight for the rights of people who have suffered serious injuries and the families of fatal accident victims. We work tirelessly to help our clients get compensation and deal with the medical, financial and emotional effects of serious accidents. We want to share with you the results of a case we oversaw in July 2013. We will supply as many details as possible while still respecting our clients need for privacy.

The Situation

Our client was traveling from Miami to Chicago by bus when the bus he was on had to make a sudden stop and ran off the road in Northern Kentucky. Since the wreck happened in Northern Kentucky, our client was forced to file a claim in a Kentucky court as well. The bus company’s insurance carrier did not believe that our client was injured in the wreck.

The Injury

Our client had been asleep when the wreck happened and was thrown into the air. He landed on an armrest on his lower back, which caused his injuries, including a disc bulge in his spinal column.

The Result

Lawrence & Associates was able to prove the injury was related to the bus wreck and forced the company’s insurance carrier to pay our client for his medical treatment and pain and suffering without him ever having to return to Kentucky or file a lawsuit. Contact us at (513) 351-5997 to speak with an attorney.


Texting While Driving… Adults Are Worse Than Teens

Posted on Tuesday, July 22nd, 2014 at 3:42 pm    

texting in the carIn a recent survey conducted by AT&T, 49% of American adult drivers admitted that they text while driving. [1] That’s a surprising statistic compared to only 43% of teens who admitted they too text, email, and check social networks while driving. While any licensed driver can partake in the act of texting while driving, as the AT&T study shows, adults are the worst offenders. Why can’t adults put the mobile phone down while behind the wheel? When asked why, respondents to the survey answered candidly that “it was a habit,” “it makes me more productive,” and “I like to stay connected.” A few years ago adults said they never did it, but in today’s fast paced world, texting while driving has become the new norm. While texting while driving may help someone stay more connected or be more productive, there can be very serious consequences of driving while texting.

Kentucky’s Texting Laws

To combat this phenomenon, Kentucky has stepped up and passed stricter laws banning texting while driving. In 2011, Kentucky created a new section of KRS Chapter 189, which prohibits text messaging while operating a motor vehicle. Punishments for a driver who is caught text messaging range from fines between $20 to $100 for each offense, excluding court costs, as well as adding on an additional 6 months onto the time a permit holder must wait before being allowed to get his or her driver’s license.

Texting Increases the Chances of You Getting Into an Auto Accident 

The reality is the repercussions of driving and texting can lead to increased chances of getting into an auto accident and even death. Researchers from Virginia Tech Transportation Institute reported that texting while driving creates a crash risk 23 times worse than driving while not distracted. When you text and drive, you are not only at risk for injury, but you are a liability to every driver around you.

If you have or know anyone who has been a victim of an auto accident involving a distracted driver who texted while driving, Lawrence & Associates can help!

Contact Us (859.371.5997) for a Free Consultation

[1] http://www.usatoday.com/story/news/nation/2013/03/28/adults-worse-than-teens-about-texting-behind-wheel/2026331/


Lawrence & Associates Provided Free Legal Consultations on Weekends at the Richwood Flea Market This Summer

Posted on Friday, July 18th, 2014 at 3:32 pm    

The Attorneys of Lawrence & Associates provided free legal consultations at the Richwood Flea Market on Saturdays and Sundays between 9am – 5pm this summer. Thanks for meeting with us!

Richwood Flea Market

Kentuckys best and most loved Flea Market since 1980! Richwood Flea Market is your one stop shopping home for all things vintage and new. Whether you are looking for a bargain or looking for a home for your store, Richwood Flea Market is the place for you. Great family fun and food!
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Lawrence & Associates

Lawrence & Associates is a firm dedicated to helping accident victims and the families of fatal accident victims get the compensation and care they need to rebuild their lives. We also help people and their businesses obtain a fresh financial start through bankruptcy. Lawrence & Associates is located in Fort Mitchell, Kentucky, and serves all of Northern Kentucky.


Tips On Dealing With Insurance Adjusters After an Accident

Posted on Thursday, July 10th, 2014 at 9:01 am    

Insurance AdjustersIn Northern Kentucky, a car accident occurs several times every hour on average. Often, following a car accident, injured Northern Kentucky drivers will receive a call from the other driver’s insurance company asking for a recorded statement about the injury. Below are tips that will ensure you get full and fair compensation for any injuries you receive in an accident.

You Must Cooperate With Your Insurance Company But You Don’t Have to Do it Directly

To some extent, your insurance company is on your side because they would prefer that the other driver’s insurance company pay for damages to the vehicle, and that will only happen if the other driver is responsible. However, your insurance company’s adjuster has far less “skin in the game” than you do, and you can’t expect that person to go out on a limb for you the way a retained attorney will. Your duty to cooperate with your own insurance company does not mean that you are required to deal with them directly, however. If you already have Northern Kentucky personal injury attorney retained, ask the insurance company to contact your attorney instead! That is what you pay the attorney for.

You Do Not Have to Cooperate With The Other Person’s Insurance Company

In Northern Kentucky, it is legal for the other driver’s insurance company to contact injured motorists, and even to tell the injured motorist that they have to give a recorded statement! That is not always a bad thing; in fact, if your injuries are minimal or non-existent and the police report places liability on the other driver, you may want to talk to the other driver’s adjuster to speed things along. However, if you are being treated by a doctor in Northern Kentucky for your auto related injuries and do not see any end to the treatment in sight; you should contact a Northern Kentucky personal injury lawyer first.

The Other Driver’s Insurance Company Adjuster Is Your Opponent!

It is important for injured Northern Kentucky drivers, if still being treated for injuries, to contact an attorney before speaking to the other driver’s insurance adjuster because the other driver’s insurance adjuster is looking for a way to reduce the amount that has to be paid to resolve the other driver’s liability for the accident. It is rare for the adjuster to offer you nothing, but it is not the adjuster’s job to offer you a fair amount. It is not the adjuster’s job to seek justice. And it is certainly not the adjuster’s job to maximize your recovery or advise you of all the kinds of damages that are available to you.

Your First Statements Can Affect Future Settlements

First impressions are critical. Do you understand what your injuries are? If you don’t, the adjuster will set aside a sum of money as a “reserve” on your claim that represents the minimum potential injury and perhaps refuse to go over that amount later on. Only giving a detailed and credible account of your injuries and future medical treatment will create a reserve that matches your need. Don’t try to make up potential future treatment, as the adjuster is trained to spot this! The experienced Northern Kentucky personal injury attorneys at Lawrence & Associates know how to account for medical costs so you get full and fair compensation.

The Insurance System is an Adversarial System That’s Is Best Handled by a Lawyer

Nearly everyone that is seriously injured in a car accident, in Northern Kentucky and elsewhere, winds up needing an attorney because the insurance system is an adversarial system, pitting you against a multi-billion dollar insurance company. Most Northern Kentucky citizens prefer not to deal with adjusters directly and do not know how to effectively negotiate a settlement. Most also prefer not to deal with the headaches and paperwork associated with an insurance claim.

If you or someone you know was hurt in an accident, please contact Lawrence & Associates today to get full and fair compensation for your injuries!

Contact Us (859.371.5997) for a Free Consultation


Know How Kentucky Personal Injury Protection (PIP) Affects You!

Posted on Friday, March 28th, 2014 at 2:20 pm    

PIP Personal Injury Propection ClaimInsurance policies are generally quite confusing and often vary between insurance companies. Most of them promise you a better rate, or better coverage in the event of an accident. Knowing what some of the standard policies cover will help in choosing the right coverage for you. For example, one thing that does not vary between insurance companies that do business in Kentucky is the minimum PIP coverage. PIP stands for ‘Personal Injury Protection’ (also known as Basic Reparation Benefits in other states). In Kentucky, every car insurance company licensed to sell insurance in the Commonwealth is required to provide $10,000 of minimum No-Fault benefits in the case of an automobile accident. This minimum benefit amount is per person, and it covers medical expenses and/or wage losses attributed to the accident.

PIP also may allow for an extension of time in which you may file a claim resulting from an automobile accident. Generally speaking, in Kentucky the statute of limitations is two (2) years from the date of the accident/collision.[1] However, if PIP benefits are paid, then the statute of limitations will be extended by two (2) years after the LAST PIP payment. For example, let’s say you’re involved in a car crash while driving on I-71 in Kentucky on January 1, 2014. You will have until January 1, 2016 to file a claim/suit against the other driver (assuming a valid claim exists against him/her). However, if you are injured in that car accident and your last medical bill is paid by your PIP on July 1, 2014, you will have until July 1, 2016 to file the lawsuit.

If you or someone you know is dealing with an accident related injury in Kentucky or Ohio and have questions regarding PIP, workers’ compensation, or other things regarding an injury claim, please do not hesitate to contact Lawrence & Associates for more information and assistance. We can help!

Contact Us (859.371.5997) for a Free Consultation

[1] KRS 304.39-230(6)

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