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Damages

I have health insurance so I only had to pay my co-pays. How are my medical expense damages calculated in my case?

I was injured in an auto accident and I need to fix my car. What type of claim do I have?

I have missed time from work and I may not be able to continue my job because of my injuries. What are my damages?

How is my pain and suffering amount calculated?





Q: I have health insurance so I only had to pay my co-pays. How are my medical expense damages calculated in my case?

The at-fault party is responsible for all reasonable medical expenses incurred for reasonable and necessary medical treatment obtained for injuries caused by the incident.  In California, if the injured party has health insurance then the adverse party is responsible for the amount paid or owed for the medical expenses.  This would include the amount paid by health insurance and co-pays.  This may be considerably less than the amount billed by the hospital or doctor.  The health insurance company, and some auto insurance medical payment provisions, will often have a reimbursement right from the injured person's recovery for the amount they paid.  These reimbursements often involve formulas as well as negotiation.  Mr. Shapiro will handle these communications in order to help make sure you comply with your contractual obligations and maximize your net recovery.


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Q: I was injured in an auto accident and I need to fix my car. What type of claim do I have?

When someone is injured in an auto accident they usually have two types of claims: Bodily Injury and Property Damage.  Bodily injury involves medical expenses, loss of earnings, and pain and suffering.  Property damage involves the damage to their car as well as personal property.  Insurance companies usually handle these separately.  For a bodily injury claim you should hire Mr. Shapiro and not settle until the full extent of your damages are known.  For property damage you can address the damage to your car as soon as possible.  If you have collision coverage you can work with your own insurance company.  If not, you will have to deal with the insurance company for the at-fault driver.  Do not give a recorded statement or discuss your injuries.  In either case you are entitled to the amount of the repair or the value of the car, whichever is less.


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Q: I have missed time from work and I may not be able to continue my job because of my injuries. What are my damages?

Many injured people will miss time from work.  It is important to get a doctor's note whenever possible for time missed even if self-employed or if your employer does not require it.  You are entitled to a loss of earnings claim for time missed even if you use sick-time benefits.  This will usually be based on the hours missed and your rate of pay.  Most people will only be temporarily disabled and will be able to return to work with the help of appropriate medical care.  However, some people will be permanently injured and unable to return to their occupation.  This is known as loss of earning capacity.  These damages are based on the difference in earnings between what the person was making and what they are able to make, if anything, now that they are permanently injured.  Loss of earnings and loss of earning capacity claims can be very complicated and sometimes retained expert analysis is required.


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Q: How is my pain and suffering amount calculated?

First of all, it is NOT calculated based on multiplying the medical expenses.  This is an absolute myth.  Some people will have huge emergency room bills and never treat again.  Others will have permanent burn injuries for which there is no helpful medical care.  These examples illustrate that each injured person must be examined on a case-by-case basis in estimating what amount a jury would award to compensate them for their pain and suffering, also known as general damages.  Factors include the type of injury sustained, the affect on the person's activities, and the length of time they are suffering.  Only an experienced personal injury attorney, such as Mr. Shapiro, with knowledge of jury awards in various jurisdictions, can estimate how a jury will assess any particular plaintiff's general damages.


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