Getting Medical Care After Your Albuquerque, New Mexico Car Accident, Crash

By Mark Caruso, Personal Injury Attorney (505) 883-5000

You've been in a wreck. You're injured. You need medical care. The doctor's office says they won't accept your health insurance, and the auto insurance company for the at-fault driver won't pay your medical bills (or maybe they won't even return your calls). What do you do?

Auto liability insurance does not work like health insurance. They are not going to pay your medical bills as you go along. The auto insurance company expects you to go out and get all the medical care you need. Then, when you've completed all of your medical care, they want you to gather your medical bills and ask for reimbursement in one lump sum. That's right. You only get one bite at the apple. It's a one time settlement payment. And you cannot go back later and ask for additional money if your injuries turn out to be worse than you thought.

Getting medical care after a car wreck can be complicated and frustrating. A common mistake is failing to contact an experienced injury lawyers like Caruso Law Offices as soon as possible. That error may result in a "gap" in medical care, which the auto liability insurance company will use to argue that you did not go to the doctor because you were not really injured. The insurance company knows it's not true, but they don't care about that. Their goal is to pay you the least amount of money possible. It is extremely important that you get the medical care you need as quickly as possible after the wreck.

You may have been transported to the hospital by ambulance. Or you may have gone to the Emergency Room on your own. Maybe you haven’t been able to see any health care provider because of your concern about who will pay. You will be billed for the treatment you received--whether you have insurance or not. But what do you do after that? At Caruso Law Offices we can help you get the medical care you need, and we can make the at fault driver’s insurance pay for it. Here are some options that you should consider.

• Health Insurance: If you have health insurance coverage, you should use it. Unfortunately, several of Albuquerque’s HMO plans (Presbyterian, Lovelace and Blue Cross/Blue Shield of NM) are now refusing to pay for medical care following a car wreck. Most plans will still pay for the ambulance and the emergency room, but follow up care is usually restricted. Some health plans just push prescription drugs rather than physical therapy and other treatment. You'll still be responsible for deductibles and co-pays associated with your plan, but it sure beats having to pay the whole amount out of pocket! Remember, all plans require you to reimburse them from any settlement proceeds. However, I can usually negotiate a significant discount when your case is resolved.

•Letters of Protection: You'll need a lawyer for this. A Letter of Protection ("LOP") is an agreement made with the doctor's office by your lawyer and you promising to pay the bill from the settlement proceeds. Doctors are not required to accept LOPs, but many doctors will do so. Meet with me to get my list of most local medical doctors, osteopathic doctors, dentists, psychologists, chiropractors, accupunturists, physical therapists, medical massage therapists, MRI’s and others who accept LOP’s. This means that you won’t pay any money out of your pocket at each visit, and you won’t get any bills until we get a settlement. These doctors agree to wait to get paid from the settlement and don’t charge any interest while waiting to get paid.

Because I have been in business for 30 years (25 years in Albuquerque) I have established great relationships with some of the best doctors in Albuquerque. Some medical doctors in Albuquerque refuse to accept a LOP from any other law firm except our firm and one or two others. I will help you find the best health care provider in the best location for you. I also know which doctors you should avoid because of bad reputations with insurance companies. I can usually get you in to see a doctor the day after I begin working on your claim. There is no reason why you shouldn’t find a health care provider to treat your injuries, and there is no reason why you shouldn’t get the best medical care possible. After all, you did not cause the wreck, and the at-fault driver’s insurance should pay for your medical care. I can get you the medical care you need following your wreck.

•Med Pay: You may have Medical Payments Coverage ("Med Pay") on your own auto insurance policy. This coverage typically provides benefits of $2,000 Med Pay can be assigned to medical providers so the doctor's office can bill your own auto insurance company up to the amount of your coverage limit. You should consult me before using Med Pay because there may be strategic reasons to use the coverage for some bills but not for others. Remember, your Med Pay plan requires you to reimburse your own insurance company from any settlement proceeds. However, I can usually negotiate a significant discount when your case is resolved.

•Medicaid & Other Government Benefits: If you already receive Medicaid, Medicare or other government benefits before your wreck, then you should be able to use that coverage for your injuries. It is also possible you may qualify for government benefits after the wreck. In that case, Medicaid may actually go back and pay all of your medical bills from the date of the wreck. Keep in mind, all government benefits require repayment when you recover money in your case. However, I can usually negotiate a significant discount when your case is resolved.

•Pay As You Go: This is the option of last resort if you don’t have insurance coverage available and you don’t want to issue a LOP.

• • • •

I hope this summary really helps you understand how you can get immediate medical care following your accident. I would love to give you an hour of my time to personally meet with you to discuss your specific car wreck and the medical care we can help you get for your injuries. Please call me at (505) 883-5000 at our Northeast Heights Office or at (505) 369-1361 at our Westside Office for a personal appointment with me, not a paralegal. The consultation with me is free, and you are under no obligation to retain me to be your attorney.

Before I began helping people like you, I represented insurance companies. I know how insurance companies operate. Now I only represent victims of car wrecks. I promise to use my experience as a former insurance company attorney to get you the most money possible. To do so you and I must cross every “t” and dot every “i” in order to anticipate and out-smart the tactics and strategies of the insurance company claims adjuster. Remember, their job is to pay you the least money possible, and they will use these tactics and strategies against you unless we are confront them up front.

When we meet I will explain to you that we are only paid if we recover an injury settlement for you. If we don’t get you any money, then we don’t deserve any fees. We don’t charge any attorney fee to get you the highest settlement for your property damage and rental car/loss of use and depreciation/diminution in value of your vehicle. I will also offer you our reduced attorney fee of 29% if we can settle your case without a lawsuit. That means that you put more money in your pocket, and our firm gets less money. We can do this because we don’t spend thousands of dollars on television, billboards and yellow page advertisements.

Please call me today at (505) 883-5000 at our Northeast Heights Office or at (505) 369-1361 at our Westside Office to immediately meet with me to discuss you car wreck. You’ll get honest answers based on my 30 years doing personal injury claims. You’ll also get a discounted 29% attorney fee. I look forward to our personal and confidential meeting. Please call me today so that you do not have a gap in your medical treatment.

Wrongful Death Claims in Albuquerque, New Mexico

What is Wrongful Death?

A wrongful death lawsuit is filed against a person or people who have caused the death of another person. The death may have been premeditated or resulted from careless, irresponsible or negligent behavior. The lawsuit is filed on behalf of any surviving dependents or family members and, if successful, provides them with some compensation for the death. The process begins with the Court appointing a personal representative for the estate of the deceased individual.  Usually this is a relative. The personal representative appointed by the Court is in charge of the entire case and makes all the important decisions as to the direction of the case.

Wrongful death can result from a large number of circumstances in which somebody has died needlessly due to another’s carelessness. Wrongful death can include the following:

• A fatality resulting from any sort of vehicle collision
• Dying during an operation that was botched or after the wrong diagnosis had been made
• Fatalities caused by wrong prescriptions or an overdose of a drug used in treatment
• Being killed through the use of a defective product

Purposes of Wrongful Death Claims

Wrongful death claims are not designed so that surviving family members can benefit financially off of somebody else’s death. They have two primary purposes.

1. They provide assistance to a spouse, children or elderly parents who were financially dependent on the person that died. The payment, if granted, is given to the surviving relatives in a carefully prescribed manner. An economist expert is hired by the attorney to review the tax returns and other income documentation to help determine the real loss to the family.  Wrongful death laws do change a little from state to state, so that here in New Mexico, the statutes are somewhat different from what they are in California, Nevada or Texas.
2. Wrongful death laws act as a social deterrent. They serve as a warning, not just to the third party involved in the death, but to anybody else in the community who may act in the same manner.

Who is Entitled to a Wrongful Death Claim?

The lawsuit is brought before a Court and a juty will ultimately decide, on the basis of the evidence presented by the family and the economist expert hired by the attorney,  whether a lawsuit will be successful. The jury will also make a decision about how much should be paid out to the estate of the deceased individual. This will be based on who the likely heirs will be and what their needs are, now and into the future.

Usually, it is the surviving spouse and the dependent children who are the first in line to benefit from a wrongful death claim. There may be other people who benefit in the absence of either spouse or children. These could be the parents, especially if they were dependent or living at home with the deceased. If there is nobody that appears to fit any of the above descriptions, then the judge may decide to make a payment to anybody else who is next of kin or according to normal rules about intestate inheritance.

Wrongful death law is relatively new in the United States. In the past if somebody died as a result of an unexpected, yet needless death, then the possibility of making a claim for damages also ceased. This was changed over time because states decided that dependents of people who had died were suffering financial hardship as a result of the death.

Caruso Law Offices has had 30 years experience handling wrongful death claims.

If you have had a close relative die recently in what you feel was a wrongful death, then contact the Caruso Law Offices in Albuquerque, New Mexico at 505-883-5000. After a discussion of the circumstances surrounding the death, our firm will be able to give you a detailed opinion about the possibility of bringing a wrongful death lawsuit against the person or people who may be considered responsible. We do not charge anything for a consultation and you will not have to pay any legal fees unless we win a claim on your behalf. At our firm, we have 30 years experience and have successfully won many wrongful death claims for our clients over the years.

Caruso Law Offices provides legal service for anybody in Albuquerque, New Mexico area that has had a close relative die due to somebody else’s actions and may want to pursue a wrongful death lawsuit. If you have had a member of your family die needlessly due to somebody else’s negligence or irresponsible action, then contact us. We will work tirelessly on your behalf to make sure that justice is received.

 

 

Payment of Medical Expenses Following Albuquerque Car Accident

By Mark Caruso, Personal Injury Attorney (505) 883-5000

You've been in a wreck. You're injured. You need medical care. The doctor's office says they won't accept your health insurance, and the auto insurance company for the at-fault driver won't pay your medical bills (or maybe they won't even return your calls). What do you do?

Auto liability insurance does not work like health insurance. They are not going to pay your medical bills as you go along. The auto insurance company expects you to go out and get all the medical care you need. Then, when you've completed all of your medical care, they want you to gather your medical bills and ask for reimbursement in one lump sum. That's right. You only get one bite at the apple. It's a one time settlement payment. And you cannot go back later and ask for additional money if your injuries turn out to be worse than you thought.

Getting medical care after a car wreck can be complicated and frustrating. A common mistake is failing to contact an experienced injury lawyers like Caruso Law Offices as soon as possible. That error may result in a "gap" in medical care, which the auto liability insurance company will use to argue that you did not go to the doctor because you were not really injured. The insurance company knows it's not true, but they don't care about that. Their goal is to pay you the least amount of money possible. It is extremely important that you get the medical care you need as quickly as possible after the wreck.

You may have been transported to the hospital by ambulance. Or you may have gone to the Emergency Room on your own. Maybe you haven’t been able to see any health care provider because of your concern about who will pay. You will be billed for the treatment you received--whether you have insurance or not. But what do you do after that? At Caruso Law Offices we can help you get the medical care you need, and we can make the at fault driver’s insurance pay for it. Here are some options that you should consider.

• Health Insurance: If you have health insurance coverage, you should use it. Unfortunately, several of Albuquerque’s HMO plans (Presbyterian, Lovelace and Blue Cross/Blue Shield of NM) are now refusing to pay for medical care following a car wreck. Most plans will still pay for the ambulance and the emergency room, but follow up care is usually restricted. Some health plans just push prescription drugs rather than physical therapy and other treatment. You'll still be responsible for deductibles and co-pays associated with your plan, but it sure beats having to pay the whole amount out of pocket! Remember, all plans require you to reimburse them from any settlement proceeds. However, I can usually negotiate a significant discount when your case is resolved.

•Letters of Protection: You'll need a lawyer for this. A Letter of Protection ("LOP") is an agreement made with the doctor's office by your lawyer and you promising to pay the bill from the settlement proceeds. Doctors are not required to accept LOPs, but many doctors will do so. Meet with me to get my list of most local medical doctors, osteopathic doctors, dentists, psychologists, chiropractors, accupunturists, physical therapists, medical massage therapists, MRI’s and others who accept LOP’s. This means that you won’t pay any money out of your pocket at each visit, and you won’t get any bills until we get a settlement. These doctors agree to wait to get paid from the settlement and don’t charge any interest while waiting to get paid.

Because I have been in business for 30 years (25 years in Albuquerque) I have established great relationships with some of the best doctors in Albuquerque. Some medical doctors in Albuquerque refuse to accept a LOP from any other law firm except our firm and one or two others. I will help you find the best health care provider in the best location for you. I also know which doctors you should avoid because of bad reputations with insurance companies. I can usually get you in to see a doctor the day after I begin working on your claim. There is no reason why you shouldn’t find a health care provider to treat your injuries, and there is no reason why you shouldn’t get the best medical care possible. After all, you did not cause the wreck, and the at-fault driver’s insurance should pay for your medical care. I can get you the medical care you need following your wreck.

•Med Pay: You may have Medical Payments Coverage ("Med Pay") on your own auto insurance policy. This coverage typically provides benefits of $2,000 Med Pay can be assigned to medical providers so the doctor's office can bill your own auto insurance company up to the amount of your coverage limit. You should consult me before using Med Pay because there may be strategic reasons to use the coverage for some bills but not for others. Remember, your Med Pay plan requires you to reimburse your own insurance company from any settlement proceeds. However, I can usually negotiate a significant discount when your case is resolved.

•Medicaid & Other Government Benefits: If you already receive Medicaid, Medicare or other government benefits before your wreck, then you should be able to use that coverage for your injuries. It is also possible you may qualify for government benefits after the wreck. In that case, Medicaid may actually go back and pay all of your medical bills from the date of the wreck. Keep in mind, all government benefits require repayment when you recover money in your case. However, I can usually negotiate a significant discount when your case is resolved.

•Pay As You Go: This is the option of last resort if you don’t have insurance coverage available and you don’t want to issue a LOP.

• • • •

I hope this summary really helps you understand how you can get immediate medical care following your accident. I would love to give you an hour of my time to personally meet with you to discuss your specific car wreck and the medical care we can help you get for your injuries. Please call me at (505) 883-5000 at our Northeast Heights Office or at (505) 369-1361 at our Westside Office for a personal appointment with me, not a paralegal. The consultation with me is free, and you are under no obligation to retain me to be your attorney.

Before I began helping people like you, I represented insurance companies. I know how insurance companies operate. Now I only represent victims of car wrecks. I promise to use my experience as a former insurance company attorney to get you the most money possible. To do so you and I must cross every “t” and dot every “i” in order to anticipate and out-smart the tactics and strategies of the insurance company claims adjuster. Remember, their job is to pay you the least money possible, and they will use these tactics and strategies against you unless we are confront them up front.

When we meet I will explain to you that we are only paid if we recover an injury settlement for you. If we don’t get you any money, then we don’t deserve any fees. We don’t charge any attorney fee to get you the highest settlement for your property damage and rental car/loss of use and depreciation/diminution in value of your vehicle. I will also offer you our reduced attorney fee of 29% if we can settle your case without a lawsuit. That means that you put more money in your pocket, and our firm gets less money. We can do this because we don’t spend thousands of dollars on television, billboards and yellow page advertisements.

Please call me today at (505) 883-5000 at our Northeast Heights Office or at (505) 369-1361 at our Westside Office to immediately meet with me to discuss you car wreck. You’ll get honest answers based on my 30 years doing personal injury claims. You’ll also get a discounted 29% attorney fee. I look forward to our personal and confidential meeting. Please call me today so that you do not have a gap in your medical treatment.

What Are The Medical Expenses The Insurance Company Should Pay After My Albuquerque Accident Claim



Mark J. Caruso, Personal Injury Attorney

     So often I am asked this question..."What medical expenses can I get from the insurance company now that we know the collision wasn't my fault?"  This is really an easy question to answer, because state law dictates what you are entitled to.  However, just because you might be claiming a medical expense doesn't mean that you automatically get the money for those medical expenses.  It is still up to you and your attorney to provide the insurance company with the facts and evidence to prove the damage.

     Under the law of the state of New Mexico and most other states, medical expenses must be reasonable, necessary and a direct result of the injuries sustained in the collision. 

     The medical expenses must be reasonable in price compared to charges made by othere health care providers in the same community.  This can be easily proven, and our firm has the annually published medical fees to help prove the reasonableness of the charges. 

    The medical expenses must be necessary and needed because of the injury from the collision. No one would expect the insurance company to pay for a medical expense that you really didn't need.  You are, however, required to mitigate your damage.  That means that you are allowed to have diagnostic tests and examinations to determine whether you have an injury.  If you have some pain that you didn't have before the collision, you are expected to take reasonable precaution to determine if you have an injury.  If you ultimately determine that you don't have any injury, the insurance company will still pay for the cost of the examination and diagnostic x-rays and other tests. 

     The medical expenses must be a direct result of the injuries sustained in the collision.  You can't ask the insurance company to pay for anything that their driver didn't cause.  However, they must also pay for the aggravation of a previous injury. As an example, let's say that your leg already had degenerative problems because of your age.  It really didn't cause you any problems before the accident, but the twisting of the leg in the accident required you to now have physical therapy and ultimately a surgery.  You aggravated the degenerative condition so now you must have the extra medical care.  This would be a valid claim against the insurance company.  The medical records provided by your doctor should clearly indicate that the medical care was needed as a result of the collision.  If it doesn't state this on the records, then you should contact your doctor or his/her staff immediately to determine what he/she believes was the cause of the injury in the first place. 

     Once you have finished all of your treatment, it is realitively easy to determine your total medical expenses.  You need to use the retail price of the medical expenses, not the amount paid by your health insurance or the amount you paid as a deductible or co-pay.  It is usually a simple addition of the charges.

     Sometimes doctors will state that you need to get extra money from the insurance company for future medical expenses.  An example would be a doctor stating that you need one physical therapy visit per month for a total of 12 more months.  You would need to calculate the cost of  each visit and multiply times the number of visits the doctor says that you need and you then have an additional number for future medical care.  Again, the same rules apply to future medical expenses that apply to the past medical expenses.  The future medical expenses must be reasonable, necessary and a direct result of the collision. 

   This discussion above is merely a synopsis of the law.  I would ask that you personally call me, Mark Caruso, for a free consultation at 505-883-5000 if you have any questions.  During this conversation will will discuss what happened in your accident, how you were injured and the medical care that you have received or will be receiving.  It costs you nothing to talk to me, and I would like to help you even if you chose not to have us represent you.

  If you mention this blog we will also give you a discount on your attorney fee.  Rather than pay a full 33 1/3% fee that most lawyer charge, we will reduce the fee to 29% if we can settle your claim without a lawsuit being filed.  This puts more money in your pocket.  I hope to hear from you. 

The "Personality" of the Albuquerque Insurance Claims Office

          As a former insurance company attorney I got to learn the personality of the various insurance companies.  Yes, that's right....personality.  When I talk about their personality, I mean their attitude, character and likeability.  Some insurance companies are, quite frankly, easier to deal with than other insurance companies.  Some insurance companies just don't care if you file a lawsuit against their insured.  Other insurance companies will do whatever it takes to settle the case.

          Here are some examples, as they apply to Albuquerque.

          Progressive Insurance is one of the only insurance companies with adjusters based in New Mexico with claims adjusters that are actually New Mexico residents.  These adjusters are easy to talk to, understand New Mexico culture and really show an interest in trying to be fair to fellow New Mexicans in the valuation of cases.  Progressive adjusters will often meet with our lawyers and our clients to get a real feel for the client and their claim.  The handling of claims is more personalized, and there is a good liklihood that the claim will settle without a lawsuit.

          Allstate, on the other hand, is now completely based in Dallas, Texas. There is no  claims office in New Mexico.   Their claims adjuster's attitude is, well, no better way to describe it but "Texan".  The adjusters know little about New Mexico, and they never pronounce  our Spanish names the right way.  It often seems like the client is only a "claim number" rather than an actual person. They tend to make very low offers of settlment, don't want to personalize the claim and really appear not to care if the lawyer needs to file a lawsuit against their insured.  That's why most claims against Allstate require a lawsuit to get the client the full value of their claim.

         There are dozens of insurance companies selling insurance in New Mexico.  State Farm, Farmers, Geico, Progressive, USAA, Fred Loya, Young America, Nevada General, Hartford and AAA are among the largest.  Each has its own personality and attitude when evaluating cases.

         Caruso Law Offices, PC has been handling car accident cases against these insurance companies and others since 1987.  Understanding their personalities is extremely important in knowing how to get our clients the most money possible.  Each claims adjuster has their own likes and dislikes, and each has a certain way they like to evaluate their cases.  Some insurance companies pay extra when a Medical Doctor is involved in the case, and others substantially increase the amount when there is an ambulance. The differences are endless.

         Attorney  Mark Caruso used to work for the insurance companies before he began working for victims of personal injuries.  As a former insurance company attorney he knows the ins and outs of the insurance claims business.  That's why doctors, other attorneys, body shops and even insurance agents refer to Mark Caruso to handle their car accident claims. 

         If you have an auto accident call attorney Mark Caruso for a free consultation.  You will meet with an attorney, not a legal secretary.  We have two offices to serve you...Our Northeast Heights main office is located at 4302 Carlisle NE (Montgomery & Carlisle)  phone is 505-883-5000.   Our West Side satellite office is located at 2929 Coors NW  Suite 310, (Coors & I-40) phone is 505-369-1361.  

          We look forward to hearing from you. 

Albuquerque Accident Attorneys Should Discount Their Fees

You have probably seen all the attorneys advertising on television, billboards and the sides of buses that they will represent you in your personal injury claim on a percentage fee basis.  This is called a contingency fee.  A contingency fee means that you pay the personal injury attorney no hourly fee, but instead pay a "percentage fee" at the conclusion of the claim.  If the lawyer recovers no money on the claim, the attorney gets no attorney fee.

The New Mexico Rules of Professional Conduct set the ethical rules for attorneys to follow when charging clients a contingency fee. The rules require the contingent fee to be reasonable, and require that the contingent fee agreement be in writing and signed by the client and attorney.

Most every auto accident and personal injury  attorneys in Albuquerque, NM  charges a contingency fee of  33 1/3% for all injury cases that are settled prior to a lawsuit being filed. This seems a little steep, especially because so little work is done by the attorney before the lawsuit is filed. Most of the initial gathering of medical records and establishing of liability are done by a paralegal or legal assistant supervised by the attorney.  However, if a lawsuit is filed because the case could not be settled, then the attorney has much more involvement in the claim.

Beginning in 2009 Caruso Law Offices pioneered a new approach to attorneys fees in Albuquerque, NM.  In compliance with the "reasonable fee" requirement of the Rules and knowing that less work was required to settle a case if no lawsuit was yet file, we discounted our percentage contingency fee.  We discount the contingency fee to only 29% if a case is settled before a lawsuit is filed.

The result is that more money goes into the  client's pocket! It also means quicker settlements for clients. As an example, using a settlement of a $50,000 case, the attorney fee would be $14,500 rather than $16,666.  That's $2,100 more into the client's pocket rather than the attorney's pocket.

The response from clients to the discounted contingency fee has been amazing. Caruso Law Offices receives most of its personal injury client referrals from word of mouth, and little advertising is really needed.

Some might believe that a discounted fees means a lesser qualified attorney or law firm. Not so! Mark Caruso, the senior attorney at Caruso Law Offices,  is a former insurance company attorney who now helps injured victims.  He has over 30 years of experience helping injured victims. He is also licensed in both New Mexico and California. Because Caruso Law Offices does not do television, billboard or bus advertising, its overhead is smaller, and it can help the client by putting more money in the client's pocket. Helping the clients should be the number one priority of every attorney, and it is the priority at Caruso Law Offices.

The discount really means  that the attorney isn't spending lots of money on advertising and can afford to pass the savings to his clients.  Advertising is an expensive overhead.  Freeway billboards can cost $5,000 a month, and some attorney television budgets are $20,000 monthly.  The advertising does not mean that the attorney is a better attorney, only that he is spending more on advertising and probably charging the higher 33 1/3% fee rather than the discounted 29% fee.

If you would like to personally talk with Mark Caruso at  a free and confidential consultation, you can call him at 505-883-5000 or toll free at 800-657-9292. We have two locations in Albuquerque--the NorthEast Heights and the West Side.  You can also see our web site at www.carusolaw.com We look forward to hearing from you. Thanks. Mark