Pezzano Mickey & Bornstein - Attorneys at Law
Pezzano Mickey & Bornstein, LLP (908) 782-0075 Flemington - Phillipsburg - Bridgewater
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Research Your Accident

With all the lawyer advertising on the internet, you would think it would be easier to get some good, useful information about your New Jersey personal injury or workers’ compensation case. This website was designed to provide valuable information to help you. If your question is not answered here, call or email us for a free, no obligation evaluation of your case. You will also find vital information in my book “Five Deadly Sins That Can Wreck Your New Jersey Accident Case”. You can order a free copy here. You’ll get even more information when you subscribe to our newsletter. Knowledge is power.

Can I sue the other driver if I was at fault for the accident?

New Jersey is a “comparitive negligence” state. This means that if your responsibility for an accident is fifty percent or less, you can still recover compensation for your injuries but the amount of your damages will be reduced by the percentage of your responsibility. If your responsibility for the accident is greater than fifty percent, you cannot recover any compensation for your injuries.

 Who pays my medical bills if I am in a car accident?

Under New Jersey’s “No-Fault” law, your own car insurance company pays your medical bills resulting from an automobile accident even if the accident was the other driver’s fault and even if you were not in your own car at the time of the accident. Payment by your insurance company is subject to a deductible and co-payment. Unless you make a different selection, you have a $250 deductible and a 20% co-payment up to $5000. PIP (personal injury protection) benefits may include payment for medical expenses, lost wages, essential services, survivor benefits and funeral expenses. A standard policy covers medical bills up to $250,000. A basic policy is also available which only covers up to $15,000 in medical bills with some limited exceptions. Be careful when purchasing your automobile insurance. A small savings on your premium could result in a huge loss for you if you don’t have enough coverage to pay your medical bills.

Can I use my health insurance to pay my bills if I am injured in a car accident?

In New Jersey, your automobile insurance is the primary insurer for medical bills resulting from accident-related injuries unless you have specifically selected your health insurance as your primary coverage. There are many situations in which some or all of your medical bills are not covered by your auto insurance. These situations include co-pays and deductibles, treatment which your insurance company determines is unnecessary or unrelated to the automobile accident or bills mistakenly submitted to your health insurance carrier by your medical provider. Although health insurance carriers should decline to pay medical bills which should be covered by your auto insurance, many companies automatically pay them. This is not at good as it sounds. In some instances, your health insurance carrier has a legal right to assert a lien which means that if you recover any money in a settlement or lawsuit, the insurance company is entitled to be paid back everything it paid from the money you receive. In order to avoid this situation, your attorney should be knowledgeable about this type of situation and should make sure that your bills are being paid by the proper party.

What if my insurance company refuses to pay for my medical treatment?

There are many rules which must be followed in order to ensure payment of medical bills. Many services are subject to pre-certification and bills must be submitted to the automobile insurance company within a certain time period. You should be sure your medical provider is familiar with these requirements. Disputes over payment of medical bills are generally resolved through a form of alternate dispute resolution known as arbitration. In this proceeding, a medical review organiztion (MRO) decides disputes as to diagnosis, medical necessity of treatment or diagnostic test, whether the injury is causally related to the accident and appropriatness of protocols used by the provider.

Who pays me if I can’t work due to my injuries?

Income continuation benefits are available as part of PIP benefits. However, either state or private disability payments must be exhausted before income continuation benefits are available.

My insurance policy has the “limitation on lawsuit” threshold? What does that mean?

New Jersey residents injured in an automobile accident are bound by either the “limitation on lawsuit” threshold (formerly known as the “verbal” threshold) or the “no limitation on lawsuit” threshold. Basically, having the “no limitation on lawsuit” threshold means that an injured person has an absolute right to bring a lawsuit for injuries resulting from an automobile accident no matter how minor those injuries may be. On the other hand, the “limitation on lawsuit” threshold requires that the injuries be permanent meaning an injury that has not and will not heal to function normally, even with medical treatment. as established by a certification signed by a physician. When purchasing car insurance, be mindful of the fact that electing the “limitation on lawsuit” threshold will lower your premium but will also prevent you from filing a claim or lawsuit unless your injuries are permanent.

The car that hit me fled the scene. Do I still have a case?

If your injuries are caused by a driver who leaves the scene, your Uninsured Motorist Coverage acts like liability insurance for the other driver and is available to pay a claim for injuries. Likewise, your Underinsured Motorist Coverage can provide additional coverage for another driver who causes your injuries but who has limited insurance coverage.

How will I get my car fixed?

If the other driver is at fault, his or her insurance carrier is responsible for your property damage. That claim can usually be resolved informally between you and the insurance company. Make sure when signing any settlement papers or checks that it is for the property damage claim only and not for any bodily injury claim. Often it is easier to have your own insurance company pay your property damage claim under your collision coverage. Assuming liability is on the other driver, your insurance company will pay you for the damage, less any applicable deductible you have, and then subrogate which means they will seek reimbursement from the other driver’s insurance company. Once they receive payment, they will reimburse you for your deductible. If they settle with the other insurance company for less than the full amount of the claim, you will receive a proportionate share of your deductible.

What will my claim be worth?

There is no chart or formula for determining the value of an injury claim. Many factors go into the evaluation of your case such as: the nature and extent of the injury; any residual symptoms or disability you have after receiving medical care; how your injuries have affected your employment and/or lifestyle from the time of the accident to the present and into the future; whether you have any out-of-pocket medical bills and/or lost wages; whether there are any liens against your claim which must be repaid such as healthcare liens or Medicare liens; etc. That is why it is vital to your case that you have an attorney who is experienced in personal injury litigation. The law office of Wendy S. Bornstein is uniquely equipped to handle even the most serious personal injury case. In addition to being a Certified Civil Trial Attorney, Wendy Bornstein is a former insurance company defense attorney and knows firsthand what will make the insurance company pay full value for your claim.

If I fall on someone else’s property, doesn’t their insurance company have to pay for my medical bills?

Not necessarily. In general, the insurance company doesn’t have to pay anything unless its insured is legally responsible for your injuries. That legal obligation depends upon several things, including your status on the property. For example, the property owner might have a different degree of responsibility if you were on the property for business as opposed to social reasons. Some liability insurance policies have “medical payments coverage” which might be offered to you for unreimbursed medical expenses whether or not the property owner was at fault. The most common medical payments coverage limits are $1,000 and $5,000.

If I slip on ice, who is responsible for my injuries?

It depends on where you fell. Residential property owners are generally not responsible for injuries resulting from ice on abutting sidewalks although they would be responsible if the icy condition was directly on their property. Commercial landowners and tenants are responsible not only for icy conditions on their property but for icy sidewalks as well. In many instances, if the property owner has contracted with a snow removal company, that company may share the responsibility depending upon their obligations which should be spelled out in the contract.

My child was bitten by a neighbor’s dog. Do I have to prove that the dog was vicious or that it bit someone before?

No. New Jersey has strict liability for dog bites. This means that even if this is the first time the dog bit anyone, the owner is legally responsible.

I fell and injured my leg. I injured the same leg in the past. Am I still entitled to collect money damages for my injury?

You are entitled to collect money damages for an injury which was caused by someone else’s negligence. If your present complaints are solely the result of a prior injury and you had those complaints before the new accident, you cannot recover damages for those complaints. However, if the new accident aggravated or worsened your prior injury, you can recover to the extent the previous injury has worsened.

After my accident, my doctor told me that my x-rays showed a pre-existing degenerative condition in my back but I never felt any pain before the accident? Does this prevent me from receiving compensation for my injuries?

No. The person legally responsible for your injuries takes you as they find you which means that if you had a pre-existing condition that was not symptomatic and it becomes symptomatic as a result of an accident, you are entitled to recover for the injury and any aggravation of a pre-existing injury.

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