2013 Poll: Worst Insurance Companies to Handle Your New Mexico Car or Truck Accident Claim

Fred Loya Insurance, Young America Insurance, Nevada General Insurance, Allstate Insurance and Geico Insurance are the 5 worst insurance companies for your car, truck, motorcycle, bicycle or pedestrian personal injury claim.

By:  Mark Caruso, Personal Injury and Wrongful Death Attorney (Albuquerque, NM)

 

 

If you have a New Mexico personal injury claim against Fred Loya Insurance, Young America, Nevada General Insurance, Allstate Insurance or Geico Insurance, you may have a tough time dealing with the claims adjuster according to a recent 2013 informal poll of New Mexico attorneys.

 

These insurance companies and their claims adjusters rank the highest among all insurance companies in New Mexico in complaints to attorneys about the handling of car accident claims involving property damage and personal injury.

According to Albuquerque personal injury attorney Mark Caruso the poor attitudes of insurance claims adjusters employed by these four companies cause clients to contact Caruso Law Offices and other New Mexico personal injury law firms for help.

Clients are frustrated when the claims adjuster won’t pay for all the repairs to their car or give them a rental car. What irritates clients the most is when a claims adjuster challenges the client’s complaint of pain or injury or tells the client to just take a Tylenol and get some rest.

One reason why these four insurance companies may be so difficult to deal with is because the personal injury claims adjusters for these four insurance companies are based outside of New Mexico.

 

Fred Loya, which according to Mark Caruso is the worst of the bunch, is based in Texas and only recently began selling automobile insurance in New Mexico.  Their claims adjusters are Texans, and they just don’t have enough years of experience evaluating the dollar value of cases in New Mexico. Most personal injury attorneys will agree that cases are evaluated differently in Texas than in New Mexico.

There have been many instances where Mark Caruso has had to “educate” these out of state claims adjusters about New Mexico law and the valuation of injuries in New Mexico.

As a former insurance company attorney, Caruso has insight as to how these adjusters should evaluate cases and the process that they use in reaching a settlement value.

Under our state’s law New Mexicans are entitled to have their vehicle repaired to pre-accident status or be paid the market value of the vehicle if it is totaled. They are entitled to payment for the loss of use of their vehicle during its unavailability. New Mexicans are also entitled to money from the insurance company for medical expenses, pain and suffering, lost earnings and permanent injuries resulting from the collision.

Caruso advises people with property damage and personal injury claims against Fred Loya Insurance, Nevada General Insurance, Young America, Allstate Insurance and Geico Insurance to immediately contact a personal injury attorney for a free consultation.

 

Claims adjusters have no special duty to you to point you in the right direction. Instead, their job is to settle claims as cheaply as possible so that they may be rewarded in bonuses and a pat on the back by their claims supervisor.

 

A personal injury attorney such as the Caruso Law Offices will point you in the right direction, even if all you do is have a free consultation. A personal injury attorney’s loyalty is to you–no one else. Mark Caruso will give you a free consultation to discuss your claims against these five insurance companies and other insurance companies that might be causing you problems. He will also give you some additional insight that can’t be published in this public blog.

 

 

Call Mark Caruso at (505) 883-5000 for a telephone or in office appointment. We have 2 offices in Albuquerque to serve you–the Northeast Heights (Montgomery and Carlisle) or the Westside (I-40 at Coors). We handle cases statewide and make home visits, hospital visits and after hours appointments. Also, visit our main web site at www.carusolaw.com



- See more at: http://carusolaw.com/2013-poll-worst-insurance-companies-to-handle-your-new-mexico-car-accident-claim/#sthash.ImOYJaBh.dpuf

 

 

HB 1869 Health insurance liens and subrogation in Texas – new law takes effect Jan 1, 2014

Finally! A bill passes in Texas creating a law that actually helps people who have sustained a personal injury. This blog post helps explain what the new law means to people who have used their health insurance to cover medical bills due to a personal injury.

House Bill 1869 (HB 1869) was signed by Governor Rick Perry in late May 2013.  It is known as the Subrogation Reform Bill.  It places a limit on the amount a health insurer (such as Blue Cross Blue Shield, Aetna, Humana, etc.) can recover out of a personal injury settlement in Texas, however the new law does not affect all types of health insurance plans, only certain types.

Let’s begin by talking about health insurance subrogation and health insurance liens: what they are and how they work.  Let’s say Paul Plaintiff is rear-ended at a stop light by Dan Defendant, suffers a serious neck injury and four months after the accident Paul has neck surgery.  Paul has health insurance with United Healthcare (UHC) and Paul uses his health insurance to pay the medical bills.  The total amount UHC pays for Paul’s neck surgery and all of Paul’s treatment related to the car accident is $37,000.  Dan Defendant has automobile insurance with Progressive, and Progressive reviews Paul’s injury claim and offers Paul a $50,000 settlement which is Dan’s policy limit for bodily injury.  UHC has a $37,000 lien (or “subrogation interest”) against Paul’s $50,000 settlement from Progressive. In other words, UHC has the right to be reimbursed $37,000 from Paul’s $50,000 settlement. Here’s why…

Buried somewhere in Paul’s UHC health insurance contract (which is probably a very long document) there will be subrogation language.  This contract language will say, essentially, if the person covered under the health insurance contract is injured due to a third party’s negligence or intentional act, and the injured person is going to get a settlement from the third party’s insurance company, then the health insurance company is entitled to be paid back up to the amount it paid out for medical treatment due to the accident.  So in Paul’s case, UHC has a $37,000 lien against Paul’s $50,000 settlement, essentially leaving $13,000 to compensate Paul for having neck surgery.

If that doesn’t seem fair to you, and if you think: “It’s health insurance, that’s what it’s there for…UHC shouldn’t get most of Paul’s money!” then I agree with you.  Thankfully so do State Representative Four Price (R-Amarillo) and State Senator Robert Duncan (R-Lubbock) who championed the Subrogation Reform bill.

HB 1869, the Subrogation Reform bill, places a limit on the amount certain health insurance plans can claim as a lien against a third party settlement. It is important to remember that not all health insurance plans are covered by HB 1869.  HB 1869 will take effect as a new law on January 1, 2014 and will be codified as Chapter 140 of the Texas Civil Practice & Remedies Code.

What types of health insurance plans are NOT covered by HB 1869  Medicare plans, Medicaid plans, CHIPS, workers compensation plans, and self-funded ERISA plans. 

The types of health insurance plans that ARE subject to the limitations created by HB 1869 are ERS plans (state employee coverage), insured ERISA plans and every other health insurance plan and every non-ERISA self-funded plan that is sold or issued in Texas.

What is the limit on how much a health insurance plan covered under the new law can take from a settlement? If the Plaintiff (insured person) is represented by an attorney, then the most the plan can take is 1/3 of the insured person’s settlement.  If the Plaintiff is not represented by an attorney, then the most the health insurance plan can take is 50% of the settlement.

So under the new law, using Paul Plaintiff’s accident as an example, if UHC’s lien was being dealt with on or after Jan 1, 2014 when the new law takes effect, the most UHC could get from Paul’s settlement is 1/3 of $50,000 which would be $16,666.66 (assuming Paul is represented by an attorney) or 50% of $50,000 which would be $25,000 (if Paul is not represented by an attorney).  Either way under the new law Paul is better off than if UHC’s lien was being resolved under current law (where UHC could insist on getting $37,000 of Paul’s $50,000 settlement).

This covers the high points of HB 1869, but of course there is more to it than I can include in this blog post.  For example, there are aspects of HB 1869 that affects whether a health insurance plan can attach its lien to first party insurance coverage for an automobile accident, such as PIP (Personal Injury Protection), UM (Uninsured Motorist) and UIM (Underinsured Motorist).

If you have suffered a personal injury, either in Houston or somewhere else in Texas, and you would like to better understand your legal rights, contact me for a no-charge consultation.  I am Board Certified by the Texas Board of Legal Specialization in Personal Injury Trial Law and I have dedicated my legal career to representing injured Texans.

Visit my web site here

How Much Can I Get For Pain and Suffering After My Albuquerque Car Accident?

One of the most common questions I'm asked by clients is, "How much is my pain and suffering worth under New Mexico law?"

By:  Mark Caruso, Personal Injury and Wrongful Death Attorney (Albuquerque, NM)
 

My response is always that I quantify pain and suffering using the facts of each case. I have been an attorney for 31 years. During that time I have exclusively handled personal injury and wrongful death claims. I worked as an insurance company attorney for a part of that time. So, I will give you my own analysis.
 

The purpose of compensation for pain and suffering is to compensate you for what you have been thru because of the car or truck accident that caused your injuries.

 

This not only includes the physical pain, but also includes the psychological effects, the stress, the time at the physician's office, the effect on your lifestyle and hobbies, and basically how the accident has affected you as a person.
 

The amount of the medical bills does not always dictate the amount of pain and suffering.

 

Clearly, victims with broken ribs or bones have less medical bills but have much higher pain and suffering than soft tissue cases. Soft tissue cases usually have higher medical bills, because treatment is more intensive, while broken bones can usually be casted and left without alot of follow up care. Also, not much can be done to treat broken ribs.
 

Based on my experience of 31years of handling  personal injury  and  wrongful death cases, I believe that the pain and suffering for soft tissue cases are worth about 3 times the reasonable and necessary medical bills. In addition, there should be compensation for lost earnings, future medicals and permanent impairment. I believe that broken bone cases are worth about 7 times the medical bills.
 

 

Arbitrators in Albuquerque have been typically awarding 3 times the medical bills in court mandated arbitrations in Bernalillo County. Juries are much more inpradictable.

 

It is extremely important that injured patients communicate to their health care providers all of their pain and suffering and carefully describe how the injuries have affected them. If they don't communicate pain and suffering to their health care providers, they will have a much more difficult time getting 3 times the reasonable and necessary medical bills. 
 

Health care providers won't fabricate complaints and symptoms of pain and suffering, so if there are no complaints by the injured patient they will have nothing documented by the health care provider. Picture it this way. You need to give the doctor the ammunition for your gun. They need you to feed them the information so they can document your complaints. 
 

It is more difficult for men to communicate pain and suffering to their doctor.

 

The reason is that most men find it more difficult to complain about their pain. Men are macho, and it may be considered a sign of weakness to complain of pain. Nevertheless, men must report the pain to their doctor to get full value for their pain and suffering.
 

Insurance company adjusters and their attorneys, judges, arbitrators and jurors will carefully read the medical records written by the health care provider. If no pain and suffering is mentioned, don't expect a large amount of pain and suffering.

 

A personal diary of how the injuries have affected you is also helpful.

 

The diary can track specific instances an dates of pain and suffering. The diary should include names of people who witnessed the discomfort and the degree of discomfort. The diary can also be read by the decision maker in determining how the injuries affected your daily life.
 

Attorney Mark Caruso is a former insurance company attorney who now represents injured clients in their  personal injury  and  wrongful death  claims.   Caruso Law Offices  has two locations in Albuquerque to serve its clients--Northeast Heights and Westside. Mr. Caruso will also meet you at your home, work or hospital on weekends and after-hours.

For a FREE consultation you can contact  Mark Caruso  at the Northeast Heights Office (Montgomery & Carlisle) at 505-883-5000 or his Westside Office (Coors NW and I-40) at 505-369-1361.


Your consultation will be with  Mark Caruso,  not a legal assistant or paralegal. He will give you a confidential and honest evaluation of your claim, discuss medical treatment and explain  Caruso Law Offices'    discounted 29% contingency attorney fee  on all pesonal injury  and  wrongful death claims.

Medical Expenses Paid by NM Auto Insurance Company 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. 

Best NM Lawyers--AVVO Lawyer Ratin "9.6 SUPERB" Rating

Attorney Mark Caruso receives high marks and ratings from clients and other attorneys in handling of Albuquerque, NM personal injury and wrongful death claims.

   
Albuquerque personal injury attorney Mark Caruso has just been ranked by a prestigious attorney and lawyer rating ranking service as a  "9.6  SUPERB"  on AVVO Lawyer Ratings.   Mark Caruso ranks extremely high in the areas of Experience, Industry Recognition and Professional Conduct.  Mark Caruso has received numerous attorney and lawyer peer endorsements as well as the highest client ratings for his handling of personal injury claims. His attorney and lawyer peers have ranked Mark Caruso is one of the highest rated personal injury attorneys in the State of New Mexico.

 

     This AVVO lawyer rating of "9.6  SUPERB" makes Mark Caruso and Caruso Law Offices one of the highest and best AVVO rated personal injury attorneys and law firms in New Mexico. A perfect score is a 10.
     Thank you to the many clients, attorneys and lawyers who helped Caruso get this "9.6  superb" rating. The AVVO lawyer rating cannot be bought with paid advertising, but is earned from experience, industry recognigion, lawyer and attorney peer reviews, client reviews and professional conduct. It is considered the most verifiable attorney and lawyer  rating service available today.
     Avvo Lawyer Rating is guided by two basic principles:

1. Provide an unmatched level of transparency. Many of the online resources available today only show information about the lawyer who pays the most to be there. Avvo plays no favorites. We provide an unparalleled level of transparency that shines the same light on all licensed lawyers, enabling people who may know very little about law to make smart, informed decisions.

2. Provide more information and better guidance. We believe that access to easy to understand information about lawyers, coupled with guidance on how to use that information, is the best way to help people choose the right licensed professional. Information is empowering: the more people learn about their lawyers, the more comfortable and confident they'll feel seeking help. This benefits clients and great lawyers.

     Caruso Law Offices only handles personal injury cases.  As a former insurance company attorney, Mark Caruso and his staff us their experience to get the most money possible for their clients.  Because Mark Caruso knows the ins-and-outs of the insurance claims business, the claims adjusters' dirty tricks don't work on him.  Most cases settle out of court without a lawsuit, and Caruso is a strong believer in pre-litigation mediation and settlement conferences to get his cleints the most money possible.  However, Caruso and his staff are committed to take all cases to arbitration or trial if the amount the insurance company offers is unfair.

    Mark Caruso offers a free initial consultation with an attorney (not just a paralegal, like most other attorneys) to discuss your case.  You can expect confidentiality, honesty and great nuggets of legal help and information from this free initial consultation.
     Caruso Law Offices is located in Albuquerque, New Mexico and has two offices to serve its clients. Telephone is 505-883-5000  website is www.carusolaw.com and email is mark@carusolaw.com

Are medical bills from a car accident negotiable?

The answer to this question is: it depends on the bill. In my personal injury practice, negotiating medical bills is a significant part of getting clients' claims resolved. Some medical providers are willing to offer a discount to someone injured in an accident who does not have health insurance and is paying the bill out of an insurance settlement. Usually whether a discount is agreed to by the medical provider (or even necessary in the first place) depends on the amount of the settlement.

For example: if you have a $2,000 hospital bill and $3,000 in other bills for a total of $5,000, but your claim settles for $30,000 (e.g. because you were hit by a drunk driver on her third DWI charge), the hospital probably will not be inclined to give you a discount. From the hospital's perspective, you got enough money from the settlement to pay the hospital bill in full.

There are also cases at the other end of the spectrum: not much insurance proceeds and medical bills that far exceed the settlement amount. Usually hospitals are practical about these situations and will work with the injured person's attorney to agreed on a reduction of the hospital that allows the injured client to keep some compensation out of the settlement.

If you have been hurt in an accident and you're not sure how to handle your medical bills, give me a call, send me an email or submit your case online and I would be glad to give you a no charge consultation. 

Best and Highest Rated NM Lawyers- Million Dollar Advocates Forum, The Top Trial Lawyers in America

Million Dollar Advocates Forum admits Albuquerque, NM personal injury and wrongful death lawyer Mark Caruso to prestigious group of lawyers who have settled many million dollar claims against insurance companies.

In December 2012 Albuquerque personal injury attorney Mark Caruso was recently named a life member to the "Million Dollar Advocates Forum, The Top Trial Lawyers in America".

Established in 1993, the Million Dollar Advocates Forum  is one of the most prestigious groups of trial lawyers in the United States.  Membership is limited to attorneys who have won million and multi-million dollar verdicts and settlements. There are over 4000 members throughout the country. Fewer than 1% of U.S. lawyers are members.

 

The quality of attorney membership in the Million Dollar Advocates Forum is very impressive and includes many of the top trial lawyers in the country. Many of our members, including Mark Caruso,  have achieved numerous million and multi-million dollar results (several members have won billion dollar cases). Their practice areas include most areas of litigation, including: major personal injury, products liability, malpractice, construction, environmental, employment, insurance and business litigation. The common fact is that each attorney has demonstrated, in an objective and tangible way, their ability to accomplish superior results in complex cases. Certification by the Million Dollar Advocates Forum provides recognition of such accomplishment and a national network of experienced colleagues for information exchange, assistance and professional referral.

Mark Caruso and Caruso Law Offices are located in Albuquerque, New Mexico.  The firm exclusively handles personal injury cases, and it offers two Albuquerque locations for its clients.  Telephone is 505-883-5000  website is www.carusolaw.com  and email is mark@carusolaw.com

Albuquerque Personal Injury Attorney Mark Caruso

Lawyer Mark Caruso

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Albuquerque Personal Injury Attorney Mark Caruso, Highly Rated Albuquerque Personal Injury Attorney

Lawyer Mark Caruso

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