Expert: Doctor Settlement - 6/15/2007

Question
My Wife and I were recently rear-ended.
I have a $2500 deductible on my PIP coverage.  However, I am pretty sure that I am covered by my regular health insurer up to that limit (with it's lower dedcutibles and co-pays).  However, I we will still incur some medical expenses -- we were both treated at the ER.  So far I am OK except for minor neck stiffness; my wife requires additional PT and testing for pain, numbness, etc.

I have selected the limited (Verbal) Lawsuit threshold on my policy.  I understand this limits my ability to recover non-economic damages (Pain and Suffering) except for serious injuries.  And the medical is considered no-fault in NJ (no personal responsibility?)
Can I still recover my actual damages (i.e. out-of-pocket) medical costs from the at-fault party?
And should I consider an attorney in case our injuries do become more serious?
Thank you!

Answer
Hi Michael,

It sounds like the injuries for both you and your wife will heal with treatment.  Thus, neither injury would qualify as satisfying your state's verbal threshold as follows: "A permanent injury within a reasonable degree of medical probability. An injury shall be considered permanent when the body part or organ, or both, has not healed to function normally and will not heal to function normally with further medical treatment. N.J.S.A. 39:6A-8."

As for deductible expenses, your choice in purchasing insurance will govern what amount you agree to assume.  Some policies have low deductible, while others, who have health insurance, opt for higher deductible levels.  Whatever you selected, you are stuck with.  Those so-called out of pocket expenses should be paid by your health insurer, or they will be borne by you.

If your wife's case becomes more serious, then you will want to speak with an attorney about it.  Your doctor's report must, in addition to the standard above, recite that there is objective evidence of the injury (i.e. x-rays or tests subject to verification, as opposed to subjective complaints of pain).

But those personal injury attorneys offer a free consultation, so I would suggest giving them a call with additional questions.  And in particular, if your wife's injuries continue to resist treatment, as some serious soft tissue injuries do, then it would be best to gather copies of her medical records and let an attorney see if he would like to present a claim for pain and suffering.

Best wishes,

Dr. Settlement, J.D. (Juris Doctor)
www.SettlementCentral.Com