Personal Injury Law (Accidents/Slip & Fall)/Foot Wedge and Fall at Home Goods
My personal injury is being handled by a Risk management and commercial insurance company for Home Goods. (Zurich North America). I am still being treated by an Orthopedic doctor and Occupational Therapist for a ligament sprain on my left hand. I have been out on full disability since October 20, 2015. As a therapeutic massage therapist I need full strength and range of motion in order to earn a living. I am 64 years old and plan to work another 3 years before retirement. My injury was sustained by a faulty recessed support structure underneath the shelving in their Wall Art department. My foot wedged under the ledge, I fell forward, and two of my fingers on my left hand hyperextended to break my fall; thus, torn ligaments. Had my fall not been broken, I would have a concussion since my face bounced off the edge of the shelf and hit the floor. Home Goods sent me to their Urgent Care after offering to call an ambulance. My friend is a witness. I also have photographs of the broken shelf supports that created the unsafe conditions. My question is do I need to go outside of Zurich North America who has a claim they are managing in order to collect pain and suffering? Do I start by representing myself with a demand letter? How do I find out who to address it to, should I go that route? The CEO? I am not retrainable at my age, and it appears that I may never be able to return to my profession. My reportable income is $40,000 per year plus $10,000 in cash gratuity (not reported) Thank you for your opinion. I am scared for my future.
This is a typical type of case that I have handled for about 38 years now. To give a complete answer I would have liked to know if you are employed at a massage therapy office or some type of clinic so that it would be easy to document your earnings and therefore, loss of earnings and earning capacity. I would also like to know the billed amount for your medical/therapy care for the wrist injury. For the purposes of this answer I will presume that your ambulance and ER costs were probably $3,000 +/-. I will further presume that you made a couple of trips to the ortho and see the OT twice or three times per week and that total costs for those services to date are maybe $4,000 +/-. I will further presume that by the time you reach maximum reccovery (called "permanent and stationary".......not getting better, not getting worse) your total special damages (billed charges) would be about $7-8,000 again +/-.
The first question is, will the store accept full liability for the accident or will they, as they are legally entitled to do, DENY LIABILITY and blame you for being careless and negligent and argue that 1000 people were in the same place within the past month and you are the only person to hurt themselves and that you were'nt paying attention to what you were doing. Even if that is a totally bogus argument, they can make it. Legally, they OWE YOU NOTING until they argee to settle with you or until you get a judgment in court against them.
Understand that whether it be Walmart, Home Depot or a store like this one, they get many many injury complaints by customers on a daily basis. Most of those claims are weak or bogus. The fact that they provided initial ambulance service means that you do take your case more seriously than almost all the other claims they get. They would like to settle the matter with you but I do not believe there is any chance at all that they will pay you tens of thousands for your loss of earnings. And you couldn't make a claim in good faith for 3x $50,000 based on no more than a sprain. Even if your doctor wrote a report saying you are permanently disabled, I guarantee you they would offer maybe $15 - 20,000 tops and if you don't like that, then your only option is to bring suit during which they will deny liability, have their own chosen ortho exam you and his report would say you are not permanently injured and that in any event, you have no case of negligence against the store............whatever the truth may be. That is how these things work.
As far as you dealing directly with the insurance company, you may do so if you chose. You write and speak to the ADJUSTER and the insurance company. The Risk Manager of the store would provide you with the contact information. They would give that to you once they see the claim cannot be settled "in house". This will happen when you tell the Risk Manager that you are going to be claiming more that just a few thousand.
Another point: If the accident happened in October, it is far too soon to discuss settlement. You have no way of knowing how long it will be until you reach the "permanent and stationary" condition and whether you still have any significant degree of disability at that time that would be considered permanent. You just don't know that yet and if you expect compensation for months or years of loss of earnings, you have no case for those damages until your orthopedist if willing to go on record saying you have a significant activity limiting and long lasting disability due to the accident. By the way if you have any history prior to the accident of carpal tunnel or anything else in that wrist, the calculus changes drastically and not in your favor. They will find this out.
So, if your wrist does get better and enough so that you can get back to work.......and I suggest you do that as soon as you feel able regardless of what your doctor say, you should do so. Reason is there is no guarantee and strong possibility that you will never recover all earnings you lose if you stay off work for several more months or longer. The claim would then be high enough that their insurance company would use their big legal teams to fight your case with the gloves off. So, if you can get back to work and would be satisfied with something less than $25,000, go ahead and try to settle it with the insurance company. A $25,000 settlement without legal costs is like a $38,000 settlement with an attorney.
But if you want anything more (this isn't exact science, just my very rough numbers), then you will have no chance of success without your own attorney that presents them with the threat of a lawsuit, which you do not present on your own. Also, a good personal injury lawyer knows how to best document your injuries, disability, and total damages and shares an interest with you in getting the highest possible result.
I could go on and on. Read this over. Provide me with more detailed information and questions you will have and I will be glad to offer more thoughts if you wish. You can contact me directly at firstname.lastname@example.org. P.S. The statute of limitations in CA is 2 years.