The term “slip and fall” refers to accidents in which a person injures himself by slipping, falling or tripping due to dangerous and hazardous conditions of the surroundings. Such slip and fall accidents can take place inside or outside a building. The indoor accidents are caused due to unsuitable conditions such as bad flooring, wet floors and dimly lighted steps or stairs whereas the outdoor accidents generally occur due to weather-related and other hidden hazards. For instance, a person can easily slip and fall in a parking lot because of an icy patch outside the door of his car and injure himself. Minor things such as a pothole on the road can also be the cause of slip and fall accidents. Slip and fall incidents are taken very seriously in New York. Victims of slip and fall accidents in this city have the right to file a case and hire lawyers for their injuries. Slip and fall lawyers in New York have a thriving practice due to a great demand for such legal services. They apply personal injury law in slip and fall cases. The main focus of New York slip and fall lawyers is premises liability as most slip and fall injuries are caused due to poorly maintained or designed premises.
Slip and fall accidents fall under the category of negligence law and deal with the concept of premises liability. Victims typically, file cases against property owners, as they are the ones who are responsible for the hazardous conditions of premises. It is the duty of property owners to ensure that the property is safe and that the buildings have no internal or external structural defects that would cause an accident.
New York slip and fall lawyers carry out aggressive personal injury lawsuits on behalf of their clients who have undergone serious injuries. The pivotal objective of slip and fall lawyers is to settle claims of their clients and obtain a justifiable compensation for them in a speedy and efficient manner. Most slip and fall lawyers in New York offer evening and weekend appointments to their clients as per their convenience. It is advisable to call for an appointment before trying to meet with a slip and fall lawyer as they have erratic schedules, having to split time between consulting and representations in the courts.
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Slip and fall accidents cause personal injury when somebody falls down on another’s property that is in a dangerous situation. Risky conditions that can cause trouble are snow, poor lighting, unexpected slits in floors or blocks on the ground. Personal injury slip and fall settlements can claim compensation for medical costs, pain and suffering as well as economic troubles.
Personal injury slip and fall settlements normally have scope outside the court. One can initially talk with the property owner regarding hazardous conditions that caused the injury. They can try to meet the sufferings of the injured one at a cost acceptable by both parties. Settlements to cover lost income due to the incapability to work and property damages are very supportive for the victim. Doctor’s visits, hospitalization and rehabilitation therapy are quite costly. Personal injury slip and fall settlements also reimburse medical bills. Records of injuries and other economic and non economic expenses are needed to claim a settlement.
One can pursue a claim against public or private property that causes personal injury due to negligence. If the property owner does not agree with the conditions, the help of expert attorneys handling personal injury slip and fall settlements becomes crucial. They assist in filing suits and claims, evaluate the damages and try to get maximum compensation. The service of a competent attorney protects the rights of victims injured by the ignorance of others.
Submit details about the personal injury if you have personal insurance policies that allow for medical claims. If the landowner has an insurance policy, the victim has the right to claim for compensation from that particular policy as well. Reviewing similar cases is useful in claiming adequate compensation. It gives an overall idea regarding procedures and the amount of compensation allocated for various personal injury slip and fall settlements.
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Claiming compensation out from an injury that is caused by a slip, trip or fall can be tricky. If you slip on a patch of water at work, do you hold your employers liable or the plumbing company who did not work properly on the plumbing system? If you slipped on a road or a pavement, do you sue the council or the private firm that maintains the road or pavement?
Thankfully, you do not have to answer that question; your solicitor can answer that for you. Then again, you are required to present time-sensitive evidence. If you slipped on that puddle of water, check with your officemates that they saw it before your injury. If you need help in the documentation, your solicitor might have his own set of investigators who can gather the evidence for you, and properly at that.
Yes, a simple slip can cause head injuries, back injuries, broken bones and even paralysis. However, compensation claims for injuries arising from slipping and falling is one of the most abused. In the beginning, the councils simply paid out to anyone making a claim (for slipping on a road or a pavement) because an investigation would have cost more. The tide has turned however, and there are already strict guidelines and a good set of laws in place. You will find that although you tripped over a broken pavement slab, you cannot file a claim if the crack’s lip does not reach the height requirement. And if you slipped on a slab that was broken only within the last 48 hours, the council will also not be held liable – they would not have known about the slab.
Thankfully though, the laws are kinder to those who have a genuine claim to file. These claims are often handled swiftly. Remember, though, that compensation claims for slips, trips and falls are only possible when the council or your employer has a proven liability. Do not expect a check in the mail if you tripped on your own shoelaces.
The rule of thumb then on claiming under “Slips, Trips and Falls” type of injury is that your slipping, tripping or falling was not your fault and you suffered from injuries that resulted in medical bills, loss of income, and pain.
In general, however, slips, trips and falls that were not your own fault could get you awarded for damages. These can include accidents that happened at work, or in public places, or in buildings, which were caused by uneven flooring or wet flooring. If you have any doubts on whether you are entitled to compensation or not, go and seek your solicitor’s advice.
Aside from work places and roads, other circumstances under which you may make a claim for slips and falls include (a) shops that do not keep their floors dry or free from any spillage, (b) sports centers that do not keep their floors dry and free of hazardous objects, and (c) other people’s homes that have not been kept safe.
A new Medicare law, effective July 1, 2009, requires liability insurers (which include carriers who write CGL policies, auto policies, homeowners’ policies and those defendants who are self-insured such as supermarkets) to determine and report whether a claimant is covered and is entitled to Medicare benefits. If the claimant received Medicare benefits Medicare is holding out both hands to make sure they get 100% reimbursement.
The growing Medicare shortfall in Washington has many politicians looking for ways to bridge the funding gap. As a result a new law, effective July 1, 2009, has been enacted which requires liability insurers (which include carriers who write CGL policies, auto policies, homeowners’ policies and those defendants who are self-insured such as supermarkets) to determine and report whether a claimant is covered and is entitled to Medicare benefits. If the claimant received Medicare benefits during their treatment for the injury, Medicare is holding out both hands to make sure they get 100% reimbursement, despite the comparative negligence of claimant.
This new law will pose new challenges for plaintiff’s attorney, the insurance carrier for the defendant and the mediator who is attempting to resolve the claim. If the attorney or insurance carrier does not comply, they risk being sued by the Government for reimbursement up to five years post-closure and monetary fines.
What is the new law?
On December 29, 2007, President George Bush signed into law the “Medicare Medical, and SCHIP Extension Act of 2007.” The new legislation amends the Medicare Secondary Payer Act (MSA) by establishing new reporting guidelines beginning July 1, 2009. Under the new rules, all liability insurers, and self-insurers will be required to determine whether any individual who files a claim against the insurer or any entity insured or covered by the insurer is entitled to Medicare benefits. If so, the insurer must provide Medicare with that individual’s identity and any other information that maybe required under the law. This information must be furnished to Medicare within the time specified by after the claim is resolved through settlement, judgment, award or other payment (regardless whether or not there has been an admission or determination of liability). If an insurer fails to notify Medicare in accordance with these guidelines, a civil penalty of $1,000 per day will be charged per claimant. The new legislation clearly indicates a shift in policy which will result in the federal government monitoring general liability claims more closely. The fines represent a new enforcement push by Medicare to hold attorneys and insurers liable.
What does it mean for Plaintiff’s Attorney?
Plaintiff’s attorney will begin to take a closer look at the case he or she accepts. The attorney should change the client intake form to ask very comprehensive health related questions, whether the client is entitled to Medicare, how long has he been on Medicare, which type of Medicare and whether the claimant has used Medicare to obtain treatment for his/her injuries. The client should be advised in detail about the new Medicare Recovery Act and that Medicare is looking for 100% reimbursement, not taking into account if there is any comparative negligence. The client should be told there is no hiding from Medicare because it will be notified upon a settlement or judgment and the lien may take months if not years to resolve.
Think twice before accepting a small personal injury case involving Medicare recipients where liability is disputed. A settlement amount will have to cover Medicare charges up to 100%, attorney fees and provide money for the plaintiff. If that type of recovery does not seem likely consider rejecting the case.
However, Baby Boomers are increasing and may be a good part of an attorney’s personal injury practice. It is estimated that in the next couple of years, approximately 25% of the Country’s population will consist of baby boomers who are Medicare recipients. If the claimant has undergone limited treatment using Medicare and needs additional treatment, consider advising the healthcare provider to bill plaintiff directly or consider finding a doctor who will take the treatment on a lien. This way a Medicare lien will be avoided or at least a very minimal lien incurred. If liability is undisputed, have the medical provider bill the insurance carrier directly.
What if the attorney has a case where Medicare has a substantial lien? If it is before July 1, 2009, consider settling the claim before that time. If you cannot, again advise the client of the new Medicare Recovery Act and the reporting requirements.
If there is a settlement and Medicare does not know about it and mistakenly pays for services it has a right to recover, it can go after the attorneys whose fees are paid out of the settlement. Also the Medicare recipient can lose his or her benefits. Lawyers could be exposed to malpractice claims for not handling a client’s benefits properly. Insurers can be liable for monetary fines for failure to report. If a plaintiff loses his Medicare benefits, the plaintiff may bring a legal malpractice claim against the attorney and a bad faith claim against the insurer for not making sure Medicare benefits were protected.
After July 1, 2009, makes sure the claim is settled for an amount that will cover the Medicare lien. It may be possible to comp the lien, but do not count on it. In making settlement demands, assume that you will pay Medicare 100% reimbursement in what is paid out. Make sure all charges refer to the injuries that your client sustained. Medicare will not be speedy to resolve these claims, so discuss with the client about holding the amount in a trust account until the CMS lien is resolved rather than disbursing the entire amount owed to plaintiff.
It is unknown whether plaintiff’s attorney will have to worry about set asides calculations for future medical care and submit them to Medicare for approval. Currently, there is no formal process of liability settlements for future medical care.
Finally, negotiations with the liability insurance carrier will become more difficult. They will demand information about your client, such as social security number, so that they can comply with the requirements and avoid fines. Also, even though Medicare may ignore the comparative negligence issues, Insurance adjusters will take the position that despite Medicare’s 100% reimbursement, it will not pay 100% of the medical bills. An insurance carrier will not want to increase the cost of a claim and stand firm on its position.
This new law will pose challenges for the plaintiff’s attorney who is attempting to resolve the claim. The key is to be aware of the Medicare Reimbursement ActComputer Technology Articles, and to prepare the parties prior to a settlement of the barriers that the Medicare Recovery Act may present.
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ABOUT THE AUTHOR
Elizabeth A. Moreno is a mediator and arbitrator and is a principal of Centurion Mediation, LLC which provides quality mediation for less than $300 per hour at a location convenient to the parties in the Los Angeles, California area. Ms. Moreno has mediated and arbitrated over 300 matters. She is serving a three year appointed term with the State Bar of California ADR Committee. Ms. Moreno practices in the following areas Insurance, Personal injury, Employment, Business Disputes, Real Estate, Malpractice, and Residential Construction Defect.
