THE SAN ANTONIO NO-FAULT LAW BENEFITS

The limit for no-fault PIP benefits is $10,000 per individual for the loss sustained due to disease, sickness, or bodily injury ($5,000-death) that arise out of the possession, maintenance, or usage of a vehicle. You can consult a car wreck lawyer to verify this.

medicalpaymentscoverageMEDICAL PAYMENTS

Personal injury protection pays 80% of all medical benefits for every reasonable expense for necessary surgical, medical, dental, X-ray, as well as rehabilitative services, which includes prosthetic devices, crutches, wheelchairs, slings, splints and neck braces. Medically necessary nursing and hospital services, and ambulance are covered, and benefits are paid for essential remedial treatment as well as services permitted and recognized under the state laws for an injured individual who relies exclusively on spiritual means with the aid of prayer for healing purposes due to religious beliefs.

If you’ve been through an auto accident, bear in mind that if you have coverage for medical payments through your car insurance policy, the coverage for medical payments will be secondary to the PIP coverage. The additional medical expenses, the 20% not covered, and perhaps the deductibles will or will not be insured by the further medical payments coverage. This system depends on what particular policy you have agreed to.

BILLING REQUIREMENTS

Florida Statutes state that as regards any services or treatment, other than certain emergency and hospital services, the charges statement provided to the insurance company by the provider will perhaps not include. In addition, the injured party and the insurer are not obligated to pay, payments for services or treatment rendered over 35 days before the statement’s postmark date, except for past due amounts formerly billed at an appropriate time. And excluding that, if the provider presents the insurer with a treatment initiation notice within 21 days following the first treatment or examination of the claimant. The statement could include charges for services or treatment rendered up to but not over 75 days before the statement’s postmark date. The insured individual has a duty to give the provider the correct address and name of the PIP insurer. Failure to do so could cause delayed settlements to the provider.

At the initial service or treatment provided, you’ll be obligated to sign an acknowledgment and disclosure form affirming that the services were truly rendered. It is your duty and right to affirm that the services stated were rendered; that you weren’t asked to request services from the provider; that the provider clarified the services; and that if you inform the insurance company of a billing inaccuracy, you may be enabled to have a share of the savings of the insurers.

Bear in mind that you may be eligible for a certain percentage reduction in the amount funded by the insurer of the vehicle if you inform that insurer about a billing inaccuracy.

A Bird’s Eye View on Malpractice

A specialized but important offshoot of negligence practice is professional liability or malpractice. The idea behind professional liability is that those who have special training and expertise should exercise the degree of care in dealing with patients or clients commensurate with other members of the calling. For example, for the purpose of treating injuries a doctor is held to the standard of care of other doctors similarly situated rather than the standard of care of someone who has not been to medical school.

Medical Malpractice Cases Have Become Intense

It is no secret that malpractice litigation has mushroomed in recent decades. The willingness of injured people to sure professionals has provoked widespread controversy. Injured plaintiffs are no longer willing to sit back and endure careless mistakes to those to whom they entrust their lives and fortunes. Defendants and insurance companies claim that increased litigation drives up the cost of services and drives competent professionals out of the business.

Although these questions cannot be answered in this book, the prospective lawyer may want to consider the social policy considerations inherent in this debate. Rhetoric sometimes casts the question in terms of pro- or anti-lawyer sentiment, but this is not an accurate characterization, because lawyers represent partisans on both sides of the issue. The real questions involve how and when injure persons should be compensated for injuries and when they should bear the risk of loss themselves.

The largest segment of malpractice litigation involves doctors. It is not the case that doctors must always be correct, only that they must make reasonable judgments under the circumstances. Doctors are also required to inform patients of the potential risks of a particular proposed course of treatment. In medical malpractice, as well as other forms of professional liability, expert testimony is usually required to establish the elements of the plaintiff’s case.

In order to show what a reasonable doctor would have done, the plaintiff’s lawyer must introduce testimony from another doctor to that effect. Because of this requirement and the complexity and medical problems themselves, malpractice litigation can be an extremely complicated business. As with other areas of tort law, insurance is almost always present, and settlement of claims occurs far more often than jury trials.

Medical Malpractice and other Liability Cases

Although medical malpractice dominates the professional liability field, other professionals are increasingly subject to suits by their clients. Lawyers, accountants, ministers, teachers, and other professionals have successfully been sued for malpractice. Even in areas that have not traditionally been recognized as professions, individuals holding themselves out as possessing superior expertise have been held to the standards they profess.

Thus, a plumber may hold himself out of the public as knowing more about how to fix pipes than ordinary laymen. He cannot be heard to complain that he did as good a job as an ordinary person when his plumbing job is done poorly compared to the work of other plumbers. In this environment, everybody who possesses special knowledge or qualifications (and probably charges higher fees accordingly) should understand the professional standard to which they will be held under the law and should obtain insurance to protect against the risk of malpractice.