Grand Rapids Personal Injury Lawyer

Uninsured and Underinsured Motorist Coverages: The best money you'll ever spend

Timothy Smith — Mon, 28 Sep 2009 17:54:23 GMT

Everyone knows that no matter where you live, you are required by law to have car insurance. Michigan is no exception to this. Also, Michigan is a no-fault auto insurance state. In Michigan, your no-fault insurance pays all your medical bills in the event that you are injured in an auto accident. So, if you have the minimum required no-fault insurance you have all the insurance you need, right?

Actually, wrong, for a number of reasons. Basic no-fault insurance doesn’t pay to have your car repaired. Nor does it pay if your car is stolen. To cover those costs you will need collision and comprehensive insurance. But beyond those situations you should seriously think about getting uninsured/underinsured motorist coverage (UM/UIM).

Here are some reasons why:

While no-fault insurance covers your medical costs and lost wages without regard to who is at fault, there are some situations in which personal injury claims against the at fault driver are allowed. Suits are permitted in accidents in which there have been a death or severe bodily injury or permanent disfigurement. Essentially, in these cases, the injured party will be allowed to sue to recover pain and suffering damages from the person at fault.

This is fine, as far as it goes, but what happens in the event that the at fault driver is either uninsured, or has insurance with very minimal coverage? The answer is that the injured party gets little or no recovery. UM/UIM insurance bridges any gap between what an injured party is entitled to and the limits of the at fault party’s insurance coverage.

Assume that you are severely injured in an auto accident. Assume further, that a jury finds you are entitled to $100,000 of compensation for pain and suffering. If the driver has only $20,000 in coverage [the minimum required here in Michigan], you will lose any amounts above that figure. If you had $100,000 or more worth of UM/UIM insurance, you would receive the entire sum awarded to you by the jury.

Essentially, underinsured and uninsured motorist coverages are the only coverages that cover you for bodily injury if you are injured, maimed or killed by another driver's negligence. You may have purchased an expensive policy with $500,000 limits on bodily injury, but, that is the money that your company pays to someone that YOU hurt when YOU cause an accident. It doesn't help you one bit when someone runs a stop sign and injures you.

The only way to be fully protected in case of an accident is to purchase and maintain underinsured and uninsured motorist coverage. Check with your agent right now to make sure that you have the coverage in place to protect you and your family.

Originally posted at InjuryBoard by Timothy Smith

A rare win for car crash victims in the Court of appeals

Timothy Smith — Fri, 18 Sep 2009 07:22:31 GMT

Since the Kreiner decision came out of Michigan's Supreme Court, citizens injured through no fault of their own have faced an uphill battle to receive any compensation for their pain and suffering. Michigan's Supreme Court, who at the time was dominated by a majority of conservatives [all of whom received significant campaign contributions from the auto insurance industry], made it nearly impossible for any auto accident victim in Michigan to prevail against the negligent driver that crippled them.

But, we seem to see a swing back towards common sense when it comes to Michigan car accident law. The recent Court of Appeals case of Craiger v. Oakley is a perfect example.

In Craiger, the Plaintiff went to the hospital after being involved in a car accident caused by defendant Oakley. Oakley was driving a van owned by his employer, Port Huron Auto Glass. After suffering pain throughout his body, plaintiff’s doctor performed an MRI which revealed a meniscal tear. Plaintiff then underwent surgery but his knee continued to hyper extend [flex to far forward], leading the doctor to perform knee replacement surgery.

Plaintiff first filed a suit seeking first-party benefits such as payment of medical bills and lost wages from Farmers Insurance and also pain and suffering damages from the defendants. The trial court granted Defendants’ motion for summary disposition after they argued that plaintiff’s knee problems were not related to the car accident. The trial court generally found that the plaintiff did not show he suffered a threshold injury. In Michigan, an injured person must not only show that the other driver was at fault, but that they were in fact injured AND that the injury was so severe, that it altered their life in a significant fashion.

The Court of Appeals held that the trial court erred in granting the defendants’ motion for summary disposition. They found that the Plaintiff did present a question of fact concerning the issue that his knee problems resulted from the car accident. Furthermore, the Court of Appeals agreed that the plaintiff did meet the threshold injury by showing he suffered an impairment of an important body function and that it was objectively manifested. They did agree that the trial court correctly noted that the plaintiff ended his career as a commercial painter due to financial reasons; however, the Court of Appeals said that painting was still plaintiff’s trade and now he lost the option of going back to that trade in better economic times. The Appeals Court described why they felt this injury was serious enough for the plaintiff:

The trial court erred when it found that, even if plaintiff demonstrated that his knee injury was caused or exacerbated by the accident, plaintiff could not meet the test of establishing a threshold injury. Plaintiff showed that he suffered an impairment of an important body function and that this impairment was objectively manifested. Plaintiff has further demonstrated that his general ability to conduct the course of his life has been affected.

Plaintiff suffered pain for a year after the accident, was forced to undergo major reconstructive surgery, and had great difficulty walking for seven weeks following the surgery. He underwent physical therapy from the surgery until October of 2006. Thus, the “nature and extent of the impairment” and “the type and length of treatment required” factors involved in this case support plaintiff’s position that he suffered a threshold injury. Plaintiff suffers continued, and presumably permanent, residual effects. Although plaintiff’s level of pain has apparently diminished since the knee replacement surgery, he still reports discomfort that occurs five or six times each day.

The trial court correctly noted that plaintiff had ended his career as a commercial painter due to financial reasons, however, painting was still plaintiff’s trade and he has now lost the option of returning to that trade in better economic times. One of plaintiff’s physicians stated that plaintiff was employable in a career that involved “no repetitive bending or prolonged standing.” This restriction would prevent plaintiff from returning to work as a painter. Furthermore, plaintiff formerly enjoyed woodworking, including restoring cabinetry, and had been offered a contract to restore the cabinets in a house, but could not do so because of the accident. He claimed that he could no longer participate in this activity because he could not walk up and down to varnish pieces of wood.

Plaintiff’s injury caused him to have to make a decision between a lifetime of knee hyper extensions resulting in “sharp screaming pain” and having his knee joint replaced with synthetic parts. While the knee replacement has led to some improvement in his ability to function, plaintiff is still missing a portion of his body that he will never retrieve. Plaintiff must forever depend on an artificial joint for his mobility and continues to suffer from chronic pain in his knee which will prevent him from returning to work in his previous occupation and prevents him from enjoying his woodworking hobby.

Although the length of time a plaintiff is off work following a car accident seems to be a yardstick for our state courts, this decision still comes to the correct conclusion. You may recall prior posts of mine that describe victims of auto accidents who were left with permanent limps and disfigurement, yet their cases were thrown out of court for not being "serious enough". But here, the Court of Appeals got it right. They reversed the decision of the trial court and sent the plaintiff back to have his day in court.

Originally posted at InjuryBoard by Timothy Smith

Slip and Falls and the "Open and Obvious" Defense

Timothy Smith — Thu, 17 Sep 2009 17:12:29 GMT

Over the last few years Michigan courts have gone out of their way to throw plaintiffs out of court. Even "Black Ice" which by its very nature can't be seen, was looked at as "Open and Obvious" which allowed a court to dismiss valid claims against business owners who failed to keep their premise safe for those that were invited to shop in their store. A recent decision seems to swing the state's jurisprudence in favor of the injured once again.

In the matter of Janson v. Sajewski Funeral Home, Inc, Plaintiff Janson slipped on black ice and fractured his right ankle. Defendant Sajewski claimed that because of the cold conditions and light precipitation that this black ice was "open and obvious" thus relieving the defendant of liability under a negligence theory.

Under a negligence cause of action:

a plaintiff must prove: (1) the defendant owed a duty to the plaintiff, (2) the defendant breached that duty, (3) the defendant’s breach caused the plaintiff’s injuries, and (4) the plaintiff suffered damages.”

If a dangerous condition is open and obvious then there can be no duty owed by the defendant because it would be reasonable that a person would simply avoid it. This is a common defense for many business owners.

The court here rules however, that most people in Michigan know that ice can persist even when it is not visually apparent. The defendant's operator in the Jason case even testified that it seemed slippery where Janson fell even though he had salted the parking lot earlier. Additionally, there was no snow in the area and the roads had already been salted by a truck. Therefore, "in the absence of some other, visible indicia of an otherwise-invisible hazard, black ice per se simply cannot be “open and obvious.” The court reversed the initial ruling that the open and obvious doctrine applied. For those injured this was an important battle that fortunately looks to be a return to a common sense approach to the law by our Court of Appeals.

Originally posted at InjuryBoard by Timothy Smith

Conceptualizing Brain Injury as a Chronic Disease

Timothy Smith — Thu, 17 Sep 2009 17:05:49 GMT

“Man is not a rational animal, he is a rationalizing animal.”---Robert A. Heinlein

As a species we naturally try to find patterns out of chaos. From the Biblical story of Adam’s attempts to name all the animals, to Plato’s ideal Forms, to the classification systems of modern biology and botany, one of the ways we attempt to control our surroundings is by classifying them. The upside to this of course has been the tremendous scientific progress of the past five centuries, made possible in large measure by the regularization of knowledge.

A downside to it is that often, when we encounter something new we attempt to fit it into existing categories. Or, when we learn something new about an existing idea, many of us prefer to leave it in its assigned category. Sometimes this leads to bitter quarrels; we begin to fight over the borders of categories while ignoring the new knowledge itself. Some examples of this sort of ludicrous controversy include arguments over whether Pluto is or is not a planet or disagreements over how to classify the platypus. In any event, there seems to be something reflexively contrary in human nature which leads us to resist any effort to move things from one conceptual pigeonhole to another.

One of the modern day bugbears concerns medicine. Namely, what constitutes a disease or sickness? Are the flu, cancer, and tuberculosis diseases? Almost everyone would agree that they are. How about alcoholism, depression, and attention-deficit-disorder? It is not difficult to find folks who do not believe that any of this last list are diseases. Much of the debate is merely semantic; is a condition acute or chronic? However, those semantics can have consequences. Much care of long-term disability has been pigeonholed as mere rehabilitation. This has led to decreases in research funding for many areas.

One of the more important medical areas that has lagged due to this sort of pigeonholing is the long-term care of traumatic brain injuries (TBI). Lay people tend to see brain injuries as an event rather than a process. Moreover, many assume that those with traumatic brain injuries either die almost immediately or recover. In reality, this condition can persist for years, with only gradual if any improvement. As trauma medicine advances, injuries that would have been fatal even a few years ago are now survivable. This trend will accelerate, and as it does we are likely to see increasing numbers of patients coping with significant long-term brain injuries.

It is with these facts in mind that the Brain Injury Association of America (BIAA) is attempting to change the way we think about traumatic brain injuries. Long-term brain injuries carry with them whole hosts of effects which carry over into every area of human health and have been little researched.

It is the position of the BIAA that only by ‘rebranding’ brain injuries can we escape the mental categories in which we have placed traumatic brain injuries. If this is so, and we can begin thinking of these injuries as something that we may someday be able to fix, then we can redirect our research efforts toward helping the millions of Americans living with TBI.

A very interesting approach, indeed.

Originally posted at InjuryBoard by Timothy Smith

A Guide to Selecting Legal Representation for Brain Injury Cases

Timothy Smith — Thu, 17 Sep 2009 16:55:34 GMT

With any injury resulting from the negligence of another person or company, victims may seek restitution for the damage caused. In many cases injuries are relatively minor, pain and suffering is short-term, and recovery is reasonably quick. In these cases, some of which are for relatively low stakes, it is important to select an experienced and skillful attorney. It only gets more important as the injuries become more severe and the chances of full recovery grow slimmer. Perhaps the most severe of the many long-term injuries is a traumatic brain injury, with its attendant need for medical, rehabilitation, and other health services not just for a few months or even years, but potentially for a lifetime. It was with these concerns in mind that the Brain Injury Association of America (BIAA) formed in 1980. The BIAA serves as a clearinghouse for information and support for the millions of Americans living with a traumatic brain injury.

Lay people sometimes have a tendency to see lawyers as a sort of multi-function tool. As though any lawyer has the training and skill to perform any needed task. In fact, the legal world is highly specialized, and just as one would not go to a dermatologist for open heart surgery, one should seek appropriate counsel for specialized legal tasks. Traumatic brain injuries often call for an attorney with a specialized legal skill-set. Some clients who have survived a brain injury need an attorney family law, estate planning, or even criminal law experience. With an eye toward these concerns, the BIAA has presented a brief guide to selecting appropriate counsel for brain injury survivors.

The questions suggested by the Brain Injury Association of America are excellent. these are questions that you or your family should be asking of your potential lawyer. Here is how my firm would answer these questions:

Who else in your practice would you involve in my case? What role(s) would these people have? Describe their background and expertise. On each case, depending upon your situation, you might have as many as 5 different attorneys working on your case - together- as a team. My background includes 17 years representing individuals with brain injuries. I also sit on the Board of Directors of the Brain Injury Association of Michigan. Other attorneys would include Page Graves - former professor of Michigan Auto No-Fault Law at the Detroit College of Law in Lansing; Brad Wierda - a 12 year veteran in the insurance defense industry who is now handling plaintiffs cases through my office; James Baker - a No-Fault specialist with this office; Robert Whims - a seasoned trial attorney with over 300 trials under his belt including a number of multi-million dollar verdicts; and Andrew Shotwell - our probate specialist when we have issues involving Guardianships and Conservatorships for our clients. There will also be 4 legal assistants and a paralegal assigned to your claim.
Who will be my primary contact with your practice? I am always the primary contact and you will be able to contact me by phone or email 24/7
Are you or your law firm able and willing to advance as much as $50,000 in the investigation, preparation and presentation of my case? The proper handling and workup of any claim involving a closed head injury is a very expensive undertaking. We only retain and work with the most skilled experts in the areas of neuropsychology, vocational assessments, economic valuations and other areas of expertise. This requires 10's of thousands of dollars. At Smith and Johnson, we have funded cases to the tune of over $100,000.00 to get the client the correct result. The proper funding of your lawsuit by this firm will not be a problem.

How much of your practice is devoted to personal injury? The great majority of my practice is devoted to personal injury. I handle some other litigation issues from time to time, but the main focus of my practice is personal injury.
Of your personal injury cases, how many are devoted to brain injury? I would estimate that approximately 25% of my current files involve a brain injury.
What results have you achieved? The attorneys here have excellent success in trying cases throughout Michigan including a record verdict in one Northern Michigan county. I was recently recognized by the ATLA as one of the top 100 Trial Attorneys in Michigan. I was listed as an "A-List" attorney by Traverse the Magazine. I received the highest rating [AV] one can receive from Martindale-Hubbell as a 34 year old. I was listed as a "Michigan Super Lawyer" by Super Lawyer magazine which only lists the top 5% in each state.
What have you worked on in the past six months? The last 6 months have included presenting a national webinar on "Endocrine System Dysfunction following TBI" to practicing attorneys throughout the country as well as reviewing and litigating TBI cases throughout Michigan.
What special training or education do you have specific to brain injury or benefits that people can get after brain injury. I can't point to any specific training per se other than representing individuals with closed head injuries and staying up to date on the medical literature by reading medical texts and journals. I do regularly provide training and education to other attorneys on how to properly handle cases involving a closed head injury. I am a frequent speaker through both the Michigan Trial Lawyers Association and trialsmith.com.
What is your involvement with legal associations, local, state or national brain injury associations or other organizations? I sit on the Board of Directors to the Brain Injury Association of Michigan. I'm a member of the Traumatic Brain Injury Litigation Section of the Association of Trial Lawyers of America. I sit on the legal advisory counsel to the Sara Jane Brain Foundation.
How do you stay up to date with personal injury law and brain injury issues? Through regular reviews and reading of new medical journals as well as active participation with the top brain injury attorneys in the country through the Traumatic Brain Injury Litigation Group
How did you first become involved in brain injury cases? In 1993 I was hired by an individual to represent him in a case involving a traumatic brain injury. I have been a passionate advocate for the survivors ever since.

Many of the issues in a matter involving a traumatic brain injury are similar to those in any other personal injury or wrongful death: seeking legal help immediately following an injury, identifying the correct defendant, and protecting your funds following any judgment. The BIAA piece provides brief advice on all these issues and also contains links to a directory of service providers dedicated to the three million Americans living with a traumatic brain injury. However, the seriousness of the injury and the fact that a plaintiff may only have one chance at recovery mean extra care should be taken during the selection process. In the wake of any severe injury, talking to a lawyer may be the last thing on your mind. Thinking about these issues before you are forced to deal with them may make things easier should you or your family ever be involved in a serious accident.

Originally posted at InjuryBoard by Timothy Smith

Great New York Times Article Regarding the Power of the Brain to Heal Itself

Timothy Smith — Tue, 11 Aug 2009 16:24:56 GMT

The Science of Identity

For all that scientists have studied it, the brain remains the most complex and mysterious human organ — and, now, the focus of billions of dollars’ worth of research to penetrate its secrets.

This article from the New York Times takes an interesting look at an age old question. Some philosophers refered to it as the "Mind-Body conundrum". The problem, at it's most simple level is, "how can some thing tangible, organic and objective [the brain] produce something intangible, inorganic and subjective [the mind]?".

This article probes this issue from a different angle as it asks, "How and where does our sense of 'self' come from"?

A small group of brain scientists is now investigating misidentification syndromes, as the delusions are called, for clues to one of the most confounding problems in brain science: identity. How and where does the brain maintain the “self”?

What researchers are finding is that there is no single “identity spot” in the brain. Instead, the brain uses several different neural regions, working closely together, to sustain and update the identities of self and others. Learning what makes identity, researchers say, will help doctors understand how some people preserve their identities in the face of creeping dementia, and how others, battling injuries like Adam’s, are sometimes able to reconstitute one.

Ultimately, what researchers are looking into, specifically in the field of neuro-biology, is an understanding of what it means to be human. Recently, researchers have begun utilizing very advanced neuro-imaging of the brain as it processes information related to personal identity. What they have noticed is that certain areas of the brain are particularly active during these process, in particular, the cortical midline structures - the areas which "run like an apple core from the frontal lobes near the forehead through the center of the brain".

What this tells us is that when we have injury to these frontal lobes [which is very common in auto accidents], often times, our ability to be aware of not only "who" we are but "who" the people around are, is diminished.

Ultimately, damage to this frontal lobe area affects our ability to not only understand who we are, but what is an is not appropriate, from a behavioral standpoint, as we related to the world around us.

Most importantly, what experts are discovering is that the brain is "plastic" and it can heal itself. But, how exactly does it do this?

Essentially, the damaged sections of the brain can re-route electronic signals around the damaged parts to achieve the same result. But, scientists and researchers are telling us that for the brain to learn how to re-route these signals, to circumvent the damaged sections of our brain, we need to be actively engaging TBI survivors through communication, problem solving and helping them meet different social expectations.

For people recovering from a severe brain injury, several recent experiments suggest that there is some promise in hitting it hard with what it has lost, contact with its familiar, social environment. In one 2005 brain imaging study, neuroscientists in New York found that the sound of a loved one’s voice activated widely distributed circuits in the brains of two severely brain-injured patients who were only occasionally able to respond to commands. Last year, a team of Spanish neuroscientists duplicated the finding.

For those InjuryBoard readers that are dealing with this issue, click through to the NY Times article here. It's definitely worth the read.

Originally posted at InjuryBoard by Timothy Smith

PDA 4 Memory Project Using Technology to Assist Brain Injury Survivrs

Timothy Smith — Fri, 07 Aug 2009 16:02:53 GMT

I recieved a nice email from Michelle Wild this week. Michelle is a professor at Coastline Community College in California. For the last 22 years she has been a professor at Coastline's Acquired Brain Injury Program and was recently nominated for the U.S. Professor of the year because of her work at CCC.

Michelle was kind enough to fill me in on a new program at Coastal involving the use of smartphones and PDA's to assist the brain injured as memory or cognitive prosthetic devices. The proper use of these tech devices help the survivor make the cognitive connection to overcome acquired deficits in:

Professor Wild reports that:

Unlike a typical memory workbook or PDA manual, which many users find frustrating and technical, our training material is much more than a reference source; it is consciously structured to be a learning tool for adults with ABI.

This program of study provides a broad range of benefits. It benefits those living with a brain injury by presenting information in easy to follow steps, by offering training videos that can be watched, paused and reviewed whenever necessary, by focusing on day-to-day activities where you would use your smartphone/PDA to compensate for memory deficiencies, by integrating review and reference of cognitive skills throughout the learning process and by basing the program design on feedback from individuals living with brain injuries.

The program benefits Professionals by providing them with a structured curriculum that can be used during therapy sessions, by complimenting exisiting cognitive therapy, by integrating cognitive remediation strategies while teaching how to use a PDA/Smartphone, and by providing structured homework assignments which include training videos.

For caregivers, the benfits are invaluable. The program will teach them about cognitive skills impacted by the injury and will explain how a memory prosthetic device can help. In turn, the use of the PDA/Smartphone by the injured party will free up the caregiver's time as it promotes autonomy, follow through on appointments and tasks, and increases the self-esteem of the injured person.

Some quotes from attendees to this program:

"My husband has a brain injury and he has both short-term and long-term memory problems. The Pharos device has helped him immensely with reminders of appointments. I also have the Pharos device and it has become very helpful in my keeping appointment schedules."

"First off, WOW! Tons of good stuff here by way of the level of detail, organization, comprehensiveness of the skills training across both the workbook and video clips."

"Improving my life organization and decreasing piles and piles of paper was my goal. I found my solution with this hands-on, easy-to-follow PDA training."

"The Pocket PC has been a transformative tool in my life. It has strengthened my ability to be independent, efficient, and productive. It has given me hope and a concrete vehicle with which to create a new fulfilling and fruitful future for myself."

My review of the course leads me to believe this is a great tool for individuals with brain injuries, doctors and therapists who treat these folks and their familial caregivers that are helping them 24/7.

Originally posted at InjuryBoard by Timothy Smith

Free Center for Disease Control Tool Kit on Concussion for High School Coaches

Timothy Smith — Wed, 05 Aug 2009 18:00:12 GMT

My oldest daughter plays tennis on the local high school tennis team. Although, her chances of getting concussed while trading baseline shots with an opponent is pretty low, there are other sports in high school where the chances of "getting your bell rung" are pretty high.

It is critical that the coaches who are supervising our children during these extracurricular activities have an understanding of concussions and what to do when a student/athlete suffers one.

I've already sent this link to area coaches, but I'm hoping that readers of this column take the time to forward this link to their area schools to make sure that our children's coaches can identify the problem and take steps to make sure that our children enjoy a fun filled and safe athletic experience while in school.

If you have children that are playing sports, have them and the rest of the family watch this video because if the trainers and coaches don't recognize the problem, maybe the family will.

http://www.youtube.com/watch?v=yIqZDbk3M40

Originally posted at InjuryBoard by Timothy Smith

Cognitive Rehabilitation Services for our Wounded Veterans.

Timothy Smith — Wed, 05 Aug 2009 15:57:25 GMT

I'm pleased to see that the invisible injuries suffered by our veterans as a result of concussive injuries sustained during their duty are starting to be recognized as a serious medical situation requiring the attention of our government. Statistically speaking, proper care of this disease [traumatic brain injury] can cost 10's of thousands of dollars, sometimes even hundreds of thousands of dollars.

To provide our returning veterans with these therapy services under TRICARE is an important step to their recovery and hopeful return as a productive member of our society. Without these benefits, families of wounded veterans will be helpless to cure or accommodate the disease of acquired brain injury.

Here is a brief press release from the National Brain Injury Association:

FY10 National Defense Authorization Act (S. 1390)

On Thursday, July 23, 2009, the Senate passed its version of the FY10 National Defense Authorization Act. During debate, Senator John McCain for Senator Graham offered an amendment that authorizes the Secretary of Defense to carry out a pilot program for providing cognitive rehabilitation therapy services under TRICARE. Both BIAA and the Wounded Warrior Project have worked tirelessly to advocate for the inclusion of this amendment. To view the amendment, click on the link below:

http://www.biausa.org/elements/policy/2009/ndaa_cognitive%20_rehabilitation_amendment_2009.pdf

The amendment requires the Department of Defense to consult the Department of Veterans Affairs, The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury and relevant national organizations with experience in treating traumatic brain injury. It also requires the Secretary of Defense to submit a report to congress evaluating the effectiveness of the program and making recommendations of the appropriateness of including cognitive rehabilitation as a benefit under the TRICARE program.

In response to the adoption by unanimous consent of this amendment into S. 1390, a representative from the Congressional Budget Office reached out to BIAA to ask advice regarding the cost and duration of cognitive rehabilitation therapy in order to formulate a cost estimate for the pilot program. BIAA authored the following comments in response:

http://www.biausa.org/elements/policy/2009/cbo_request_july_09_cog_rehab.pdf

Currently, the Senate is gearing up for a conference with the House to agree on final language. The informal process began this week even though house conferees have yet to be named. With hope that finalization will happen in early September, be on the lookout for BIAA action alerts to urge congress to retain this important amendment as part of the final package.

In conclusion, BIAA is thrilled to have the opportunity to work on this important inclusion in S. 1390 and believes that this is a much needed step forward in providing access to brain injury care for returning service members.

I hope that by December, I will be urging each and everyone of my InjuryBoard readers to contact your representatives once this important package comes to a final vote. Proper medical and therapeutic care is the least we can do for our men and women who put their lives on the line for this great country of ours.

Originally posted at InjuryBoard by Timothy Smith

Wrongfully Denied Insurance Claims

Timothy Smith — Tue, 04 Aug 2009 09:37:07 GMT

My readers may not know this, but Michigan is one of only four states that doesn't protect its consumers from some of the most underhanded practices in the home, auto and health care insurance industries - wrongful denial of benefits.

Wrongful denial consists of an intentional business plan by these companies that delay or deny legitimate property, auto or health care claims at the expense of the consumer. By not honoring their contractual duty to be there for consumers in their time of need, insurance companies boost their profits, forcing Michigan families into bankruptcy and even foreclosure just to care for the people they love.

The story of State Representative Mike Simpson is both heartbreaking in it's brutality and typical in that I see this type of behavior daily here in Michigan. Why? Because in Michigan, if an insurance company acts wrongfully in denying claims, the only punishment is a $500 fine....

Here is Representative Simpson's story:

State Rep. Mike Simpson: Representative Mike Simpson, and I don't just stand in front of you today as a legislator, I also stand in front of you as a victim. I applaud these individuals for coming forward to publicly talk about a crisis and a tragedy in their life is incredibly difficult, and it talks a lot of guts. And your story… is my story. In 1993, my daughter was diagnosed with lung cancer, and within nine months I buried my daughter. And, I remember, on December 11th, 1993, looking at the MRI report with the diagnosis with the doctor because it was my birthday. And the doctor told me that she had a 3% chance of living. I picked up the phone, I called my insurance company, they said Mr. Simpson, don't worry, we'll take care of you. Boy, did they take care of me. I soon found, that I was in the fight of my life not only trying to help my daughter fight off a disease that was most assuredly going to take her life, I was also fighting my insurance company because they didn't want to pay the bills. They're your best friend in the world when you make your premium payments, but when you have a claim you're the enemy. It's just wrong. That's why I ran for office the first time. I never wanted to see this happen to another family. These are not isolated circumstances, they happen hundreds of times all across this state every single day. And the people standing behind me, they put a human face on the reality of what we always kind of look the other way, it didn't happen to my family so we don't worry about it.

During that nine-month fight, I sold everything I owned. You'd sell your soul to save your child. But it wasn't enough, and ultimately it bankrupted my family, it crushed us. Our American dream had turned into an American nightmare, and after my daughter's death I found myself standing in front of a federal bankruptcy court judge, detailing how many pieces of clothing and toys my other two surviving children own, and could we please keep them or did we have to give them to the creditors too. It's time to put consumer back in consumer protection in the State of Michigan. It's that simple. You know if we enter a contract or make a promise we have to keep it. If we commit fraud and break the law, we go to jail. If the insurance company does it, they get a slap on the hands from the insurance commissioner and they got to pay 500 bucks. To most of these CEOs, that's a missed lunch or a golf date, that's it. For the main purpose of making sure their bottom line looks better, they destroy lives in a heartbeat and never look back. And this is only one of four places in this country that you can do that. Michigan, Massachusetts, Louisiana and Nebraska and that's it. We're the disgraceful part of the Final Four, and today the House Dems are saying no more.

The State House here in Michigan has drafted a series of bills that will protect consumers from this type of behavior by insurance companies here in Michigan.

The bills include laws that would:

* Strengthen consumer protections by punishing insurance companies that wrongfully deny consumer claims with penalties, including a $1 million fine.

* Punish corporate leaders who knowingly create, foster or encourage wrongful denial of claims by making the misconduct a felony that could result in four years in prison plus a $50,000 fine.

* Create a whistle-blower protection plan to shield employees who report that an insurance company is engaging in wrongful denial of claims.

In auto accident claims, the wrongful denial of valid medical claims is rampant. It has even prompted investigations by numerous media outlets here in Michigan.

http://www.youtube.com/watch?v=JJ5f3SH667Q&eurl=http%3A%2F%2Fwww%2Emichiganautolaw%2Ecom%2Fcaraccidents%2Fcarinsurancebasics%2Ephp&feature=player_embedded

If you believe that this type of behavior must be corrected, click here to sign a petition to learn more and show your support as a consumer here in Michigan for increased protection from these predatory practices by insurance. No more profits over people. It's time for a change.

Originally posted at InjuryBoard by Timothy Smith