Tag: insurance

Brain injury from a fall or accident causing personal injury

Posted by Daniels Law on

A blow to the head is a serious matter.

It could be a car accident, or maybe a trip / slip / stumble and fall.

The human skull does a pretty good job of protecting the human brain.

But it doesn’t protect perfectly.

So we see people with brain injuries of all kinds. The obvious injuries are where the skull is broken, when you can see brain tissue through an open wound, which is pretty good evidence that the brain is injured.

What many people do not know: Sometimes people suffer a brain injury even with the skull intact.

Many of these are so-called “acceleration injuries.” This means that a blow suddenly pushes the head in one direction, and when the head stops moving, the brain tissue inside does not.

This can cause all sorts of problems, one of which is what doctors call “axonal shearing,” which happens when tiny brain structures are damaged by the sudden acceleration / deceleration of the human head.

In the last fifteen years, doctors have learned a lot about brain injuries because our soldiers have suffered combat wounds abroad. Explosive explosions regularly cause acceleration injuries that were previously seen only in places where a person was hit by a solid object or in a car accident. For people suffering from traumatic brain injury, improving medical knowledge is a good thing. But we still have a long way to go, because traumatic brain injuries are very often a hidden injury. While people understand obvious injuries, such as the sight of a cast over a broken leg, people can be skeptical about injuries they cannot see.

So it’s incredibly important to recognize a traumatic brain injury, whether it’s your own injury or someone you love.

First steps.

Often, a person with a traumatic brain injury won’t recognize they are injured. In fact, it is usually the people around the injured person who first notice that “something is not quite right.”

My friend Tom Dempsey has developed a questionnaire for the examination of suspected brain injuries that we use in our law firm. The first page of the form is for the person with suspected brain injuries, the second two pages are for family and friends to fill in. With the information from this form, a doctor or lawyer will have a better idea of what questions to ask and what steps to take to confirm or exclude the suspicion of traumatic brain injury.

Testing.

If there is good reason to believe that a person is suffering from a traumatic brain injury, medical providers must evaluate the patient and conduct proper tests.

The best minimum application is for the patient to see a neurologist for an examination. If necessary, there are other specialists who can be helpful, such as neuropsychologists or neuropsychiatrists. A neuroradiologist can carry out various studies to help treating doctors locate problems.

While an emergency room X-ray or CT scan may look normal, other more specialized tests such as an MRI, PET scan, DTI or SPECT scan may reveal hidden problems.

The good news is that 85% of victims of traumatic brain damage will recover within two years, with the remaining 15%, often referred to by doctors as the “miserable minority,” facing a tougher time.

Irrespective of this, as in all medical fields, the sooner a patient receives adequate medical care, the better his or her chances of a good outcome.

 

Three key principles in total loss wildfire insurance claims 

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If you suffer a disaster such as a total loss from wildfire and need to claim on your insurance, consider these three principles:

Get a copy of your policies and read them.

Insurance always starts with a written policy, so the first thing to do when you get ready to make a claim is to get a copy of any policy that might cover your damaged property and read it through from front to back.

If you do not have your insurance policy forms because they have been lost, destroyed or are otherwise unavailable, you will need to obtain a policy reconstruction from the insurance company. Ask your agent or go directly to the insurance company’s policy services department. If you cannot remember who your insurance company is, you will need to do a little detective work. Start with your checking account. A check of your bank records may well lead you to any insurer that could provide insurance coverage for your damaged property.

Check your coverages.

Your insurance policy covers certain types of losses and excludes protection for others. That’s why it is important to get a copy of the contract right at the start.

A problem that often occurs after a catastrophic loss is the damaged property is not fully insured. Where a broker or broker advises you professionally on appropriate coverage or binds coverage based on their own professional expertise, you may have a claim for professional negligence if the property is not insured to its full value.

Watch out for Time Limits

Property insurance policies generally have their own deadlines, known as “limitation periods,” and the period during which legal action must be filed to enforce the contract is frequently shorter than the period applicable to a simple written contract.

If in doubt, consult a lawyer about the time limits for your claim. Be proactive. Once you have suffered a loss, a clock ticks somewhere that could limit your ability to claim back the insurance benefits.

 

Additional living expense coverage basics for a total wild fire loss

Posted by Daniels Law on

A few words from Daniels Law partner, Bill Daniels:

When we had a house fire in 2009, our big problem was what to do with the horses.

We have lived on a small horse farm in the San Fernando Valley for about thirty years. My wife Cheryl is a serious animal person.

So when the fire burned down our house, it threatened to scatter our entire family and also all our pets and livestock.

The tally back then, if I recall, was a quarter horse gelding, two Arabian mares, a retired blind pony, two pygmy goats, three domestic cats, four Labrador dogs (two black, one brown and one white) and one domestic rat.

Imagine you are looking for a rental home to relocate this crowd and you have an understanding of the predicament we were in. Fortunately, we now had homeowner insurance that included basic fire protection. In addition to property damage services, there was something known in the insurance industry as “ALE.”

The ALE coverage is intended to reimburse you for the additional costs you incur as a cause of a damage. In our case it was the house fire.

In general, this includes things like rent for temporary furniture, pet boarding, moving costs, the extra cost of meals in restaurants when you don’t have room to cook and so on.

How much ALE coverage is offered depends on your insurance policy. Some policies have no monetary cap, which can help ease the pain if your assets do not fully contain what you have lost. Others have duration and dollar limits. They vary from case to instance.

Whatever the details, ALE can be a lifesaver during the reconstruction process, which can take many months or more than a year.

So if, after a fire during rebuilding, you ask every time you buy something, “Did we have to get this (whatever the item is) because we lost our house?” If the answer is yes, maintain the receipt and attach it to your claim.

Some folks will have a separate bank account to track their spending, which can make things a bit easier.

That’s because documenting what you spent on things that ALE covers can become incredibly important. If you have a dispute about how much the insurance company owes you, having good records can really help you out.

One strategy to make things easier is to arrange for the insurance company to pay you a lump sum upfront for a known price item, such as renting a rental property that is calculated to include enough money for the time you need to properly rebuild. This can reduce you the hassle of waiting for an insurance check each month, especially for certain items that you can not finance on your own.

In our case, we were a bit creative in solving the livestock situation. The fire burned down our main house, but a small guest house remained intact. So instead of evicting everyone from the property, we persuaded the insurance company to pay for a rented RV camper for the renovation, which took just over a year.

The RV camper gave us a kitchen, which we needed as the guest house has none. In addition, there was an additional bedroom for our daughter, who was still living at home at the time.

In the end, we had a win-win solution: my wife kept her herd together, the insurance company saved a lot of money on food and special rental apartments for people with animals.

The lesson we have learned is: be prepared to negotiate for your own benefit, but also be practical and reasonable.

Of course, this is a good recipe for life in general.

Hiring a contractor after a total wild fire loss in California

Posted by Daniels Law on

Probably the best tip we can offer on the contractor’s hiring front is to check a builder’s license or the registration of a home improvement vendor to see if the candidate you’re thinking of has problems in the past that could point to problems in the future.

The California Department of Consumer Affairs Contractors State License Board is a good place to start. This is a website where you can verify a contractor’s license online. Googling “Check Contractor License California” should transport you easily to the Board’s license check page, where you can search for license number, company name, personal name, etc.

Previous testing of a license can save many problems in rebuilding your property. We learned this the hard way after hiring a paver contractor years ago to repave a driveway. It was only after the contractor broke his contract and that we realized that we were not his first victim. If we had known about the license check website, it would have saved us a lot of trouble.

A license check also helps you avoid hiring an unlicensed contractor, which is a known hazard after catastrophic fire damage. Contractor licenses are designed to protect the public from unscrupulous souls; do not be tempted to ignore this protection. The state licensing office also publishes a checklist for homeowners to download and follow.

It asks for useful things like:

Have you received at least 3 local references from the contractors you are considering?

Did you call the contractor first or did they call you?

Will the developer get a permit before the work starts?

Have you read and understood your contract?

This contract is, by the way, an important part of the reconstruction process; a contract is a legal document, so read before signing and ask questions before committing yourself.

Some important points that belong in a contract for reconstruction are the time of commencement and end of the work, a detailed description of the work to be done, the material to be used and the equipment to be installed, any down payments required and a timetable for payments.

You should also receive a “notice to the owner” from your contractor describing liens and ways to prevent them.

The Licensing Committee notes: “Even if you pay your contractor, a lien can be transferred to your home by unpaid workers, subcontractors or material suppliers.

A lien can result in you paying twice or, in some cases, losing your home to foreclosure.

One final thought: after a disaster such as a wildfire, local contractors are in short supply.

Prices may reflect this fact, and rapid reconstruction may not be an option, given the facts imposed by supply and demand.

However, when selecting your contractor, make certain that the repairs and rebuilding are on a time line you can live with. Also, it is always good practice to walk the job every day, so your contractor knows you are paying attention to what they are doing.