Author: Keenan Powell

If you decide that you want to hire an attorney for your personal injury claim, you should first interview a few to see who you like.  It is important to feel comfortable with the attorney and be able to communicate with him or her.  Most personal injury attorneys provide one free consultation.

When interviewing attorneys, you will want to know how long they have been litigating personal injury cases, what kind of associations they belong to, whether they take continuing legal education, whether they have malpractice insurance and what their fees are.

You are entitled to hire an attorney on an hourly basis rather than contingency fee however most attorneys will require a retaining if you choose to do so.

If you choose to hire an attorney based upon contingency fee, you need to know if you will be expected to advance costs and what the per centage of the fee will be.  Most attorneys start their fee  percentage at 33 1/3% if the case settles without filing suit.

Never consult or hire someone who is not licensed to practice law in the State of Alaska.  There are people who claim to be paralegals or some other kind of legal professional but they have not gone to law school, have not passed the bar examination, are not regulated by the Bar Association and do not carry malpractice insurance.  If they give you bad advise or make a mistake in your case, you have no recourse against them.

By hiring an attorney licensed to practice law in the Alaska, you have the comfort of knowing that they are required to take at least 3 hours of ethics classes per year, that they are governed by the Bar Association and should have malpractice insurance.   In the event that something goes wrong, you can file a compliant with the Bar Association and/or file a malpractice suit against them.  You also may file a fee arbitration petition in the event that you do not agree with the fees that were charged.

By hiring an experienced attorney, you have the comfort of knowing that, in your best interests, that person in considering the ramifications of every action taken or not taken which can be particularly important in proper documentation of the claim, negotiations, settlement and timely prosecution of the case.  People who do not practice law do not have this experience.

Finally, practicing law without a license is a crime.  It should be reported to the Alaska Bar Association and to the District Attorney’s Office.

An Explanation of Benefit (sometimes called "Explanation of Medical Bill Payment" or "Explanation of Review") is the document that an insurance company is required to send you when it receives a bill from your health care provider.  The insurance company is required to tell you if it is going to pay the bill and if it is not, why not.  The forms are difficult to read but it is important to take the time the time to understand what the insurance company is saying because it might be screwing you.

If the insurance company is denying the bill, then it needs to explain the reason.  Frequently the company will reference a code in its explanation but doesn’t give you the codes.  If that happens, send a letter (USPS priority so you can track receipt) demanding the codes.  And keep a copy of that letter.

Read the reason for denial.   If the insurance company is wrong, then follow the procedure that the insurance company provides for appealing the decision.  Some insurance companies will spell out a particular procedure on the back side of the form and there will be deadlines.  Follow the procedure to the letter.

If your EOB doesn’t have a procedure, write to the insurance company and explain to it why it is wrong.  Again, keep a copy of the letter and track its delivery through USPS.

Sometimes, your automobile insurance company may deny payment of a bill because the bill was not coded as a motor vehicle accident.  Assuming that the bill is a legitimate cost of treating your motor vehicle accident injuries, then you need to call the billing department of your provider and explain to them the coding problem.  The billing department’s telephone number will be on the bill that they sent you.  They are generally very helpful and would be happy to do what is necessary to smooth out a problem.

Insurance companies are under an obligation to deal with you in good faith and there are several specific mandates that they are required to obey:  A person may not commit any of the following acts or practices:

• (1) misrepresent facts or policy provisions relating to coverage of an insurance policy;
  
• (2) fail to acknowledge and act promptly upon communications regarding a claim arising under an insurance policy;
  
• (3) fail to adopt and implement reasonable standards for prompt investigation of claims;
  
• (4) refuse to pay a claim without a reasonable investigation of all of the available information and an explanation of the basis for denial of the claim or for an offer of compromise settlement;
  
• (5) fail to affirm or deny coverage of claims within a reasonable time of the completion of proof-of-loss statements;
  
• (6) fail to attempt in good faith to make prompt and equitable settlement of claims in which liability is reasonably clear;
  
• (7) engage in a pattern or practice of compelling insureds to litigate for recovery of amounts due under insurance policies by offering substantially less than the amounts ultimately recovered in actions brought by those insureds;
  
• (8) compel an insured or third-party claimant in a case in which liability is clear to litigate for recovery of an amount due under an insurance policy by offering an amount that does not have an objectively reasonable basis in law and fact and that has not been documented in the insurer's file;
  
• (9) attempt to make an unreasonably low settlement by reference to printed advertising matter accompanying or included in an application;
  
• (10) attempt to settle a claim on the basis of an application that has been altered without the consent of the insured;
  
• (11) make a claims payment without including a statement of the coverage under which the payment is made;
  
• (12) make known to an insured or third-party claimant a policy of appealing from an arbitration award in favor of an insured or third-party claimant for the purpose of compelling the insured or third-party claimant to accept a settlement or compromise less than the amount awarded in arbitration;
  
• (13) delay investigation or payment of claims by requiring submission of unnecessary or substantially repetitive claims reports and proof-of-loss forms;
  
• (14) fail to promptly settle claims under one portion of a policy for the purpose of influencing settlements under other portions of the policy;
  
• (15) fail to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement; or
  
• (16) offer a form of settlement or pay a judgment in any manner prohibited by AS 21.96.030;
  
• (17) violate a provision contained in AS 21.07.

AS 21.36.125(a).

If you’ve done everything that you can do to get the bill paid and the insurance company is wrongfully refusing to pay it, you can file a complaint with the Division of Insurance:  http://commerce.alaska.gov/ins/Insurance/filingAComplaint.html.

Bike to School Day was May, 2013 and Bike to Work Day is May 17, 2013.  Approximately 1,500 people commute to work in Anchorage by bike, more in the summer.  http://www.adn.com/2010/03/20/1192613.  And with the advent of more cyclists, it’s important to keep a few things in mind:

Drivers - If you hit a cyclist, you’re going to get into a lot of trouble.  You could end up being cited by Anchorage Police, having a claim filed against your insurance and/or sued.  And that’s if the cyclist lives.  If the cyclist dies, the criminal charges could be serious.  The reason that you’re going to get into trouble is that your bigger and faster and can do more damage with your car.  As a driver of a vehicle, you have a duty of "due care to avoid colliding with other traffic."  AMC 09.16.140(B).

Your duty is greater if you observe a child.  You shall give warning by sounding your horn when necessary and shall exercise proper precaution when observing any child.  AMC 9.16.140(A).

This is especially true if the cyclist is a child.  When you see a child walking or biking on the road or near the road, it is a good idea to slow down and watch them because children tend to make sudden movements without forethought.  And if something bad happens and you weren’t exercising proper precaution, you will get into a lot of trouble.

The majority of vehicle vs bicycle accidents occur when the vehicle is stopped at an intersection waiting for traffic to clear so the driver can turn right.  Generally the driver is watching for on-coming traffic to the left and doesn’t think to check the sidewalk or bike trail for traffic coming from the right.  As a driver, you have the duty of due care which means looking both ways for traffic before entering an intersection.

If you are a driver and involved in an accident with a pedestrian or cyclist, report it to your insurance company.  You are obliged to stop, render assistance and provide your name and insurance information just as if you were involved in a collision with another car.

Cyclists - Watch for inattentive drivers.

There are a number of city ordinance which govern riding bicycles in Anchorage.  Amongst the ones most commonly violated are:

1. The duty to obey traffic control devices.  AMC 09.38.030.  When riding a bike, you are required to obey traffic control devices (lights and stop signs) as if you were driving a vehicle.

2. Riding on the wrong side of the road.  The law requires you to ride on the right edge of the roadway wherever practicable, if you are going to ride in the road.  AMC 09.38.060.  If the right side of the road is too narrow to ride safely, then you may ride on the left side of the road.  AMC 09.38.060(A)(3).

3. It is against the law to ride a bicycle on the sidewalk of a business district, AMC 09.38.070, begging the question: how are you to get to work?  I’ve never seen anyone pulled over by a police officer for riding on the sidewalk in a business district, but you should be aware that the rule is for your safety.  People pulling in and out of business driveways are not on the lookout for cyclists.  If you are hit by a car when you are riding on the sidewalk, you will be responsible at least in part for causing the collision.  The long view is that if you are responsible for causing the collision, then you will not obtain a settlement from the driver’s insurance for your medical bills.

4. When you are riding on a sidewalk or bike path, you are obligated to yield the right-of-way to pedestrian.  AMC 09.38.070.

5. When you are riding on a sidewalk or bike path, you shall give an audible signal by voice or by bell before overtaking and passing a pedestrian.

6. Bike helmets are mandatory for any person 15 years of age or younger riding in a public place.  AMC 09.38.200.  The child’s parents can be fined if the child is not wearing a helmet.

For a complete list of the applicable laws, see http://www.muni.org/Departments/OCPD/Planning/AMATS/Documents.  Search for the Adopted Bicycle Plan Appendices.

If you are riding your bike and are involved in a collision with a vehicle, get the driver’s name and insurance information, the license plate of the vehicle and photos of the vehicle damage.  Then call a personal injury attorney.  Contact Keenan Powell: keenan@keenanpowell.com, (907) 258-7663.

It snowed again.  A particularly nasty wet snow making for icy roads.  And we had lots and lots of  accidents yesterday: 164 by 9:30  PM according to Anchorage Daily News.

More big news:  Anchorage Police Department has a new policy.  It won't file a police report unless the officer thinks that the accident caused an injury.  So you can't rely on the police officer to take the witness' names and phone numbers, much less the name of the other drivers involved.  You need to do that yourself.

Not only that, APD probably won't take photos at the scene.  Take photos on your cell phone.  Be sure to get the license plate number of the other car.  Be sure to get photos of damage to the other vehicle as well as the  scene of the accident.  Why do you ask?  Because the other driver could claim that you caused the accident or his damage was minor and to prove your case, you will need  photos of his car to prove how his car impacted yours and how severe the impact was.

After an accident, the law requires you to stop, contact the other drivers or pedestrians involved, exchange name and insurance information, and render assistance to injured persons.  For your own protection, get the names and phone numbers of all witnesses, photograph the scene and the vehicles involved in the accident.

Go to the hospital if you need medical attention.

Then, call you insurance company and report the accident.  And then call the other driver's insurance company to report it as well.  You can google the insurance company and obtain a number to call.

The next day, follow up with any medical providers to whom you were referred by the emergency room.  Or if you didn't go to the hospital, but you're starting to hurt, go to your doctor or to a minor emergency clinic.

Don't expect the other driver's insurance company to pay your medical bills.  Even if the insurance company accepts  liability, it will wait until the end of the case and sometimes it will send the medical records to its own doctor to evaluate them, to see if they have a reason not to pay those bills.

One common defense  the insurance  company will raise is to claim that chiropractic care was excessive and that in a simple whiplash case, the injured person would recover in 6-12 weeks even without chiropractic treatment.  It's called the Quebec defense.   If you have been seeing a chiropractor for 3 months or more and  you aren't better, you should check in with a medical doctor to get his opinion as to whether your chiropractic  care is appropriate and also to find out if your injury is more severe than chiropractic care can treat.

How do you pay for the medical bills  before your case is settled?  Your medical payments benefits which you purchased with your automobile liability insurance should be billed first.  For more information regarding automobile  liability insurance, look at "Car Accidents and P.I." page.

If you don't have medical payment benefits, bill your group health insurance provided by your employer.

If you don't have  group health insurance, you'll need to pay your bills directly, find a sliding fee scale clinic or  enter into an agreement with the provider to pay him when the case is settled.

For more information, contact Keenan Powell:  keenan@keenanpowell.com.  Phone: 907 258 7668 or 888 368 5678.