I represent customers and invited guests injured due to the negligence or carelessness of business owners. As a former insurance company trial attorney, I litigated many hundreds of premises liability cases, ranging from slip and fall cases, elevator injury cases, escalator injury cases, stairway injury cases, inadequate lighting cases, as well as automatic sliding door injury cases, where I represented Stanley Doors. By far, the most common type of premises liability claim in Florida is a slip and fall or a trip and fall injury case. A slip and fall may cause significant injuries, ranging from herniated lumbar or cervical discs and knee injuries to traumatic brain injuries. This article will briefly discuss how insurance companies evaluate cases.
Elements of Damages:
In this article, it is assumed that the business owner is at fault. Negligence, fault and comparative fault will be discussed in a separate article. Once liability is established, a personal injury attorney must prove his or her client’s damages. Damages include future and past medical and physical expenses, past and future nursing expenses, loss on income, loss of future earning capacity, pain and suffering, inconvenience, mental anguish, loss of capacity for the enjoyment of life, scarring and disfigurement and others.
Medical Treatment and Treating Physicians:
Insurance companies insuring these businesses typically hire outside counsel or assign in-house counsel to represent the business in any litigation. The job of the personal injury attorney is to advise his or her counterpart and the insurance company of the injured client’s damages early on and throughout the case. As a injury trial lawyer, I regularly submit a demand to adjusters before filing a premises liability lawsuit. I provide medical records and any relevant photographs. I want the adjuster to know the seriousness of my client’s injury early, on if possible. I do not select physicians or surgeons for my clients to see. When I was an insurance defense attorney, I would review medical records to determine if the plaintiff was sent to a particular physician by the attorney. I tell my clients to research physicians themselves and to ask friends and relatives.
I advise clients to look for physicians with great reputations, certifications, teaching experience and at least ten years’ experience after medical school. Insurance defense attorneys and adjusters give more weight to well-known physicians in the community.
The most important person for a injured person, following a slip and fall or other premises liability injury, of course is a treating physician, not the lawyer. The obvious reason is that the physician is tasked with diagnosing injuries, helping reduce pain and treat injuries. Second, the testimony of a treating physician at depositions and trials is critical. Treating physicians provide opinions as to future medical expenses, disability, restrictions, future pain and suffering and more. These opinions are used at trial and mediations to settle injury cases. These opinions are also used by insurance adjuster to value claims. When I was an insurance defense attorney at some of the largest insurance defense firms in Florida, I was required to complete forms (insurance companies love forms) evaluating the treating physicians and how I thought that physician would appear before a jury.
Evaluation of Injured Claimants:
Insurance companies and its lawyers review plaintiffs’ social media. They also require defense counsel to fill out forms and evaluate how the plaintiff will appear before a jury. Jurors tend to increase values of verdicts if the jurors empathize and like the plaintiff. How an injured plaintiff appears and his or her demeanor goes a long way. I sit down and prepare my personal injury clients for hours before their deposition. Lawyers who do not adequately prepare injured clients are doing those clients a disservice and reducing the value of the claim.
I instruct clients in great detail how to deal with difficult questions at depositions, at medical evaluations and how to appear at mediations, where typically both the adjuster and attorney are present. Essentially, before a trial there are only two times where an adjuster, insurance defense attorney and the injured plaintiff see each other face-to-face. The first is at the deposition of the plaintiff. The second is at mediation, which is required before trial in Florida. It is not only important to prepare clients for how they answer questions, but also to prepare them how to sound when answering questions and to make sure that he or she is so prepared that they feel relaxed and calm. Clients should appear relaxed, confident and sure of their answers. Many insurance lawyers will purposefully rattle plaintiffs to see how they react at trial. Will the injured claimant come across as harsh? Will the injured party appear to not be sure of their recollection of the event? Does the plaintiff appear dishonest? The more composed, empathetic, sincere and cordial plaintiff will receive a larger verdict than a harsh, bitter and unfriendly plaintiff at trial.
Medical Bills in Evaluating Slip and Fall Injury Claims:
It is excellent legal advice to remind injured clients to keep up with all medical appointments and to make appointments if they are pain, experiencing worsening of conditions, having trouble sleeping at night, etc. First, we need for treating physicians to go to bat for their patients. Doctors don’t like it when clients no-show medical appointments. Second, insurance adjusters treat periods of weeks
or months without seeing a physician that they must not be in pain and must be fine, when in reality it is not the case, and the patient is trying to battle through pain and other issues on their own. Not going to the doctors when patients really need to, does not help the valuation of the claim. Insurance companies need to see that there is a need for ongoing medical treatment, that there are future medical costs.
These are just a few of the ways that insurance carriers determine what a slip-and-fall claim is worth. For more information, speak with a personal injury attorney experienced in litigating slip-and-fall cases. I have been a personal injury attorney for nearly twenty years. I litigate cases involving slip and falls from our offices in Stuart, West Palm Beach, Delray Beach, Boca Raton and Deerfield Beach, Florida. For more information, you may contact us at 800-650-1243 day or night.