Being injured or in an accident can have broad reaching financial implications. In addition to the costs of care, you can lose income if you are off work and may incur additional legal costs. Finding ways to recover some of those expenses can help you avoid the debt problems that can occur after an injury. Our guest, personal injury lawyer Lisa Morell, explains when you might want to talk to a personal injury lawyer to review your benefit options.
A common cause of bankruptcy in Canada is the financial burden caused by an injury. Depending on how badly you’re injured after an accident, you might need time off from work. If you don’t have an adequate emergency fund, or proper insurance coverage, resorting to debt to make ends meet can be catastrophic.
To ensure you can cover a potential loss of income after a car accident, Lisa recommends getting the right auto insurance policy ahead of time. This can mean paying for additional options that go beyond the minimum coverage. To keep insurance premiums down, many policies have reduced standard accident benefits. To increase your limits, you now need to purchase additional benefits. It’s important to read your policies and know what you are paying for.
When the worst happens, your next step is to find ways to recover as much of the costs related to your injury as possible.
If your injury is not serious, and you expect to recover in a week or two without incurring significant costs or time off, then you likely don’t need to talk with a personal injury lawyer. However, there are times when seeking professional advice makes sense.
- A lawyer can help you properly classify your injury. The Ontario Minor Injury Guideline (MIG) provides accident benefit guidelines for victims who have a “minor injury,” such as a sprain, strain, or whiplash-associated disorder.The goal of MIG is to provide faster treatment, improve the use of healthcare resources, and provide more certainty around costs to healthcare professionals and insurers. A rising concern with MIG, however, is the limited amount of benefits available to the injured party – just $3,500 – compared to non-MIG injuries that have higher limits. In an effort to save on costs, an insurance company may wrongly classify your injury as minor, limiting your access to proper funds for recovery.A lawyer can help you present evidence to prove that your injury is non-minor, so that you receive the proper insurance coverage you had been paying for.
- A lawyer can walk you through the accident benefit system. After an accident, accessing treatment and refunds can be a complicated procedure. You have to find treatment providers who are licensed on the Health Claims for Auto Insurance (HCAI) system, as they are the only providers who can submit claims to your insurer. Moreover, the submitted claim then needs to be approved or denied by your insurer. Lisa points out that throughout this process, there are opportunities for different pitfalls that a lawyer can help you overcome by giving you the right guidance early on.
- A lawyer can help you access benefits you might not have known about. If you were involved in a collision that was your fault, you still have entitlement to benefits from your own insurer even with today’s no-fault insurance. Another common misconception is that you won’t have access to benefits if you were injured as an uninsured pedestrian. Reviewing your situation with a lawyer can ensure you don’t miss any opportunities for financial recoveries.
For more details on what you need to do following an accident, including how personal injury lawyers are compensated, listen to today’s show with guest Lisa Morell, or read the complete transcription below.
FULL TRANSCRIPT – SHOW 219 Avoiding Debt Problems After Personal Injury
Doug Hoyes: A few weeks ago I got a letter in the mail from a person who read my book, “Straight Talk on Your Money”, and she said it was the greatest book she ever read. Actually she didn’t say that, but she did say it was easily readable, so that’s good, and then she also said, and I quote: “In terms of your book, if I may provide one constructive comment, it might be appropriate to be reminding individuals who have the misfortune of losing their employment, or being injured in accidents, of the importance of getting legal advice so they will know their legal rights. Too often we see clients who did not know they could access benefits after a car accident, especially if they were a pedestrian, or individuals who quit their jobs, and did not know they might have actions for wrongful dismissal or entitlement to disability benefits through a group insurer. And so far, at least, most damage awards are non-taxable.” Hmm, interesting.
Well, that got my attention because I know that there are many people who get into financial trouble as a result of being in an accident, or getting injured, and that causes them to lose income and they have expenses related to their injury, and so they have no choice but to use debt to survive.
So, is it possible to recover some of those costs if you are injured in an accident? How does that work? When should you talk to a personal injury lawyer? To find out, I am joined today by that very person who sent me that letter, so let’s get started. Who are you, and what do you do?
Lisa Morell: I’m Lisa Morell; I’m a personal injury lawyer in Kitchener, Waterloo. I have an office on Victoria Street and I specialize primarily in car accidents, but other sorts of insurance disputes as well: Disability claims, entitlement to Canada Pension. But we do a lot of car accident work.
Doug Hoyes: Excellent. So we are going to talk about that today, and so thanks for being here in our Kitchener studio, and thanks for reading the book. So, let me start by reading my standard disclaimer. You know, this is my show, I get to pick the guest, no one gets paid to appear on the show, and no one can pay me to be on the show.
Lisa Morell: Wait a minute, I don’t get paid?
Doug Hoyes: No, no, there’s no payments, no payments here, and of course it’s not a commercial for our guests. I’ve got you on the show because you’ve got some stuff I’d like to hear about, that’s why you’re here. And yes, I do get the irony that we’ve got the personal injury lawyer and the bankruptcy guy talking, so those are two interesting professions.
So let’s get started with, I guess, a general question. What is a typical person that you would typically help? So you said you do a lot of car accident work, so walk me through that scenario, then. Someone’s in a car accident, what kind of car accident are we talking about? They get rear-ended, like what happens?
Lisa Morell: Well, someone’s in a car accident and the accident could be their fault, or it could be the fault of the other driver. A lot of clients don’t realize, even if the accident is their fault, that they have entitlement to benefits from their own insurer. That’s what no-fault insurance is. It’s an entitlement to benefits from your own insurer – medical, rehabilitation benefits and income replacement benefits, those sorts of benefits; you’re entitled to those from your own auto insurer, even if the accident is your fault.
Doug Hoyes: So that’s what no fault means, it doesn’t matter who did it. So, I’m in a car accident and whether I caused it or didn’t cause it, I talk to you and then what are the next steps that you would take?
Lisa Morell: Well, I would advise you to notify your own insurer if you’ve been injured, and then you submit an application for accident benefits, which is a form that’s about 33 pages long, with various entitlements, depending what category you fall in. If you’re employed there’s an employer certificate, and they’re all called OCF forms. So they make it fairly complex for the average person to sift through if they’ve just had the traumatic experience of probably being injured in an accident, and your own insurer has the benefit of something called a minor injury guideline, so if you don’t have a fracture, you probably have a sprain or a strain, which sounds like it’s minor but a sprain or a strain is probably not minor if you don’t get better in like a week.
If you don’t get better in like a week, you probably need some treatment and you probably need a lawyer to assist you in working the file to get you out of that minor injury guideline, because there will be a whole lot else going on. If you deal with your insurance company directly they will be very happy to help you and refer you to insurer-preferred clinics and referral sources that won’t be active in terms of trying to get you out of this minor injury guideline. Because if you’re in the minor injury guideline your entitlement to medical treatment, the cost is capped at $3,500, whereas the policy that you’ve paid for would provide access to up to $65,000 for medical rehabilitation benefits and attendant care for a period of five years following the accident.
So, if you’re hurt in an accident and you’re not getting better after a week on your own and you’ve perhaps used up the minor injury guideline, so you have no access to any more treatment, you’re in a bit of a rut and even if the accident is your fault you should be seeing a lawyer who could assist you in accessing treatment, which could result in a settlement down the road.
Doug Hoyes: And so in my head I’m thinking, well I go to a lawyer because I’m going to sue someone, but the way you’re describing it, no, that’s not how it is going to work all the time, maybe even most of the time, it’s just someone who understands that, yeah, here are some basic rights that you’ve got, you have to have someone who is at least willing to push back on the insurance company, for example. That’s really what you’re describing. Am I right?
Lisa Morell: That’s right.
Doug Hoyes: And so, you know, making up numbers off the top of your head, of the people who come to see you that you help, how many times- what percentage actually end up going to court and you’re having to sue as opposed to how many times are you able to just, you know, through discussions and moral suasion and letters with the insurance company and whatever get the client what they need?
Lisa Morell: Well, in terms of the accident benefit claim any disputes go to a tribunal. It’s a one-person tribunal and the submissions could be done in writing, there are various formats for the hearing. And in certain circumstances you might have the right to sue the other driver if the accident is the other driver’s fault. Now, I still see people regularly who think no-fault insurance meant that you can’t sue the other driver anymore, but it’s nothing to do with whether you can sue the other driver. If the accident is the other driver’s fault and you don’t get better from your injuries and you have permanent and serious impairments, or if you lose your job or if you don’t get back to work, you have to meet a certain level of impairment, but if you’ve got an injury and you’re not getting better and it’s affecting your life, you probably need that threshold, you probably have a claim against the at-fault driver.
And now, suing somebody and going to court these days are really two separate things. We issue statements of claim and serve them – that’s suing someone. We do that all the time and generally I mean all of these matters even for the other driver are handled by their insurer, and if the other driver doesn’t have an insurer then your own auto insurance policy requires your insurer to respond to the claim. So even if the driver is unidentified or something, you would still have a claim that you could get an insurer to respond to. So we sue insurers and we sue other drivers all the time, but very few cases in the Province of Ontario actually go to a trial.
Doug Hoyes: Because there are all these other mechanisms that you describe. So I’m in an accident, what kind of costs can I recover, then? So let’s say I get rear-ended, I’ve got whiplash so I need some medical treatments, and let’s say also I have to be off work for three months. When I’m suing- or either making a claim to my insurance company or suing the other driver, do I have recourse for getting my medical expenses covered, for lost income, those sorts of things? What would be covered?
Lisa Morell: Well, in terms of the accident benefit file, or the file with your own insurer, which I sometimes call a treatment file, they are obligated to pay for treatment costs up to a certain amount, which is $65,000 if you can get out of the minor injury guideline, but you have to work with treatment providers who are licensed to bill the insurance company directly, and you also have to access your collateral benefits first before you access the benefits that are available to you.
Doug Hoyes: So what do you mean, collateral benefits?
Lisa Morell: Like if you have benefits through your employer, if you have some coverage for physiotherapy, the physiotherapist you see on the auto accident will bill it to your group insurer first and then they pick up the shortfall.
Doug Hoyes: And what about lost income, then? Is there any ability to recover some or all of that, or is that not possible?
Lisa Morell: From your own insurance company you can get 70%, I think, of your gross income up to a maximum of $400 a week, and then you can look to the at-fault driver for the shortfall. So you can basically get back most of your income. In terms of what you can recover from your own insurer, the important question is going to be, “What coverage do you have?” There are a lot of optional benefits out there that can be purchased at a minimal cost that makes the premium of your policy increase slightly, but it gives you access; if you’re hurt in an accident it gives you access to benefits that are ten times, or 50 times better than what you would have if you hadn’t purchased these optional coverages. And very few people know about these optional coverages. Brokers have been inconsistent in terms of telling people that they should buy these optional coverages.
Doug Hoyes: So, in terms of practical advice for people who are listening, because this is kind of what this whole show is about, I guess there is the first piece of practical advice: Understand what insurance you have and understand what your options are, because there may be, for a relatively minor cost, additional insurance you can purchase that covers a whole bunch more than what your standard policy would cover.
Lisa Morell: That’s correct. And there’s all sorts of optional benefits that are available. For example you can increase your income replacement benefit from $400 a week up to $1,000 a week, which would be very helpful. If you’re in an accident and you make, you know, about $1,000 or $2,000 a week you’re not going to want to live on $400 a week, that’s going to be a bit of a hardship.
Doug Hoyes: And so if I’m with a company that has a group insurance plan, obviously it will be pretty much standardized. What you’re talking about is talking to an insurance professional about purchasing additional coverage. Is that typically –?
Lisa Morell: Well, on your auto policy.
Doug Hoyes: I see, on your auto policy.
Lisa Morell: Many of these coverages used to be included in your rate, and then as they’ve talked about, you know, trying to keep insurance premiums low, they then have reduced the amount of coverages by making what used to be standard coverages now optional coverages and, you know, telling consumers that now they have the option of just buying what they need. But the reality is, is that most people need most of those optional coverages; they might just not know to buy them.
Doug Hoyes: Got you. So that’s a very good point, then. So understand what you’re purchasing when you’re buying your auto insurance, don’t just necessarily default to the absolute minimum, because for a slightly increased cost – and obviously it’s going to be different in every case – you may be able to get a lot more benefit. So you’ve got to really look ahead: Well, if I did get injured in a car accident and I was going to be off work for a period of time, and I was going to have additional medical costs, there are insurance policies that can cover most or all of that, is what you’re saying.
Lisa Morell: That’s right, you can have better coverage or you can have very standard, minimal coverage.
Doug Hoyes: So when is it that someone who has been in an accident should approach a lawyer? I mean if it’s a minor fender-bender and I’m not injured in any way, okay, I mean should I still be talking to a lawyer? What’s the threshold where you say to people at the very least you should give us a call?
Lisa Morell: I think if you’re not better in two weeks.
Doug Hoyes: Two weeks.
Lisa Morell: Because I think that if you really have a minor injury guideline and you could be treated within that framework of $3,500 I think if you didn’t have any treatment and you wait two weeks you’ll be better.
Doug Hoyes: You’ll be better anyways, yeah. Well if you whack your arm I guess it’s going to get better on its own and if you break it it’s not going to get better on [your] own. So let’s say that’s my injury. I broke my arm. Now, that’s not a hard thing to fix. It takes time but I go, they put a cast on it, and I’m good to go. So in that hypothetical situation should I be talking to a lawyer about that? It’s going to take longer than two weeks for my arm to be fixed but I guess I can be back to work pretty quickly. Where do you draw the line?
Lisa Morell: You probably should talk to a lawyer if you have a fracture, because then you’re not in that minor injury guideline, you’re automatically out of the minor injury guideline, and if the accident is not your fault there might be some recourse to compensation from the driver who caused the accident. And even a fracture, depending on your age and everything else, probably will have some ramifications. In terms of your immediate, even personal care, you might require some assistance getting dressed, or with your … doing your hair, or —
Doug Hoyes: Yeah, so you can’t tell on day one what the long-term implications are going to be. And in my world there is the Ontario Limitations Act which determines when a creditor can sue someone who hasn’t paid their bills. Two years is a standard limitation period. How does it work in the case of an auto accident? Is there a period of time where I have to contact the insurance company, file a claim, talk to a lawyer, all that kind of thing?
Lisa Morell: You should really- if you’re hurt in an accident you should let your insurance company know right away, and they generally like you to put your application for accident benefits in within 30 days. That being said, there’s lots of occasions where they’re later than that and they’re accepted by the insurers, because it depends on the circumstances. There’s lots of people who are in accidents and don’t realize that they access to accident benefits because they don’t know- they don’t have auto insurance themselves. If they’re a pedestrian and they’re hit by a car and they don’t have auto insurance, they may or may not find out from the at-fault driver that they have access to that policy of insurance.
Doug Hoyes: So the default position would be: Well, if you’re not sure talk to a lawyer. So let’s say I was in an accident a week ago and I’m still feeling not quite myself so I give your firm a call, at what point do I have to start paying you for your advice?
Lisa Morell: Oh, we don’t charge anything unless we obtain a settlement for someone, and there’s no charge at all, like some firms there are some charges for something called disbursements, which that could be like costs of obtaining medical reports or court filing fees, or various fees that we’ll have to pay along the way. We charge absolutely nothing to our client unless we get them a settlement, and there could be other reasons. I mean if they get better they might not need tests to get compensated; the claim against the at-fault driver is subject to a two-year limitation period and it’s also based upon having suffered a permanent and serious impairment that significantly impacts many of your activities of daily living.
So you might now know until around the two-year mark, which is considered to be, you know, a point to assess your maximum medical recovery. You might not know if you’ve got a permanent and serious impairment. I see many clients who sustain, for example, a whiplash injury, or a soft tissue injury – these are all words that are designed to make it sound your injuries aren’t significant.
Doug Hoyes: Soft tissues, yeah.
Lisa Morell: Soft tissue or whiplash. But they could have sustained an injury to their neck which is causing them a great deal of pain, that initially after the accident they think, oh well, I’ve sustained a whiplash injury, I should be better in a few days, a few weeks, a few months, but what if you’re not better in two years? Then it’s looking like maybe it’s a permanent injury, or maybe at the one-year mark you go to see your family doctor and your family doctor sends you for a diagnostic test and you find out there’s a herniated disc and it’s not going to get better, so you might not know until the one-year mark that you’ve got a permanent and serious injury.
So this limitation period, hypothetically, runs from when a reasonable person would have known they weren’t going to get better, and that certainly depends on the type of injury, so it’s possible to sue well beyond the two-years, depending on the nature of the injury. If you lost your leg, for example, I think you probably know on the day of the accident you’ve sustained a permanent injury, but I see so many clients who have sustained different types of soft tissue and whiplash injuries that result in various things, like if you’ve got this whiplash injury to your neck, the next thing you know you’ve got headaches, or you can’t sleep at night so you’re fatigues during the day, which might make you irritable, and then you’re irritable with the people around you who are all irritable with you. And the next thing you know, you’re feeling depressed and maybe you can’t work and you’ve got some financial pressures so you need to see a psychologist, and, you know, who knows when all this is going to get better.
Doug Hoyes: Yeah, so there’s a lot longer of a time frame where things can happen. So the default position then is talk to a lawyer; that kind of makes sense to me. So when I phone up a lawyer, whether it’s your firm or someone else, what are the questions I should be asking them? What do I need to know from my lawyer? I mean the obvious question that comes to my mind, if I may answer my own question, is so where are you guys?
Lisa Morell: Well, we’re here in Kitchener.
Doug Hoyes: So are you local?
Lisa Morell: We’re local.
Doug Hoyes: And why is that important? Are there meetings that we’re going to be having in person a lot, or is everything done over the phone and it doesn’t really matter where the lawyer is?
Lisa Morell: Well, I mean it depends on what type of practise the lawyer has and how the lawyer prefers to practise, and you want to find somebody who will be compatible with what your needs are as a client. I think for most people a good indication as to whether they would want someone to represent them, is the person willing to meet with them and provide them with a consultation, or are they dismissed when they call with a suggestion that “Why don’t you call back in a year if you’re not better” or something like that. If they’re not prepared to spend the time to meet with you upfront to find out if you’re hurt that might be an indication that —
Doug Hoyes: Yeah, what kind of service you’re going to get in the future.
Lisa Morell: If you are hurt.
Doug Hoyes: Yeah, if you’re going to brush me off right at the start, then we probably aren’t going to have a great long-term relationship. And then, in terms of costs, you already mentioned that your firm, you know, you’ll pay us when we win, and up until then there’s nothing, obviously, you’re doing on a contingency basis. There are other firms that are going to want some money upfront; they’ve got to order the medical tests; they’ve got to do that. So I guess that’s another question that would be obvious to us.
Lisa Morell: And there are some firms that just want to act for you if you’ve got a permanent and serious impairment and meet that test to get money from the at-fault driver, but they don’t really want to help you with the first part, the accident benefit file.
Doug Hoyes: Which to me is probably the most important part, because that’s going to be a very common thing in virtually every situation, where the permanent impairment, big lawsuits, that’s a very rare thing. So if that’s what you end up helping me with, you know, making sure all of this 35-page form gets filed and I understand what my right are, how do you get compensated in that case, then? Is it a percentage of what I ultimately receive? Is it an hourly rate? How is it going to work in that case?
Lisa Morell: There’s a lot of cases that, you know, you get settlements on the claim against the at-fault driver and they’re not- you know, people are getting better, or the limitation … they don’t have to go to trial is what I’m saying – there’s lots of cases that are in between. And the accident benefit file is key because that’s how people access their treatment after the accident which documents their injury and also helps them make their recovery.
In terms of how we’re going to get paid, we’re going to charge a percentage, but it’s going to be less any contribution that either insurer might make to your costs. On the first party settlement file, the accident benefit file, it’s … I’d say at this time it’s fair to say it’s uncertain if there’s going to be a settlement, so it’s uncertain if our client is going to have to pay us on that first party file, and that’s for a number of reasons.
There was a study done a couple of years ago called the “Marshall Report” where they actually recommended getting rid of full and final settlements, which at this time can happen after the one-year mark on the accident benefit file, which means you won’t get a settlement on that file, so if that happens that will probably mean you’ll have to fund counsel privately if you want them. And then we’ve moved to a new tribunal, called the Licensing Appeal Tribunal, where there are no costs awards for successful parties. So if costs are incurred to advance your entitlement to treatment, the insurance company doesn’t have to pay them.
Doug Hoyes: So when I’m talking to the lawyer upfront I should be asking about that. So okay assuming that the —
Lisa Morell: What if there is no settlement, what happens then?
Doug Hoyes: And then what’s the potential obligation for costs on my point of view, and obviously I assume you can’t tell right to the penny here’s what it’s going to cost, but I assume you’d be able to say, well, in ballpark figures these are the number of hours we’re going to have to put in to help you with the forms and doing this and doing that, here’s what you’re likely to have to incur. Is that how it would work?
Lisa Morell: Yeah, more or less. I mean the issue is when you meet with the lawyer you have to find out … It’s all well and good to say that it’s going to be contingency and you’re going to get paid out of a settlement, but what if there is no settlement on either file, how much are you going to have to pay? How is the lawyer going to get paid?
Doug Hoyes: And that would be an excellent question to be asking.
Lisa Morell: Or what if you get better and that’s the reason that there’s no settlement? Or what if you decide that you want to get a different lawyer? Maybe you’ve hired some lawyer from out of town and you found out that you don’t know who is really acting for you and you’re not happy with their service and you want to change to a local lawyer for example, then what is going to happen with the bill for the lawyer who is in Toronto? So there is retainer agreements that spell these things out, and a lot of retainer- it’s quite standard for these retainer agreements to provide that if you don’t cooperate with referrals, or if you change lawyers, or if there’s no settlement, that you have to pay the lawyer on an hourly basis.
Now, in our case I don’t- it’s a very simple retainer. If there is no settlement there’s no charge. But other lawyers are more interested in pursuing costs incurred for clients who get better. And I found interestingly … I’ve only had a handful of files that I’ve closed because clients get better, because clients get better. Because most often by the time somebody comes to see a lawyer, even if it’s a couple of weeks after the accident, they’re coming to see a lawyer because in their mind they’re worried that there’s something- that they might not get better and what’s going to happen, so generally I don’t close many files because clients are better.
Doug Hoyes: Which is unfortunate, but that’s your right, that’s why they’re coming to see you. So okay, there’s going to be an upfront retainer and so the client wants to understand what that is, and that’s potentially what their obligation is. Now, you mentioned the word referral, and so this is the last question I want to ask you about, which is I hear all these ads on the radio all the time for different lawyers, particularly in Toronto and bigger cities, not so much in Kitchener I don’t think but, you know, call us and we’ll help you out.
And I’ve read stuff in the media, and I don’t know if everything I read in the media is true or not. I assume if it’s in the newspaper it must be true, but some of these law firms are really just referral sources, so you call them up and they take all your information and next thing you know I’m dealing with some lawyer somewhere else. And that kind of worries me because I phoned company ABC and I thought I was going to be dealing with company ABC, is that something that as a consumer I should be concerned about? It seems like a worry to me. I kind of like to know who I’m dealing with. If I call your law firm am I going to be dealing with one of your lawyers, or is there the chance you’re firing me off to somebody else?
Lisa Morell: Well, referral fees have been permitted for a number of years by the Law Society and they’ve now become a subject of debate because of how they’ve been used in different circumstances to funnel clients to different sources of referral fees, I suppose. I’ve never really been involved in referral fees. I find- personally, like, I have some sort of a question about it because often- you know, we’ve been- I’ve been practising law in Kitchener for almost 25 years this coming February, so a lot of people know me.
So they’ll call me up when they’ve got a problem, a family law problem or a workplace- an employment problem, different problems, and they’ll say, you know, I know you do personal injury but I need a real estate lawyer. So I’ve always thought that the best thing is for me to try and recommend a lawyer based on my personal knowledge, who I think would do a good job for the person, or who I think would be a good fit with the person who is calling, and I see that as helping me out because then it helps me find a constructive way to deal with the enquiry.
But I think it would be different- and referral fees are always supposed to be disclosed, and I don’t think that they are. I think it would be different if I said, you know, I think Bob would be the best lawyer to help you with your family dispute but Mike gives me- you know, he gives me $100 for every client I send over so I’m going to recommend Mike. I just struggle with it, ethically, how referral fees affect professional judgement.
Doug Hoyes: Yeah, in your business, from that point of view, is almost exactly the same as our business, because there’s lots of companies out there that are nothing but referral agencies. You call them up, you know, Joe the dead guy, and Joe the dead guy isn’t actually going to do the work, he charges you some kind of fee, or maybe he doesn’t, he then refers you to somebody and then there’s the referral fee pay back and that’s how he makes all his work so …
And you’re saying it’s similar in your business, but you and I have the same approach. If someone calls me up and says, yeah, I need some help with my taxes, well I’m not a tax accountant but I do know in your town here’s a guy who is really good, and we’re exactly the same, we don’t accept any referral fees either, because if I refer you to the best person for the job you’re going to be happy and then when your buddy needs my services you’ll refer them back to me. And that’s kind of what you’re describing, right, that that lawyer will then- or the community in general knows who you are, the work all comes back to you anyways, you don’t have to worry about referral fees.
So I guess the final question to ask a lawyer when you’re making that initial call is, so who is going to be doing the work? Is it going to be someone at your firm or somebody else? Is that not a basic question to be asking them?
Lisa Morell: Well, I think that’s a very fair and prudent question to be asking, because I mean I have clients who sometimes come after they’ve been to see a firm in another city that is a large entity, and they’ve never met the lawyer, they’re dealing with paralegals and they’re dealing with clerks, and they’ve never met the lawyer. I mean I think it’s important these days that the lawyer … I mean people expect it, people expect their lawyer to be accessible to them to return phone calls, to answer emails, and to have the time to meet personally with them along the way to explain things.
And in the case of a car accident or a personal injury action, or a lawsuit, these things are important because there’s a lot of concepts that are relatively complex.
Doug Hoyes: Which is why you’re going to a lawyer.
Lisa Morell: So you need somebody to sit down and, you know, take ten minutes and explain to you what it is when you can ask them questions to clarify so that you understand. I mean we’re living in a society now where we think, oh everything can just be done electronically, right?
Doug Hoyes: Or Google.
Lisa Morell: Yeah, or Google.
Doug Hoyes: I can look it up on Google and I’ll be fine. But yeah, and that’s why you go to a professional, so I think it’s great to go to a professional, but it’s also great to understand your rights and understand the questions you’re asked, which is exactly why I wanted you on the show. So what final advice, then, would you give people who are listening to this today? If they’ve been in an accident, they know someone who has been in an accident, what kind of things should they be thinking about, what’s your general advice?
Lisa Morell: They need to take the time early on, as early as possible, if they think they’ve been hurt. It’s really important to take the time to find a lawyer who will take the time and sit down with them to discuss their particular situation so that they have an understanding and they have a plan if they don’t get better, and they have access to a lawyer who can assist them in making these referrals for treatment.
The accident benefit system creates a really complicated way to access treatment. It’s not- a lot of people come in and they think it’s going to be like their group insurance, their group insurance says you can spend $500 on glasses, you go to any optician and you get your glasses, you submit your invoice, or maybe it’s even paid automatically at the till, and the insurance company pays for it.
It’s not like that and that’s why you need a lawyer. How it is, is you have to figure out if you’re in this minor injury guideline or not. You have to find good treatment providers who are licensed on what’s called the HCAI system, only they are licensed to bill the insurer. It’s very difficult to get treatment providers who are not licensed on this system to bill the insurer and have the insurer pay for them.
If you have access to $65,000 every treatment plan has to be prepared by one of these licensed treatment providers, and then the insurance company has the option to decide if they’re going to approve the treatment or if they’re going to deny the treatment. And if they deny the treatment, then you have to go probably for an insurer exam so one of their doctors can decide if it’s reasonable and necessary.
And all along this way there’s different pitfalls. You could have treatment providers who have you sign a paper saying that they can just keep treating you even if you’re not approved, and then at the end of the day you don’t have a lawyer and there’s a big bill for all this treatment that the insurance company should be paying for. It’s just key, because it’s a complicated process, that you have legal advice early on so that you know what you’re dealing with, otherwise you’re left with doing what your insurer recommends you do.
Doug Hoyes: Which may not be in your best interests. So it’s a complicated process, that’s why you need to consult a lawyer, so that’s I think excellent advice. So how can people find you? What’s the name of the law firm, how can they track you down if they’ve got questions?
Lisa Morell: It’s Morell Kelly. We have a website, it’s www.morellkelly.com. So we have a fairly simple process where we just have a client complete a confidential online intake, and the majority of people who complete an intake, I have them in for a consultation.
Doug Hoyes: It’s as simple as that, and you sit down and take it from there.
Lisa Morell: Yeah, meeting clients is a key part of this type of practise, because there are so many issues that arise, right? I mean somebody gets sent to a doctor hired by the insurance company. There’s all sorts of things that can happen. What if the insurance company is trying to send you to Whitby? Do you really have to go to Whitby to have a general physician look at you to see whether you need another course of physiotherapy? Aren’t there any general physicians closer? That’s why you need to have access to a lawyer who could, you know, say to the insurance company, “Find a general physician in Kitchener, my client doesn’t have a day to go to Whitby.”
Doug Hoyes: And that’s why the local representation is important, so excellent. Well I think that’s very good advice, Lisa, thanks for being on the show.
Lisa Morell: Well, thank you for having me, Doug.
Doug Hoyes: Thank you, I appreciate it. So that’s our show for today. We’ll have a full transcript and links to everything we talked about today – including links to Lisa’s website so you can track her down – over at hoyes dot com, that’s h-o-y-e-s dot com.
Thanks for listening. Until next week, I’m Doug Hoyes and that was Debt Free in 30.
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