Glossary Continuation

Glossary of Personal Injury Law Terms

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Insurance Policy Terminology



Traffic Collision Report

Every personal injury case involving a vehicle should generate an official report, but this will only happen if the traffic collision is reported to the proper authorities. In California, most traffic collisions are investigated by the California Highway Patrol, and the official CHP document summarizing the collision is called a Traffic Collision Report. If the collision occurred within the limits of a city, the local city police department will usually be the investigating agency, and most police departments use report forms very similar (or identical) to the CHP Traffic Collision Report.

Motorists in California are required by law to report any traffic accident in which they are involved if anyone sustains an injury or if any vehicle sustained more than $500 in damage. If the police are actually called to the accident scene, they will usually prepare a collision report themselves, of which the people involved in the accident are entitled to receive copies. Alternately, a motorist may go directly to a CHP or police department office and submit a report of their own, but this should be avoided because these self-reports are not as effective and don't carry as much weight as reports prepared by police officers.

A Traffic Collision Report will summarize the statements of the people involved in the collision, summarize the statements of any witnesses to the collision, and describe many relevant facts regarding the involved people, vehicles, streets, weather conditions, etc. An experienced personal injury attorney will be able to rapidly determine the relevant facts of the collision by closely reviewing all elements in the Traffic Collision Report, by having an investigator contact all listed witnesses, by examining and comparing the location and physical details of the accident scene with the facts listed in the report, and, where necessary, by seeking correction from the investigating officer of any obvious errors that may be contained in the report.

Very few police officers have much formal training in either accident reconstruction or the legal requirements of establishing liability, so the conclusions they place in a Traffic Collision Report are not exactly written in stone -- rather, their conclusions are usually only the starting point in determining liability.



Treating Physician

A treating physician is a doctor who has actually provided medical care to an injured person, as opposed to a doctor who may be hired as an expert witness by one or another side in a lawsuit to provide technical expert opinion testimony or conduct an independent medical examination.

A treating physician provides two critical services for an injured person. First, and most importantly, the physician provides the necessary medical treatment, specialist referrals, etc., needed for the injuries suffered. Second, the physician is both an ordinary witness to relevant facts in the personal injury case (i.e., the observed symptoms and injuries) as well as being able to provide expert medical testimony within the scope of the physician's expertise. On both counts, having a skilled physician is of prime importance in a personal injury case.



Trial

Some cases just don't settle. For whatever reason, the opposing sides just don't see eye-to-eye on important issues of liability and/or damages. The case has probably already gone through the settlement demand stage, the filing of a lawsuit, discovery, arbitration and/or mediation, and is now ready for the formal conclusion of the court process -- a trial and a jury verdict.

There is no stage in the entire process of resolving a personal injury claim in which an individual claimant or an inexperienced attorney will be more vulnerable than at trial. The personal injury attorney must be completely familiar with the both the statewide rules and the rules of the local court that may apply to trial scheduling, jury selection, introduction of evidence, questioning of witnesses, requests for jury instructions, and so on.



Uninsured/Underinsured Motorist/Coverage/Claim

California law requires that all drivers have a certain minimum amount of bodily injury liability insurance coverage when operating a motor vehicle. Unfortunately, many people either can't afford insurance or choose not to purchase it for their vehicles. If you're injured by a person with no insurance, what can you do? If someone can't afford to buy insurance, then they're unlikely to have enough income or assets to compensate you for the injuries they caused, so suing them directly may be pointless.

Well, California law also requires that whenever someone purchases automobile insurance, the insurance company must offer them Uninsured/Underinsured Motorist coverage with the policy, and this coverage can only be dropped if the person purchasing the insurance signs a special waiver. The Uninsured Motorist portion of this coverage protects the policy owner, family members residing with him/her, and occupants of his/her vehicle if they are injured by a person who has no insurance at all. The Underinsured Motorist portion provides coverage when the policy is for an amount greater than the amount of the negligent person's insurance policy. (This is a very simplified description of the law. In fact, UM/UIM coverage often presents some very complicated situations, and it is always a good idea to seek an attorney's advice about UM/UIM claims.)

UM/UIM claims are very different from other claims, because they are presented to an injured person's own insurance company. These claims will often involved discovery patterned along the same rules as for personal injury lawsuits, but instead of heading toward a trial in the long run, UM/UIM claims are ultimately resolved through binding arbitration.



Witnesses

Witnesses in a personal injury case can come in two different categories: ordinary witnesses to events (also referred to as percipient witnesses) and expert witnesses. Expert witnesses are medical, engineering, or other professionals who by virtue of their expertise are entitled to provide evidence in the form of "expert opinions" regarding the facts of a case.

Ordinary witnesses to events are often vital to the successful conclusion of a personal injury case. In particular, witnesses who are not associated with either the plaintiffs or defendants in a case are often viewed as neutral parties with no reason to favor one side over the other, and therefore their presumably unbiased statements can carry great weight. An experienced personal injury attorney will always have a staff employee or private investigator interview any and all neutral witnesses in a case. This must be done very carefully so that it does not later appear to be producing bias on the part of the witness. It is also vitally important to know when to have the witness's recollections reduced to a written, signed statement, and when it is better not to have this done, because the written statements may be acquired by an opposing party through discovery.



Wrongful Death

When a person dies due to the negligence of someone else, a wrongful death claim results. The rules for wrongful death insurance claims and wrongful death lawsuits are generally the same as for claims and lawsuits resulting from non-fatal injuries, however there are at least two important factors which are different: 1) If the deceased did not die immediately, then compensation for certain damages sustained by the deceased may be pursued by his/her estate; and 2) it must be determined which of the deceased person's surviving relatives are entitled to receive compensation by way of a wrongful death claim or lawsuit. In California, the relatives entitled to do this are specified by statute. Obviously, these situations can be further complicated by the presence of a will and/or by disputes among the surviving relatives, and a personal injury attorney will be able to help sort out these matters.



Insurance Policy Terminology

The following insurance policy terms are defined in very broad language. The specific definition of each term can only be determined by a very precise reading of the particular insurance policy in which they are contained -- the meaning of a term is rarely identical from one insurance policy to another. The terms may be further limited or expanded by the laws of the state where the policy was issued and/or the state in which an accident occurred.

The most frequent disputed term in any policy is the "insured," that is who may be covered for a loss by the policy. This generally breaks down into two categories: the "named insureds" and all other insureds. The "named insureds" are the people in whose names the policy is actually issued -- if you have an auto insurance policy issued in your name, then you are a "named insured under the policy." Other people not named on the policy may also have coverage available under the policy. Again, only a detailed reading of the policy mixed frequently with a lot of arguing (and an occasional lawsuit) can determine who is and is not an insured.



Bodily Injury

Bodily Injury Coverage will cover claims made against the policy by people who were injured in accidents caused by the named insureds and/or another person who may have been driving a covered vehicle with the insured's permission. This will generally cover all aspects of damages except for property damage which has its own separate coverage. There are frequently restrictions on who may make a claim for Bodily Injury. For example, if the injured person is a member of the insured's household, they are frequently excluded from coverage. Also, injuries caused by intentional act, such as an assault and battery, cannot (by law) be covered by insurance in California.



Collision/Property Damage

Collision/Property Damage Coverage will cover damage to vehicles and their contents involved in an accident -- both your vehicle and any vehicle you may have been responsible for damaging. If a person has struck your automobile in an accident, you may be able to pursue a claim for property damage under either your insurance policy or under the negligent party's policy. If you have a deductible on your own collision coverage, then this amount can only be recovered from the negligent party or his insurance company. If the damage is paid for under your own policy, then your insurance company will seek reimbursement from the negligent party or his/her insurance company.



Comprehensive

Comprehensive Coverage will generally cover damage to your vehicle and its contents from causes other than traffic collisions. The specific will often vary from policy to policy, but this generally covers such things as theft, vandalism, and non-collision physical damage.



Medical Payments

Medical Payments Coverage will cover a certain amount of reasonable and necessary medical expenses incurred by any person involved in an accident caused by the named insured or other driver of a covered vehicle, or any person injured on a premises covered by the policy. If you don't have other health care coverage adequate for your injuries, then Medical Payments Coverage can help you get the prompt medical care needed for your injuries. It can also be used to pay for medical expenses for items not covered by your standard health insurance.

If you use Medical Payment Coverage under your own policy, then you should be aware that many policies try to require that some or all of the coverage provided to you must be repaid to the insurance company if you ever receive compensation from the negligent person or his/her insurer. This repayment can often be reduced or even waived, and an experienced personal injury attorney will know how to do this.



Uninsured/Underinsured Motorist

Uninsured/Underinsured Motorist Coverage provides you with coverage for injuries caused in a traffic accident by a negligent person who either has no automobile insurance at all (uninsured) or has insurance that is inadequate to fully compensate you for your damages (underinsured).

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