Med pay is coverage under a driver’s auto liability policy which pays for medical expenses incurred as a result of an injury sustained in a motor vehicle collision.  It is a separate category of coverage under a driver’s automobile liability policy, and should not be confused with a person’s health insurance coverage (which might be through a person’s employment).

Here is how a driver’s med pay coverage works, and why it is important.  If an insured driver is injured in a motor vehicle collision, the med pay coverage in their policy (provided they have paid a premium for such coverage) applies to cover the medical expenses arising out of injuries suffered in that collision.   The med pay coverage is “primary,” meaning that it is the first avenue of coverage the insured driver should look to.  The med pay coverage should pay for medical expenses arising out of injuries from the collision, up to the limit of the coverage for which the premium has been paid.

Very often, drivers are unaware of their own med pay coverage, or are unsure how it operates, and therefore it is not used.  The benefit of the med pay coverage is that it pays for medical expenses arising out of the incident, without any copay, share of costs, or deductible (compared to a health insurance type of coverage).

Very often, medical providers (such as hospitals, doctor offices, etc.) are also not aware that the med pay coverage is primary, and will simply bill medical expenses to the patient’s health insurance coverage, especially when that information may already be in their computer database for the patient.  When that happens, the insured driver is not receiving the benefit for which they paid the premium.

When a medical provider bills a patient’s health insurance coverage rather than the med pay coverage under the patient’s auto policy, the driver is not getting the benefit of the bargain for which they paid the premium.  In this circumstance, it is a good idea to invoke the med pay coverage to reimburse the driver/patient for the share of costs/deductible/copay that may not be covered under the health insurance policy.
The premium cost for obtaining medical payments coverage in an auto policy is inexpensive, at least when compared to the premium costs for obtaining health insurance coverage.  Once a basic policy of auto liability coverage is in place, it is relatively cheap to increase the medical payments coverage.  Given the number of uninsured or inadequately insured (also called underinsured) drivers on the roadways, increasing one’s med pay coverage is a very smart economic decision.

Most drivers are overwhelmed with decisions to make once they have been injured in an automobile collision.  The Janssen Malloy LLP attorneys are well versed in how the various automobile insurance coverages operate and stand ready to assist you in answering those questions and protecting yourself, if need arises.

The verdict has forced corporations that operate skilled nursing facilities to pay attention to the minimum nurse staffing requirements necessary to ensure the health and safety of the residents.

Janssen Malloy LLP partners W. Timothy Needham and Michael J. Crowley spent seven months in trial on Lavender vs. Skilled Healthcare LLC in 2010.   Both Mr. Needham and Mr. Crowley have served on the Board of Governors of the Consumer Attorneys of California, and Patrik Griego currently serves on that organization’s Board of Governors.

The Consumer Attorneys of California champions the rights of injured people, safety and responsibility, and the right to trial by jury.

The Janssen Malloy firm continues its representation of providing the highest qualified and most vigorous advocates for its clients throughout the North Coast in personal injury, healthcare, employment, elder abuse, real estate and criminal litigation.  The firm also provides a variety of business and transactional services, including real estate, business planning, employment advice, corporation and contract law, as well as estate planning and probate.

Janssen Malloy LLP is proud to welcome Ms. Burroughs to our partnership.

News Release – For Immediate Release

June 21, 2011

Contact: Deborah Mathis, Communications Director – (202) 797-8600 or dmathis@publicjustice.net

Six California Lawyers Who Won Historic Verdict for Nursing Home Residents Are Finalists for Trial Lawyer of the Year Award

A team of California lawyers is in the running for the 2011 Trial Lawyer of the Year Award, presented annually by the Public Justice Foundation, a national organization of public interest attorneys and advocates headquartered in Washington, D.C.

After six years of litigation that included a seven-month trial in Lavender v. Skilled Healthcare Group, attorneys Tim Needham of Eureka, Calif., Michael Thamer of Callahan, Calif., Chris Healey of San Diego, and Michael Crowley, Patrik Griego and Amelia Burroughs, also of Eureka, won a staggering $677 million jury verdict against Skilled Healthcare Group, Inc., a for-profit corporation that owns and operates nursing homes throughout the U.S. The lawyers represented a class of approximately 32,000 current and former nursing home residents and their families in their lawsuit against Skilled Healthcare.

Contacted by some residents’ families, Needham and his team took on the case and discovered that the nursing homes weren’t employing enough staff to provide adequate care, and that Skilled Healthcare had, in fact, intentionally understaffed all of its 22 California nursing homes in order to cut overhead and boost profits.

The $677 million was the largest ever verdict against a nursing home chain.

Needham, Thamer, Healey, Crowley, Griego and Burroughs are among 36 total lawyers—spanning six cases—named as award finalists for their extraordinary legal work in the public interest. Fifteen cases were nominated for this year’s award. They involved a range of issues: from marketing smokeless tobacco to children, to predatory lending by mortgage brokers, to discrimination against Native American farmers.

Detailed summaries of Lavender v. Skilled Healthcare Group, Inc. and the other finalist cases are accessible on the Public Justice website at http://www.publicjustice.net/Newsroom/News/2011-TLOY-Finalists-Selected.aspx.

The winner of the nationally prestigious award will be announced on July 12 at the Public Justice Foundation Annual Gala and Awards Dinner in New York City.

Public Justice is a national public interest law firm that fights injustice and holds corporate and government wrongdoers accountable. See our website at www.publicjustice.net.

Avi Kramer
Communications Coordinator
Public Justice Foundation
1825 K Street, NW Suite 200
Washington, DC 20006
(202) 797-8600 x240
http://www.publicjustice.net/
http://twitter.com/Public_Justice
http://www.facebook.com/publicjustice

The case illustrates the challenges of putting on a complex personal injury matter.  The plaintiff’s logging practices safety expert, Dr. John Garland, of Oregon State University, in Corvalis, Oregon, did  site inspections of the actual heel boom loader, logging truck and trailer used on the date of the incident to provide information regarding the safety lapses that led to the injury.

In addition to the testimony from Mr. Neves’ treating orthopaedic surgeon regarding the nature and permanent effects from the crush injury, Plaintiff’s counsel engaged vocational rehabilitation expert James McGowan and economist Mark Cohen to provide testimony regarding the impact of the injury had on Mr. Neves’ employability, and his lost earnings as a result of the hand crush injury.

Michael Crowley and the other partners at the Janssen Law Firm have handled numerous log landing, timber falling, and logging operations cases that resulted in serious injury or death to members of our community in Humboldt County.  Their expertise in such matters assists the injured and their loved ones in obtaining justice and full compensation for injuries caused by the dangerous conduct of others.

Mr. Needham and his law partner Michael J. Crowley were selected as California Lawyer Attorneys of the Year (CLAY) award winners for their efforts in the Lavender v. Skilled Healthcare litigation.  Mr. Needham’s nomination for the Public Justice Trial Lawyer of the Year award is a national recognition, recognizing his expertise in the tremendous trial result he achieved in the Skilled Healthcare litigation.

Mr. Needham and one of his co-counsel in the Skilled Healthcare litigation, Michael Thamer of Callahan, California, recently traveled to North Carolina to lecture on nursing home litigation before attorneys in that state, who wanted input on the creative lawyering done in the Skilled Healthcare case to handle the understaffing claims in a class-action format.

The Janssen Law Firm as a whole is extremely proud of Mr. Needham’s nomination for the Public Justice Trial Lawyer of the Year award.  The Janssen Law Firm has a well-deserved reputation for its expertise in complex litigation, particularly in the area of elder abuse and nursing home litigation.

If you have a loved one in Northern California that has been a victim of elder abuse or neglect, the Janssen Law Firm trial lawyers stand ready to assist you.

Mr. Crowley and Mr. Needham’s co-counsel in the case, Christopher J. Healey of the Luce Forward Firm in San Diego and sole practitioner Michael Thamer out of Callahan, were similarly recognized as California Lawyers of the Year for their work as part of the lead trial team in the Skilled Healthcare trial.  The jury in the Skilled Healthcare case found that the chain was responsible for 1.2 million violations of the state’s minimum staffing law, and determined that the maximum damage amount of $500 per violation should be assessed as to each facility, for each patient, on days of violation during the six year period of the class-action.

In addition to the significant amount of damages found by the jury, the jury found the “predicate findings” for punitive damages, but the corporate defendants agreed to pay $50 million in a cash settlement and $12.8 million to cover the cost of court ordered injunction compliance with the State’s minimum nurse staffing requirements.

The Janssen Law Firm is known for having specific expertise in elder abuse actions, both on an individual level regarding neglect, abuse and wrongful death cases as well as the innovative handling of the Skilled case in a class format.  The result of the Skilled Healthcare verdict has changed the landscape in the healthcare field and sent a strong message to the industry that “the business model of understaffing to jack up profits will simply not be tolerated.”

Janssen Law Firm partner Patrik Griego is a prior recipient of the California Lawyer of the Year award for his work on another class-action matter, involving wage and hour violations for agricultural workers.   Mr. Griego made significant contributions in the Skilled case in trial preparation and in presentation of witnesses.  Janssen Law Firm attorney Amelia F. Burroughs also made significant contributions both leading up to and during the trial of the Skilled case.  The Janssen Law Firm is proud of all the lawyers from the firm who contributed to the success of the case, as well as  the firm’s entire staff and other lawyers and partners who worked so hard to conduct the firm’s other business while Mr. Crowley and Mr. Needham were embroiled in the six and half month long jury trial.    It truly was a team effort.

Drange noted that patients like Diana Medal, a class member and resident in the Granada Healthcare Facility in Eureka, went through a “living hell.”  Chronic nursing understaffing at the facility meant call lights weren’t answered, bed pans were not provided and incontinent patients were left in their own waste.   “It wasn’t that nursing staff didn’t care,” Medal said, “it’s that they didn’t have time. ”

Former CNA Vali McGrath couldn’t take the chronic understaffing anymore and advised her supervisor that if they didn’t give her another staff CNA on that shift she would have to walk out.

Cindy Cool, who’s father Jack Sterns was an Alzheimer’s patient at Eureka Healthcare and Rehabilitation stated that when visiting him she would find his sweat pants soiled and urine dripping down into his shoes, and she saw other patients walking around with their catheters dragging on the ground leaving a trail of urine behind them.  The staff at Eureka Healthcare and Rehabilitation didn’t even know that her father had dentures when she asked when the last time they had been cleaned.  Ms. Cool echoed that the staff really did care for the patients but were so short handed they simply couldn’t care for everyone.

The class action case was built around California Health and Safety Code Section 1430 (b), which allowed individuals to sue over violations of patients rights such as understaffing.   Even though the statute allowed for a maximum amount of damages of only $500 per violation, once the 1.3 million violations were multiplied by the number of patient days, the jury did the arithmetic and rendered the huge verdict.

Janssen Law Firm lead trial counsel Timothy Needham and Michael Crowley noted that the defendants fought tooth and nail on every issue in the case.  The team of plaintiffs’ trial counsel logged nearly 29,000 hours of lawyer time on the case, spent more than $1.7 million on case costs, survived 129 law and motion matters, 14 writs and two appeals.  The six and a half month long trial was the tip of the iceberg of the amount of underlying time that went into the case.

All three parts of Mr. Drange’s coverage of the Skilled Healthcare matter can be found at the Times-Standard website – by using the following links:

1. ‘I went through hell’ – Patients, nurses share their stories in wake of lawsuit.

2.  Fighting ‘tooth and nail’ – The agreement that kept a company alive.

3. ‘Business as usual’ – Injunction looming for Humboldt County facilities in lawsuit.

Mr. Harvey was run over by the defendant driver, who was driving under the influence at the time of the incident.  The defendant is currently being prosecuted for vehicular manslaughter in Humboldt County Superior Court.

It is not uncommon for the underlying facts of a wrongful death case to also be the bases for a criminal prosecution.  It is important for family members of the decedent in a wrongful death matter to understand the distinction between the two.  The criminal prosecution is handled by the District Attorney’s Office with punishment determined by the court at the time of sentencing.

A wrongful death case is a civil action for damages to compensate the family members of the decedent for a loss of care, comfort, society and affection as a result of their loved one’s death.  The purpose of a wrongful death lawsuit is not to “punish” the defendant, but rather to achieve compensation for the survivors for the loss of their loved one.

The Janssen Law attorneys are experienced in handling the difficult and emotionally stressful issues that accompany a wrongful death matter, and stand ready to assist your family in such a difficult time.

In most cases involving a significant amount of damages,  it is typical for a mediation to occur prior to trial.   A mediation is a voluntary procedure where the parties select a mutually agreeable facilitator or mediator (typically an experienced trial attorney or retired trial judge) to conduct settlement negotiations with a focus on resolution of the dispute.   Money spent on the resolution process at mediation can save tens of thousands of dollars at trial for expert  testimony and exhibits.

In mediation, the mediator has no authority to force any of the parties to agree to anything;  it is a voluntary process where the parties input gives them some degree of control over the outcome.   In a trial, that control is handed over to the jury, or the court, who may view the case quite differently than the self-interested prospective of the litigants themselves.  The Janssen Law Firm has had very good success in putting the appropriate cases through mediation as an alternative to the expense and uncertainty of trial.

Another dispute resolution mechanism is that of arbitration.  For example, in auto cases in which the defendant driver is either completely uninsured or underinsured (inadequately insured) the California Insurance Code provides that a person’s dispute with their own insurance carrier about resolution of that claim is conducted via an arbitration procedure.   In an arbitration, both sides select a mutually agreeable arbitrator, typically a lawyer or a retired judge, who would conduct an evidentiary hearing on the issue of liability and damages.   The arbitrator then renders a written ruling of his or her findings, the result of which is binding.

The advantages of arbitration are that it can be cheaper than the extensive costs connected to a trial, much of the evidence can be submitted in documents, and it achieves finality because the result is binding without the right of an appeal.

There are, of course, cases that simply must go through jury trial and the attorneys at the Janssen Law Firm excel in that arena.  In fact, usually the best way to get the appropriate settlement result prior to trial is to properly and aggressively prepare the matter for trial, letting the other side know that you are fully prepared to try the case through verdict and prevail.

The attorneys at the Janssen Law Firm are experienced in all three of the dispute resolution procedures outlined above, and stand ready to help you.