Navigating the complex world of legal jargon can be daunting. This is especially true when dealing with the aftermath of an injury. This blog post is designed to help demystify the legal terms and concepts you might encounter during the personal injury process, including:
- Insurance
- Claims v. cases
- Liability
- Damages
Whether you’re a victim seeking justice or someone wanting to understand the legal landscape, learning these terms and phrases will ensure you’re well-equipped to handle the challenges ahead with confidence and clarity. Remember, knowledge is power! The more you know, the better you can understand your case and make informed decisions throughout the process.
INSURANCE
When dealing with personal injury, understanding your insurance coverage is crucial. The right insurance can provide essential financial support, helping you to manage the costs associated with injuries (e.g. bills for medical treatment) and losses (e.g. the inability to work in your preferred job). This section will explain key insurance terms and concepts, ensuring you know what protections are available and how they apply to your situation.
Liability auto coverage: Liability auto coverage provides financial protection for a person who is at fault in a car crash that causes bodily injury to another person. In other words, the liability coverage provides payment to the person or people injured in a crash.
Most of my clients believe that the insurance they purchase for their vehicle is only there to protect others if they get in an accident (liability coverage). While this is true, the biggest protection afforded by the coverage you purchase for your vehicle is underinsured/uninsured motorist coverage.
UN-insured motorist coverage (UM): Uninsured motorist coverage safeguards an injured person in the event of an accident where the at-fault person does not have insurance or does not remain on scene after a crash (hit-and-run). When the at-fault person is uninsured or unknown, the injured person uses the UM coverage on their own policy to cover medical expenses and other damages.
UNDER-insured motorist coverage (UIM): Insurance providers in Virginia offer a range of coverage options. Underinsured motorist coverage comes into play when the at-fault person has purchased less coverage than the injured party and helps cover the gap when the at-fault person’s insurance limits are insufficient to compensate for the injured person’s damages. This coverage can provide added protection in cases of serious accidents. For example, if the at-fault person has $100K in coverage, and the injured person has $250K in coverage, UIM coverage allows for the injured person to take full advantage of his or her policy, even though the at-fault person has less coverage. For more information about policy coverage and limits and Virginia, click here.
Medical expense benefits: Medical expense benefits provide coverage for medical treatment and related costs resulting from a car crash, regardless of fault. Also known as “med pay,” this coverage provides reimbursement for the cost of medical treatment. This benefit can help cover medical bills and related expenses for the insured driver and passengers.
Medpay is elective coverage, meaning that some people purchase it while others do not. If you do not have medpay on your policy, you should consider adding it!
Subrogation: Subrogation is the word that insurance companies use for “reimbursement.” It is the legal process that allows an insurance company, like a health insurance provider, to pursue reimbursement from a third party responsible for the injury or damages. In personal injury cases, subrogation often arises when the injured party’s health insurance provider seeks reimbursement from the at-fault party or their insurance company for medical expenses paid.
CLAIMS v. CASES
If a personal injury claim cannot be resolved through negotiation, it becomes a case and may proceed to litigation. This process can be complex and requires a clear understanding of legal procedures and terms. In this section we discuss and define “Plaintiff,” “Defendant,” and “Preponderance of the evidence”.
Plaintiff: The plaintiff is the individual who initiates a civil lawsuit by filing a complaint against the at-fault person, known as the defendant. In personal injury cases, the plaintiff is typically the injured party who seeks compensation for the injuries and losses caused by the negligent or wrongful actions of the defendant. The plaintiff bears the burden of proving the case by presenting evidence to support their claims of negligence and resulting losses.
Defendant: The defendant is the party against whom a civil lawsuit is filed by the plaintiff. In personal injury cases, the defendant is typically the individual, business, or entity alleged to be responsible for causing the plaintiff’s injuries and losses, through their negligent or wrongful actions. During the legal proceedings, the defendant has the opportunity to respond to the plaintiff’s allegations, present defenses, and show that he or she was not responsible for the plaintiff’s injuries.
Preponderance of the evidence: This refers to the burden of proof that the plaintiff must meet in order to prevail in a civil lawsuit.
In practical terms, the preponderance of the evidence means that the plaintiff must present enough evidence to convince the jury or judge that it is more likely than not that the defendant’s negligence or wrongful actions caused the plaintiff’s injuries and damages. This standard does not require absolute certainty or proof beyond a reasonable doubt, as in criminal cases, but rather a greater weight of evidence in favor of the plaintiff’s claims.
Claims v. Lawsuits: First things first. What is the difference between a personal injury claim and a personal injury case? A personal injury claim refers to the initial demand for compensation made by an injured party to the insurance company. This often happens before the filing of a lawsuit, while a personal injury case refers to the formal legal proceeding of filing of a lawsuit in court. Both involve seeking compensation for injuries and damages caused by the negligence or wrongful actions of another person or entity.
Personal injury claim: The claim typically begins with the injured party notifying the at-fault party or their insurance company of the injuries and damages suffered as a result of the accident or incident. During the claim stage, the injured party may work with their attorney to gather evidence, assess damages, and negotiate with the defendant’s insurance company to reach a settlement agreement without filing a lawsuit. The goal of the claim is to resolve or settle without going to court.
Personal injury case: If the parties are unable to reach a settlement agreement during the claim stage, or if the defendant does not accept responsibility or refuses to pay a fair amount, the injured party may proceed with a formal lawsuit. This initiates a personal injury case. In Virginia, this typically involves filing a complaint. The complaint outlines the case from the plaintiff’s perspective and includes allegations of negligence or wrongdoing by the defendant (i.e. what the defendant did wrong), and the damages being sought (i.e. what the plaintiff believes will right the wrong). Once the lawsuit is filed, the case enters the litigation phase and the parties set a trial date with the court. Typically, even when a trial date is scheduled, the parties continue to work towards resolving the case out-of-court. If a settlement cannot be reached before the scheduled trial date, a judge or jury will determine the value of the case based on the evidence presented.
LIABILITY
Determining liability is a cornerstone of personal injury disputes. Establishing who is legally responsible for an injury involves understanding various legal concepts and rules. In this section, we will clarify:
- What liability means
- How it is determined
- The implications of different liability principles, such as negligence and contributory negligence, under Virginia law.
In the context of personal injury law, “liability” refers to the legal responsibility or obligation of a person, entity, or party for the injuries or losses suffered by another person as a result of the at-fault person’s negligent or wrongful actions. It involves holding the at-fault person accountable for the conduct that caused harm to the injured party.
Liability is typically determined by establishing the legal elements of negligence, including:
- Duty
- Breach of duty
- Causation
- Damages
In a personal injury case, the party found liable (responsible) may be required to compensate the injured party for their losses. This includes:
- Medical expenses
- Lost wages
- Pain and suffering
- Other damages (see Damages, below)
Negligence: Negligence is a fundamental concept in personal injury law. It refers to the failure to exercise reasonable care, resulting in harm or injury to another party. In Virginia, to prove someone’s negligence, the following elements typically must be established:
- Duty: The defendant owed a duty of care (legal obligation or responsibility) to the plaintiff.
- Breach: The defendant breached that duty through their actions or inactions.
- Causation: The defendant’s breach of duty directly caused the plaintiff’s injuries.
- Damages: The plaintiff suffered actual harms and losses as a result of the defendant’s actions. (See Damages, below).
Contributory negligence: Virginia follows a contributory negligence rule. This means that if the injured party is found even slightly at fault for the accident, they may be barred from receiving any compensation for their injuries. It’s important to understand how this legal principle can impact your case, so remember, call a personal injury attorney before you talk to your insurance company!
Proximate cause: Proximate cause is a legal concept that connects a defendant’s actions to the plaintiff’s injuries. To prove proximate cause, the plaintiff must show that the injuries were a direct and foreseeable result of the defendant’s actions.
Example 1: Imagine you are driving and stop at a red light. Another driver, who is texting and not paying attention, crashes into the back of your car, causing you to suffer a neck injury. In this case, the proximate cause of your neck injury is the crash, which was caused by other driver’s negligent action of texting while driving. It is clear that the other driver’s failure to pay attention directly led to the crash and your resulting injury. This means the other driver’s actions are the proximate cause of your injury, making the other driver responsible for the damages.
On the other hand, the proximate cause can be difficult to establish in cases where the connection between the defendant’s actions and the plaintiff’s injuries is not direct or foreseeable.
Example 2: Suppose a driver negligently leaves their car parked in a no-parking zone. Later, another driver swerves to avoid hitting the parked car, loses control, and crashes into a pedestrian on the sidewalk, causing serious injuries. The pedestrian might try to argue that the illegally parked car was the proximate cause of their injuries.
However, this connection is more complicated. In this scenario, establishing a proximate cause is difficult because: (1) the illegally-parked car did not directly cause the accident; and (2) the other driver’s inattention and decision to swerve, which led to the crash, introduces an additional factor.
In this case, a court might determine that the connection between the parked car and the pedestrian’s injuries is too indirect, and that the other driver’s negligence in failing to pay proper attention and/or remedial actions (i.e., swerving) might be seen as the primary cause. This breaks the chain of causation from the parked car to the pedestrian’s injury.
DAMAGES
Once liability is established, the next step is assessing the damages or losses. This section will break down the different types of damages that can be claimed in a personal injury case, including both economic and non-economic losses. Understanding these categories will help you know what to expect and how to maximize your recovery in a personal injury dispute.
In personal injury law, “damages” refer to the monetary compensation awarded to a plaintiff (injured party). This is awarded as a result of their injuries or losses caused by the negligent or wrongful actions of another party (defendant or defendants). Damages aim to provide financial relief to the injured party for the harm they have suffered. This compensation is intended to restore the injured party to the position they were in before the injury occurred, to the extent possible. Below, I’ve listed the types of damages that plaintiffs may seek.
- Economic damages: Economic damages are losses that can be easily calculated or quantified. This includes costs related to medical treatment, such as hospital bills, medication, rehabilitation, and therapy. There can be compensation for income lost due to the inability to work as a result of the injury. Economic damages also include costs associated with repairing or replacing damaged property. We call them “economic damages” because they can be proved with simple math such as looking at a bill or multiplying an hourly wage by the amount of time missed from work.
- Lost income and lost earning capacity: Lost income represents the wages or salary lost due to the injury and recovery period. Calculating these damages accurately is essential for fair compensation.
- Non-economic damages: Non-economic damages cover intangible losses such as pain and suffering, mental anguish, emotional distress, and loss of enjoyment of life. These damages seek to compensate the injured party for the physical and emotional toll of the injury and cannot be proved by simple math.
- Mental anguish: Mental anguish refers to the emotional distress and psychological impact caused by the injury. Understanding how mental anguish is compensated can help your attorney develop and convey the various impacts the incident and your injuries have on your overall life and well-being.
While these terms may seem a bit confusing and overwhelming at first, with a little practice and this blog post as a reference, you have the basics to start building your knowledge arsenal. Remember, knowledge is power when it comes to personal injury claims. Understanding legal jargon is crucial for a successful resolution in personal injury cases and fostering a strong attorney-client relationship.
By understanding these concepts, you can better communicate with your legal team and actively participate in your case, ensuring your rights and interests are fully protected. As always, if you or someone you love has any questions or needs representation for an injury, please don’t hesitate to call. We’re here to provide the support and expertise you need to navigate your legal journey with confidence. For a free and confidential case evaluation, call Allen & Allen today, at 866-308-1307.
