Auto Insurance No Fault Benefits Overview

Male: So when someone goes out to get an auto policy of insurance, how much time you think you spend to explaining you the No-Fault Benefits? Frank J. Dibari: I would say not enough time as they’re should be. I think a lot of people when they’re applying a policy. I worried about getting their car fixed. Male: I think the way without—if I gain to accident am I going to be covered? Am I going to be protected? Frank J. Dibari: Right. Male: Right? Frank J. Dibari: I don’t think—I think that the No-Fault is not covered enough and I think that it should be. Male: So you say if I took a 100 people off the street who have auto you know, who have auto insurance and I ask about their No-Fault insurance they would probably be coolest most of them. Frank J. Dibari: Yes, as our some of our clients. Male: That may do? Frank J. Dibari: They— Male: Well you can't blame them because nobody’s there to explain it to them and you know if you really want it to spend the time ritual the paperwork, you probably won’t understand half of what’s there anyway but when you know—what is some things that you think somebody can do to enhance their own auto policy when it comes out to their No-Fault insurance? Frank J. Dibari: Well, the basic policy is $50,000.00 from medical coverage and then includes up to $2,000.00 a month for lost wages and for a few dollars more, you can get up to a 4100,000.00 for medical coverage and $4,000.00 for lost wages. So if you’re somebody who makes over $2,000.00 a month and you get into an accident and you missed out from work you’re only going to be entitled to $2,000.00 a month if you buy the basic policy which these days is very difficult to survive on. Male: The stuff you know when you have a client sitting before he was been above than an accident and they have serious injuries fractures or some that requires surgery and you have to tell them this the world is really turned upside down. Frank J. Dibari: We have clients who were made in the hospital for a week and you could use up $50,000.00 in less than a week. Male: Yeah. Frank J. Dibari: Surgeries and procedures and I would say definitely when you’re speaking to the person who was writing a policy look into possible spend the whole that more money for extra coverage. Male: Now I’m looking at the benefits that you get from No-faults, I know you get the general the basic policy. You get the $50,000.00? Frank J. Dibari: Right. Male: $2,000.00 and wages. Frank J. Dibari: Correct. You’re entitled to $25.00 a day for what’s considered other necessary expenses which is if you need to take a taxi cab to and from the doctor. If you need to hire household help and you’re able to do that but again its $25.00 a day and that’s basic if you pump it up one, you can get $50.00 a day. Male: Right, makes a difference. Frank J. Dibari: And again we get clients who get the household help and they’re charging the client more than $25.00 a day so the client is responsible for the balance. Male: Right. Frank J. Dibari: So again, the basic No-Fault policy—you know its been around for years now I don’t think its really change with the financial you know ask it to what’s going on today and I think really a basic policy should be a $100,000.00. Male: Do you know why No-Fault came in to existence? Frank J. Dibari: It came to an existence basically because when you’re involved in a car accident they want to make sure that you’re covered by somebody and another problem that clients have when they come into the office is, they always asked why is it going through my insurance policy? Male: I didn’t cause the accident? Frank J. Dibari: Right. Male: Why do I have the benefit? Frank J. Dibari: That person around the red light, why I’m paying for my own medical bills and the reason why it came to an existence is because you can get hit by somebody who doesn’t have insurance. It’s protecting you so that you are covered. Male: I think the situation where there is an into section accident has a question of who had the red light and who had the green light and you’ve got three or four people in this car and three or four people in that car. Everybody in this medical treatment, well if you don’t have this No-Fault system then everybody is left to resolve the liability issues before you forgot which cars is going to pay for you treatment. Frank J. Dibari: Right. It is there so that you can get immediate treatment and you don’t have to work out with this person’s 75% liable and this person 25% liable, its there so that you’re covered immediately. Male: That’s the good part. Frank J. Dibari: That’s the good part. There are probably more bad parts in No-Faults than there are good parts unfortunately. Male: Oh I mean it invites fraud because you know my understanding of no fault and I was to you known we’ve handled thousands of No-Fault matters. Is the insurance companies are under a duty to pay for your treatment if it’s for injury that is related to the accident? Frank J. Dibari: Related to the accident and considered medical in necessary. Male: And it’s reasonable? Frank J. Dibari: Right. Male: So its usually hard to prove that an injury is not you know a new injury is not related if your back or your neck hurts something like that when you break something. I think the reason the system was put in effect thou was to limit the lawsuits that stand from car accident cases? Frank J. Dibari: Well it’s supposed to put you back to where you are, had the accident on occurred and then there are certain elements or criteria that you have to meet where then you can make a claim against the other driver. If you don’t meet those certain elements, it’s supposed that you just put your back to where you were and no harm no foul. Male: It’s makes you whole again? Frank J. Dibari: Right. Male: Go to the doctor, you’ve had an accident. Get your treatment, get well. If you’re going to be at work you get lost wages. If you’re out of pocket expenses for traveling too from doctors or guest, miles we’ll reimburse you. Frank J. Dibari: Right. Male: Get well, get on with your life. Now if you want to bring their claim against the person that causes these injuries too you have to have serious injury. Frank J. Dibari: Right and there are nine injuries that are listed. You have to meet one of those nine injuries. Male: Nine categories. Frank J. Dibari: Nine categories and if you meet one of those nine categories you can make a claim against the person who was responsible for your injuries. Above and beyond what you got compensated from No-Fault. Male: When you look at these categories, you know some of them are pretty heavy. You know death, and disfigurement. Frank J. Dibari: Right. Male: How do you read that ninth category there? I think its says any none permanent injury which prevents you from performing substantially all of your customer activities for the first 90 or the first 90 or— Frank J. Dibari: 90 have the first 180 days. Male: How do you read that because I know a lot of people looking it as—if you try to work for 90 days you’ve satisfied that but— Frank J. Dibari: Well I mean the first thing you have to look is, Doctor has to document everything. Male: Right. Frank J. Dibari: You can't just say I feel like I can't work. Doctor has to say that you can't work and you don’t necessarily mean it or you mean it if you had to work for 90 days and you had to treat for 90 days or you meet that threshold, it doesn’t necessarily mean that it say— Male: That you got to do on the lottery. Frank J. Dibari: Right. Male: You’re entitled to be compensated. Frank J. Dibari: Right and its negotiable. We had cases where the clients treat for 89 days and there is nothing we can do. The insurance company feels that it’s not a serious injury and— Male: Didn’t meet that 90-day threshold. Frank J. Dibari: It doesn’t have to be the first 90 days. It has to be 90 out of the first one 180 days so you have six months. 180 days and six months and you can treat within that six months and then you met that serious injury criteria. Male: I’m sure you’ve been ask this question because I have clients who want to know if they can work or can they return to work or you know whatever reason I was telling them its between you and the doctor. Sometime they try to go back to work and they just find that it’s aggravating where pain or conditions have and then able base that work. Frank J. Dibari: Right. Male: We’ll try to go back to work so that’s where 180 days come into. Frank J. Dibari: Right and also I usually tell the client, tell the doctor what your daily duties are at work. It depends on the job if you’re a brick layer or if you work in construction and you have to use a sledge hammer. Male: Righ. Frank J. Dibari: You should tell the doctor that because your job can be hurting you more and if you have a desk job and you can get up and stretch every so often you don’t necessarily have to missed 90 days of that in order to meet the criteria. Male: And also then the language and the category itself is customary activities. Frank J. Dibari: Right. Male: So it doesn’t have to be worked. It can be if you’re somebody who likes to exercise, who jogs everyday, who was in a bowling league. It can do these things anymore. Frank J. Dibari: Right. Male: I would say even includes you know relations with your spouse or whatever your customer activities are. If you can document that you cannot perform this for this type of period of time then you can satisfy that statute which made you be entitle to be compensated but the value of the compensation would depend on the injury. What is the injury? Frank J. Dibari: Right. A lot of clients feel that they have their MRIs were positive and— Male: Which show hernia disc let say. Frank J. Dibari: Correct. You know unfortunately hernia disc affect different people in different ways. There are some people who have herniated disc who can't work for 90 days. That hernia disc is isn’t necessarily an injury on those nine categories. Its how that hernia disc affects you.