Butler Kahn recently obtained a $250,000 settlement in a car accident case involving a wrong-way driver.
Here’s more about the case.
Facts of the Car Wreck
One summer night, the Rogers family* was driving south a state highway in Dalton, Georgia. As the Rogers family approached an intersection, a vehicle driven by Mr. Oliver, pulled out and made a left turn in front of the Rogers family’s car. The issue was that Mr. Oliver failed to see – or just ignored – the no-left-turn sign at the intersection. He made an illegal left turn and began driving north in the southbound lanes of the highway.
No left turn sign at intersection
Shortly after Mr. Oliver turned left, he collided head on with the Rogers family. Both vehicles were totaled.
Photo of the Rogers family’s vehicle
All members of the Rogers family that were in the vehicle were hurt in the wreck. The oldest sibling, Valerie, was the driver. She suffered soft tissue injuries in her back. The second-oldest sibling, Gloria, suffered compression fractures in her back and had to undergo surgery. The mother, Martha, broke her pelvis and also had to undergo surgery. Maddy, one of the siblings, hurt her shins. Lastly, the youngest sibling, Marcus, suffered a cut to his face that required stitches.
The responding police officer deemed Mr. Oliver at fault for the wreck and gave him a ticket for driving on the wrong side of the road.
Pleading Guilty to a Traffic Ticket
In October, Mr. Oliver went to court for his ticket. At that court appearance, Mr. Oliver had three plea choices: guilty, not guilty, and nolo contendere. Pleading “guilty” is exactly how it sounds—you admit you are guilty of the offense. Pleading “not guilty” also is exactly how it sounds — you are telling the court you are not guilty of the offense. Pleading “nolo contendere” or “nolo” means a defendant accepts the conviction or responsibility of a crime but does not admit that they are guilty of the crime. This is an importance distinction in civil cases because a person who pleads “nolo” to a traffic ticket does not admit to committing the traffic offense.
Thankfully in the Rogers family case, Mr. Oliver chose to plead guilty to his ticket. He was required to pay a $120.00 fine.
Mr. Oliver’s sentence from his traffic ticket
Mr. Oliver’s guilty plea to his traffic ticket meant he admitted to driving on the wrong side of the roadway. If the Rogers family’s civil case were to go to trial, Mr. Oliver’s admission to driving on the wrong side of the road would come into evidence.
Health Insurance Reimbursement After a Car Wreck
Many health insurance companies claim they are entitled to be reimbursed for any expenses they pay when someone is hurt in a car wreck. This reimbursement is supposed to come from the settlement money their insured receives from an at-fault driver. For example, if a health insurance company pays an emergency room bill, that health insurance company may claim their insured must pay them back if their insured receives any money from the at-fault driver.
In Georgia, there are only a few health insurance polices that are entitled to reimbursement. Those insurance polices are either self-funded ERISA plans, government plans like Medicaid or Medicare, or other federal health insurance plans. That is because Georgia has the “made whole doctrine,” which means an insured does not have to pay back their health insurance company unless the insured receives more money than their economic and noneconomic damages. In other words, unless the insured receives enough money to “make them whole”, then they do not own their insurance company any reimbursement.
In Mrs. Rogers case, her health insurance company claimed it was entitled to be reimbursed nearly $40,000.00 in claims it paid for Mrs. Rogers’ medical treatment. The health insurance company also initially claimed it was a self-funded ERISA plan, which is one of the health insurance plans that is entitled to reimbursement.
At Butler Kahn we do everything we can to ensure our clients only reimburse valid claims by health insurance companies. After multiple phone calls, letters, and demands to the insurance company, we determined the health insurance plan was not a self-funded ERISA plan. This meant the health plan was not entitled to reimbursement and Mrs. Rogers did not have to pay any money back to her health insurance plan. That left a lot more money in her pocket when the case was over.
$250,000 Wrong-Way Driver Car Wreck Settlement
The at-fault driver, Mr. Oliver, had a minimum limits insurance policy. In Georgia, that means he carried only $25,000 per person/$50,000 per accident in coverage. Luckily, the Rogers family had a few insurance policies with underinsured motorist (“UM”) coverage. We were able to find all of those policies and then “stack” them, which basically means to add them all together to provide additional insurance coverage. These UM polices totaled an additional $200,000 in available coverage.
We made an offers to both Mr. Oliver’s insurance company and the Rogers family’s insurance company for the available limits. Both insurance companies accepted, and we were able to recover a total of $250,000 for the Rogers family.
* The names in this writeup have been changed for the privacy of those involved.
