Using my 30 years of experience as a Car Crash Attorney I am writing a series of Blog Articles explaining how car crash claims are handled in North Dakota. This is Car Crash Blog Volume 6: Allocation and Coordination of No-Fault Benefits.
My prior posts have discussed No-Fault benefits. (These informational articles can be found on my websites: 25% Contingent Fees on Selected Car Crash Cases.) When you suffer severe car crash injuries the two most important and often-used No-Fault Benefits are medical expense and wage loss benefits. Because the mandatory No-Fault Benefit is limited to $30,000, your No-Fault Benefits may not cover all of your medical expenses and wage loss.
Allocation of No-Fault Benefits and Coordination of Benefits are two important ways that you can maximize your No-Fault Benefits.
In St. Alexius Hospital v. Eckert, 284 N.W.2d 441 (N.D. 1979) the North Dakota Supreme Court ruled that a person injured in a car accident could decide how to allocate his/her No-Fault Benefits to a specific type of benefit. In the Eckert case the Mr. Eckert was injured in a car accident. He directed his No-Fault insurance company to pay his loss wage benefits and not to pay his medical expenses. Mr. Eckert decided it was in his best interest to maximize his loss wage No-Fault benefits and have all of his medical expenses paid by his medical insurance.
Even though the ability to allocate the use of No-Fault Benefits has been available since 1979 it is not used very often. My experience leads me to believe that most No-Fault insurance companies do not discuss allocation of benefits with the injured person and many crash injury victims do not consult a personal injury attorney soon after a crash when an allocation can be made.
There are a number of factors to be considered before deciding to allocate your No-Fault Benefits. Factors that must be considered include:
* Are you at fault for causing the car crash?
* Was the car crash caused by a third-party that may be liable for to you for your car crash injuries?
* Do you have a substantial loss wage claim?
* Will you be disabled for a long time?
* Do you have medical insurance that will pay for your medical expenses?
Connected with your decision to allocate your No-Fault benefits is an understanding of the coordination of your medical expense payments.
After it has paid $10,000.00 in medical expenses your No-Fault insurance company is allowed to coordinate the payment of medical expenses with your health insurance company. If your car accident injuries were caused by a third-party and you intend to assert a claim against the at-fault driver it is better that your medical expenses be paid by your No-Fault insurance rather than your health insurance.
Your health insurance company will assert a subrogation or reimbursement claim against any amount you recover from an at fault party as compensation for your personal injuries. This can result in a reduction of the amount of money that you will actually receive. This often happens when the at fault driver has insufficient liability limits or if some of the fault for your injuries is assigned to you under North Dakota’s comparative fault system.
I have seen No-Fault insurance companies improperly coordinate benefits and use the coordination of benefits provisions to stop paying medical benefits.
Anytime your medical expenses get close to or exceed $10,000 you should consult an experience North Dakota personal injury attorney to assist you with the coordination of benefits and the subrogation claims that will be made by your health insurance.