Massachusetts Lawyer Blog

In Coombes v. Florio, 450 Mass. 182 (2007), a physician owed a duty of reasonable care to those foreseeability put at risk by a doctor’s failure to warn the patient of the side effects of the patient's treatment. In Coombes a young boy was struck and killed by a car driven by one taking medications, but who had neither been warned of the medications' side effects, nor been told not to drive while taking these medications. See Massachusetts Bar Association review of Coombes. Thus, liability under Coombes could be extended and include those not having any doctor-patient relationship. A recent case dealing with negligence, duty, and foreseeability sought to expand this holding even further, but it was unsuccessful before the Massachusetts Supreme Judicial Court (SJC).

In Leavitt vs. Brockton Hospital, Inc., Sheila Smith and Karen Sullivan (slip opinion), a pedestrian involved in a car accident had undergone a colonoscopy earlier in the day and was walking home from Brockton Hospital when struck by another vehicle. While heading to the accident's location, a Whitman police cruiser was hit by another vehicle resulting in an officer being seriously and permanently injured. The police officer sued the hospital for negligence claiming they had breached their duty of care, among other things, when they released the previously sedated patient without an escort. The Supreme Judicial Court agreed the case had been properly dismissed by a lower court and upheld that court's decision.

In a footnote, the court noted the different standards for reviewing a motion to dismiss because the standard had changed from the time of the judge's ruling to the time of the SJC's review. Regardless, the court opined this case would have failed under either standard.

After the judge had ruled on the hospital's motion to dismiss, we adopted as applicable to our civil rules the United States Supreme Court's revision of the standard for reviewing the adequacy of a complaint challenged by a motion to dismiss pursuant to Fed. R. Civ. P. 12 (b) (6). See Iannacchino v. Ford Motor Co., 451 Mass. 623, 635-636 (2008), quoting Bell Atl. Corp. v. Twombly, 127 S. Ct. 1955, 1966 (2007) ("What is required at the pleading stage are factual 'allegations plausibly suggesting [not merely consistent with]' an entitlement to relief . . ."). The hospital does not ask that we apply the new, "stricter" standard. See Flomenbaum v. Commonwealth, 451 Mass. 740, 751 n.12 (2008). The complaint would not survive the hospital's motion to dismiss under either standard.

Technorati Tags: negligence, duty, police, hospital, Coombes

This Mass PI law post is last in a series of five that revealed some of the themes to be on the lookout for when settling your car accident case (or questioning whether you need a lawyer at the start of  your Massachusetts personal injury case.)

Wolf in sheep’s clothing – The friendly insurance adjuster (from the car that hit you) wants to check in on you and see how you’re doing.  In order to help you and get your bills paid, they’d like to come visit you at your home and go over some simple forms (some don’t even announce their visit and just show up).  Perhaps the tape recorder comes out, perhaps the wolf asks the questions in a cunning way, perhaps you're left wondering what just happened or even worse, perhaps you think he/she seemed like a nice person.  If so, there may not be any pleasant fairy tale endings in store for you.  If the wolf's already been around, get help quickly you're case becomes his next snack.

This Mass PI law post is the fourth in a series of five discussing themes to watch out for when settling your car accident case (or questioning whether you need a lawyer at the start of  your Massachusetts personal injury case.)

Fear of trial – How far do you want to take your case? Are you willing to lose it all?  In addition, are you willing to go through all the pre-trial actions and wait for a trial date in the distant future? These are fears that can be relied on and can often lead to low settlement offers being offered, and unfortunately too often, accepted.

Next installment: Part 5 -- Wolf in Sheep's Clothing

This Massachusetts PI law post is the third in a series of five addressing some of the themes to be on the lookout for when settling your car accident case or questioning whether you need a lawyer at the start of  your Massachusetts personal injury case.

Wait them out – A driver injured when another car struck her from behind suffered injuries and incurred minor damages.  The medical bills were just under the threshold for a claim to be pursued ($2,000 at the time).  Don’t expect the insurance company to tell you about the out of pocket expenses you can be reimbursed for and make your claim actionable.  In other instances, they can just wait you out and offer to make a small payment knowing you are getting collection letters and want to protect your credit.  If you don't know about the tort threshold is, are close but not sure what counts, or concerned about your unpaid bills, then consult with a MA personal injury attorney.

Next installment or Part IV: Fear of Trial

This post is the second in a series of five that addresses some of the themes to be on the lookout for when settling your car accident case (or questioning whether you need a lawyer at the start of your Massachusetts personal injury case.)

Blame the victim -- The at-fault driver’s insurance company tries to pressure you into a speedy, unfair settlement and if you don’t agree they threaten to sue you. The theory becomes you’ll get nothing, and be responsible for the unpaid bills. I have an elderly client they tried this with. She was parked at a light and rear-ended but they tried to bully her and claim it was “her” fault. Don't let them push you around. If it starts, end the conversation and get an attorney.

Next installment #3 -- Wait them out.

Auto accident laws (in Massachusetts or anywhere for that matter) should exist to protect consumers involved in auto accident claims and settlements, but the victims of car accident injuries will likely tell you the process can be confusing and daunting.  For many, it appears, the laws protect the insurers more than the injured.

Massachusetts personal injury attorneys help balance the equation against the powerful insurance companies as well as keep in check the unfair or deceptive practices that can be employed.  Without a MA lawyer to help assess a Mass. personal injury case (property damage, lost wages, car accident injuries, insurance, medical bills, out of pocket costs, prescriptions, …), how does the average consumer know if a settlement of their car accident claim is in their best interests?  The insurance company/industry wants you to believe they can help you with this and you don't need a lawyer.

This post is the first of five that addresses some of the themes to be on the lookout for when settling your car accident case or questioning whether you need a lawyer at the start of your Massachusetts personal injury case.  In the posts to follow, I'll touch on a few general themes such as: lowball offers, "friendly" adjusters (who aren't your friend), delay tactics, blaming the victim, and fear of trials.  While having an attorney won't necessarily prevent these tactics from arising, your lawyer can deal with these head on and refocus the discussion back on obtaining the highest value for your case.  In sum, the theory behind these posts is: "forewarned is forearmed."

It's not uncommon for death and probate cases in Mass to involve people who are suffering a loss and experiencing grief. As their lawyer in a wrongful death case or in a Massachusetts probate estate matter, I'm often directly discussing what caused the death of their loved one or the final wishes of a spouse, parent, child, or friend. Some of our discussions can be difficult and quite emotional

It seems whenever someone begins to cry or need a moment, they almost instinctively need to apologize afterward and then offer a reason for why they shouldn't be getting emotional. I've heard person after person explain how they "should" be experiencing their grief. I've never quite understood this -- many times their loss moves me too.

While I'm no psychologist, I've never found there to be any set rules here. While it's somewhat slanted in its origin (and in a couple of places maybe), I came across this article discussing the Ten Common Myths and Realities About Grief. I'm listing an excerpt of some of the myths below to give you the general idea.

• "It has been a year since your spouse died. Don't you think you should be dating by now?"
• "You look so well!"
• "The best thing we can do (for the griever) is to avoid discussing the loss."
• "It has been six (or nine or 12) months now.
• "Don't you think you should be over it?"
• "You need to be more active and get out more!"
• "You are young, and you can get married again."
• "Your loved one is no longer in pain now. Be thankful for that."
• "She cries a lot. I'm concerned she is going to have a nervous breakdown."
• "Grief support groups are too depressing and not helpful."

Again, I'm no psychologist, but I'm guessing the list (on myths about grieving) could be expanded quite a bit and, like me, many lawyers in Mass and elsewhere have seen it firsthand.

Some bereavement support resources (these may change but a search for "bereavement support group" and then your area may offer some local results) are below. Also check with your local hospice, hospital, funeral home, city/town hall, or attorney for local options if you are interested.

Some links from today...

• Massachusetts Center for Sudden Infant Death Syndrome

• MGH Bereavement Support Group

• The Good Grief Program

• The Good Grief Program Family Resources Page

• Hospice of the South Shore Bereavement Care: 781-794-7803

• Quincy Hospital Bereavement Support Group: 617-376-5502

• Grief and Loss Resources from website of Help Starts Here also see their article on Grief and Loss - Your Options: Bereavement Support Groups -- An Effective Tool for Healing.

Blogs, social networks, and the web extend well beyond Massachusetts borders thus it's often instructive to look around the country and consider how laws are developing elsewhere as they relate to blogging and cyberspace in general. Trial lawyers of both today and of the future will need to be well versed in the law and understand this evolving interactive arena that changes day-by-day. Blogger and California law professor Eric Goldman recently mentions a case involving blog postings being introduced as evidence in a trademark infringement lawsuit. He quotes the court's holding which excluded the blog's comments from evidence.

The Court declines to consider these postings in reaching its decision. The Court is concerned, on this record, that the blog entries lack sufficient indicia of reliability.FN4

Nothing is known about the persons who made the entries, about whether they are related in any way to either party or whether they are describing true events and impressions. Moreover, the authors' meaning and the import of the blog entries are far from clear.

FN4. This should not be construed as a ruling by the Court that entries on Internet blogs could not, on a different record, be reliable and admissible.

(The case was as consumer confusion case on whether "Mooo Tracks" ice cream infringes upon "Moose Track" ice cream. Blue Bell Creameries, L.P. v. Denali Co., LLC, 2008 WL 2965655 (S.D. Tex. July 31, 2008)).

You can look at this from two perspectives, the blog comments were kept out. On the other hand, there were some criteria listed for their exclusion. If these were met, would the comments be allowed into evidence here? It would seem so, why shouldn't they be? Look to the next round of cases to have greater foundations laid down concerning the inclusion of blog comments as evidence.

Like many attorneys I talk with, I'm already seeing more of my clients who are relying on blogs or websites for much of their news. The constantly dwindling size of my newspaper backs this up too. Some do believe, "If I read it, then it's true," but as we know, that's often not the case.

Reliability, validity, authenticity are continuing concerns of justice and in the short term, it seems the web won't make things easier in these areas. Here the law still has much to work out regarding how it's going to keep pace with the web, social media, web 2.0 or whatever name or thing is next. Smart trial lawyers will need to keep pace with these evidentiary possibilities as more and more communications and events are recorded somewhere someplace electronically. Appellate courts and lawyers should see interesting and intellectually stimulaing times ahead in this area of law. While some of the tools of proof may be new, the principles remain the same -- it may just take a little time to connect the two.

Personal injury lawyers, in Massachusetts often get a bad rap with "ambulance-chaser" being a well-known knock on PI lawyers. Did you know the moniker "ambulance-chaser", however, might be better suited for the other side of the courtroom in car accident case, not the plaintiff's?

Last night I was reviewing a claim against a reckless driver, and once again I was struck by how quickly the defendant's insurance company had visited my client and manipulated her into signing a medical authorization.

As I was thinking about this family, I began seeing the young girl sitting on her family couch while crying in pain. She's sitting alongside her father who just wants to take care of her while the cagey insurance adjuster pushes and pushes for more and more information against her until he has what he came for and leaves -- it reminds me of how aggressive and abusive the real ambulance chasers of today are.(p/>

There was no reason for this victim to:

• Meet with this insurance adjuster, especially at her home while she recovers;
• Not have a lawyer with her;
• Provide a statement; or
• Authorize complete access to all of her private medical records.

This story, however, isn't unfamiliar or uncommon. The insurance company had taken the all too familiar 'wolf in sheep's clothing' approach. Luckily the young girl's father found this whole approach odd. Once the shock of it all left, he questioned why he had let this man into his home in the first place. Once I was contacted, I was able to revoke the medical authorization immediately and order the investigator to stop contacting or harassing this family at their home.

If you've been injured in an accident and don't have an attorney, don't allow the following to be used to coerce your in a deceitful manner:

• Shock of the accident,
• Guilt,
  
• Immediacy of an unexpected visit,
• Caring or friendly approach,
• Assurance that you don't need a lawyer,
• Your desire to be helpful,or
• Your hope to resolve things quickly
  

If you have already met with their adjuster before being represented by legal counsel, then have your lawyer get a copy of your statement and terminate any authorizations immediately. By acting quickly you may be able to limit the disclosures that probably don't need to be made.

Wilson & Whitaker, LLC represents people who have been harmed or suffered a loss in a personal injury or wrongful death case involving a Massachusetts transportation or auto accident.

An interesting article on law.com recently discussed the issue of lawyers asking jurors about their medication use. With so much of the population on medication, is drug use something that should be questioned of potential jurors? If so, how far should questioning go? Do we ask a general question? Whether the use of medication will interfere with a juror's duties, or do we delve deeper into more specific questions about the person, their conditions, and their treatments? The article, by Julie Kay, offers pros and cons while raising issues likely to continue making headlines(juror falling asleep in murder trial, someone goes off their medications during trial...).

As an attorney-advocate there may be times when seeking this information makes sense for my client. As the lawyer for my client I have the duty the pursue what's in my clients best interests. Personally, however, I think when we start asking jurors to divulge what medication they're taking, we're crossing a finer line. We have to wonder if the jurors' themselves aren't thinking, "Who is actually on trial, here?" Of course there are going to be exceptions to every rule, but speaking from a policy perspective, I'd rather have privacy rights' invasions remain the limited exceptions and not become the standard rule.

"Mediation’s Seven Deadly Sins - Avoiding the Seven Sure-Fire Ways to Torpedo Your Mediation, Upset Your Client and Enrich the Other Side" was the name of a discussion sponsored by the Section of Dispute Resolution held during the 2008 Annual American Bar Association Meeting in New York.

While mediation provides an opportunity to examine settlement, it also provides an opportunity to examine the other side, their case, and how a party may respond in court. One of the panelists, Joel Davidson, said

He sees the mediation process as a chance to get his point across in a specific way. He said he likes to show the person on the other side that I know the issue well.

... mediation provides the opportunity to examine how clients handle themselves. If a client does not come across rationally during mediation, I know that in advance of a trial...

Mediation, however, can also provide a receptive forum for an apology. Often parties want to apologize but are told not to apologize by their attorneys. The attorneys often fear an apology could be used as an admission of liability against them in court and/or reduce their bargaining position in settlement discussions. Handled properly, however, a sincere apology during mediation can sometimes go a long way towards resolving a a brooding conflict. Davidson notes mediation may,

... provide an opportunity for clients to either apologize for a wrong or acknowledge a misunderstanding. This simple communication may be enough to move a case toward settlement.

More and more, I'm finding people want to resolve their Massachusetts divorce, personal injury, or business case in mediation. There are a number of factors that contribute to this (control over the outcome, avoid formality of court, ease of scheduling, ...), but I'm sensing the Mass. economy is playing a role in this increase too.

People seem inclined to seek resolving their MA disputes fairly and quickly while avoiding the high costs and endless delays contentious litigation can sometimes bring. While not all cases can be resolved in mediation, many can. There's really nothing to lose in mediation. In the end, the parties have to agree on the ultimate solution in mediation (they can have an attorney review their agreement first or participate in the mediation with them).

I've been thinking about this more and more as I've begun to formalize our mediation practice offerings at Wilson & Whitaker, LLC. I've created a temporary website focusing solely on mediation as our Weymouth law firm continues to expand our mediation services. Let me know your thoughts and what questions you may have about mediation practices or disputes Massachusetts lawyers deal with.

From the SJC, a Diagram (see below) showing the Massachusetts Court System. Also, a resource titled, Representing Yourself in a Civil Case: Things to Consider When Going to Court.

When asked, "What are my chances at winning at trial?", most lawyers in Massachusetts or elsewhere would reply, "It depends." A recent article in the New York Times is offering some percentages and cost estimates that will likely raise a few eyebrows.

The article entitled, Study Finds Settling Is Better Than Going to Trial, discusses a study finding settlement is statistically generally the best option. The article indicates plaintiffs were wrong to go to trial in 61% of the cases and defendants were wrong to proceed to trial in 24% of cases. Both were wrong because they could have settled the case for an amount better than what was achieved at trial.

The article reports:

...in just 15 percent of cases, both sides were right to go to trial — meaning that the defendant paid less than the plaintiff had wanted but the plaintiff got more than the defendant had offered.

It's worth noting, however, that the estimated cost for making the wrong choice was a lot greater for defendants ($1.1 million) than it was for plaintiffs ($43,000).

While numbers are one factor to consider in proceeding to trial, the issues of civil justice, correcting a wrong, or having your day in court are worth something of societal value too. These are issues that can't be measured in dollars or percentages, but at the same time lawyers need to advise their client's to pursue their best interests. In the end, the right question may not only be: "What are my chances of winning at trial?" but also ,"Why do I want to go to trial?" The decision is always the clients and it's a decision that should be based on what is right for them, even when it's against all odds.

This morning my daughter suggested we take the net (from that game where you hit the thing that looks like an empty ice cream cone) and use it to play volleyball.  I knew immediately she was talking about the net from the old badminton set because the "empty ice cream cone" was certainly the birdie we hit back and forth about a month ago.  In communication and in law context is everything -- both combined can lead to real value.

You shouldn't need to talk in legal mumbo jumbo to get your point across or to achieve the result you desire.  Find a lawyer who knows the law but also gets where you are coming from.  Seek out an attorney who will invest in building a relationship with you.  This is the foundation for providing value -- a real value that seeks to first understand and then meet your needs.  Anything else is just an empty ice cream cone...

While not specific to Massachusetts, a recent AAJ Law News Digest (by email, June 5, 2008) cited three articles illustrating interesting developments in arbitration and law, as well as an interesting poll.

Costs vs. Benefits in Arbitration

In No Room for Error in Arbitration?, Thomas E.L. Dewey and Kara Siegel, New York Law Journal, June 03, 2008, write:

Arbitration of commercial disputes has become increasingly common, due in part to the widely held perception that arbitration is a less expensive and more expeditious method of dispute resolution. Recent court decisions, however, have underscored the fact that those perceived benefits come at a price: the U.S. Supreme Court ruled in April that parties cannot agree to a higher standard of judicial review of arbitration awards, and appeared to question the validity of a long-standing doctrine that does permit courts to overturn arbitration awards that are in "manifest disregard" of the law. The net result: parties who agree to arbitrate their disputes should understand that it will be very difficult to obtain relief from an erroneous arbitration award.

Franchise Concerns in Arbitration

In Pressure Grows to Rethink the Use Of Mandatory-Arbitration Clauses By Richard Gibson, he states:

Most franchise contracts once called for mandatory arbitration of issues, rather than going to court. But these days there is growing pressure -- from franchisees, judges, Congress and even some franchisers -- to rethink that longstanding arrangement. 'The trend toward arbitration has pretty much ended,' says Peter Lagarias, a franchisees' attorney in San Rafael, Calif. Among the concerns is that there is no guaranteed right of appeal. 'You have to take what the arbitrator decides,' says Joshua Becker, an in-house counsel for fast-food franchiser Kahala Corp. For that reason, he says, Kahala, whose brands include Blimpie submarine sandwiches and TacoTime, favors resolving issues with franchisees in court."

Doctors Not Treating Patients without Arbitration

The Tampa Tribune Editorial, New 'Hello' In Health Care: Sign Here Not To Sue, states:

"It's not uncommon today for a woman visiting her gynecologist to give up her right to sue if something goes wrong. The doctor simply won't treat her unless she agrees to take any potential claim to an arbitration panel rather than the courts. The same goes for many acute-care hospitals and nursing homes, where stressed-out families with little choice are handed 60-odd pages of documents to sign. Sandwiched near the end, the mandatory-arbitration agreement gets the briefest of explanations. Binding arbitration - not health precautions and explanations - is the new 'hello' in health care. It's a physician's answer to the threat of litigation and the high cost of malpractice insurance. Like some trial lawyers who have convinced clients to sign away their constitutional rights to limited legal fees, doctors are getting patients to sign away their constitutional right to sue, too. This troubling new practice is a barrier to the doctor-patient relati onship, akin to signing a pre-nuptial agreement before getting married. The practice is a form of blackmail: Sign it or get out."

Consumer Poll Results on Arbitration

The AAJ on their webites provide the article, New Poll: Americans Say “No Thanks” To Binding Arbitration:

Washington, DC—Americans generally disapprove of binding arbitration provisions in consumer contracts as an alternative to civil legal proceedings involving a judge or jury, according to a recent national poll by survey firm Peter D. Hart Research Associates Inc.

“Mandatory binding arbitration doesn’t give consumers a choice,” said American Association for Justice President Kathleen Flynn Peterson. “This poll proves that when asked to choose, consumers overwhelmingly say ‘no thanks’ to unfair arbitration agreements. Arbitration can only be a valid and effective method of resolving disputes when both parties agree voluntarily.”

Consumers are sometimes required to sign a contract with a company when purchasing products or services ranging from cell phones to nursing home care. These contracts often include a binding arbitration provision which states the consumer agrees to have any dispute with the company decided by an arbitrator, rather than by a judge or jury in a civil legal proceeding.

Binding arbitration has even been enforced in nursing home deaths. Massachusetts resident John Donahue suffered an eye injury so severe that it required removal of his eye while under the care of a nursing home. The infection caused by his injury eventually led to his death. When his daughter Marlene Owens went to file a claim against the nursing home corporation she was told that her father signed a binding arbitration agreement without any family members present. The nursing home insists that the case be taken to arbitration and the case is currently pending.

According to the polling, when consumers learn that the company picks the arbitrator, and they give up their right to take the case to court and binding arbitration applies even if they are seriously injured, 81 percent disapprove.

The poll also shows broad support for Congressional legislation called the “Arbitration Fairness Act” that seeks to protect Americans from abusive arbitration agreements. The legislation would ensure that the decision to arbitrate be made voluntarily and after a dispute has arisen. In addition, the legislation enjoys very strong support across party lines with no statistically significant differences between Democrats (+38) and Republicans (+37).

Last week, the U.S. House and Senate passed The Food, Conservation and Energy Act of 2008 conference agreement containing a voluntary arbitration provision which would allow farmers to opt out of binding mandatory arbitration clauses at the time they sign a contract with a processing company. The enactment of this provision would mark a significant step forward for farmers who are subject to these abusive contracts.

Summary

Is arbitration right for you? What are your downsides and upsides? These are questions to consider anytime you're faced with an arbitration clause or are considering including one in your contracts. The larger issues remains, are forced arbitration agreements fair and should they be allowed under law? It appears both consumers and companies are now giving this some additional thought.

Something to think about the next time a defense expert or doctor treats a car accident victim with disdain. Perhaps they don’t really dislike the injured person (who they’re showing disgust towards). Maybe they’ve just been coached by the insurance company’s defense lawyer as part of the “litigation plan.”

Although not from Massachusetts, defense attorney Jenifer L. Kienle generally discusses how mental health professionals and experts should be coached to avoid forming favorable impressions of an injured car accident victim. In her article, “The New Science of Stress - Why Defending a Fender Bender Lawsuit When the Plaintiff Claims Post Traumatic Stress Syndrome Requires a New Litigation Plan,” she states:

Finally, choosing a defense expert also requires an understanding that treaters in the mental health field frequently become involved with a patient, and while exploring their personality, subconsciously begin to "like" the plaintiff. … be alert to any defense expert who, after spending considerable time interviewing the plaintiff, reports his/her impression of the plaintiff in complimentary terms. This may be a sign the expert's professional judgment (and ultimate diagnosis) is impeded by favorable feelings toward the plaintiff. Avoid this trap with early, frequent and candid discussions with the expert so that his/her favorable impressions of the plaintiff can be managed. [bold added for emphasis]

If you’ve been injured in a car accident, the stress can be real. It can cause anxiety, loss of sleep, fear of driving, and many other emotional and physical symptoms. Don’t ever let a supposed "expert" make you feel bad or question the legitimacy of what you are going through. You’ve suffered enough and it wasn’t your fault. Remember, even though they’re “professionals” they’re not being paid to like you. As you can see from above, some "defense experts" are even being coached to ensure they don’t. They're not being genuine and they're not playing fair, you need an advocate who can understand what you're going through and who isn't afraid to challenge the defense expert's bias or the people who pay them.

Whether you’re a passenger, driver, or pedestrian in a Massachusetts auto accident, the insurance issues can be tricky. It’s not uncommon for someoe injured in a car accident to go see a medical provider thinking their medical care should be covered by the person who caused their accident. If it’s not covered, they believe their medical insurance company should cover the bills. After all, that's why we pay so much for all this insurance, right? But did you know that thinking the insurance issues are simple and will take care of themselves could lead to receiving big bills for unpaid medical expenses?

The failure to take the right steps with insurance coverage in MA accidents can lead to a bill going unpaid and later ending up in collection. This is not a good result for someone who was injured by another in a car accident. Here’s a very basic overview for someone injured in an accident. (For simplicity sake, I’ll assume no time was missed from work, but that’s a bad assumption for lawyers to make in most serious car accidents.)

The first $2,000 in medical bills should be paid by your Auto Insurer’s Motor Vehicle Personal Injury Protection (PIP) insurance benefits. If you have health insurance, then your health insurance provider should pay for claims beyond the first $2,000 unless you have MedPay benefits under your auto insurance policy. If you have MedPay, a recent case confirms your health insurer may defer coverage to the MedPay insurer and the MedPay policy should pay until it maxes out its payments in accordance with the policy. Then, your health insurer would make the remaining payments. For the purposes of this post, I won’t get into how these issues also relate to settlements and trials.

No matter what, however, don't make the costly mistake of going outside your health insurance plan or you risk having to pay for the medical services out of your own pocket. “[E]ven when there is health insurance, PIP does not cover claims denied by a health insurance provider because the insured has failed to comply with the health insurance contract, for example by seeking out-of-network care.” Dominguez v. Liberty Mut. Ins. Co., 429 Mass. 112, 115-117 (1999).

If you don’t have health insurance, then your PIP benefits should pay the first $8,000 in claims and if you have MedPay benefits, it should pay until the coverage limit is reached.

The interplay of PIP, MedPay and Health Insurer issues was recently addressed with the Massachusetts Supreme Judicial Court (SJC) concluding there is “… nothing in the statutory language governing PIP or MedPay to prohibit health insurers from deferring coverage due to the existence of MedPay benefits...” Metropolitan Property and Casualty Insurance Company vs. Blue Shield of Massachusetts, Inc. SJC-09944 (slip opinion)

Justice Bostford, writing for the court, provides a statutory framework of the insurance issues raised.

Statutory framework. The Massachusetts "no-fault" insurance plan, adopted in 1970, originally provided for PIP benefits (up to $2,000) to be paid in place of tort recovery for injuries that caused less than $500 in medical expenses. See § 34A (defining "[p]ersonal injury protection"), as amended through St. 1970, c. 670, §§ 1, 2; G. L. c. 90, § 34M, inserted by St. 1970, c. 670, § 4; G. L. c. 231, § 6D, inserted by St. 1970, c. 670, § 5. See also Pinnick v. Cleary, 360 Mass. 1, 5-10 (1971). In 1988, in an effort to bring the statutory amounts in line with escalating medical costs and further to control automobile insurance premiums, the Legislature increased the tort threshold to $2,000 and increased PIP coverage to $8,000, but provided that PIP would pay only the first $2,000 in medical expenses in cases where the insured also had health insurance that would cover expenses above that amount. See § 34A, as amended through St. 1988, c. 273, §§ 15-16; G. L. c. 231, § 6D, as amended by St. 1988, c. 273, § 55. See also Creswell v. Medical W. Community Health Plan, Inc., 419 Mass. 327, 329-330 (1995). This "coordination of benefits" scheme providing for the sharing of costs between automobile and health insurers is expressed in two sentences in the final paragraph of § 34A:

"[P]ersonal injury protection provisions shall not provide for payment of more than two thousand dollars of expenses incurred within two years from the date of accident for [medical and funeral services] if, and to the extent that, such expenses have been or will be compensated, paid or indemnified pursuant to any policy of health, sickness or disability insurance . . . . No policy of health, sickness or disability insurance . . . shall deny coverage for said expenses because of the existence of personal injury protection benefits."

§ 34A, as amended through St. 1988, c. 273, § 16. Under these provisions, PIP only covers medical expenses above $2,000 if they are not covered by health insurance. Moreover, even when there is health insurance, PIP does not cover claims denied by a health insurance provider because the insured has failed to comply with the health insurance contract, for example by seeking out-of-network care. Dominguez v. Liberty Mut. Ins. Co., 429 Mass. 112, 115-117 (1999).

MedPay benefits are not part of the statutory scheme that established the no-fault system with its central feature of PIP benefits. Since 1943, G. L. c. 175, § 111C, has authorized, for various types of liability insurance policies, including automobile policies, optional endorsements to provide coverage for reasonable medical and related expenses. G. L. c. 175, § 111C, inserted by St. 1943, c. 375, § 1. Beginning in 1968, however, under G. L. c. 175, § 113C, automobile insurers doing business in the Commonwealth have been required to offer every person purchasing a policy the option of purchasing "medical coverage, so called . . . to a limit of at least five thousand dollars." G. L. c. 175, § 113C, as amended by St. 1968, c. 643, § 3. This obligation to offer optional medical, or MedPay, benefits is reflected in Part 6 of the standard Massachusetts automobile insurance policy (policy). In particular, Part 6 of the seventh edition of the policy, applicable to the accident in this case, provides in relevant part: "Under this Part, we will pay reasonable expenses for necessary medical and funeral services incurred as a result of an accident. . . . We must sell you limits of $5,000 per person if you want to buy them." Thus, it appears that G. L. c. 175, § 111C, authorizes automobile insurers to offer MedPay coverage, and G. L. c. 175, § 113C, requires them to do so. Accord Morin v. Massachusetts Blue Cross, Inc., 365 Mass. 379, 385 & n.5 (1974).
[Footnotes deleted]

In the end, it’s important to realize protecting your case (and your credit rating) is not simply about liability but also requires dealing with complicated insurance issues. Failure to take the right steps in a Massachusetts auto accident can lead to collections efforts against you and ultimately to you paying out of pocket for an injury (even when you were a passenger or completely blameless.)

A study entitled Legal Liability: The Consequences of School Injury in the Journal of School Health, May 2007, Vol. 77, No. 5, (Abstract only) examined cases involving schools, lawsuits, and injuries. Schools paid awards about 2/3 of the time, either by verdict (26.8%) or settlement (40.4%). The average case lasted just under 4 years from the time of injury to the case’s resolution by trial or settlement. Surprisingly, they found it difficult to predict the cases resulting in an award, stating: “this study found no difference on any case characteristics between cases that resulted in awards and those that did not.”

They authors concluded,

Many of the injuries documented in this study may have been prevented through better maintenance of school facilities, equipment and playing fields; addition of safety features and equipment; improved supervision of students; education of school officials, students, and parents; and enforcement of building codes and rules, especially during sports and recreational activity.

Award Range: $1 to $15,398,762; Mean: $562,915; Median: $50,000; 25th percentile: $9,750; and 75th percentile: $300,000.

Public records can be helpful in government matters but also for business purposes, in automobile and personal injury cases, or many others types of litigation.

People sometime ask, "How do I get a copy of a local government record?" In Massachusetts, the Secretary of State has published A Guide to the Massachusetts Public Records Law, updated January 2008.

Records are presumed public unless they fall under one of sixteen exclusions, but fees may be charged to obtain them.

The difference between the federal Freedom of Information Act (FOIA) and the Massachusetts Public Records Law is FOIA applies to federal records while the Massachusetts Public Records Law applies to state and local records.

Bruce Selya, a judge since 2005 with the 1st U.S. Circuit Court of Appeals has been named chief judge of The U.S Foreign Intelligence Surveillance Court of Review. This court handles appeals over wiretaps of suspected terrorists or spies. It was created to hear government appeals when lower courts reject the government's application.

The Providence Journal reports Selya will take over as chief judge on May 19 and his term will run through 2012. Selya, from Rhode Island, was a federal judge before being appointed to the Federal Appeals Court in 1986.

A Congressional Research Service Report, The U.S. Foreign Intelligence Surveillance Court
and the U.S. Foreign Intelligence Surveillance Court of Review: An Overview, dated January 24, 2007, by Elizabeth B. Bazan, Legislative Attorney, American Law Division provides a 15 page report. The Report's Summary states:

The national debate regarding the National Security Agency’s Terrorist Surveillance Program (TSP) focused congressional attention on the U.S. Foreign Intelligence Surveillance Court and the U.S. Foreign Intelligence Surveillance Court of Review created by the Foreign Intelligence Surveillance Act. Congressional interest in these courts has been heightened by the January 17, 2007, letter from Attorney General Gonzales to Chairman Leahy and Senator Specter advising them that a Foreign Intelligence Surveillance Court judge had “issued orders authorizing the Government to target for collection international communications into or out of the United States where there is probable cause to believe that one of the communicants is a member or agent of al Qaeda or an associated terrorist organization,” stating that all surveillance previously occurring under the TSP will now be conducted subject to the approval of the Foreign Intelligence Surveillance Court, and noting that the President has determined not to reauthorize the TSP when the current authorization expires. This report examines the creation, membership, structure, and jurisdiction of these courts. It will be updated as subsequent events may require.

Wikipedia gives a general overview of the topic,

The United States Foreign Intelligence Surveillance Court of Review is a U.S. federal court authorized under 50 U.S.C. § 1803 and established by the Foreign Intelligence Surveillance Act of 1978 (known as FISA for short). It is a three judge panel whose sole purpose is to review denials of applications for electronic surveillance warrants (called FISA warrants) by the United States Foreign Intelligence Surveillance Court (or FISC). Each judge of the FISC, in turn, has the jurisdiction to oversee requests for surveillance warrants by federal police agencies (primarily the F.B.I.) against suspected foreign intelligence agents inside the United States. Any appeals from the Court of Review are made directly to the Supreme Court. Like a grand jury, the Court of Review is not an adversarial court; rather, the only party to the court is the federal government, although other parties may submit briefs as amici curiae. Records of the proceedings are kept, but they are classified, although copies of the proceedings with sensitive information redacted may be made public.

The judges of the Court of Review are district or appellate federal judges, appointed by the Chief Justice of the United States for seven year terms. The terms are staggered so that there are at least two years between consecutive appointments. A judge may be appointed only once to either this court or the FISC.

The Court of Review was called into session for the first time in 2002 in a case referred to as "In Re Sealed Case No. 02-001". The FISC had granted a FISA warrant to the F.B.I., but had placed restrictions on its use; specifically, the F.B.I. was denied the ability to use evidence gathered under the warrant in criminal cases. The Court of Review allowed a coalition of civil liberties groups, including the American Civil Liberties Union and the Electronic Frontier Foundation, to file briefs as amici curiae arguing against the F.B.I's new surveillance regulations. The Court of Review held that the restrictions that the FISC had placed on the warrant violated both FISA and the USA PATRIOT Act and that there was no constitutional requirement for those restrictions.

Current composition of the court listed by Name, Circuit, Appointed, Expiration of Appointment Edward Leavy (presiding), Ninth, September 25, 2001, May 18, 2008 Ralph K. Winter, Jr., Second, May 18, 2003, May 18, 2010 Bruce Marshall Selya, First, October 8, 2005, May 18, 2012 List of former judges Laurence H. Silberman, D.C., May 18, 1996, May 18, 2003 Ralph B. Guy, Jr., Sixth, October 8, 1998, May 18, 2005 The exact dates of Judge Silberman's tenure are uncertain.

In 2002, Anita Ramasastry, an Assistant Professor of Law at the University of Washington School of Law in Seattle and the Associate Director of the Shidler Center for Law, Commerce & Technology wrote a critcal review entitled, "THE FOREIGN INTELLIGENCE SURVEILLANCE COURT OF REVIEW CREATES A POTENTIAL END RUN AROUND TRADITIONAL FOURTH AMENDMENT PROTECTIONS FOR CERTAIN CRIMINAL LAW ENFORCEMENT WIRETAPS"

While "A history of Foreign Intelligence Surveillance Court" indicates:

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