Personal Injury Terminology

Accident Report – A formal, detailed recording of an event documented from the scene of the incident by an authority figure, like a police officer or hospital staff member. We track the Police Reports on the Incident Tab of a Case.

Arbitration – The hearing and settlement of a legal dispute between the plaintiff and defendant by a neutral third-party whose decision will be final. Often considered a mini-court case; often the third-party is an off-duty judge or attorney. The two parties enter a contract in which they agree that the arbitrator's decision will be final. It is often considered a more efficient, faster, and cheaper route than litigation.

Attorney-Client Privilege – A law that prevents anything said between an attorney and their client from being disclosed or forced to disclose. This prevents people from not trusting their lawyer, and vice-versa, while also preventing the opposing party from requesting the information in discovery. Everything that is said between an attorney and the client is private.

Attorney Lien - An amount owed to another attorney, this could be if they referred a case, co-counseled a case, or were subbed out on a case. 

Bad-faith Claim – An assertion filed by an insured person against their insurance provider for unreasonably denying or delaying their claim, or for refusing to pay out a full insurance claim without cause; usually filed when a person’s claim was denied, but they feel it should have been covered.

BI Adjuster - Bodily Injury Adjuster

Bodily Injury – Any damage to a person’s body; for example: bruises, burns, cuts, poisonings, broken bones, nerve damage, etc. 

CFA - Client Fee Agreement, a client signs this when the firm represents them, similar to a retainer. 

Claim Adjuster – The liaison between the insured and the insurance company, responsible for investigating and overseeing the claim on behalf of the insurance company, as well as approving medical and rehabilitation treatment plans; they work for the insurance company and are obligated to them.

Contingency Fee – A sum of money that a lawyer receives as payment only if the case is won and is typically 30-40%. Can vary depending on if the case settles or goes to litigation. 

Date of Loss - This is when the incident occurred, can also be referred to the DOL or DOI - Date of Incident. 

Demand Letter – A formal letter sent to the opposing party formally requesting some action from them and usually with the threat of legal action.

Deposition – out-of-court question and answer session under oath; testimony given under oath, recorded in an authorized place outside of the courtroom and usually documented by a court reporter; the questions will be asked by the opposing attorney, with the party’s attorney present, in order to have an official, written account of what happened.

Discovery – The legal process by which opposing parties obtain evidence from one another, typically includes interviews, depositions, requests for documents and records, request for plaintiff to receive a medical exam, and request for admissions. 

Expert Witness – Testimony given by someone who is qualified to speak with authority about scientific, technical, or professional matters. For example, an attorney may bring in a neurologist to testify about their client’s brain damage so that the court can hear the information directly from an expert. Experts can be very expensive, and we track them on the Expert Witness Tab.

First-Party Insurance - Client's car insurance.

First-Party Claims – Claims made towards one’s own insurance company (as opposed to against someone else’s insurance company).

Health Insurance Subrogation - Subrogation company collects funds on behalf of the insurance company. A firm would need to send letters to subros to get health insurance liens.

Health Care Expenses – The costs incurred by seeing a number of different healthcare providers, such as doctors, therapists, and specialists; the collective cost of all one’s medical care.

HIPPA Act – Acronym that stands for the Health Insurance Portability and Accountability Act; a US law designed to provide privacy standards to protect patients’ medical records and other health information; requires patient’s or authorized person’s approval to gain medical information.

Insurer – The company or entity that provides coverage through an insurance policy.

Insured – The individual protected under an insurance policy.

Interrogatories – Written questions created by one party’s attorney for the opposing party to answer under oath within a specific amount of time. After the document is filled out, the plaintiff’s attorney reviews it then it is signed by the answered in front of a notary.

Lien - A health care provider can have a signed lien in which they agree to treat a client with the promise of being paid once the case settles. Depending on the state these amounts can be negotiated.

Letter of Protection – Or LOP, a letter sent by a personal injury lawyer to a healthcare professional that gives permission for an injured person to obtain the medical care they otherwise cannot afford on credit in exchange for a promise to pay for the services directly out of their settlement or judgment. Similar to a lien, LOP is state-specific.

Liability – Legal responsibility for one’s acts or omissions; an obligation one is bound to by law to perform, typically involving the payment of monetary damages. One of the most significant words in the field of law.

Litigation – The process of taking legal action and/or filing a lawsuit.

Mediation – Outside help settling a dispute; a non-binding method of resolving a case in which a neutral third party, agreed upon by both parties, helps the disputing sides to reach a mutually agreeable settlement.

Medical Malpractice – Negligence by a professional healthcare provider, such as a doctor or hospital, who departs from the applicable standard of care, and by act or omission causes injury to a patient. Often difficult to prove; requires expert witnesses that can testify to the wrongs committed. 250,000 max in CA. 

Miscellaneous Lien - An extra cost on a case that needs to be paid before the client can be paid, could be back child support or back taxes

Medpay - Medical Payments, coverage is a part of your auto insurance policy that provides for financial compensation for certain medical expenses and lost wages for you and your passengers who are in your vehicle when you're involved in an accident while driving. Some states it needs to be paid back, other states it doesn't.

No-Fault State - States that have adopted no-fault laws require that every auto owner carry a minimum amount of personal injury protection (PIP) insurance.

Out-of-Pocket Expenses – Money spent out of the injured party’s own funds on costs related to their injuries, which may include: travel, medications, assistive devices, etc. 

PIP – Or Personal Injury Protection; a type of auto insurance coverage mandated in some states, Florida and Texas for example, requires insurers to provide first-party benefits for medical expenses, loss of income, funeral expenses, and similar expenses regardless of who is at fault in the accident. 

PD Adjuster - Property Damage Adjuster

Plaintiff – The person in a court or legal case that is suing, usually the person who is injured.

Pleading – Generally, any document, statement, or request filed with the court; a formal document in which someone that is part of the legal case makes or responds to allegations, claims, denials, or defenses.

Policy Limits - The amount of coverage someone pays for on their insurance.  California law is 15/30, which means $15000 for the accident, $30000 total if more than one person was involved. 

Premise Liability – The legal principles that hold landowners and tenants responsible when someone enters their property and gets hurt due to a dangerous condition; premises liability claims are usually based on negligence. This concept comes from laws that state that a person can reasonably expect to be safe when they enter someone else’s property.

Proceeding – Any hearing or court appearance related to a legal case.

Product Liability – The accountability of a merchant, business, or manufacturer for bodily injury or property damage because of a defect in their product. 

Retainer Agreement - The plaintiff signs this when they choose a law firm to represent them.

Request for admission – A request made by a party in a lawsuit to another in that lawsuit to admit to the truthfulness of a fact or the genuineness of a piece of evidence.

Settlement – Conclusion of a legal matter; negotiated agreement by opposing parties in a civil suit before or after litigation has begun but before the court hears the case, eliminating the need for the judge to resolve the controversy.

Slip-and-Fall – A personal injury case in which a person slips or trips and is injured on someone else’s property; usually falls under the broader category of premises liability claims. Slip and fall accidents usually occur on property owned or maintained by someone else who is then held legally responsible.

Stacking of Coverages  – The application of two or more policies’ limits to a single occurrence or claim; commonly applied to auto liability or uninsured/underinsured motorists’ coverage when two or more vehicle policy limits can be stacked to apply to a single accident. We have a checkbox for this on the insurance.

Statute of Limitations - A statute of limitations or SOL is the time period in which you may file suit claiming damages. The statute of limitations can vary from case to case depending on the state, case type, defendant type and age of the client. 

Subpoenas – A command, issued by the court, to appear at a certain time and place to give testimony for a case.

Subrogation – A legal right that allows one party to make a payment that is actually owed by another party, and then later collect that money from the party whom originally owed it. For example, if you are in a car wreck and it is taking too long for the at-fault driver’s insurance to pay for your car to be repaired, your insurance may step in and cover the cost. However, they are not legally or contractually obligated to pay for the repair, they are just doing it to help out their customer. Subrogation allows your insurance company to later reclaim that money from the at-fault driver’s insurance company. This also prevents the claimant, the person who needed the car repaired, from being paid for the repair twice: once by their insurance and then again later by the other insurance. Subrogation also applies to other types of insurance, like health insurance. For example, your private healthcare may pay for some initial treatments after a car accident, but later they will be reimbursed if some other form of payment, like PIP, comes through.

Third-Party Claims – Liability claims brought by a person allegedly injured or harmed by the insured. The insured person is the first party, the insurance carrier is the second party, and the injured person/claimant is the third party; a claim brought against another party’s insurance company, rather than their own. See First-Party Claims.

Third-Party Insurance - Defendant's car insurance. 

Traumatic Brain Injury (TBI) – A type of injury that occurs when an external force causes brain dysfunction; usually results from a violent blow or jolt to the head or body. An object penetrating the skull, such as a bullet or shattered piece of skull, can also cause traumatic brain injury.

Underinsured Motorist Coverage (UIM) – An auto insurance policy provision that extends coverage to include property and bodily damage caused by a motorist without enough insurance coverage. It’s designed to provide the injured party with compensation above what is allotted by the at-fault party’s policy.

Uninsured Motorist Coverage (UM) – An addition to a standard automobile insurance policy that provides coverage in the event the other driver is both at fault for the accident and is not insured; protects the first-party from having no coverage in the event that someone who is driving without insurance crashes into them.

Verdict – A formal decision about the outcome of a case made by a judge or jury.

Workers’ Compensation – The system by which state-required no-fault benefits are provided by an employer to an employee—or the employee’s family—due to a job-related injury (including death) resulting from an accident or illness which happened at work.

Wrongful Death – A claim made on behalf of the survivors or beneficiaries of a person who has died as a result of wrongful conduct—either negligent or intentional. Such claims are generally made by those who were financially dependent upon the deceased. Damages could include medical expenses prior to death, loss of earnings of the deceased during their expected natural life, and loss of consortium (deprivation of a marital/sexual partner or familial relationship).