Boston Injury Lawyer Blog

Boston Municipal Court's Appellate Division recently decided an important case clarifying a Massachusetts insurer's use of the Personal Injury Protection Application in relation to extending Personal Injury Protection benefits. Boston personal injury and car accident attorney Thiadora A. Pina, of the Law Office of Neil Burns, notes this case lends direction to a long standing issue regarding payment of PIP benefits. "Massachusetts insurers have long held to the notion that you must return their individual form in order to be eligible for PIP benefits," notes Attorney Pina. "Finally, we know the issue remains prejudice to the insurer, not what particular form is filed."

The facts of the case recently decided concerned a 2005 motor vehicle accident in which a claimant was injured while an occupant in a motor vehicle insured by defendant Pilgrim Insurance Company under a standard Massachusetts automobile policy that provided personal injury protection benefits. Six days later, on February 8, 2005, Pilgrim was notified of both the accident and the claim by its insured, and of the injuries sustained in the accident.

On February 8, 2005, Pilgrim sent its insured a PIP package, which was resent to the insured's attorney on March 14, 2005 after Pilgrim was notified that its insured had retained counsel. Ultimately, Pilgrim never received a completed PIP package per se from either the insured, or her attorney. By letter dated August 15, 2005, the attorney notified Pilgrim that he no longer represented the insured.

The insured was treated by Advanced Spine Centers, Inc., and was billed $5,910.00 for its services. Advanced Spine updated Pilgrim several times during the course of its treatment regarding the insured's medical notes and bills. In response, Pilgrim sent form letters advising that it was unable to issue payment because it was 'waiting for the insured to submit an application for benefits.' On July 12, 2006, Pilgrim sent Advanced Spine the same form letter, but inserted the following language: 'Personal Injury protection benefits were denied. Please contact the claimant for additional information.'

The attorneys to the case agreed that the issue presented was whether the insured's failure to submit the specific PIP package sent by Pilgrim was a material breach of the cooperation clause of the standard automobile policy and a violation of G.L.c. 90, §34M, which precluded her recovery (and, thus, Advanced Spine's) of PIP benefits.

The Court concluded that "Neither [the insured's] motor vehicle policy that was made part of the record, nor G.L.c. 90, §34A, requires any particular form to be used by the PIP applicant to provide the necessary information to the PIP insurer. ... We find no prejudice to Pilgrim in the manner it received the information it had requested in the PIP package. Pilgrim was in possession of all the information that it needed to process [the] PIP claim. . . ."

It should be noted that both Advance Spine and the insured's attorney had sent several additional documents, including the treatment bills and records, to Pilgrim. Thus, enabling the Court to conclude that "Pilgrim was in possession of all the information that it needed to process [the] PIP claim. . . ."

We welcome you to contact our office with any questions.

Massachusetts' Boston Municipal Court, Appellate Division, recently held that a Massachusetts insurance company cannot be held liable under Massachusetts General Law Chapter 93A when it refuses to pay a medical bill submitted under the PIP portion of an automobile insurance policy when the treatment associated with the bill is not "reasonably clear." The attorney's at the Boston Law office of Neil Burns can help if you are injured in a car accident. The details as described below show there are many details involved in filing a personal injury. The Boston lawyers at the Law Office of Neil Burns can help.

The case involved the defendant, Commerce Insurance Company, who the injured plaintiff charged with violating Massachusetts General Law Chapter 93A, when Commerce Insurance refused to pay the injured plaintiff's $250 medical bill. The Court affirmed the lower court's decision dismissing the case because it found that under the circumstances, the insurer acted reasonably.

Continue reading "Massachusetts 93A Damages Against Insurer" »

The Massachusetts House, sitting in Boston, overwhelmingly approved a bill that would require Massachusetts and Boston area restaurants and bars to purchase a liquor legal liability insurance policy to cover bodily injury or death. "While we don't usually comment on House bills, we wanted to bring this Bill to people's attention," said Boston personal injury lawyer, Neil Burns. "We represent clients injured in Boston area bars and restaurants and this Bill will aid with collectability."

By a margin of 145-4, the House approved the Bill and sent the Bill onto the Senate. As House Bill 275, it would require restaurants and bars to purchase a liquor legal liability insurance policy to cover bodily injury or death. The policy would be required to contain minimum coverage of $250,000 for injury to or death of one person, and $500,000 for more than one person.

Continue reading "Massachusetts Bars May Need Insurance" »

In the Boston suburb of Natick, Massachusetts, a 2009 house fire caused serious damage. Fidelity National Insurance Company refused to pay the claim, and the home owners have been fighting in court every since. Boston Attorney Neil Burns has seen this scenario many times, and has successfully fought insurance companies in order to protect the rights of his clients.
The judge in the case in Natick, Massachusetts recently ruled that the home owners were entitled to a protective order, barring the insurer from conducting unreasonable discovery. The homeowners, or plaintiff's, filed a complaint for declaratory and injunctive relief against the defendant insurance company to compel payment of a claim they brought under their homeowners' policy. During the course of the case, the plaintiff sought to prevent the defendant from conducting unreasonable discovery and the judge ruled that the plaintiffs were entitled to a protective order.

The judge noted that "[C]ertain of [defendant] Fidelity's requests, i.e., information regarding substance abuse or applications for public assistance, are completely irrelevant at this juncture, given the complete dearth of evidence to establish that the fire that affected the plaintiffs' home was anything but accidental. Since December 15, 2009, the sole evidence pertaining to the source and origin of the fire indicates that it was simply an unfortunate event, and there is no credible information pointing to anything untoward about the plaintiffs' claim.
"As Fidelity has not offered any information to counter the Natick fire investigator's report that the fire appears to have been accidental, the court concludes that Fidelity's requests are unduly burdensome and serve no purpose other than to annoy, embarrass, or oppress the plaintiffs. ... While Fidelity maintains that the requested documents and examinations under oath are necessary in order to complete its investigation into the plaintiffs' claims, it has not made even a minimal showing that further examination is likely to substantiate its allusions that the plaintiffs intentionally caused the fire. ... Whatever private suspicions Fidelity may harbor, they are not sufficient to justify Fidelity's dragnet of every aspect of the plaintiffs' personal lives. Because the court can discern no good-faith basis for Fidelity's assertion that additional inquiry into the plaintiffs' highly personal affairs is 'reasonably required,' a protective order is appropriate to prevent Fidelity from abusing its contractual and statutory right to discovery. ..."
The case cited above is: Beck, et al. v. Fidelity National Insurance Co. (Muse, J.) (Superior Court) (Civil Action No. 10-01004) (April 1, 2010).

A case filed in the Boston Municipal Court shows how important it is for Massachusetts residents to timely file all insurance documents following a car accident where you are injured. As a Boston car accident attorney helping those injured in car accidents, I cannot stress how important it is to contact an attorney as soon as practicable following the accident. Certain Massachusetts car accident insurance forms must be timely filed in order to preserve your claim, and the Personal Injury Protection form is one of those forms.

In March 2010, a case originally decided at the Boston Municipal Court was upheld by the Appellate Division. The Court found in favor of the defendant insurance company because the plaintiff, or the person injured in the car accident, failed to file their Personal Injury Protection (PIP) Application in a timely fashion. The Court ruled that because the form was filed too late, the injured person was not entitled to personal injury benefits.

This is extremely important because it is the Personal Injury Protection part of your insurance policy that pays for medical bills and lost wages when you are injured in a car accident. So, if you do not file the form in time, there will be no money available to pay your medical bills or lost wages. Now, it is true that before the insurance company can refuse to pay your medical bills or lost wages, they must show they were prejudiced in the delayed filing of the application, and that the delayed filing prejudiced the insurance company by depriving it of evidence critical to the investigation and payment of, and defense against, your claims. That's a lot of legal language in order to say that you must timely file all car accident insurance forms, because negative consequences, including the denial of your claim, may result from you failure to do so.
The case cited above is: Burgos, et al. v. Pilgrim Insurance Company (Lawyers Weekly No. 13-017-10) (10 pages).

Boston experienced its largest fire in years, when a 9-alarm fire recently ripped through a residential building in Boston's Back Bay neighborhood. The Boston injury attorneys at the Law Office of Neil Burns can help if you are injured in a fire or other catastrophic event. And while the Boston accident attorneys at the Law Office of Neil Burns can help you, rental insurance can also help take care of you and your belongings.

On April 7, 2010, a large fire tore through a 10-story condominium building in Boston and one firefighter was injured." There were flames shooting out of the Mass Ave. side of the building. It was pretty intense. They had some trouble getting the ladder trucks up there because the flames were coming out so strong," witness Maureen Toomey said. "From what I heard, the fire started on the seventh floor and went up," said a resident who lives in the building. "It used to be a hotel, and they converted it into apartment buildings."

The building was heavily damaged. A Boston Fire Department spokesman estimated that the fire caused at least $3.5 million in damage. Thus, for the residents of the building, smoke, water, and other damage could be heavy, with lots of personal belongings lost. In addition, the building was evacuated and residents were not allowed back in. The Law Office of Neil Burns reminds you of the value of renter's insurance. Renter's insurance can provide for replacement housing, and can compensate you for damages incurred inside your individual apartment, like many of those in the Boston Back Bay fire.

In Massachusetts, the Boston Municipal Court's Appellate Division decided the case of Cotton v. Hanover Insurance Company (Lawyers Weekly No. 13-010-1), in favor of the insurance company because the claimant failed to show up to two scheduled medical examination appointments.

In the Cotton case, the judge denied "personal injury benefits" to the injured person because he failed to attend two scheduled independent medical examinations. These are also known as "insurance medical examinations." The injured person tried to argue that an insurance company must show actual prejudice before it can deny an injured person's claim for benefits even if an injured person fails to attend two medical examination appointments. But the Court disagreed.

It was held that the trial judge acted permissibly in finding for the insurance company without requiring the defendant insurance company to show that it had been prejudiced by the plaintiff's conduct, or by the injured person's failure to attend the medical examination appointments.

Continue reading "Attending Massachusetts Insurance Medical Examinations" »

As a Massachusetts resident, if you suffer an injury, you must timely file your claim. "A Boston resident, for example, would have to file their case at the appropriate court within three years from the time they knew about the injury," notes Boston injury attorney Neil Burns, "if you fail to timely file, you lose your right to file, forever. If you're injured, don't delay in calling us."

In a recent case at the Boston Municipal Court, the judge dismissed the case where a plaintiff filed a personal injury action against a defendant hair dye manufacturer after expiration of the applicable three-year statute of limitations. The Judge's said that "The parties agree that the applicable statutes prescribe a three-year limitations period. ... The parties also agree that the statutes of limitations began to run when [plaintiff Anne-Marie] Cormier had notice of the injury. The parties differ, however, as to the date on which Cormier knew, or should have known of her injury. Cormier claims that for statute of limitations purposes, she did not learn, and could not have learned, of her injuries until after she was examined by the dermatologist. [Defendant] L'Oreal [Paris] maintains that the statutes of limitations began to run when Cormier reasonably knew she was injured and that her injury may have been caused by L'Oreal.

Continue reading "Injury Claims In Massachusetts Must Be Timely Filed " »

Boston residents should choose their Massachusetts car insurance carefully. "There is more to choosing car insurance than just the cost," says Boston car accident attorney Neil Burns, "you must also conisder who you are protecting in case of a car accident." Take the recent case of Wagenmaker v. Amica Mutual Insurance Co. (Lawyers Weekly No. 01-079-10) (3 pages) (Per Curiam) (1st Cirtcuit). In that case, the passenger in a vehicle was involved in accident when the car she was travelling in was struck by an unidentified vehicle. This type of car accident is commonly known as a hit and run. The passenger was injured in the accident, and sought to sue the driver's insurance company because the other vehicle, though at fault in the accident, was not identified. Thus, the passenger sought uninsured motorist benefits under a policy issued by Amica Insurance since they covered the owner of the car in which the plaintiff was a passenger.

But Amica denied the claim. The Court found that Amica was right in denying the passenger's claim because the owner of the vehicle had cancelled his uninsured motorist coverage some nine months before the accident. "... The change was reflected in the policy's amended declarations page, which clearly indicated that the car was 'NOT COVERED' for damages by an uninsured driver."

Continue reading "Choosing Massachusetts Automobile Insurance " »

A Boston hair salon known as Kay's, located on Blue Hill Avenue in Dorchester, Massachusetts, now owes a Brockton women $500,000.00 after the Appellate Division Court upheld the jury's 2009 award. Boston personal injury attorney noted that negligence claims such as these, often tried at the District Court level, are then appealed when one side has a legal disagreement with the verdict, such as this case.

The case began in the fall of 2004 when Marie Duvivier, a Brockton woman nearing 60, made an appointment at Kay's in Dorchester for a sewn-in "weave" process that would address her problem with thinning hair. After arriving, Duvivier was told that the stylist she was scheduled to see was unavailable to do the weave - which involves attaching non-growing hair to natural hair to lengthen and thicken it - and that another stylist would do "a quick weave."

Continue reading "Dorchester Hair Salon Owes $500,000.00 for Bad Weave" »

Boston and all Massachusetts drivers will continue to see managed auto insurance competition in the state. The Massachusetts Supreme Judicial Court ruled in favor of the Massachusetts Division of Insurance's decision to temporarily exempt auto insurance companies that are new to the Bay State from having to cover high-risk motorists. The Massachusetts Division of Insurance recently allowed managed competition as a way to allow auto insurer companies to compete for good drivers, giving consumer more choices than ever before. The argument is that competition results in better rates for better drivers across the Commonwealth of Massachusetts, and the Law Office of Neil Burns wants to inform Massachusetts residents that they should now compare auto insurance rates before buying or renewing their auto insurance policy.

The Supreme Judicial Court's ruling was the result of a 2008 lawsuit filed by Arbella Mutual Insurance challenging the fact that national insurance companies that are new to the Massachusetts insurance market did not have to cover high-risk drivers for two years. Arbella argued that exemption put Massachusetts insurers like Arbella at a disadvantage, because they are required to insure high-risk motorists and split the losses, based on their market shares in the state. The court ruled that although the new companies don't incur the losses of insuring bad drivers, they contribute administrative costs to the Massachusetts Automobile Insurance Plan, which provides insurance for high-risk drivers. In effect, the Court said that that was good enough to allow the exemption to stand.

Continue reading "New Massachusetts Insurers Avoid High Risk Drivers " »

Safety Insurance Group, Inc., a leading Boston based writer of personal automobile insurance in Massachusetts, recently announced that it has reached an agreement with the Massachusetts Attorney General's office to change the way in which it calculated motorcycle insurance premiums for certain types of coverage dating back to January 1, 2002. Wherefore, our clients and all Massachusetts residents who own and insure their motorcycles in the Commonwealth may be getting a refund.

Policyholders whose premiums would have been greater under the method agreed with the Attorney General will not be billed for additional premiums. Policyholders who would have been charged less will receive a refund in exchange for a release of any claims they might have against Safety related to the premium calculations.

According to Safety's outside counsel, Peter Rice, "Although we disagreed with the Attorney General on a number of points, we believe that after extensive discussions Safety has arrived at a resolution of the issue and an agreement with the Attorney General's office that provides for the best interests of Safety's policyholders. Safety had followed standard practices generally used by many Massachusetts insurance companies to calculate appropriate premiums for motorcycle coverages. It cooperated fully with the Attorney General's review of those industry-wide practices and participated in the development of the new method."

Safety is working with the Attorney General's office to identify the policies on which refunds will be issued and the amount of the refunds to each individual policyholder. Safety will notify policyholders of the amount of any refunds offered and, upon receipt of the appropriate releases from the policyholders, intends to issue the refund checks in August 2010.

If you have any questions regarding your right to a refund and how the refunds are calculated, contact your insurance agent. At the Law Office of Neil Burns, we are committed to insuring our clients remained informed regarding insurance policies and practices whereby the consumer's best interest may have been jeopardized.

Following a bodily injury claim, your insurance company has the right to request that you present to a doctor of the insurance company's choice for a medical examination. No matter who is at fault in an automobile accident, your insurance company always pays the medical bills through insurance coverage that you purchased called, Personal Injury Protection (PIP). This part of your insurance policy mandates that you must cooperate with your insurance company after you present a claim to your insurance company. This part of your policy also mandates that as part of this cooperation, you must present to a doctor for a medical examination if your insurance company requests you do so. Thus, the right to present to the insurer's doctor is not optional.

When you present for the insurer's medical examination, you should bring with you any documents/medical records you have in your possession that related to your accident or injury. You do not need to order records, have them mailed to you, or drive around to your doctors to get records. But if you have the relevant medical records in your possession, then you should bring them along.

Continue reading "The IME -- Insurer's Medical Examination" »

Massachusetts has several laws which govern and direct certain aspects of the insurance industry. This article will briefly discuss the two most useful to the physical medicine provider: Massachusetts General Laws, Chapter 93A and Chapter 176(d). They regulate unfair and deceptive acts and practices within the insurance industry.

These two statutes, for example, govern what constitutes a "reasonable" investigation by the insurer, whether the insurer acted in a timely manner in processing claims/bills, or whether the insurer offered a reasonable settlement in an ongoing matter. A Chapter 176(d) violation is a per se violation of chapter 93A.

Built within Chapter 93A is the availability of double or triple damages (meaning once damages are found a judge may double or triple the amount) and the possibility of costs and attorney fees. This is such a big deal because our civil justice system is neither designed to punish a defendant (that is left to criminal law), nor award attorney fees and costs: known as the American Rule, each party is left to pay their respective costs of litigation, win or lose.

Continue reading "Triple damages in Massachusetts When Using 93A " »

Time and time again we urge our Massachusetts clients to pay for Underinsurance Coverage in their motor vehicle policies. For some reason insurance agents neglect to inform their customers that this is some of the most critical coverage you can purchase.

In Massachusetts, you are only required to have $20,000 of liability coverage. Thus, if you are injured by another driver, no matter what your lost wages are, no matter how high your medical bills are, and no matter how badly injured you are, you can only get $20,000 from their insurance company. It is not likely that they have any other assets to pay you.

There is an answer, however: buy more Underinsurance coverage! If you were to purchase a $100,000 policy from your insurer, you, or anyone in your vehicle, would be covered up to that amount in the event the other driver caused damage to you.

Please see our website for a more detailed explanation of underinsurance in Massachusetts.