How Campbell & Associates does more to protect our clients’ rights to “no-fault” insurance benefits than any other personal injury firm in WNY.

At Campbell & Associates, we do more than any other personal injury firm in Western New York to help ensure that our clients receive and maximize their right to no-fault benefits.  Although insurance carriers are legally obligated to provide no-fault benefits, they typically will not do so without eventually attempting to cut injured people off.  The most common way they do this is by forcing recipients to submit to so-called “independent medical exams”.  These exams are performed by doctors paid by the insurance company, who assess patients to see if they still require ongoing medical treatment or are still disabled.  Although they claim to be “independent”, there are typically only two interested parties in any such exam – the patient and the insurance company – and only one of those parties is paying the doctors.

Most firms leave their clients to navigate the often-complicated no-fault process by themselves, and simply focus on the bodily injury (“pain and suffering”) portion of the client’s claim.  Often, this includes having clients go to the scheduled medical exams by themselves, without any sort of backup.  Here at Campbell & Associates, we try to ensure that our investigator is there with the client to observe the exam and make sure that the doctor does a fair, impartial exam.    Some exams are actually videotaped.  If the carrier still attempts to deny benefits, we sue them.  We have never lost one of these cases. 

If you’ve been involved in a car accident that was not your fault, please call Campbell & Associates at (716) 992-2222.  Our experienced and caring attorneys and staff will do everything in our power to ensure that you receive the best representation possible, including the so-called “no-fault” portion of your case.

New York is a “no-fault” state when it comes to motor vehicle collisions.  This means that, regardless of who is responsible (or “at fault”) for causing the collision, all involved parties are eligible to receive certain benefits.  This applies to drivers, passengers, and pedestrians or bicyclists who are hit by cars.  The benefits are covered by the insurance policy of the vehicle you are driving, riding in, or hit by.  We help clients to complete and submit their no-fault application in a timely fashion.

No-fault insurance (sometimes also referred to as Personal Injury Protection or “PIP”) provides reimbursement for legitimate economic losses (“basic economic loss”) arising from the subject incident/collision, notably medical expenses and lost earnings.  Motor vehicles in New York state are required to carry at least $50,000.00 in no-fault coverage, and that will typically be the available coverage limit, unless the insured has purchased additional protection (“APIP” or “OBEL” benefits).

With regards to medical expenses, no-fault benefits will cover:

  • Ambulance and hospital expenses;
  • Doctor’s bills;
  • Prescription medications;
  • Therapeutic care, such as physical therapy, acupuncture, etc.;
  • Diagnostic tests, such as x-rays and MRIs;
  • Travel expenses (to/from medical appointments);
  • Household help;
  • Other reasonable expenses.

Additionally, no-fault benefits will compensate you for 80% of your lost earnings, up to a maximum amount of $2,000.00 per month.  The no-fault insurance carrier will be responsible for paying lost earnings for up to three years from the date of the subject incident (subject to certain restrictions) or until $50,000.00 in combined benefits (medical and/or wage, etc.) have been paid, whichever occurs first.  These are the minimum benefits required by law – some policies provide additional no-fault coverage.

A couple very important things to remember: (1) no-fault benefits do not apply to motorcycle riders; however, it does apply if you are a driver or pedestrian hit by a motorcyclist.  (2)  You only have 30-days to notify the applicable no-fault insurer and submit a “no-fault application”.  Therefore, even if you don’t think your injuries are serious or long-term, you should still find out what the applicable insurance company is and submit an application as soon as possible. Remember: if you’re a driver or passenger, it’s the vehicle you were in; if you’re a bicyclist or pedestrian, it’s the vehicle that hit you; or, if for some reason the applicable vehicle is uninsured or otherwise can’t be ascertained, it’s the carrier for a vehicle owned by you or a relative you live with.

For the best personal injury service anywhere in Western and Central New York, please call Campbell & Associates at (716) 992-2222 for a free consultation.

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Brachial Plexus and Erb’s Palsy – The Perils of Childbirth

As discussed more generally in the Childbirth Injuries section, the birth of a child is a wonderful yet fraught time in any parent’s life. While medical advances have made childbirth exponentially safer than it was even 100 years ago, one type of birth injury is still quite common: brachial plexus injuries. [1]

The brachial plexus is a root bundle of nerves in the shoulder region of the arm that empowers movement and sensation in the arm, hand, and fingers. It starts at the spine and then branches out to various parts of the arm, controlling all sensory and motor function. Brachial plexus injuries typically occur when the baby is positioned in such a way that its shoulders are obstructed and cannot breach smoothly. This condition is referred to as “shoulder dystocia.” In those situations, it is up to the doctor to either consider an alternative to vaginal birth (e.g. Cesarean section) or to maneuver the baby’s position such that it can be born safely and without injury. Unfortunately, doctors sometimes use far too much force when moving and pulling the child’s shoulders and/or arms (especially given how fragile newborns are), which can bruise, tear, or even completely sever the brachial plexus. When the upper trunk C5-C6 nerves are severed, this is referred to as Erb’s palsy.

The result is partial or even complete paralysis of the arm. Fortunately, the condition can often be fixed via surgical intervention or physical therapy, depending on the severity of the injury. Infants who suffered from Erb’s palsy have gone on to play in the NFL (Adrian Clayborn) and be Hollywood stars (Martin Sheen). However, according to the American Academy of Orthopaedic Surgeons, 5-10% of infants that suffer a brachial plexus injury during birth will experience permanent functional disability. [2]

Some signs and symptoms to be aware of in your newborn include: limp and useless arm and hand; arm pain; numbness; lack of response to heat or cold; and a lack of touch sensation. If your newborn child is exhibiting any or all of these symptoms, please do not hesitate in seeking medical advice – babies are resilient, and the sooner the problem is addressed, the better the potential for a full recovery.

However, these injuries are almost always preventable. Doctors are expected to recognize shoulder dystocia and either maneuver the child without causing injury, or change course and pursue an alternate delivery method (generally a C-section). Not to do so results in great pain and suffering to both the parent and the child, as well as the potential for a lifetime of physical difficulty. Therefore, if your child has been diagnosed with a brachial plexus injury and/or Erb’s palsy, we invite you to call Campbell & Associates at 716-992-222 for a free consultation.

Example Verdicts and Settlements for Brachial Plexus/Erb’s Palsy

N.W., Pro Ami v. Clements, M.D.; Clark, Clements and Syeda, M.D. P.C. (2016 WL 4773203) – Newborn infant’s representatives claimed she suffered right Erb’s palsy, a right brachial plexus injury, and other injuries as a result of shoulder dystocia. They sued the Defendant gynecologist and his practice under a variety of theories, including: negligent delivery and application of excessive force to the right arm and shoulder; failing to perform appropriate maneuvers to deliver her; failing to timely recognize and address the increased risk of Erb’s palsy, given the babies fetal weight; and failing to discuss a Cesarean section as an alternative. The Defendants denied liability, but ultimately agreed to a structured settlement in the amount of $2,000,000.00.

Fisch, Pro Ami v. Wind, M.D. (NY St. Ct. 2008) – A female infant suffered a brachial plexus injury during her child birth. The infant Plaintiff (via her parents) contended that the Defendant gynecologist failed to exercise the skill and knowledge necessary to perform the delivery, that he used excessive force during the delivery, and that he failed to provide the proper standard of care. The Defendant denied liability, but the parties ultimately agreed to a pre-trial settlement of $1,950,000.00.

Kwabena v. Defendant (1995 WL 259593) – A newborn infant suffered brachial plexus injury and Erb’s palsy when abundant traction (force) was used by the Defendant intern during childbirth. The plaintiff, through his mother, contended that the Defendant intern was negligent and that the Defendant hospital negligently failed to have a staff obstetrician available. The Defendants denied that excessive force was used, and claimed that the infant was examined and found to be in normal condition following delivery. They further contended that the infant Plaintiff’s condition was caused by a congenital irregularity. The jury found for Plaintiff in the amount of $1,000,000.00 (just over $1.5 million, adjusted for inflation). [3]

1 – Brachial Plexus Injury: A Survey of 100 Consecutive Cases from a Single Service, Neurosurgery, Vol. 51, Issue 3, 1 September 2002, Pages 673-683.
2 – https://orthoinfo.aaos.org/en/diseases–conditions/brachial-plexus-injuries/
3 – https://www.bls.gov/data/inflation_calculator.htm