Category: Personal Injury

Wrongful Death

Children’s Medicaid Reimbursement

As personal injury lawyers, our primary duty to our clients is to maximize each client’s net recovery. So, while it’s great to get a significant settlement on behalf of a child, such a settlement is much smaller when a large portion must be repaid to a health insurance company or Medicaid. At Gomez & Golomb, we work hard dealing with and extinguishing any Children’s Medicaid Reimbursement claims not allowed under Georgia law.

An example is when a minor is injured. PeachCare/Medicaid often pays the medical bills and claims a lien against future settlements in these situations. After careful review, we interpret Georgia and federal law to hold that PeachCare has no right to reimbursement for any settlement with a minor. We, therefore, fight these reimbursement claims tooth and nail.

In Georgia, an injured child only has a claim for pain and suffering. Southern Guaranty Ins. Co. v. Sinclair, 228 Ga. App. 386 (1997) discusses this concept. In that case, the Court held that a minor has no claim for medical expenses because that obligation rests with the child’s parents. This reasoning makes sense because until a minor child reaches the age of 18, they cannot be bound under contract. Therefore, in a Children’s Medicaid Reimbursement situation, a child cannot be liable for medical expenses nor claim reimbursement of medical expenses.

The United States Supreme Court held that Medicaid/PeachCare can only reach settlement monies paid to reimburse medical bills following an injury. Thus, PeachCare/Medicaid can claim a lien against that part of an injured person’s recovery only for money received for medical expenses. Arkansas Dept. of Health and Human Services v. Ahlborn, 547 U.S. 268; 126 S. Ct. 1752 (2006).

Reading Sinclair and Ahlborn together, Medicaid/PeachCare cannot claim a lien against a minor child’s settlement proceeds. To shield a settlement from Peachcare/Medicaid, we structure the settlement between the wrongdoing party and the minor child. The settlement clarifies it only covers pain and suffering.

If you have a question about these issues, please call Gomez & Golomb LLC at 404-382-9994. 

Wrongful Death in Georgia – Who Makes the Claim

If your loved one has recently passed, we offer our sincere condolences. Losing a loved one is tragic, but at some point, the living must go on living. This means educating yourself regarding your family’s legal rights in order to make a full recovery on behalf of your loved one.

If your loved one’s death was caused by the negligence of another, who is entitled to make a claim? A claim may include include funeral expenses, medical expenses, pain and suffering before your loved one’s death, and the value of your loved one’s life that has been cut short?

To understand who can make a claim, we must first understand that Georgia law allows two different claims following a wrongful death: one is just referred to as a “wrongful death claim”, and the other is referred to as an “estate claim” or “survival claim”. The same person can bring both claims, but this isn’t necessarily the case.

Wrongful Death Claim

Under Georgia law, this claim belongs to the loved one’s spouse and children. See OCGA § 51-4-2. If the loved one had no spouse or children during their life, the loved one’s parents are entitled to make the claim. See OCGA § 19-7-1. Finally, if no spouse, children, or parents are alive, the court can appoint an administrator or executor to make the claim. See OCGA § 51-4-5. Relatives such as a sibling, uncle, aunt, or grandparent have no right to prosecute the wrongful death case.

We will discuss this in further detail in another blog. However, generally, a wrongful death claim includes recovery for the value of your loved one’s life had he or she not died prematurely.

Estate/Survival Claim

The administrator of your loved one’s estate is the party entitled to make claims for funeral, medical, and other necessary expenses and any claim for pain and suffering before death. OCGA § 51-4-5.

If you have any questions about who can make a wrongful death claim on behalf of your loved one, please call us. We have provided a very general overview, but many details and complications come up when applying these rules in real life.

Uninsured Motorist Insurance in Georgia: Notice

First and foremost, you should buy uninsured motorist insurance! This type of insurance covers situations in which you are injured by driver who has no insurance or minimal insurance. This is an optional coverage, which everyone should get because it is relatively inexpensive and there are many uninsured and underinsured drivers out there.

If you have (hopefully) purchased uninsured motorist coverage, how quickly do you need to notify your insurance carrier? According to a recent case, as soon as possible. In Hyde v. State Farm, A20A1221 (2020), a negligent driver injured the claimant on August 18, 2016. An attorney notified the claimant’s employer on December 6, 2016, who in turn notified State Farm on December 7, 2016. However, the attorney did not directly notify State Farm until much later.

Because the attorney addressed the December 7, 2016 letter to the employer, the Court of Appeals ruled that State Farm did not receive notice. Moreover, the Court of Appeals ruled that under the State Farm insurance policy, notice is required “as soon as reasonably possible after the injured insured is first examined or treated for the injury.” Here, the notice was not as soon as reasonably possible. Finally, the Court of Appeals ruled that the delay in providing notice was not justified.

At our office, our standard procedure is to notify the at-fault driver’s insurance company and your insurance company as soon as possible. This avoids any chance of losing your right to recover due to late notice. Please call us at 404-382-9991 if you are in a car accident and need an attorney. We will come to you if you do not have a ride.

Were you injured or a crime victim on someone else’s property?

an example of an invitee

If you slip and fall or a rape victim on someone else’s property, the reason why you are on the property matters. Whether you can recover for your injuries often turns on your relationship with the property owner. The law has fancy words to describe the different types of relationships, which we cover below.

The first type of relationship, that of a trespasser, is easy to understand. A trespasser is someone who goes onto someone else’s property without invitation or permission. An example is if someone breaks into your house. If the trespasser gets hurt, you are responsible only if you intentionally tried to hurt the trespasser. This becomes relevant in a landlord-tenant situation. If a lease does not identify a tenant, arguably the tenant is a trespasser and will have a tough claim against the landlord. However, this can be overcome if the landlord knew the tenant was living on the property but took no action.

The next step up is a licensee. This is a person invited onto the property as a social guest but who does not provide a benefit to the owner. A licensee is on the property only for his own convenience. O.C.G.A. § 51-3-2. So, if you invite a friend to your house, your friend is an invitee. If a licensee is injured, the property owner must exercise reasonable care to prevent injury.

Finally, there is what is known as an invitee. An invitee is a person who is invited and provides benefit to the owner. An example is if you go to Publix to buy groceries. You have been invited by the Publix onto the property and are benefiting Publix by buying groceries. With regard to an invitee, a property owner must exercise ordinary care to keep the property safe. This is a higher standard than a licensee. And requires the owner to inspect its property to make sure it is safe for its customers.

If you are injured or are a crime victim on someone else’s property, please call us. Our number is (404) 382-9991.

Sue A Drunk Driver

In Georgia, if a drunk driver causes a car crash, the injured party can sue a drunk driver and recover additional damages known as punitive damages. What are punitive damages? We have written about punitive damages before. These are damages unrelated to the party’s injuries, but, rather, are to punish, penalize, and deter bad conduct. In theory, even if your injuries are minor, you could get a large punitive damages award. Punitive damages are a warning to the drunk defendant and the public that drunk driving is not tolerated. In other words, because drunk driving is a dangerous and preventable act, punitive damages mean you will pay a high price if you are caught driving drunk.

Georgia recently clarified the law regarding punitive damages:

“At about 5:00 p.m. on September 1, 2016, Lakenin Morris was driving his older cousin Keith Stroud’s car when he collided with a car driven by 18-year-old Alonzo Reid, sending Reid to the hospital. Morris had been drinking with Stroud, and Stroud asked Morris to drive his car and gave him the keys even though Morris was obviously drunk and Stroud knew that Morris was drunk, did not have a valid driver’s license, and had a habit of recklessness. Morris later pled guilty to driving under the influence (DUI).” Reid v. Morris et al., S20A0107 (June 29, 2020).

In Reid v. Morris, the issue was whether the injured party could sue a drunk passenger for punitive damages. The passenger argued that since he was not driving the vehicle, punitive damages do not apply. The Georgia Supreme Court disagreed. Although Georgia law seems to suggest that punitive damages apply only to “active” wrongdoers such as a driver, the Supreme Court found this interpretation too narrow. Rather, the Court ruled the important question is whether the intoxication caused the collision. Here, the drunk passenger asked his drunk friend to drive his vehicle. Asking a drunk friend to drive your car is negligent and therefore ultimately caused the collision.

If you need to sue a drunk driver, call us at 404-382-9994 to represent you. We have experience getting damages not only for your pain and suffering but also for punitive damages.