BURNHAM DOUGLASS *

Areas of Practice

PERSONAL INJURY

Personal injury is a legal term for an injury to the body, mind or emotions, as opposed to an injury to property. In Anglo-American jurisdictions the term is most commonly used to refer to a type of tort lawsuit in which the person bringing the suit, or "plaintiff," has suffered harm to his or her body or mind. Sometimes when people hire a lawyer, it's a choice. We know that your choice matters. If you have been burdened by a personal injury, we are here at Burnham Douglass to help relieve those burdens as we have been doing so for the past 30 years. Let us help you make the right choice contact is for a Free, no-obligation consultation.

 

An accident can happen in the blink of an eye, changing your life forever. When it does, you have a right to the resources you need to recover, to protect your lifestyle and that of your loved ones, and to be compensated for your pain and suffering. You may face a long road to recovery. You may miss time at work. Even the simplest responsibilities may become challenging or impossible.

 

When you are injured due to someone else’s negligence or wrongdoing, you may be entitled to financial compensation for the following expenses, and more:

  • Medical evaluations;

  • Medical treatment;

  • Rehabilitation;

  • Therapy;

  • Medication;

  • Travel to and from medical appointments;

  • Home modifications when necessary;

  • Medical equipment;

  • Lost wages, past and future;

  • Psychological counseling;

  • Loss of consortium;

  • Pain and suffering, both physical and emotional.

A personal injury can be devastating, and it can occur in a wide variety of ways, including:

Car Accidents – Some of the most traumatic injuries are suffered in car accidents. Whether your injury was caused by another driver, a vehicle defect, or for many other reasons, we can help.

 

Truck Accidents – The size, weight, and speed at which trucks travel on our roadways mean there is great potential for harm when they are involved in accidents. We work tirelessly to uncover the true cause of the truck accident and hold negligent parties accountable.

Pedestrian and Bicycle Accidents – Pedestrians and bicycle riders are especially susceptible to motor vehicle accidents. Appropriate financial support is needed to help them thrive in recovery.

Slip and Fall – A serious fall, either from a height or because of walking surface conditions, can result in tragedy. Common causes of fall down accidents include poor lighting, cracked or worn sidewalks, improperly maintained parking lots, and slippery floors caused by spills that were not cleaned up properly.

Construction Accidents – Common construction site accidents include electrocution, falls, caught-between, and struck-by accidents, among others.

Medical Malpractice – You deserve the highest standard of medical care. If you have suffered because of medical negligence, we can help.

Premises Liability – Property owners have an obligation to maintain safe conditions. When they fail in that duty, people can get hurt.

Nursing Home Abuse – When a loved one suffers at the hands of staff or other residents, we step up to protect their rights and uphold the law.

Birth Injury – The time just before, during, and immediately after delivery are critical to an infant’s well-being. When injury occurs, the impact can last a lifetime.

Defective Products – Defective motor vehicle parts, medications, toys, or any other defective products can cause great harm.

Wrongful Death – When someone dies due to another person’s recklessness, negligence, or wrongdoing, loved ones are left behind to suffer. We pursue justice for victims’ families.

 

The majority of automobile insurance carriers licensed to do business in New Jersey include a clause in their policy which dictates that all disputes regarding Personal Injury Protection (PIP) benefits must be litigated under the auspices of Forthright Solutions. Forthright has been selected by the State of New Jersey to administer PIP arbitrations under the State’s Automobile Insurance Cost Reduction Act. Once a Demand for arbitration is filed, Dispute Resolution Professionals (DRPs), licensed attorneys who have years of experience in PIP litigation, are assigned by Forthright to conduct the litigation. It is important to note that the decisions of the DRPs are binding. Our lawyers have successfully represented Medical Providers, as well as, Individual Insureds, since the inception of this arbitration process.

 

Philip S. Burnham and his staff have successfully litigated thousands of PIP arbitrations on behalf of Medical Providers and Suppliers since 1993. Whether filing under an assignment of benefits for a Medical Provider, or directly on behalf of the Individual Insured, our vast experience has achieved a great success rate, which ultimately results in extremely satisfied clients.

Comprehensive PIP Services

 

New Jersey’s No-Fault Insurance PIP benefits can be confusing and frustrating. Calls from unhappy clients, whose benefits have been cut off, and calls from providers who have not been properly compensated, can be a drag on staff – monopolizing valuable time and money. The Burnham Law Group is dedicated to helping you, your clients and doctors navigate the complex system of PIP litigation at absolutely no cost to you – EVER.

 

When the Burnham Law Group represents you in your PIP Dispute Resolution, all costs connected with the initiation and resolution of the PIP litigation will be advanced by our law firm. There will NEVER be any costs or legal fee demanded from you, your clients or doctors regardless of the outcome of the PIP Dispute Resolution.

 

Pre-certification of Medical Treatment: Patients, doctors and other medical providers must pre-certify certain types of medical treatment for patients injured in automobile accidents. Failure to pre-certify or properly appeal the denial of pre-certification may result in the denial of payment. Moreover, insurance companies will frequently contest the medical necessity of treatment, as well as, the need for diagnostic tests, such as MRIs and EMG/NCV studies.

 

Our lawyers will help doctors and other providers navigate this complex process, which will result in fair and quick compensation for their services.

  • Over 98% Success Rate

  • No Costs

  • No Risk

  • Immediate Turnaround

  • Unique Process

  • Value Added Services

Who We Represent

  • Anesthesiologists

  • Chiropractors

  • Dentists

  • Diagnostic Facilities

  • Hospitals

  • Imaging Centers

  • Individual Insureds

  • Medical Providers

  • Medical Supply Companies

  • Neurologists

  • Orthopedic Specialists

  • Pain Management Specialists

  • Personal Injury Law Firms

  • Physical Therapists

  • Surgeons

  • Surgery Centers

Important PIP Notices – UPDATE

 

The New Jersey Department of Banking and Insurance (DOBI) recently adopted new rules regarding the requirements for Internal Appeals Procedures in Personal Injury Protection Benefits cases. The new appeals process went into effect on April 17, 2017. In addition, Forthright is now requiring us to submit copies of all appeals at the time of filing every arbitration; therefore, it is imperative that all appeals be provided to us or we will be unable to file the arbitrations until we receive them.

 

The insurance companies have been updating their Decision Point Review Plans to reflect these changes to the appeals process. We have organized this information in the attached chart summarizing the new requirements for each insurance company. Please make use of this convenient tool in preparing your appeals in compliance with the new rules.

 

Please be aware that several insurance companies are now requiring you to wait for them to respond to the pre-service appeal before performing the requested treatment on the patient. Failure to do so runs the risk of invalidating the assignment of benefits. These companies are highlighted in red on the attached chart.

 

Other companies (highlighted in orange on the attached chart) are now requiring that the pre-service appeal be submitted prior to performing the requested treatment on the patient. This is less of a delay than waiting for the response, but is still problematic.

 

In addition, many insurance companies (highlighted in yellow on the attached chart), are now requiring providers to submit the pre-service appeal within 30 days of the denial of precertification. Only appeals submitted within that 30 day window will be considered valid; appeals submitted after this time frame will be considered new precertification requests, not appeals.

 

If you would like us to review your new appeals or narratives and provide constructive feedback, we are happy to do so.

PIP Benefit FAQ

 

As we previously informed you, the New Jersey Department of Banking and Insurance (DOBI) recently adopted new rules regarding the requirements for Internal Appeals Procedures in Personal Injury Protection Benefits cases. The new appeals process went into effect on April 17, 2017. Please use the new Uniform Pre- and Post-Service Appeals forms we have sent you from now on.

 

The DOBI just updated their FAQ page in response to questions they received regarding the implementation of these new rules.

 

Q: How will the April 17, 2017 operative date of the new internal appeals rule be implemented?

 

A: The Department believes that the rule should apply to new pre-service and post-service appeals that are submitted on or after April 17, 2017. Appeals that are already in progress, including second level appeals, would continue under the insurer’s old system. This would result in all appeals being handled consistently in accordance with the regulation from 04/17/2017 going forward. This will be less confusing for providers and insurers and is consistent with how the effective date of other changes to DPR plans have been handled by the Department.

 

In light of this guidance provided by DOBI, we recommend that you still complete a second level appeal under the insurer’s old rules for any accounts that would have required one prior to the April 17, 2017 effective date of the new rules. For any new appeals, use the new Uniform Appeal forms in compliance with the new rules.

 

The insurance companies are in the process of updating their Decision Point Review Plans to reflect these changes to the appeals process. Farmers Insurance Company’s updated Plan (attached, see page 7) states that providers may not perform any treatment for which pre-certification is denied until the Pre-Service Appeal is completed and the appeal decision has been received by the provider or the assignment of benefits is void. So far, this seems to be the only insurance company that has required this, but we will continue to update you as more information becomes available.

For a free and confidential case evaluation with our legal team

GIVE OUR OFFICE A CALL TODAY AT 856.751.5505 OR CONTACT US ONLINE!

 

We can help clients pursue Personal Injury Protection claims after a car accident, including medical expenses, lost wages, and property damage.

After a car accident, many people assume that the at-fault driver’s insurance company will be responsible to pay for the injured party’s resulting medical bills. Under New Jersey law, this is not the case. New Jersey is one of several “no-fault” states in regards to auto accidents, meaning that drivers may only seek compensation for medical expenses through their own personal injury protection (PIP) insurance in the event of a collision, regardless of who is at fault.

 

If you have been injured in an auto accident either as a driver, passenger, or pedestrian, a knowledgeable Burlington County PIP attorney from Burnham Douglass can help you file a PIP claim and maximize your chances of securing every penny of your entitled compensation.

 

Countless clients have trusted our firm for the following reasons:

What Are PIP Benefits?

 

Each driver must purchase personal injury protection (PIP) insurance with their auto insurance policy, which covers their medical expenses, lost wages, and essential services, as well as funeral and death benefits to a person’s dependents in the event that a driver should lose their life in an accident. PIP benefits are used whenever a person is involved in an accident, regardless of fault or if a person’s vehicle was even involved in the collision. For instance, if a PIP insured person was injured in a collision while riding as a passenger in someone else’s vehicle, they would still seek compensation through their own PIP insurance.

 

PIP benefits cover multiple parties, including:

  • The owner of the insured vehicle;

  • Passengers of a PIP insured vehicle;

  • Blood or marriage-related household members of an PIP insured vehicle.

 

Medical expenses that exceed a person’s deductible will be subject to an 80%/20% copayment provision up to $5,000. In other words, once you have payed your deductible, PIP insurance pays for 80 percent of your medical bills up to a total of $5,000, while you are responsible for the remaining 20 percent. Any additional medical expenses will be completely covered by PIP insurance up to a standard maximum of $250,000 or more depending on the terms of your policy.

Can My Insurance Company Stop Paying My Benefits?

 

Under New Jersey law, PIP insurance providers have the right to have you examined by a doctor of their choice to determine if you are eligible to continue to receive benefits. In the event that their chosen doctor should determine that you have healed from your treatment, or that your injuries were so serious that additional treatment will not provide a considerable benefit, your insurance company may notify you of a termination of your benefits. You do not have to accept this decision. An experienced attorney from our firm can help you fight to continue to receive your entitled treatment.

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ATTORNEYS AT LAW

856.751.5505 | 609.788.3595

Fax: 856.751.5516

OFFICE LOCATIONS

Marlton Office

Northfield Office

8000 Sagemore Dr., Suite 8303
Marlton, NJ 08053

450 Tilton Road, Suite 200B

Northfield, NJ 08225

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Licensed in New Jersey + Pennsylvania + D.C. + Virginia + North Carolina

Admitted to practice in the New Jersey, Pennsylvania, Washington D.C., Virginia and North Carolina State and Federal Circuit Courts, Administrative Courts and the United States Supreme Court.

Burnham Douglass provides legal advice, representation, litigation, trial skills and services to people from all walks of life.

Burnham Douglass is not a partnership, it is an independent organization consisting of a limited liability company doing business as Burnham Douglass, Business Registration documents on file with the State of New Jersey.