Results 1 to 5 of 5

Hybrid View

  1. #1

    Default Trip and Fall in a Store

    My question involves an injury that occurred in the state of: California

    I was walking through a store and a pipe was sticking up on the side of an aisle, of which I tripped over and all my weight came down on my elbow and I suffered an abrasion sprain. Apparently, the store was working on some type of piping, but there was NO orange flag or sign warning of the exposed pipe. Apparently the worker forgot to mark the exposed location and or secure it while the work is being preformed.

    I made a report with the store manager and went to the emergency room at the nearby hospital, because I was in a great deal of pain. I saw an orthopedic who gave me a cortisone shot. And for a time, it seemed like the pain subsided, until a year later when the cortisone wore off (which apparently it does). I go back to my doctor and they have me do physical therapy, but to no avail. Then my doctor send me back to a different orthopedic doctor who gives me a cortisone shot in my elbow again. Although, my elbow still feels in pain. I am now requesting my doctor to put to be seen to get a MRI done.

    Okay, so the statutes of limitations in California is 2 years and the deadline is about 1 month away. I have tried to seek legal counsel, but as everyone knows, slip and fall cases are tough cases, not to mention, not very profitable. Many lawyers do not want to take on the case, because the bills only amount to around $5,000 (currently). The orthopedic doctor said that maybe surgery may be in order, if the cortisone shots don't take.

    I have a insurance claim, but the insurance has informed me that their insured does not have the typical insurance that covers the party regardless who is at fault (which is a bullshit answer). Never the less, it seems like I am on my own in regards to fighting this. I have gathered all my bills and in the process of gathering all the doctor's notes, so I can submit them to the insurance. I have a friend (who is a claim adjuster for a different insurance company) who has informed me that I may have to file suite, in order to "preserve the claim."

    What should I do? Should I try and work with the insurance to settle before the deadline or should I just assume that I need to file a civil suit for a claim over $7,500. Should I just upfront the cost and hire a lawyer? What is my best course of action?

  2. #2
    Join Date
    Sep 2011
    Location
    OH10
    Posts
    17,019

    Default Re: Trip and Fall in a Store

    You can always file a day or so before the deadline and continue to negotiate. You can also request a continuance after that, to keep negotiating.

  3. #3
    Join Date
    Sep 2005
    Location
    Behind a Desk
    Posts
    98,846

    Default Re: Trip and Fall in a Store

    An abrasion is the loss of skin; that we can assume healed a long time ago. The sprain? If you suffered only a sprain, symptoms resolved for a year, and suddenly the pain is back it suggests= reinjury, as opposed to a continuing injury. If it never got better, it suggests that you have a more significant injury than a mere sprain. If the orthopedic surgeon is talking about surgery, he's talking about fixing something - has he identified an actual structural problem in the wrist that could be repaired through surgery, or is he expressing that further diagnostic testing (e.g., the MRI) might reveal such an issue in which case surgery might be an option?

    You can try to negotiate with the insurance company and, if unable to either find a lawyer or negotiate a settlement by the time the statute of limitations is about to run, file a lawsuit in pro per. If you sue, there's a chance that the case will be reassigned to a different adjuster who deals with cases that are in litigation or that you'll be instructed to negotiate with their law firm. Your best approach depends in no small part on whether you can get a better diagnosis and prognosis than "Two year old sprain".

  4. #4

    Default Re: Trip and Fall in a Store

    Thank you for replying. Well, I got the run around from the so-called claims adjuster. They had violated many of the laws in the insurance code and I reported them to the Department of Insurance. The DOI informs me that the claims adjuster that is handling my claim is not the insurance agency for the business, but acting as a third part representative. The business, turns out, is its own entity. In California, a business does not have to have CGL (Commercial General Liability) insurance. In my case, the insurance claims adjuster was acting like a claim adjuster to resolve the issue, but in reality they are not representing the business because of a claim.

    I guess this is another one of those tricks played by claims adjusters and businesses. The Department of Insurance has informed me that there is nothing they can do, because this issue does not fall under their jurisdiction, because the business is exempt from the Insurance Codes, because they are acting on their own accord, as their own entity. Very new and fascinating to me.

  5. #5
    Join Date
    Sep 2011
    Location
    OH10
    Posts
    17,019

    Default Re: Trip and Fall in a Store

    Another issue you face is substantiation of your injury. As you said, you did not seek or need treatment for a year. The burden will be on you to substantiate you did not injure your elbow in a non related activity over the time period.

    1. Sponsored Links
       

Similar Threads

  1. Retail Fraud / Shoplifting: Left Store After Wrongful Accusation of Shoplifting, Store Took License Plate Number
    By indignant in forum Criminal Charges
    Replies: 1
    Last Post: 07-31-2012, 06:21 AM
  2. Premises Liability: Fall in a Store
    By jmill1948 in forum Accidents and Injuries
    Replies: 9
    Last Post: 05-22-2012, 07:01 AM
  3. Premises Liability: Slip and Fall on Wet Floor in a Department Store
    By jennmarc1 in forum Accidents and Injuries
    Replies: 2
    Last Post: 07-07-2008, 07:20 PM
  4. Workers Comp Slip / Trip and Fall
    By nss in forum Worker's Compensation
    Replies: 6
    Last Post: 07-02-2008, 10:13 AM
  5. Premises Liability: Slip and Fall in Store Restroom
    By sgtusmc in forum Accidents and Injuries
    Replies: 1
    Last Post: 02-10-2006, 01:55 AM
 
 
Sponsored Links

Legal Help, Information and Resources