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Glossary of Legal Terms

A

A formal documentation of the scene of an accident made by someone with authority to do so, like a police officer or first responder.
A natural event causing damage that could not have been prevented by human intervention, such as a flood, earthquake, or severe storm.
The value of property determined by subtracting depreciation from replacement cost.
Means of settling a case other than litigation.
A petition for a higher court to review a decision or denial and consider overturning it.
The settlement of a legal dispute between defendant and plaintiff by a neutral, third-party instead of pursuing formal litigation. The third party is usually an off-duty judge or other attorney. Both parties sign a contract agreeing that the third party’s decision in the matter will be final.
A transfer of insurance benefits to someone other than the policyholder with the written consent of the insured.
A law stating that everything discussed between an attorney and his or her client is private and cannot be forcibly disclosed to anyone else.

B

Describes a situation in which an individual or individuals feel a claim was unfairly denied or delayed, or that the final settlement was inadequate.
Financial assistance received through an insurance company, employer, or social security program that is paid out in a time of unemployment, disability, or illness.
Damage to a person’s physical body caused intentionally, accidentally, or through negligent acts.
The necessity to prove that one’s assertions against another party are true. For example, a plaintiff alleging that a driver was negligent must provide evidence demonstrating this to be fact via documentation, witness testimonies, etc.

C

A request by a policyholder to his or her insurance company to cover damages related to property or bodily injury.
The person acting on behalf of the insurance company to carry out necessary steps during the claims process, such as obtaining documentation, approving contractors and healthcare providers, and approving estimates for repairs.
A law (tort rule) that allows a party to seek damages even when found partially at fault. When both parties are found negligent, fault may be allocated as a percentage. If a plaintiff is found to be 25 percent at fault, for example, the defendant will be responsible for paying 75 percent of his/her/their damages. By the same token, the plaintiff will be responsible for paying 25 percent of the defendant's damages.
An injury covered by Workman’s Compensation; this is an injury that happened at work in the performance of regular, expected work duties. It does not include long-term injuries unrelated to employment.
The first document filed in a lawsuit by a plaintiff against another party, detailing the reasons why the plaintiff feels legally wronged.
Payment given to an attorney only upon successful resolution of a case. Attorneys operating on a contingency fee basis do not receive any payment until a case is won.

D

Payment awarded by the court for injury or loss. The amounts are often subjective and figure in conjectures such as pain and suffering, past and future lost wages, mental anguish, tarnished reputation, etc.
The amount of money a policyholder is responsible for paying on a claim. The insurance company will typically cover any additional costs (so long as they are listed benefits) once the deductible has been satisfied.
The person against whom a lawsuit has been filed for a negligent act. The defendant can also include the accused person’s insurance company.
A letter requesting some information or action from an opposing party with threat of legal retaliation upon failure to satisfy the demand(s).
A formal session that takes place outside the courtroom during which an opposing attorney interviews a witness under oath. Questions and answers are documented and can be used in evidence.
The release of information and documentation to opposing counsel.
Similar to a Request, this is the process by which opposing lawyers acquire information from one another regarding the case, such as interviews, surveillance footage, and medical documentation.
Driving while performing other activities, like texting or eating, that can cause an individual to lose focus on the road.
Driving while high or intoxicated due to the use of alcohol, chemical substances, or other controlled substance
A standard of safety expected from an individual or business. It is assumed, for example, that a store owner will keep the interior free of safety hazards like spills or damaged shelves that could cause products to fall on someone. They have a duty of care to maintain a safe shopping environment.

E

Monetary amounts awarded above an insurance policy’s limit. Excess judgments are usually given in the event of a bad faith claim.
When all money that is payable to a policyholder has been dispersed.
An expert in a particular medical, scientific, or other professional field who is called to give testimony regarding a specific matter. For example, an orthopaedic surgeon may be called as an expert witness regarding spine injuries sustained by a plaintiff at work.

F

A wrongful act resulting in harm to another. It does not matter whether the act was intentional or accidental-if it resulted in physical injury, property damage, or other harm, it can be considered fault.

G

Acting honestly and without the intent to defraud anyone. In regards to insurance, “good faith” is the understanding that an insurance company will carry out its duty to cover a legitimate claim without unnecessary delays or obstacles.

H

Objects or situations that increase the likelihood of injury, such as un-repaired sidewalk damage, spills, or exposed wires.
The Health Insurance Portability and Protection Act protects your medical information and prevents it from being shared without your express consent or the approval of a medical professional authorized by you.

I

Payments in the place of wages given by an insurance company when a claimant cannot work due to injury. Accordion Sample Description
A medical exam performed as a second opinion usually requested by the defendant’s insurance company.
A written agreement that stipulates an insurer will pay certain benefits in the event of medical, property, or other damages in exchange for a monthly premium paid by the insured.
A document with written questions expected to be filled out by opposing counsel within a specified amount of time. The questions are answered under oath and the final document is signed before a notary.

J

The final decision made in a case regarding the rights and claims of all parties.

K

A law that prevents people from purchasing insurance to cover damages which have already occurred.

L

When a client cannot otherwise afford healthcare, an attorney may write a letter requesting medical services be provided on credit that will be paid out of the client’s settlement funds.
Legal responsibility for one’s actions.
The maximum amount an insurer is expected to pay in one claim.
The act of filing a lawsuit.
The likelihood that a case can be won at trial versus settling outside of court.
The monetary value given to damages assessed during a personal injury claim, including medical bills, loss of income, pain and suffering, etc.
Reduced or lost income as a result of injuries sustained.

M

When a professional, such as a doctor or attorney, fails to meet certain duties or standards of care, resulting in harm to a client or patient.
A court mandate enforces a judgment or sentence.
A term typically used in Workers Compensation cases to mean that an injured individual is not expected to make any further improvements in their medical condition.
When an impartial third party helps to settle a dispute.
A formal request by an attorney that a judge rule or act in some way, which can be denied or approved.

N

Anyone formally named on insurance policy documentation.
Failure to act with expected levels of care that results in harm to another person.
Discussions that take place between a plaintiff and insurance adjuster to reach a settlement that is perceived as fair by both parties.
An individual who is licensed to witness the signing of legal documents, which they mark with a seal as proof.
A written notification to an insurance company of an event that will later be processed as a claim.

O

When an agreement is reached between the plaintiff and defendant without the need of a judge or court approval.
Any money spent out of an injured person’s own pocket to cover medical, travel, or other expenses related to their injuries.

P

A qualified person who works in a law office and assists attorneys in working on a case.
The sides involved in a lawsuit.
The person who is injured and files a lawsuit against another individual or company.
A formal declaration in a case that makes or responds to claims and allegations.
When a past case and the resulting judgment is used as the basis for ruling in a different case.
Holds property owners accountable for injuries sustained by individuals due to dangerous conditions on the property.
Appearing before a court.
An event deemed to be the ultimate cause of an injury.

Q

The standard of living a person was enjoying before an accident or injury occurred.
A claim asserting that a government contractor filed a fraudulent claim. Qui Tam helps prevent individuals from abusing federal programs, like Medicare.
”This for that.” Quid Pro Quo involves the exchange of something by each party to reach an arrangement.

R

A standard of medical care expected by any fair or reasonable person.

S

The agreement reached between opposing parties; the conclusion of the legal proceedings.
A case involving personal injury occurring when someone slips and falls on another person’s property as a result of negligence.
A baseline of medical care; how professionals with similar qualifications would have treated an individual in a similar situation.
The amount of time a person has to file a claim or take legal action, typically beginning from the date of injury or damages.
Holds a party responsible for damages even if they are not directly involved. For example, under strict liability, a car company can be held responsible for an accident that occurred because of faulty machinery.
A formal command from a court to appear at a specific time and place to testify.
Allows someone else to make a payment on behalf of a claimant while they await payment by the at-fault party. For example, an injured party’s own insurance company may help cover damages and later be reimbursed by the at-fault party’s insurance company.

T

A claim that is filed against an insurance company other than one’s own.
A wrong that is not a crime but leads to legal action against another. Personal injury is a kind of tort law.
The individual or group that is presented with evidence and makes a decision based on that evidence.

U

V

The end decision made by a judge or jury.
The examination by attorneys of potential jury members.

W

Benefits provided to an employee by an employer in the event of and accident or injury in the workplace.
A claim made by surviving family members seeking damages that have occurred as a result of a loved one dying due to the fault of another, either accidental or deliberate. These damages can include medical bills, loss of income, and loss of consortium.

X, Y, Z

At Roth Group Law, our goal is to level the playing field between policyholders and their insurance companies. Colorado requires insurance companies to process claims in a timely manner with due research, good communication, and a fair settlement. We hold insurance companies accountable that fail to do this.