“I would strongly recommend HMR Funding to any plaintiff’s trial lawyer, or people representing plaintiffs in personal injury cases, especially where it’s a more catastrophic injury, they move rapidly to get the job done.”

– John, Palm Beach Trial Attorney

Our medical funding solutions help uninsured and underinsured personal injury plaintiffs pay for the quality medical care they may require due to injuries sustained at no fault of their own.

ATTORNEYS

Is your client either uninsured, underinsured or denied coverage for some reason? Does your client need funding assistance to cover their medical expenses or help cover their living expenses while they recover from their injuries?

HMR Funding is your medical funding solution, we take the risk the same as you, so you can help your client pay for the treatment they may need to get on a path to recovery while you work to get them the justice they deserve.

Apply Now →

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PERSONAL INJURY VICTIM

Have you been denied coverage or are you an uninsured or underinsured personal injury victim, hurt in an accident that was no fault of your own. Are you in need of medical help NOW?

If you have no health insurance, or if your health insurance has high deductibles and high co-pays like most plans do today, how do you pay for the medical treatment that you now may require so you can return to work and provide for your family? If you find yourself in this situation, we can help.

Get Help Now →

You need a medical funding solutions company.
You need HMR Funding.

HMR Funding Offers Medical Funding for the Following:

Medical expenses associated with
- personal injury
- premises liability
- product liability
- medical malpractice
- and many other types of third party liability cases
Pre-settlement funding to help plaintiffs manage their living expenses as they are on their road to recovery

Our Medical Funding Can Help You Pay for a Wide Range of Medical Treatments and Facilities, including:

Consultations
Diagnostics – Imaging
Pain Management
Physical Therapy
Orthopedics
Spine Surgery
Traumatic Brain Injury Treatment
Inpatient and Outpatient Surgical Procedures

Toxicology
Home Health
Amputation Cases
Hospitals
Health Systems
Urgent Care
Neurology and Neurosurgery
Ambulatory Surgery Centers (ASC)
And more

We have years of experience and we understand the inherent challenges associated with personal injury cases. That’s why the plaintiff pays nothing to HMR until their case is either settled or won.

START THE APPLICATION PROCESS TODAY – FAST APPROVAL
If you have questions give us a call at 1-888-377-1245 or contact us.

1 Plaintiff Info

2 Plaintiff Attorney Info

3 Case Status

4 Defendant Liability

5 Injuries

6 Insurance Review

7 Additional Info

8 Checklist

9 Description

SECTION 1: Plaintiff Information - GENERAL
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email
Mobile Phone
Date of Birth*
MM
DD
YYYY
Driver's License #
Medical expenses to date

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SECTION 2: Plaintiff Attorney Information
ATTORNEY MANAGING THIS CASE
Firm name*
Attorney name*
Attorney phone*
Attorney email*
PARALEGAL SUPPORTING THIS CASE
Paralegal name
Paralegal phone
Paralegal email
Working with HMR?
Are you working with an HMR representative?*
Name of HMR representative:*

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SECTION 3: Case Status/Attributes
Date of loss/injury*
MM
DD
YYYY
Is case in suit?*
Index/Case No.
Title of Action
Venue - County
Is trial date set?*
Date of Trial*
MM
DD
YYYY
Estimate of Case Close Date
MM
DD
YYYY

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SECTION 4: Establishing Defendant Liability
Was there a Police Report/Accident Report?*
Please upload a copy of report.
allowed file types: jpg, gif, png, pdf.
Drop files here or
If charged, did the Defendant plead guilty?
Has Defendant's insurance accepted liability?*
Did Defendant's insurance pay for property damage?*
Was amount reduced due to comparative fault?*
% amount reduced

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SECTION 5: Injuries/Causation/Past Medical
Type of Accident*
Was medical treatment received by plaintiff on date of incident?*
Area(s) of the body that is injured:
Provide any insight into medical diagnosis/treatment thus far:
What medical procedure(s) are required for this patient?
Has any doctor indicated (by way of medical record or written narrative) that the injury that needs medical procedure is due to this incident (as opposed to a pre-existing condition).
Please attach medical records.
accepted file types: jpg, gif, png, pdf
Drop files here or
Are there any concerns that the injury is an aggravation of a pre-existing condition?
Please explain:
Has Plaintiff had PAST medical conditions on same body area?
What year?
Please explain:
Has Plaintiff had SUBSEQUENT medical conditions on same body area?
What year?
Please explain:
Please provide any additional insight into the causation of the injuries.

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SECTION 6: Insurance Review and Lien Verification
Insurance/Coverage Information
Defendant's Name:*
Plaintiff's Carrier:
Name of corporate entity:
UM/UIM Limits:
Coverage Amount:
Health Insurance?
Insurance Company:
Medicaid or Medicare?
Claim Number:*
Receive Social Security?
Liens
Are there any liens on the case at this time?
Total $ Value of ALL Liens
What are your expenses to date on this case?
How much have you paid for medical treatment for the Plaintiff?
Living Expense liens to date:

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Additional Information - Plaintiff
Obtained a prior advance?
If yes, please explain.*
Filed lawsuit for injury to same area of body?
Please provide detail:

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CHECK LIST - if not previously attached
Police Report/Accident Report
Please upload report if available
Drop files here or

Accepted file types: jpg, gif, png, pdf.
Declaration Page from Defendant Insurance Policy
Pleae upload declaration page from defendant's policy if available
Drop files here or

Accepted file types: jpg, gif, png, pdf.
Declaration Page from Plaintiff Insurance Policy
Pleae upload declaration page from plaintiff's policy if available
Drop files here or
Expert Witness Reports/Letters (if available)
Please upload reports/letters if available
Drop files here or

Accepted file types: jpg, gif, png, pdf.
Witness Statements (if available)
please upload statements if available
Drop files here or

Accepted file types: jpg, gif, png, pdf).
Photos of Property Damage (if available)
please upload any available photos of property damage
Drop files here or

Accepted file types: jpg, gif, png, pdf.
All Medical Records (if available)
please upload available records
Drop files here or

Accepted file types: jpg, gif, png, pdf.
Medical Bills to Date (if available)
please upload any available medical bills
Drop files here or

Accepted file types: jpg, gif, png, pdf.

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SECTION 8: DESCRIPTION OF CASE
(please be thorough)
Case description
example: My client is a 42 year old male - DOB 7/4/70 - no health insurance DOL 4/15/11- Motor vehicle accident - Have witness statements 75% admitted liability from defendant $300K defendant insurance per DEF policy declaration page Meds to date $22,000, no Medicaid or other liens (med bills attached) Injuries include spine/back - have positive MRI indicating disc protrusion Two rounds of soft tissue injections have failed - surgury likely Dr. Tom Smith at (123) 456-7890 is provider Need advance for surgery and rehab - client cannot wait and cannot work Trial date is expected spring of next year (no date at this time)
ACKNOWLEDGEMENT - RELEASE OF MEDICAL RECORDS
In connection with this case, certain medical records (“Medical Records”) related to Patient will be created, including without limitation, images, physician notes, lab reports, invoices and bills. The Medical Records constitute the Protected Health Information (as such term is defined in the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and the regulations promulgated thereunder) of Patient. The Patient has authorized this firm to release the Medical Records to HMR Funding, LLC and its affiliates and those providers HMR Funding, LLC or its affiliates may be contracting with, or considering to contract with, as the payor of medical services on behalf of the patient. The authority of Patient’s attorney under this Release will terminate upon termination of such attorney’s representation of Patient. The authority under this Release will terminate upon Medical Provider’s receipt of payment in full for all amounts owed to Medical Provider in connection with the Services. Patient may, in its sole discretion, revoke this Release at any time, by providing written notice to this firm.
LETTER RELATED TO ASSIGNMENT AGREEMENT
This Letter Agreement is delivered by the attorney of the Patient (as defined above) to HMR Funding, LLC and its Affiliates (“Assignee”) in connection with separate Assignment Agreement(s) (each, an “Assignment”) by and between Patient and certain medical providers (each a “Medical Provider”) that provide medical services to Patient in connection with the incident (“Incident”) that occurred on the Incident Date identified above. As the Patient’s attorney, we acknowledge that Patient has or will irrevocably assign the Proceeds (as such term is defined below and up to the amount (“Expense Amount”) indicated on the corresponding billing statement(s) provided by the applicable Medical provider) to the applicable Medical Provider, and that such Medical Provider then assigned the Proceeds up to the Expense Amount to Assignee, and we agree, to the best of our ability, to honor such assignments, including without limitation by causing the full Expense Amount to be paid to Assignee if and promptly after we receive corresponding Proceeds. The term “Proceeds” means proceeds recovered on Patient’s behalf that arise out of any litigation, judgment, verdict, settlement, arbitration or mediation, or any other collection activities related to Patient’s pending or subsequent claim(s) and/or action(s) related to the Incident. In the event we recover Proceeds on behalf of Patient, we agree to (a) withhold from such Proceeds, after deduction of attorneys’ fees and costs, all amounts necessary to pay the Expense Amounts, as such amount is communicated by the applicable Medical Provider to us and/or Patient; and (b) promptly remit to Assignee (at the address set forth above), the portion of such Proceeds necessary to cover the Expense Amounts.
SUMMARY*
To the best of my knowledge, the information contained in this application is true and is an accurate summary of this case. By my signature below, I/We hereby certify that this signature is on behalf of the Firm and Attorney in Charge.

ATTORNEY SIGNATURE
Attorney Name*
Title First Last

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“I would strongly recommend HMR Funding to any plaintiff’s trial lawyer, or people representing plaintiffs in personal injury cases, especially where it’s a more catastrophic injury, they move rapidly to get the job done.”

– John, Palm Beach Trial Attorney

Our medical funding solutions help uninsured and underinsured personal injury plaintiffs pay for the quality medical care they may require due to injuries sustained at no fault of their own.

ATTORNEYS

PERSONAL INJURY VICTIM

You need a medical funding solutions company. You need HMR Funding.

HMR Funding Offers Medical Funding for the Following:

Our Medical Funding Can Help You Pay for a Wide Range of Medical Treatments and Facilities, including:

We have years of experience and we understand the inherent challenges associated with personal injury cases. That’s why the plaintiff pays nothing to HMR until their case is either settled or won.

START THE APPLICATION PROCESS TODAY – FAST APPROVAL If you have questions give us a call at 1-888-377-1245 or contact us.

SECTION 1: Plaintiff Information - GENERAL

SECTION 2: Plaintiff Attorney Information

Working with HMR?

SECTION 3: Case Status/Attributes

SECTION 4: Establishing Defendant Liability

SECTION 5: Injuries/Causation/Past Medical

SECTION 6: Insurance Review and Lien Verification

CHECK LIST - if not previously attached

SECTION 8: DESCRIPTION OF CASE

You need a medical funding solutions company.
You need HMR Funding.

START THE APPLICATION PROCESS TODAY – FAST APPROVAL
If you have questions give us a call at 1-888-377-1245 or contact us.