What is a fair offer?

by lmilton1215 » Wed Jan 28, 2009 09:39 pm

Hello, I had an auto accident in May, 2006. The other driver was at fault and I suffered some injuries, primarily in my left hip. The last doctors visit I was told that not only do I have a laberal tear but I will need a hip replacement some time in my future. I am in various degrees of pain everyday. Some days are not as bad as others but the injury has impacted my ability to be active and my sex life with my husband is almost non-existent. My car was repaired for about $10,000 and my medical bills including 3 rounds of physical therapy, MRI with contrast, steroid injection, x-rays, etc. were about $9,000. I have to settle this claim by May and am not sure what is a fair settlement. They have yet to make me an offer. Should I present an offer? If so, what would be fair?

Total Comments: 18

Posted: Thu Jan 29, 2009 04:47 am Post Subject:

Hi lmilton,

You should receive compensation for your medical bills, therapies, doctors visits, including any future expense related to the treatment of the injuries, i.e. you might have to add the cost of the future surgery to the total medical expense as well.

In addition to the medical expense, you are also entitled to receive

* wage loss (if any)
* pain and suffering
* loss of consortium

Hope this helps.

Thanks,
Rupert

Posted: Thu Jan 29, 2009 05:03 am Post Subject:

Which state do you live in? since you have to settle the claim with May I guess that the statute of limitation is about to expire. I'd suggest that you consult an attorney.

It seems that you are in considerable pain after the accident and may incur medical expenses in the future even. Hence, your option is to sue the responsible driver in the small claim court and maximize the size of the claim.

Do you know the policy limit of the other driver?

Posted: Thu Jan 29, 2009 07:23 am Post Subject:

No one here can tell you what a fair settlement is as they have not been involved in your claim. Some may throw out numbers but what it comes down to is what you are comfortable with. If you are happy with $x and feel that it will cover your bills and put money in your pocket, you can't worry that you might have got $y. I would agree that you may want to consult with an attorney to have in your back pocket, but if you have went this far you may want to see what you can get on your own and save yourself 30%. You also have to remember this when discussing settlement. Lets say you want 30K and they are offering 25K and won't budge. If you go get an attorney and he gets you the 30K, your net will only be 21K since he is taking at least 30%.

Lets back track. The first thing, have you told them you are ready to settle. Most insurance companies will not just start offering money unless you are prepared to settle, when you have serious injuries. Make sure you know what you are looking for and also what your bottom line is before negotiating with them, as they know that their starting number is and their ceiling. Do they have all your medical bills and records (particularly the one that states that you will eventually need hip replacement with the labral tear). If they don't have them all, get them all of them now. If you try settlement on your own, you will have to learn to take your personal feelings out of it. Explain in written form all things you have mentioned here, but don't get hung up on little things. I once had a guy get hung up on a $20.00 shirt during a 10K settlement. Look at settlement conversations as business meetings; you are negotiating what is best for you and they are negotiating what is best for them. When they come with their first offer, again don't take it personal…..it is a negotiation. If it becomes close to the statue of limitations (May) and you have not settled, get the attorney on it so that he can file.

Also, if you have health insurance that is covering medical bills, you will want to check with your adjuster and insurance company to see if a lien letter has been sent to the insurance company to protect their subrogation rights. If they have, you need to make sure that the insurance company is paying them directly. You don't want any surprises after you have settled where your health insurance is looking for their money back from you.

Posted: Thu Jan 29, 2009 02:11 pm Post Subject:

They have yet to make me an offer. Should I present an offer? If so, what would be fair?

Das is correct we cannot tell you what your claim is worth, only offer what you need to consider in determining the value yourself...You definately need to make sure the adjuster is aware of the FULL extent of your injury....I doubt they will let you know the at fault partys policy limits...what however are your state min. limits? do you know that? if not find out...some adjusters/states/company's will freely give this information, most wont (what their insured's limits are)...It is my personal opinion (with over 20 years in the claims biz) that you have a sizeable claim, whatever you do - do NOT let this statute run...also remember that the adjust will have figured a 'range' for your injury and will of course offer the lower end of the range first...I personally would ask them to make the first offer....but you need to call them TODAY and make sure they have all your medical information...please let us know if we can help you with anything as you go thru this process...

ps i'm so sorry you are suffering with this.

Posted: Thu Jan 29, 2009 05:07 pm Post Subject:

The accident occured in Washington State. In Washington State the minimum automobile liability limits are $25k per person, $50k per occurrence for bodily injury and $10k for property damage liability.

I let them know I am ready to settle... it appears to be taking a while for them to get all of the medical records and bills. I have been assisting with this knowing that time is running out. I believe they were sent the file from my insurance company with all of their records showing all medical bills paid... somewhere around $9,000.

I have never been in an accident or in this position before. They told me once they reviewed everything they would make me an offer and I'm looking for a ballpark for what might be fair.

I did not lose any wages although I did take time out from work to go to physical therapy. Loss of consortium? How do you prove something like this??

Thanks for all of your feedback...

Posted: Fri Jan 30, 2009 04:34 am Post Subject:

I received an email from the insurance company today stating that he is swamped so he is asking an outside vendor to do a records review and summary to be done within 30 days. When he receives this he will then evaluate my claim.

Does it really take 30 days to complete a records review? What are your thoughts related to who puts in an offer first? He told me that once he is finished with the evaluation he will make me an offer. Is there some reason why I couldn't make an offer first?

Posted: Fri Jan 30, 2009 10:55 am Post Subject:

Loss of consortium?

equals

my sex life with my husband is almost non-existent

well i think your injury will speak for it's self there, hip injury surely would also play into that for most people....

Does it really take 30 days to complete a records review? What are your thoughts related to who puts in an offer first? He told me that once he is finished with the evaluation he will make me an offer.

yes it's customary to take that long

Is there some reason why I couldn't make an offer first?

You know it's a personal choice, I personally want whomever I'm talking to about what ever I'm buying or selling to make the first offer, (i never want to bid against myself) so I know instinctively the first offer is the lowest offer and then i can try and figure out how much 'room' there really is to move that offer...but you certainly could (IMO not the best thing to do especially if he didn't already ask you want you 'had in mind' which as an adjuster i certainly would've done). Be sure and call him back in 35 days if you haven't heard from him...do let us know if we can assist in any other way or how the negotiation is going

Posted: Fri Jan 30, 2009 08:19 pm Post Subject:

I wouldn't make the first demand either, just for the reasons that Lori stated. Lets say they were going to offer 30K (just using numbers) and you made a first demand of 25K. You just lost out on 5K and the adjuster didn't even have to work for it.

If I had to guess with what you stated, I bet the adjuster makes a first offer of 15K.

Posted: Sat Jan 31, 2009 11:20 am Post Subject:

I bet the adjuster makes a first offer of 15K.

depending totally on what his insured's limits are i'm betting that's pretty close for a first offer (15-18)...remember OP that will be their FIRST (and lowest) offer...

Posted: Sat Jan 31, 2009 05:03 pm Post Subject:

If the postrer is settling this on her own and does not know the exact limits how does she come up with a first offer? How can a person truly figure out what their injury is worth? If someone was never in an accident and has not dealt with this before they are treading on rough water. One wrong move and they could hurt their chances of getting a fair settlement. Hiring an atty is time consuming and, take it from me, not always the best idea.
How can she determine a starting figure? If you think 15k is a first offer then can she double this figure so she has room to negotiate? Sorry I can just imagine how lost she is in this predicament. For your average everyday person something like this is as confusing as reading another language.

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