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 Posted: Mon Apr 20, 2009 8:36 pm Post subject: High limits, Time limits, Pain and Suffering |
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I live in Texas and was in a hit and run accident so it seems that I entitled to Uninsured motorist bodily injury. My bills are in excess of 190,000 dollars my health insurance is paying it except the PIP. So when they offer me a settlement what should I be looking for? And what exactly is high limits?
Also I understand Bodily injury includes pain and suffering. I had a compound ankle fracture and fracture of right hand. I am still in therapy and I am doing very well but those two injuries will probably bother me for the rest of my life and that is what my doctors and therapists say.. I am retired so I am not losing any wages. So does that mean they are not just looking at the bills but that also? How do I put a number amount on pain and suffering?
The next question is after you give the insurance company all of your bills how long do they have to offer a settlement? Can they prolong it?. They are already giving me a hard way. I know I gave them my consent for med records 2 times and today when I called they said they can't find it. So I am thinking they starting to play games. I find the people here to very helpful so thanks in advance |
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Marbleann
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| Posted: Mon Apr 20, 2009 11:04 pm Post subject: |
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The absolutely MOST they can pay you are your policy limits (which I would expect from what your injurys are). You need to look at your policy and see what your UM limits are... | Quote: | | So when they offer me a settlement what should I be looking for? |
Were I you I'd be looking for policy limits.. | Quote: | | And what exactly is high limits? |
This means different things to different people, but is of no consequence, because you can't increase your limits after an accident...your limits are whatever you chose and have been paying for.. | Quote: | | Also I understand Bodily injury includes pain and suffering. |
that is correct.. | Quote: | | So does that mean they are not just looking at the bills but that also? How do I put a number amount on pain and suffering? |
given the amount of your medical bills I doubt this will be necessary...to try and figure out, but we would be in a better position to advise you after you let us know what your UM limits are (will look something like this: 25/50, 50/100 etc.)
| Quote: | | The next question is after you give the insurance company all of your bills how long do they have to offer a settlement? |
Well they have to order all of the doc reports, may request a narrative, also may not given the high amount of your actual medical bills... | Quote: | | Can they prolong it? |
Not without a reason... | Quote: | | They are already giving me a hard way. |
How so? this is your carrier! | Quote: | | I know I gave them my consent for med records 2 times and today when I called they said they can't find it. So I am thinking they starting to play games |
I doubt that, more likely they are just sloppy...they have to send a copy with each request they likely screwed up and sent the original.. | Quote: | | I find the people here to very helpful so thanks in advance |
That's sweet, and nice to hear...
ok, do you only have the one vehicle ? If you have more than one vehicle insured then you need to find out if TX allows ''stacking'' of UM coverage...you also need to let us know the UM limit...were you the only one injured?
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Lori
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| Posted: Mon Apr 20, 2009 11:43 pm Post subject: |
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| Thanks for your reply. I have only one car. About my coverage one person tells me 100,000 then the next person tells me 25,000. I have to get people to look for things for me in my house because I really cannot get around. I know I have the policy somewhere here and it should be with my important papers, but my house mate cannot find it. It is driving me nuts. Yes I was the only one one injured. I have to say the insurance company has been ok so far. I would not have even known I had UM if they did not keep on bothering me about the bills. I thought I was just getting PIP. I can imagine how much flack that poor adjuster who was bugging me about sending in the bills must be getting now after they saw those bills. I just moved to Texas so this is all new. NY where I lived was a no fault state so this is all new to me. Thanks for your answers. Once again someone came through here to help me |
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Marbleann
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| Posted: Mon Apr 20, 2009 11:48 pm Post subject: |
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| Quote: | | About my coverage one person tells me 100,000 then the next person tells me 25,000 |
It will be right there on your last bill..or call your agent and ask...that will be quicker for you...I'd say though either of those limits should (will) be paid, just ask for your policy limit in settlement (once you know what that is).
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"Never, never be afraid to do what's right, especially if the well being of a person or animal is at stake. Society's punishments are small compared to the wounds we inflict on our soul when we look the other way." Martin Luther King Jr. |
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Lori
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| Posted: Tue Apr 21, 2009 12:25 am Post subject: |
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| Thanks again! |
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Marbleann
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| Posted: Tue Apr 21, 2009 3:03 am Post subject: |
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Lori,
Excellent.  
I know you're not fishing for compliments or anything, but that was a great response.
InsTeacher  |
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InsTeacher
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| Posted: Tue Apr 21, 2009 9:32 am Post subject: |
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| Quote: | | About my coverage one person tells me 100,000 then the next person tells me 25,000. |
I guess your people are getting confused between your PIP limits ans your state min.liability limits. In Texas you have a total liability of 1,00,000. Out of this you have $ 25,000 for injuries that you caused to another person. Also, there's another $ 25,000 for property damage caused to the other person. As far I remember, PIP in Texas has it's basic limit at $ 2,500.
| Quote: | | I just moved to Texas so this is all new. NY where I lived was a no fault state so this is all new to me. |
So, now you gotta learn and remember things while you're out on the road.  Steven |
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steven
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| Posted: Tue Apr 21, 2009 11:00 am Post subject: |
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Ah InsTeacher you make me blush  I'm honored by a compliment from one so esteemed (im my book anyway  ).
Texas doesn't require ins, they are a financial responsiblity state, with (as steven mentioned) 25/50/25 limits...they do not require you to carry UM, so you would've had to chose UM.. Texas is not a no fault state so not sure about the PIP could have PIP without being a true no fault state...although as I understand Texas that too would be an add on coverage...what were your PIP limits?
Don't suppose you'd have any reason to believe that the person that was driving the other vehicle or owns that vehicle has a lot of money some where do you?
I'm afraid that you are not going to get what you hoped (and deserve) for you injury...As I said earlier you can on get up to the limit of UM coverage you have....You might talk with your adjuster about this other person they may have (or will) run an asset check, if by some quirk they do have money (although doubtful if uninsured) you could always sue them, but collecting on the judgement is a whole 'nuther' animal...Another thing you need to do is find out if your health carrier is going to demand repayment by way of your UM settlement, you might be able to get them to leave you alone if they realize you won't be compensated nearly enough based on your limit....
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"Never, never be afraid to do what's right, especially if the well being of a person or animal is at stake. Society's punishments are small compared to the wounds we inflict on our soul when we look the other way." Martin Luther King Jr. |
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Lori
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| Posted: Tue Apr 21, 2009 11:09 am Post subject: |
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| Quote: | | I would not have even known I had UM if they did not keep on bothering me about the bills. |
Well, I guess the reason was that though UM/UIM coverage is optional in Texas the refusal of it needs to be in writing, i.e. you have to exclusively sign the exclusion of such coverage in the plan.
Thanks,
Rupert |
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RupertWBradson
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| Posted: Tue Apr 21, 2009 9:28 pm Post subject: |
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| I appreciate all the responses. Next time I know I will look at my coverage more clearly. So far they said my health insurance is not looking for the money. But I am sure I have enough pain and suffering that they will have to pry that money out of me if they do. Because I understand some of the money is for pain and suffering. I have been laid up for 5 months and this is going to be with me for the rest of my life. Question would the insurance company just give the health insurance company a check without giving it to me at all? What does your experience tell you they will do? |
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Marbleann
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| Posted: Tue Apr 21, 2009 9:47 pm Post subject: |
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| Quote: | | Question would the insurance company just give the health insurance company a check without giving it to me at all? What does your experience tell you they will do? |
That's a difficult question, if your health carrier files a lein against your UM settlement your auto carrier has to honor this...now there could be some negotiation involved, but yes, your adjuster should let you know this if it's the case.
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"Never, never be afraid to do what's right, especially if the well being of a person or animal is at stake. Society's punishments are small compared to the wounds we inflict on our soul when we look the other way." Martin Luther King Jr. |
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Lori
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| Posted: Tue Apr 21, 2009 10:11 pm Post subject: |
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| Thanks. Does that happen often. |
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Marbleann
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| Posted: Tue Apr 21, 2009 10:28 pm Post subject: |
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yes, it does
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"Never, never be afraid to do what's right, especially if the well being of a person or animal is at stake. Society's punishments are small compared to the wounds we inflict on our soul when we look the other way." Martin Luther King Jr. |
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Lori
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| Posted: Wed Apr 22, 2009 4:51 am Post subject: |
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| Fact is I never even thought I had anything coming to me. But believe me I will get a lawyer for the pain and suffering. Suppose the insurance just says it is pain and suffering the are covering how could my health insurance recover for that? I heard that most of the time they don't bother. My auto insurance said they have not been looking for any money so far. |
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Marbleann
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| Posted: Wed Apr 22, 2009 11:13 am Post subject: |
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| Quote: | | But believe me I will get a lawyer for the pain and suffering. |
I don't think you should do that right away, from what you have posted I wouldn't think you are going to have any trouble at all getting your UMBI limits (which is the most you can get) why give up a third of that to an attorney? IMO you ought to be able to settle this yourself...now if you want to sue the uninsured guy that hit you on top of what you get from your UM settlement you'll need an attorney, (or can file in small claims I think your state has a 10k limit)...but you may have trouble getting an attorney to sue this guy, unless he is independently wealthy..which of course is doubtful... | Quote: | | Suppose the insurance just says it is pain and suffering the are covering how could my health insurance recover for that? |
Its' a lein against any and all settlements so it doesn't matter.. | Quote: | | I heard that most of the time they don't bother. My auto insurance said they have not been looking for any money so far. |
That great news! Hopefully it will stay that way, you can bet your health carrier knows (since first day of treatment) that this was an auto accident...did they send you a form letter asking if there was other insurance available to you on this injury?
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"Never, never be afraid to do what's right, especially if the well being of a person or animal is at stake. Society's punishments are small compared to the wounds we inflict on our soul when we look the other way." Martin Luther King Jr. |
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Lori
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