by Riep69 » Fri Jan 25, 2008 05:14 am
was a 22 year old passenger in a single car accident that broke my femur which resulted in 3 nights in the hospital and sugury to place a rod and screw put in my leg. I was off work for 3 1/2 months and had to go through a month of theropy before returning to work. Medical bills approx. 30k, and lost wages of around $4500. I am almost ready to settle with the insurance and would like to know where to start? What kind of settlement am i looking at? I was wondering where to start when the offering comes.... does it matter if he was drinking and driving and driving wrecklessly? didnt get a DUI though, got physical control. His coverages is 100 300 50...i would like to know a round about estimate of what I am expected to get so I know what to settle for. I talked to a lawyer and she said go for the limits...so after my bills that would leave about 70k, would the insurance settle for that?
Posted: Mon Jan 28, 2008 07:36 am Post Subject:
what exactly is an OP?
OP stands for "Original poster". :)
Posted: Mon Jan 28, 2008 04:30 pm Post Subject:
Their offer really depends on why type of company they are. You may have heard about Allstate and the Mckinsey Report? Some carriers use computer programs to determine what offer should be made (see my prior post on this). Well, the Mckinsey Report told Allstate that they could save money by not using the software as a tool and also considering the injury, rather using the software to settle claims based on loss/profit (if release, that report could allow Allstate to be sued by a lot of people). Some carriers are just looking at their bottom line. If this is one of those carriers, they might try to low ball you. I also can't say a lower offer is not appropriate (I'd have to practice what I preach and review all your medical notes). Other carriers are more liberal and can just pull the trigger on spending $100k. These carriers typically have experienced adjusters and give them authority to settle claims quickly.
I'm not trying to say your claim _is_ worth $100k (I certainly think that is a _very_ good possibility), I'm pointing out that some companies are more apt to just offer a larger settlement to close the claim and others are more apt to pinch a few pennies if possible.
If the carrier received a medical lien from a provider, they are obligated to pay that provider directly. If they don't have a lien, some adjusters will still want to pay the providers directly but this is not required. I'd recommend you determine the amount of the settlement and then contact each medical provider to confirm what is owed. At the same time you explain that your settlement is ongoing but it appears it will be low, due to a policy limits issue. You ask them to consider lowering the amount they are charging so that you can pay them. If the carrier pays them directly, the carrier will simply pay the amount billed (they cannot ask for the bills to be lowered as they are simply a "check book"). Now you know exactly what your getting if you settle for the amount being offered.
If you want to sound well informed, while negotiating ask the adjuster if their carrier uses an injury claim software program, such as Colossus. If they don't pat the adjuster on the back for working for a good company (I work as an adjuster and I think every carrier who uses these systems should be sued till they are broke)
Posted: Mon Jan 28, 2008 07:38 pm Post Subject:
so basicly i should go for the limits? How do i go about telling them i want the limits, just say "hey i wont settle for anything less than the limits....the insurance provider is progressive if that helps.
Posted: Mon Jan 28, 2008 11:11 pm Post Subject:
cbr1000, How did you find out the limits to begin with? Some states (few) require disclosure...most however guard limits like fort knox...I'm just curious how you got this information?
Posted: Mon Jan 28, 2008 11:20 pm Post Subject:
I think you should at least ask for the limits, yes. You may even want to start by letting them know you've spoken to a few attorneys (but they are not representing you) who tell you that the claim is easily worth in excess of the $100k policy limits and as their insured is under-insured, you're willing to settle for the policy limit in this case. In other words, you're sending the message that your claim is actually worth more then $100k but you're willing to take less. This sends two messages, you overvalue the claim so as to make it look like their are getting a good settlement and it also sends the message that if you were to file suit they'd be looking at a possible excess judgement against their insured. If there were an excess judgment, they'd then be open for a bad faith claim filed against them from their insured (bad faith happens when the judgement is in excess of the policy limits. The insured can then file a claim against his/her own carrier saying that if they would have offered the policy limits the claim would have settled for that amount so the insured would not be on the hook for the excess amount. The other person's carrier has an obligation to protect their insured's interest in this matter, no matter what the limits of the policy are that they have to work with).
If you simply tell them you won't settle for anything less, that could be heard as an offensive statement. Once the adjuster goes into "protect" mode, it's hard to get them out. Instead you simply want to let them know your research has shown your settlement should be more then $100k but your willing to settle for the policy limits. I'd recommend first asking them what their offer is. This will allow you to gauge where they area. A good adjuster won't want to show their hand until you make a demand (and it's really your place to "go first"). I'd _never_ make the initial offer to an attorney but I will do this to an individual as they usually have no idea where to start (this is why we always see attorneys initial demand at something stupid like $1,000,000 for a $10k claim... they then can have the adjuster make the 1st _real_ move... again, most good adjusters will tell the attorney to get back to them with a "real" demand or make an equally outrageous offer like $100. :) )
Adjusters appreciate people who are well informed and it's great when the injured person can step back from the emotional part of the settlement and just talk business. I hate to say it, but this is 90% of how the adjusters look at injury claims. It's hard to be sympathetic in many claims and still negotiate.
Progressive....? Well, they like to save a buck. Hopefully with a possible $100k claim they have given it to an experienced adjuster. Most inexperienced adjusters would have a hard time offered $100k on a claim as it is a lot of money. Find out where they stand by getting an offer from them and then go from there. Rememeber, time is on your side. The longer the claim is open the more things can happen with your condition and adjusters are paid to close claims.
Posted: Tue Jan 29, 2008 02:48 am Post Subject:
I've never worked in a state where limits are not mentioned and I never understood that. I'd think at some point you'd need to tell the person that the limits are not as high as they are asking. Frankly, I don't see the point in not telling what the limits are. Again, I've never worked in a state where it's not required to disclose them so I know I'm missing the reasoning.
Posted: Tue Jan 29, 2008 04:27 am Post Subject:
I found out the limits because it was a single car accident that involved me and my buddy, it was his truck and he was driving. He told me what his limits were so i knew what i could settle for.
Posted: Tue Jan 29, 2008 04:35 am Post Subject:
sorry, didnt meant to post that twice...thank you for all your help, now im just waiting for to adjuster to call me back so we can talk buisness. Did you say that it would be smarter for me to settle for the limits and me pay my med bills bc i could negociate some of them? Im not sure if progressive is paying the ones we sent them or not, something im gonna have to ask him if he ever calls me back. Thanks again.
Posted: Tue Jan 29, 2008 09:58 am Post Subject:
Im not sure if progressive is paying the ones we sent them or not
I would be surprised if they have paid any bills, think tcope mentioned generally bi's are settled all at once at the end...more than likely your providers have filed leins with them. Your adjuster will be able to tell you...I've never worked in a state where limits are not mentioned
I've never worked in one that it wasn't a closely guarded secret! :roll: isn't that funny....I can see the secretiveness on most claims...on one that even approaches policy limits though, I think it's silly to not openly disclose....However, (as you know tcope) we don't make the rules...I figured it must've been a friends policy...tcope has given you some great advise....only thing I would add, is same as I said early on...don't get bogged down in "I want the limits only".... remembering that an attorney will take (generally) 33.3%, so (to my way of thinking) anything above 66.6 is basically policy limits, if your were rep'd. (no way to get more than policy limits of course you understand that, except sueing you buddy, which incidently is who the attorney has to name, not progressive insurance, so if you get one don't panic about that if you decided to get an attorney and warn your buddy)...
Good luck, hope you will keep us updated.
Posted: Wed Jan 30, 2008 03:15 am Post Subject:
one last question i have untill progressive calls me back, if they ever do....ive left 3 messages and no returned phone calls. I was wondering about the taxes on the settlement, do they take taxes out of it or will i have to pay in next year?
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