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 Feb 11, 2008 06:42 am Post Subject:
So far your thinking about it wrong... you really should be getting more then the limits but your obviously willing to accept the limits as this is all you can really expect.
Look at it this way... your medicals and loss wages put your claim at $35k right now. You will probably need additional treatment. You also now have a rod and screw in your leg and this very well may cause some physical complication down the road. So you have about $40k in actual bills... is it so hard to see getting paid another $30k on top of that. That would put you at $70k. If I were a betting man (and it's not been my month) I'd say their initial offer will be close to $60. If it is, they are probably looking at settling around $75k-$80k. I can't see their initial offer being any lower then $60.
Since you really can't "ask" for more then the $100k limits, you need to keep in mind that you've already lowered your demand to the $100k limit so why should you go any lower. You can also let the adjuster know that you arrived at this amount as your medical bills and loss wages alone are about $40k right now and you've also spoken to an attorney who also thinks the claim is easily worth $100k (you might want to mention that the attorney is reluctant to take the case, keeping 33%, unless it appears the carrier won't be offering the $100k limits). Time is on your side. If you can, let your demand sit out there for a month. An insurance company does not want a $100k reserve sitting on a file for a long time.
Do I think an initial demand of $100k is not in line with your loss? Heck no. Not with what you went through. Do I think the carrier will just offer up the $100k? Heck no. Keep in mind that even if an attorney could get the $100k, his/her cut would be $33k of that, leaving $77k to address everything else. An attorney might also be able to lowered your medical bills if you were allowed to pay them directly but I think you could manage this on your own.
Posted: Fri Feb 15, 2008 06:56 pm Post Subject:
ok, havnt heard from him yet...should be soon though. He was saying last time that if my health insurance put a lein against him that they had to pay that, but what if they dont, am I going to have to pay my health insurance back? Im sure i will have to but just curious.
Posted: Fri Feb 15, 2008 07:14 pm Post Subject:
but what if they dont, am I going to have to pay my health insurance back? Im sure i will have to but just curious.
Depends... they do have a right to ask for payment but I can say that most health carriers drop the ball when it comes to attempting recovery. I've not looked over a health contract in a long time so I don't know if there is some wording in it that _requires_ you to pay back the money. Baring that, it may be up to them to seek recovery... that is, you may not have to offer it. So you _could_ be required to pay the back but you might only be legally bound to this is if it's in the health contract. In any case, I know there will be a clause that gives them the right to _ask_ for payment back and if they _ask_ then you are legally required to repay.Bottom line: They always have a right to ask you to pay back the money and if they ask, you _do_ have to pay them. If it's written in the health contract that you have to pay the money back then it's up to you if you if you contact them and tell them of the recovery (i.e. you would have a legal obligation to notify them but no one is going to inforce a penalty if you did not). If it's not in the contract, they have a right to ask for repayment and if they ask, you have to pay. But if they don't ask....
Posted: Sat Feb 16, 2008 03:23 am Post Subject: I may have some useful advice
Hello, I am a Bodily Injury Claims adjuster. I have 3 years experience in settling injury claims for a major auto insurance company.
Believe it or not, there are some fair and honest Bodily Injury claims adjusters out there and I am one of them.
You had some serious injury especially if you broke your femur and had to have surgery and an extended period of time off work.
It is VERY important to keep meticulous documentation of your medical expenses, medical records, and if you are making a loss of wages claim you have to be able to prove that you actually misssed x amount of time, how much your income is...and the insurance company will have to verify all of your lost wages with your employer.
I believe you said your medical bills alone were about 30k....and you missed a few months of work recovering from your injury.
The fact that you had to be hospitalized, have surgery, missed a substantial amount of time from work....those are concrete facts that any reputable insurance company can not dispute.
Once they see your medical documentation, diagnostic reports such as xrays, etc...
I think you may be able to reasonably expect a settlement of roughly 50k.
If there are any other verifiable factors such as permanent disability or partial disability(this has to be documented by a physician)
This was a serious injury and the insurance company knows it.
What they look for is concrete documentation of your damages.
They also consider how much of an impact this had on your lifestyle....for example if your passion in life was to hike or dance or run marathons, etc, and you had to give that up for a long time due to your injuries, this may very well be taken into consideration as part of the pain and suffering when settling your claim.
Í don't know how long ago this accident happened but don't be too quick to settle.....be aware of the statute if limitations in your state for making a Bodily Injury claim and don't settle until you are sure you are completely healed.
My advice is to not hire a Personal Injury lawyer because they will get a huge cut of your settlement.
Your medical expenses, severity of injuries, lost wages will all be taken into account.
My guestimate is that you will be compensated for economic damages and then an additional 20k or so for pain and suffering.
Good luck to you...hope this helps.
Posted: Sat Feb 16, 2008 11:49 am Post Subject:
re:health insurance subrogation...it has been my experience that most if not all health policys have a subro clause...tcope is absolutely correct as well...my advise would be though not to spend that money! (what your health carrier could request) for a long long time...check your statue on this...in my area I think it's something ridiculous like ten years!
Posted: Sat Feb 16, 2008 12:25 pm Post Subject:
Wow, big difference in oppinion here. How come one thinks policy limits of $100k and the other cuts it in half, can either of you explain?
Posted: Sat Feb 16, 2008 12:42 pm Post Subject:
"I'' think she's way off....I see this as a (near) limits claim....gotta remember though, these things tend to be kind of 'regional'
Posted: Sun Feb 17, 2008 03:01 am Post Subject:
I hope he gets what you guys are saying, policy limits, he was off work for a while and did have to go for surgery. He will have trouble probably his whole life with an injury like this. It will as the older people say, let him know when the rain is coming, I am sure this leg will bother him in some way for a long time to come.
Posted: Sun Feb 17, 2008 04:54 am Post Subject:
without hiring an attorney, can an individual send a set of interrogatories to determine what the policy limits are? what, specifically, would those interrogatories ask? thanks!
Posted: Sun Feb 17, 2008 10:52 am Post Subject:
Great question Stray! and one I don't know the answer to unfortunately...this particular OP knew the policy limits because he was a passenger in a friends vehicle....I honestly don't know...In many areas (mine included) policy limits are a closely guarded secret and if memory serves interrogatories do not compel that answer....hopefully somone else will come along that knows that answer...I've seen claims get to the court house, without limits being disclosed...so not sure they would necessarily have to answer that....
Add your comment