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 Posted: Wed Apr 09, 2008 3:09 am Post subject: Insurance co. says they will only pay 80% of lost wages |
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Insurance company is saying they will only pay 80% of lost wages due to taxes taken by employer if i had worked .Is this common, do most insurance co. pay 80 or 100%. My accident happened in TX.
Should I pursue 100%, if so what possible arguments can i use. |
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rgz4
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| Posted: Wed Apr 09, 2008 11:26 am Post subject: |
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This might be a state thing....I've seen this before when the 'owed' party is given the 'net' rather than the gross amount..really though it's fair (IMO) as you are not going to pay taxes on this right? Actually you might be getting even more if 80% is more than you would normally take home...I think you should call the Dept of Ins. for TX, they have a web site that you can get the comsumer advocates number from and find out...please do let us know.
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Lori
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| Posted: Thu Apr 10, 2008 6:12 am Post subject: are you sure its not catastropic? |
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80% is not too bad...but it really needs to find out under which category this case would fall.. Could I be sure that your injuries don't fall under the "catastropic category" ?
PIP is aimed to cover the medical expenses arising out of serious injuries when your health insurance is not sufficient to cover for it. This one should help you when you can't join work for a longer period of time too. Wish you find a way out!
Balkans_territory
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Balkans_territory
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| Posted: Thu Apr 10, 2008 6:37 am Post subject: |
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| Quote: | | My accident happened in TX. |
Would you open up a bit on this? ..Just needed to get a measure of the accident & the period of time for which you were out of work!
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plasticmind
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| Posted: Thu Apr 10, 2008 9:46 am Post subject: |
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Balkans_territory, what does this mean?
| Quote: | | "catastropic category" ? |
also sorry Balkans, but this is not correct...
| Quote: | | PIP is aimed to cover the medical expenses arising out of serious injuries when your health insurance is not sufficient to cover for it |
The injuries need not be serious at all and health ins sufficiency has nothing to do with PIP...
plasticmind, I fail to see what this has to do with the question.... 
| Quote: | | Just needed to get a measure of the accident & the period of time for which you were out of work! |
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Lori
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| Posted: Fri Apr 11, 2008 5:12 am Post subject: |
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OK...what kind of disability policy? 80% of the gross wage or 80% of the net wage. If it's the gross, unless you're making a small income,that disability benefit would normally be more than what you were bringing home when you were actually working, when you look at your tax bracket and all.
Is there any way this could be a worker's comp claim? What is the definition of disability in the policy and is your disability classified as total or partial? Policies will normally pay different benefit levels for different levels of disability. Are there waiting, or "elimination" periods in the policy? Group or individual?
We need more info, and please respond.
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InsTeacher
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| Posted: Fri Apr 11, 2008 10:43 am Post subject: |
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Ins teach, I took it that it was an auto accident, (course I could be all wet) and this is the amount of loss wages they would reimburse...80% of the OP's gross...personally I'd be thrilled with that..... 
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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: Fri Apr 11, 2008 4:22 pm Post subject: |
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Lori said:
| Quote: | | Ins teach, I took it that it was an auto accident, (course I could be all wet) and this is the amount of loss wages they would reimburse...80% of the OP's gross...personally I'd be thrilled with that..... |
Lori, I'd bet a buck that you're right, and I'm the one who's all wet. My brain, especially at that time of night, immediately went to disability. If the OP would actually respond, maybe we could clear this up!
Finally, I would agree. 80% wage loss, especially if that were of the gross wage would be great! I'd bring home more than if I was actually working, and that would be wonderful...! Sit in my house, watching ESPN and the Master's all day long? Wow...tough job but someone has to to it!
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InsTeacher
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| Posted: Sat Apr 12, 2008 8:58 am Post subject: accident |
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| RGZ..I am curious. What happened in the accident? |
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sdchargersfan
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| Posted: Sat Apr 12, 2008 11:33 am Post subject: |
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| Quote: | | I'd bring home more than if I was actually working, and that would be wonderful...! |
Me too I'm with you! But I just thought of something...Now if I was off for a period of time, I (personally) have butt loads of time and would still be paid (yes they ins carrier still has to pay me because I used my time.)...but here's an interesting question...Let's assume I didn't get paid....for a month...ok let say they want to pay my 'take home' or 'net' (seen it done)....I think I too would be entitled to the amounts of money (for instance) that I contribute to my 401K, which at this point in my life is huge....thoughts?
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Lori
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| Posted: Mon Apr 21, 2008 11:48 pm Post subject: |
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| Good point Lori. I never even thought of the 401k issue. What about for those folks whose company matches them 100%. They also would lose the money that the company would have been adding to their contribution. So now they are out twice..the money they would have added and the money they would have personally put in. |
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fireyone
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| Posted: Tue Jun 03, 2008 10:00 pm Post subject: 80% |
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| I would be surprised if 80% (net not gross) was not the purchased coverage amount. The 401k deduction would not be considered in the net account as this would be a net take home without prior deductions taking place, i.e. 401k, 403b, Health Insurance, Life Insurance, Supplemental deductions, etc. A little hard to distinguish with all of the assumptions we are making. haha But it is fun! |
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BenefitsRMyLife
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| Posted: Tue Jun 03, 2008 11:19 pm Post subject: |
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| Very true Benefits. Its cool to see all the questions and answers brought up in a question like this. |
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fireyone
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| Posted: Wed Jun 04, 2008 10:45 pm Post subject: |
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Most disability environments will pay based on the gross wage, not the gross wage MINUS pre-tax contributions.
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InsTeacher
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| Posted: Wed Jun 04, 2008 11:22 pm Post subject: |
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Ins teach I think we are talking (or assuming) this is loss of wage in an auto accident BI settlement...In that case I've never paid gross wages.
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Lori
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