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: Wed Feb 27, 2008 07:01 pm Post Subject:
just got a call from progressive today and he just recieved the rest of my info., theropy report, ect. He said that my health insurance called him and he is paying them back so im not going to have to take care of that. He said he will be calling back this time next week with an offer for me. With him paying my health ins. back that take 22k or the 30k in med bills outa the picture, so i have to keep that in mind. Ill keep the forum updated. Thanks for everyones help!
Posted: Thu Feb 28, 2008 01:59 am Post Subject:
Keep in mind that this adjuster _should_ settle the claim and secured an injury release _before_ paying _anything_. That is adjusting 101 and if he did not do this, it's a big mistake on his part! it does not really affect you but it opens up his company for a bad faith claim from their own insured if the claim does not settle.
Quickly... the carrier has $100k to settle this claim and protect their insured. They have the legal responsibility to act in good faith to use that limit to completely protect their insured. Let's say they pay $20k in meds. They not only have $80k to offer you. Let's say you don't accept it and sue their insured. You win $120k. Well now the other insured is on the hood for $20k. He can come back file a bad faith claim against his own carrier, saying if they had kept the $100k and made the offer for that amount, then you would have accepted, the suit would not have been filed and he'd not owe the additional $20k (granted, it's pretty much BS but he'd be right and he'd probably win). If that happen, the carrier would then be paying out $120k... PLUS more money for the "suffering" of their insured. All this on a $100k policy. Not a good move.
What this _does_ mean for you (if it is indeed being done) is that you would then have some _HUGE_ leverage against the adjuster. If he does not offer whatever is left of the limits, you simply point out this bad faith issue and you will see how quickly they will want to offer those limits. Granted, they won't come out and admit it, but you can simply sit back and wait... it will be offered one way or another.
I hate to even mention this but don't bring it up until you know for a fact that those bills have already been paid without you signing a release. Also, if it happens, keep it as your ace in the hole. No point in cornering the adjuster if its not needed. No adjuster want to have pointed out that they could be facing a bad faith claim... it's like teasing a tiger. Go along with the program first to see if they will up their offer to the policy limits. Even work him up and up and hole back that info until later.
Again, he might just be adding up what is owed on the health lien, not actually making the payment. I would find it hard to believe that any adjuster would make any injury liability payment of any kind without a signed release.
Posted: Thu Feb 28, 2008 03:40 am Post Subject:
wow, this insurance stuff is really confusing. haha, i think i understand it though, basicly i can get the limits one way or another, because they want to protect the insured? If he doesnt offer what is left of the limits, i tell him that it is a bad faith claim and I should get the policy limits? He hasnt paid my insurance back yet, he has to wait for them to call him back with the exact amount then we can get the ball rolling i guess.
Posted: Thu Feb 28, 2008 06:14 am Post Subject:
If he's not paid, he probably won't. It seems to me now that he just wants to see what amount is currently owed so he knows what is left.
You would not "threaten" a bad faith claim... as you cannot file one. You'd also not want to mention this quickly. _If_ payment was made on a lien with the claim settling, then you'd _mention_ that they might be open to a bad faith claim (from their own insured) if the claim was not settled prior to going to court. Again, you'd not mention this right away as it really only comes into play if the claim is not settled prior to going to court. If you bring it up, your really saying that you are going to file suit. There is no point in bringing up filing suit to start with as it's a "conversation" stopper.
It's a little like when people don't like what I have to say and tell me that they are going to get an attorney. I say, "okay". Then what can they say? They then have no choice but to get an attorney or eat their words and continue to talk with me.
Posted: Sat Mar 01, 2008 03:49 am Post Subject:
Wow just read this whole article. Definately alot of info to digest. I just have to laugh because I've been told by an adjuster that the public is misled by the fast that medical bills are a big factor in figuring out pain and suffering. From what I see here they are a huge factor and so is future medical treatments when considering a settlement amount. Is that true?
Posted: Sat Mar 01, 2008 06:20 pm Post Subject:
Medical _bills_, yes. Medical _notes_, no. That is, the cost of treatment should not be a factor in pain and suffereing. a person can have some really expensive testing done and not be injured at all. I think this is what your friend was saying. 100% correct.
Posted: Sat Mar 01, 2008 09:27 pm Post Subject:
Thank You for clarifying that Tscope. I think I get it now and that makes sense. I never thought of how expensive medical tests could run up bills and even though the person wasn't really hurt would ensure them a better settlement than one who was. So what exactly is figured in when considering pain and suffering? Is past, present and future pain a part of this? I guess what I'm asking is if pain continues and will continue to always be a factor in the persons life how does that factor in?
Posted: Sun Mar 02, 2008 12:42 pm Post Subject:
This is a real informational post, fireyone this should have really helped you out a lot huh? How are things going with you on your claim, are they anyway near the end or are you still going for the treatments.
Posted: Sun Mar 02, 2008 01:48 pm Post Subject:
I am actually confused at where my claim is at this point. I couldn't get my first round of treatment with the shots cause I had a sore throat and they were afraid I would have breathing problems since the shots cause that same area to swell. Totally understood their point but am sooo anxious to see if this is what will help me. The greenhouse starts up shortly and I really want to go back to work. I loved this job and not to mention I was the first one hired when the doors opened 6 years ago. So I usually got all the highest paying jobs (we do different things, different days all with different pays depending on what you are doing). With my arm like it is I can't see me being able to do those higher paying tasks. I don't know if we are waiting to see if the shots work or what. Even if they do the RSD is always going to cause me problems and it will also get worse so there will always be medical treatment. All I have to say is I wish this NEVER happened. I was content they way things were before, at least I knew my capabilities and could secure my own financial future.
Posted: Sun Mar 02, 2008 10:34 pm Post Subject:
I know that you are worried about your financial future but you must consider your health first off and foremost. Hopefully you will be able to do your work but if you can't there is always the possibility to ask for retraining allowance from the insurance company since you will not be able to do what you used to do, you should ask the insurance company to kick in some money so that you can go get some other occupational skills that you would be able to do with out aggrevating your injury. Have you thought about this.
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