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 Posted: Mon Apr 21, 2008 11:51 am Post subject: |
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| Quote: | | Are you saying here Lori that she can't access her underinsurance until she settles with the other carrier first? |
yes basically, they may open a reserve under her UIM, and assign an adjuster if they are pretty certain it will exceed the other limits...but the other policy would have to pay it's limits before a UIM claim could be considered... | Quote: | | I break it down like this $5,000 atty fees, $4,000 lost wages so that leaves what $6,000 for a lifetime of crap? |
The i nsurance company cannot consider the attorney fees, that was the injured parties choice to get an attorney....rather they would value the claim based on the amount of doc bills/loss of wage/disability/pain and suffering/ and further treatment. If that made the injury worth 20k or more, then after getting the necessary releases signed they would pay their insured's limits...then the injured party goes to their carrier and files a UIM claim.... | Quote: | | I can not believe holw much I struggle with my arm. I use to lift heavy things with a blink of the eye, open a jar with no trouble, little things I use to take for granted puts me in tears , especially emotionally |
I know fireyone, and sympathized with anyone that is hurt.....but if there is only 20k in coverage then that's all that can be paid...then if there is UIM then that's the way to go...if there is not, then (unfortunately) there isn't....it's like a bucket with 20k in it....that's all there is..period...no place to get anymore (unless there is UIM coverage)... 
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Lori
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| Posted: Mon Apr 21, 2008 6:40 pm Post subject: |
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Thank you for clearing that up for me. When I read this post it really hit home. Either way life has to go on and that I understand. Shawna really hit on alot of my own fears. The driver of the vehicle who hit me was a younger girl on her parents insurance so I know that with the cost of insurance they may not have had a lot of insurance.
You have always been really good to me but can I ask you another question on this? Is an injury like mine or the op's worth policy limits?
I always feel like a scum bag asking something like that but I k now for myself there are always going to be treatments and I'll pretty much not ever have the use I had before of the arm/hand.I always tell the doc to be straight forward with me and not give false hope. This is the answer I get "you'll never be how you was before all we can do at this point is help manage your pain". Thanks again. I hope this also helps out the op and she stops back and lets us know how she is doing. It is really easy to let the pain and depression take over..you just have to accept things for what they are and move on. |
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fireyone
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| Posted: Mon Apr 21, 2008 11:57 pm Post subject: |
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| Fireyone...Thanks for asking and adding to this post. I have never been involved in an auto wreck in my life and I am sooo confused. I also have so much trouble doing daily things. Sometimes I get totally frustrated and cry. I damn the person who hit me cause now I have to suffer forever. With losing work and not being able to do much like I use to I am glad this will settle soon. Whatever amount I will have to work with but I am very dicouraged at the fact that people can carry such low insurance when I don't and now I am the sucker that pays. I have always carried higher ins. cause I didn't want anyone to suffer if I hit them...I wish people would return the favor. Its not out of greed it is out of compassion if you hurt someone. |
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shawna_hottie_2006
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| Posted: Wed Apr 23, 2008 11:20 am Post subject: |
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| Quote: | | Is an injury like mine or the op's worth policy limits? |
Of course it depends on what the policy limits are...5k,10k, or a million...and will depend on the amount of med bills, any surgery, and disabilitly, future medical treatment, loss of any facets of your life (for instance if you can no longer do the job you have been doing for years and have been trained for)...so many things come into play...so to answer that question...maybe...(sorry).... | Quote: | | I always feel like a scum bag asking something like that but I k now for myself there are always going to be treatments and I'll pretty much not ever have the use I had before of the arm/hand. |
I know what you mean, but don't feel that way...you and only you know the depth of your injury and disability....so you and only you know what you are intitled to, (whether you get it or not is another question...the point I want to make is you shouldn't feel like that and in fact should feel some form of entitlement...does that make sense?).... | Quote: | | This is the answer I get "you'll never be how you was before all we can do at this point is help manage your pain" |
What are they telling you both about future treatment? The fact that you will have a life time of pain, of course will boost the settlement... | Quote: | | It is really easy to let the pain and depression take over..you just have to accept things for what they are and move on. |
you're preachin' to the choir on that one...let me tell ya'....... | Quote: | | very dicouraged at the fact that people can carry such low insurance when I don't and now I am the sucker that pays |
I understand and sympathize with this frustration....want me to make you feel a little better? I was in a moderate auto accident, while driving a company vehicle about 12 years ago...not my fault...i was going about 30 mph when hit (from 50mph saw her coming and tried to slow and get out of the way)...anyway totaled her car, about 4k in damages to the company car i was driving....anyway figured I was ok, just a little sore no biggy (always been a little too tough for my own good)....never went to the doc etc....now mind you there would've been too carriers involved...the auto policy from the old woman that hit me, and work comp.....years pass 'things' start happening....longer story short....I had three broken vert.in my back....now (as age has creeped in)...I'm a mess....nearly non-exsistant discs in my top five or six, and bone spurs etc...on the broken ones...and guess what? no way to prove the accident caused it at this late date...(I've had no other impacts so reason that's all it could've been)...and no ins. to help statutes have run...most adjusters (well me anyway) would just as soon cut off an arm than file an injury claim.....so the moral of the story is......when you are in an accident get checked including x-rays....so you see some times people suffer injuries and there is no money no where...and a life time of pain.....granted this was totally my fault (not the injury but not checking it out)....
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Lori
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| Posted: Wed Apr 23, 2008 12:18 pm Post subject: |
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I am truly sorry to hear that story. Chronic pain can really take some quality of life away. Your response did cheer me up. I was feeling like a real heel over all this, especially with my anger towards that other driver. At first I felt pretty bad for her (and a little angry) cause she was visibly upset but the more my life is disrupted the anger builds. Not too mention the fact that my 11 year old was with me and I keep thinking she could have been in this situation. I am glad in that respect that it is me still suffering.
I do n ot know her insurance amounts that is why I was interested in the under insurance. I also read in a book that if you are entitled to it they deduct from it any medical already paid out.
What I hear about treatment is always the same. First they tries the stallate block and although they got some response they didn't feel it really helped with the hardness, swelling and limited use of my arm. So they started injections right into the spot (OUCH). That was a month ago. It seemed to really help because after a day I didn't have to force my hand to stay open. I could actually hold it open without too much pain. The main injury is to my forearm but it is causing tendinitis in the rest of my arm. Well I recently returned to work with a ten lbs restriction and now it feels like it is locking back up again. I can feel all the tightness and pain (there is always some discomfort no matter what they do) returning.
I have my month after injection visit today so I will see what they say but when I talked with the pain clinic last time they said If the shots work I will continue to get those until at some point I may need other treatment. I guess you cn only have so many of these shots. What I will not let them do is transplant that little device in my spine (tens unit, I think).
My job is working with me. I really don't want to pull them too far into this because we recently changed managment and there is already alot of turmoil. I figure the slip from the doc. will show them my limitations which doc doesn't feel will change.
I spoke with someone recently about my case and I guess after today they are going to get that report and pull together all the other ones to send off. After reading the OP story I really sat back and thought about all this. Tell me what you think..please. I figure I am almost drowning here with money woes (not trying to boo hoo..) and for what? They already know my limitations for the msot part, they know I will always have this RSD and treatment to manage the pain, there is no fix to this, they really can't deny it because I was sent to the biggest hosp. in our state for testing and the results were very defined that it is RSd, never had this or any of the problems before the accident and airbag.Plus atty. feels we also have enough. So why should I sit back and suffer finacially ontop of physically. We already know my auto med. isn't gonna cover forever (probaly pretty close now to amount) So I requested to get this settlement part out of the way so I can at least close one chapter of this nightmare and put it behind me and maybe take some of the finacial stress away too. Of course until it is actually all said and done I sit here with the same worries of the OP...policy amount.
Sorry this is sooo long..its just hard trying to sum it all up in a few sentences. Well I'm off to the doc...Hope to talk to you soon. |
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fireyone
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| Posted: Wed Apr 23, 2008 12:23 pm Post subject: |
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| OOps I more thing..They can not get my records or my daughters from the chiro. I have tried and they have clled and sent letters for months now. He tells me he will take care of it and doesn't. His office has since moved to another town further away. I don't kn ow if he amybe lost them or what. He has never sent the ins. company any bills but I know he documanted everything for my daughters and my benefit. The atty says those records don't really matter with me because they have enough (whatever that means) but they are crucial for my daughters. What happens if we can't get the records? |
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fireyone
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| Posted: Wed Apr 23, 2008 8:28 pm Post subject: |
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| Got back a while ago from my appointment. We are sticking to the trigger point injection except for the next one will be given directly in to my elbow. (not looking forward to that). I asked the doc to be straight up front with me. He says he feels badly for my situation and wishes he could do more but he still says its only pain management from here on out. It is very unlikely, he hasn't seen it happen in any case, that my arm will ever go down to the size it was before. I just have to accept the fact that it isn't going to get better but he will do everything he can to make it managable. This guy is such a sweetheart. I haven't seen many docs like him. So Its pretty much the same verdict. I guess as long as I don't hold my arm next to the other no one will see that it is twice the size, although I'm sure they will see the purplish bruise. Or better yet they will think I'm muscular..just joking. talk to ya soon. |
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fireyone
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| Posted: Thu Apr 24, 2008 9:35 am Post subject: |
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| Quote: | | What happens if we can't get the records? |
Those injuries will NOT be considered in the evaluation of yours or your daughters injuries and more importantly the bills will not be paid, your claim will be settled and then you will owe the chiropractor...call the chiro and tell them you are also following up this conversation with a letter that if the insurance company doesn't have the bills and records within 30 days of your conversation then you and the insurance company will assume they will not be presenting any bills....(that'll move them!)
I have trigger point injections periodically in my neck (and back and head) as well...for me they only last about 48 hours at best...so if they help you then keep on them! I'd say....Your attorney would be the best to advise you and if the other party has low limits then you will probably know as soon as the insurance companies first counter offer (saying we only have 'blank' much money)....
I agree if you are not going to improve then it is time to move forward with the settlement and atleast try and elevate the financial hardship you are under....my prayers and best wishes are with you....(both)
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Lori
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| Posted: Thu Apr 24, 2008 10:36 pm Post subject: |
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| Thank you Lori for your help. I am glad that I am making the right decision about settlement. I was worries that maybe I was pushing the atty to soon. Wow I feel sooo bad that the trigger points only help you for such a short time. How else do you manage the pain in between? I use lidoderm patches and high strenghth Motrin. It was a choice I made myself. I refuse ant narcotics or drug that will interfere with my mental state. I walked that road with my son for five years and all my preaching and the outside help didn't do any good. I'm not against narcotics. I know they have good purposes. I just have a deeply set fear of them and having them in my house with my daughter. I will suffer through hell and back before I ever go through what I just did with my son. Anyway Thank you again. I have really come to respect you and admire you since joining this site. You seam like a very sweet person. See you around the forum. |
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fireyone
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| Posted: Fri Apr 25, 2008 9:48 am Post subject: |
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I have two different pain patches, and alternate 'nerve' pain drugs...maybe I should clarify, the plain old trigger point injections only last that long, the ones that the doc can put steroids in (three or four times a year) last about four days to a week...also the first two bo-tox injections worked pretty good, then stopped working...as with many other folks, you just put your head down, and keep on climbing the hill...  belly achin' don't do much good...i wear an awful lookin' back brace when I know I'm going to be doing things that are going to cause a lot of trouble....I have two massage chairs, and more ice and heat packs than you can imagaine.. 
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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: Sat Apr 26, 2008 1:51 am Post subject: |
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I can feel for ya there. Got those pain patches myself. Lyrica didn't work for me..too many side effects. Massage chairs are great but they need to make one for the arm. I keep getting mixed reviews on ice packs. One doc says use them 20 min. on 29 min. off...other says it only irritates RSD. I do love the heat though. It does alleviate it some. Do you alternate between two different pain patches. My patch does a pretty good job but I can only wear it for 12 hrs. The doc really wants me to use Flector patches but auto rejected them (found out today it has exhausted) and my insurance doesn't cover them either. They are way too expensive for me to purchase so that leaves me..well nowhere.
I called my health insurance company about the exhausted benefits fro auto and they were absolutely wonderful in assisting me on the steps I need to take next. I am very fortunate there. The ran my benefit plan and I will have no out of pocket expense on the trigger points at all.
My worry now is how many bills I will be recieving since it has exhausted. You know how some places wait forever to bill. I have co-pays on docs and meds. They will more than likely submit to my personal ins. but I am sur there will probaly be left over amounts...Ugghh wish this was OVER. |
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fireyone
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| Posted: Sat Apr 26, 2008 11:13 am Post subject: |
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you shouldn't have anything out of pocket well depending on the other parties policy limits....but normally you shouldn't .... when is your attorney going to make the demand?
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Lori
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| Posted: Sat Apr 26, 2008 11:15 pm Post subject: |
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They are requesting all my records from the doctors who were handling this matter as we speak. They said it could still be another 60 days. I asked if they had any idea of the other persons policy limits and they said they wouldn't know that until the first offer came in. I don't understand how that will give them any idea of ins. coverage.
They atty assistant informed me on Friday that I (my private ins) is now responsible for my med. bills and that I should keep track of anything out of pocket and send them reciepts. I have a $20 co pay on docs..perscription pay of $20. Thats all I can think of that I will have to paY BUT THEY DO ADD UP QUICKLY. I honestly don't understand how anything works to be very truthful with you. I was use to auto covering everything and I was going by what my atty said.
What I don't understand is once they submit the claim and I am still paying for these co pays out-of-pocket how will I get reimbursed if it is already all submitted? Another thing I am not understanding is that in the beginning I was to keep track of all my mileage to and from docs. I asked her if I should send that to her now and she said "well it really doesn't matter but send it anyway" I'm like HUH? doesn't matter to whom? Has she seen the gas prices ? Does she relize since this happened all I have been doing is going to doc appointments? Some of these were 100 miles round trip (special trsting..only available at big city hosp.). So to me it really does matter.
They aren't concerned about having the chiro reports for me but they are my daughter...My head is really spinning. Talk about confused. Everytime I ask the assistant what she means she replies "we have enough". I have NEVER been through this because my one and only wreck (not my fault either) back in 2002 I didn't have full tort. I just added the vehicle by phone when I got it a couple months prior and told them to set it up with the same ins. as my other vehicles (full tort).They didn't. Bet I am really giving you a headache huh? Sorry. |
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fireyone
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| Posted: Sun Apr 27, 2008 12:28 pm Post subject: |
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| Quote: | | I asked if they had any idea of the other persons policy limits and they said they wouldn't know that until the first offer came in. |
states and companies differ on this where i am and two carriers i have worked for, limits are a highly guarded secret and never to be disclosed unless it's obviously a limits case or court ordered.... | Quote: | | I don't understand how that will give them any idea of ins. coverage |
Well if you have say 15k in actual medical bills and they have 10-20k, they would probably come right back to the atty advising, that this is it...''all we have is ''x'' amount how about signing a release for this amount''....then your atty would probably recommend you doing so then filing a UIM claim with your carrier, unless the 'at fault' party is very very very wealthy..
| Quote: | | What I don't understand is once they submit the claim and I am still paying for these co pays out-of-pocket how will I get reimbursed if it is already all submitted? |
well you won't once it's settled unless maybe there is still some medpay or you negotiate an open ended release for a period of time... | Quote: | | Another thing I am not understanding is that in the beginning I was to keep track of all my mileage to and from docs. I asked her if I should send that to her now and she said "well it really doesn't matter but send it anyway" I'm like HUH? doesn't matter to whom? Has she seen the gas prices ? Does she relize since this happened all I have been doing is going to doc appointments? Some of these were 100 miles round trip (special trsting..only available at big city hosp.). So to me it really does matter. |
you are intitled to that...only thing i can think of is the paralegal thinks it's a limits claim maybe and is well over the limit...but if you have UIM it would still be important to include everything and get an actual value of the entire claim... | Quote: | | They aren't concerned about having the chiro reports for me but they are my daughter |
why aren't they? who is going to pay those bills then? (for you?) | Quote: | | My head is really spinning. Talk about confused. Everytime I ask the assistant what she means she replies "we have enough". |
I'll bet it is mine is too!  Look sometimes people (you and others in your position) forget that this atty and his/her office work for you! not the other way around, they stand to make a pretty big pay day with little effort...do not let them off so easy! keep them on the phone until you fully understand everything! and if you need to tell them that, ''hey, listen i know i'm small potatoes to you maybe, i know you have tons of cases, but i only have this one, and i need you to spend some time with me fully explaining everything after all you are getting paid for this'...i mean it...you are 'owed' a complete understanding of everything going on about your claim...!!!!!!!! no, not giving me a head ache, just wondering, and a little ticked off, (at the atty).....  get yourself a full list and call them back, and don't let them off the phone till you have full comprehension of what is going on (then tell us! )
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Lori
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| Posted: Mon Apr 28, 2008 2:03 am Post subject: |
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Thanks for getting back so quickly. I am gonna call the chiro myself on Wed. since I am off work that day. I know the atty sent out another letter to him last over a week ago. I have tried EVERYTHING to get records from him. Even visiting the office specifically for this reason before he left. The atty's have sent numerous letters and the new chiro has called him, I have called. He promises to send and I tell him he really needs to especially because of billing purposes, still never happens. I am now wondering if maybe he misplaced them.
My med bills just reached $5,000 without chiro billing but it is not going to end there...lots more trigger points, when that doesn't work possibly something else. Now doc wants me to mix in a little massage therapy to make the time between shots longer. So I am sure the bills are gonna be forever and never ending. That is something I'll cross when I get there.
Assuming I have already maxed my auto med (I'll be increasing that soon, never relized how low it was until this) and worrying about her coverage limits I'm afraid to start something else in treatment because my private health sometimes does not cover at 100%. Depends on what it is. They can cover as much as 100%(usually hosp. and tests) or as low as 50%. I am going to make a list up and give the atty a call at the end of this week to see if they heard anything from chiro. and to see what they plan on doing with my daughters case if there are no chiro records.
I'll keep you posted. thanks for your help. |
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fireyone
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