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 Posted: Fri Oct 02, 2009 4:38 pm Post subject: some advice on a big accident |
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I was involved in a pretty big accident 5 weeks ago. I was alone in the car. The other driver was ticketed and was found to be at fault. My car suffered $19,000 in damages. The rental car was about $900. The third party spoke to me and clarified that they are 100% at fault and have payed for these repairs. I bought new car seats for $500. I was told they would reimburse me and to keep the receipts.
I was taken to the ER for neck, elbow and shoulder pain. I had two digits with numbness. The x-rays of the neck indicated a possible fracture and was later ruled out with an emergency CT of my neck. The ER diagnosis was cervical radiculopathy. I was told to follow up with my primary in a few days.
My primary physician wanted to let the inflammation cool off for 2 weeks. He prescribed muscle relaxers and anti-inflammatory medication. I was given a note to work at half my capacity for two weeks. After the 2 weeks the numbness subsided but the elbow and shoulder were bad still. The neck was just tender at the end of the day. I was told to get radiographs of the elbow and shoulder and start physical therapy 3x a week for 6 weeks. The x-rays were normal. Again I was told to work at 50% my capacity
At this point it had been a month since the accident. I still had pain in the elbow, which was diagnosed as lateral epicondylitis (tennis elbow) from the impact with the glass window. The shoulder was still bad after 2 weeks of therapy so I consulted with a orthopod. A MRI of the neck and shoulder were done. The shoulder involved a procedure to inject dye into the joint space. The results were yesterday. I have an extensively torn labrum. They want 4 weeks of additional therapy and a follow-up. If I need surgery I will be not able to work for 2 months minimum. Again I was told to work at half my capacity for 4 more weeks.
I cannot be sidelined for two months. My practice will bankrupt. Can I settle, assuming the therapy will help manage the shoulder, for future medical treatment and lost wages? I know because I asked, the 3rd party does not have minimal coverage. I have underins. coverage of 250/500. I want to get feedback and avoid a lawsuit. Lawyers are salivating over this case.
Oh by the way I work 8 hours a day and earn $230 per hour. My employer is keeping track of my lost wages. It adds up to over $5000 per week plus any lost time for therapy, doctors vists, etc. My car is taken care of. I had the car inspected and appraised. It has lost 8-10k in resale value. My doctors bills will be 15k without surgery.
I need to get better but this is starting to get overwhelming. |
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donti32
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| Posted: Sun Oct 04, 2009 2:09 pm Post subject: |
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Donti32,
So sorry you had such a bad accident...
| Quote: | | Can I settle, assuming the therapy will help manage the shoulder, for future medical treatment and lost wages? |
You can do whatever you want. But I doubt the carrier will consider future lost earnings, and the surgery, you might get to them settle with an open ended release with 'x' amount of money set aside for med bills only...No one knows if you will need the surgery for sure at this point, or how fast you will recover (or not) so they cannot just assume the worse and pay you for 2months missed work and the cost of the surgery. | Quote: | | I know because I asked, the 3rd party does not have minimal coverage |
But you don't know the exact limit right? | Quote: | | I have underins. coverage of 250/500. I want to get feedback and avoid a lawsuit. Lawyers are salivating over this case. |
It's great that you have (high limit) UIM, if possible try and find out the other parties limit. Keep in mind, you must get their full limits for your UIM to kick in, you also need your carriers authorization to settle with them or you will jeopardize your UIM claim. I think (personally) I would start with asking (duh  ) for their limits. Whether I knew what those were or not. If for no other reason than to get the negotiations started.
| Quote: | | Oh by the way I work 8 hours a day and earn $230 per hour. My employer is keeping track of my lost wages. It adds up to over $5000 per week plus any lost time for therapy, doctors vists, etc. |
Does the at fault carriers adjuster know how much your loss of wage and med bills are to date? Just an fyi, your employer keeping track of this may not be enough to prove such high loss of wages. The adjuster may request a copy of last years taxes or your W2 (I would if I were handling your claim) | Quote: | | My car is taken care of. I had the car inspected and appraised. It has lost 8-10k in resale value. |
This is a totally separate issue/claim than your injury and you need to go ahead and get your Dimished value claim settled now...
| Quote: | | I need to get better but this is starting to get overwhelming. |
I totally understand that.
What state are you in? Have you provide the adjuster with any med bills etc yet? any loss of wage statements? Has there been any settlement discussions at all?
It's up to you, but personally I wouldn't even be ready to 'start' to talk about this if I were in your position. IMO, it's too early given your injuries. Unless of course they will pay policy limits (with your carriers ok, don't forget that!). and then you could leave your UIM open. You need to find out your states statute of limitations as well.
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Lori
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| Posted: Sun Oct 04, 2009 3:41 pm Post subject: |
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I am in Illinois. PI is 2 years. PD is 5 years.
I am not even close to speaking to the other parties carrier about a settlement. I have asked about limits and the adjuster told me he does not have the minimum. I also asked if she thought i needed to involve my UIM. She stated you should be okay.
I have spoken to them about my profession as a surgeon and my dominant hand / arm was injured. They freaked out a bit but stated they needed a letter from my practice and it needed to make "sense." I have no problem opening my tax records if we go to trail but personal info like that will be between my employer and them in that letter.
I want my shoulder to be 100% and not have any future deficit.
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| Posted: Sun Oct 04, 2009 4:19 pm Post subject: |
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| Quote: | | I want my shoulder to be 100% and not have any future deficit. |
Absolutely! Just don't get into any hurry about settling. Have you put your carrier on notice that a UIM claim may be forth coming? If not, you should.
Also, re: your DV claim. You should (IMO) go ahead and get this handled/settled.
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Lori
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| Posted: Sun Oct 04, 2009 6:46 pm Post subject: |
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thanks, I will give notice in the morning. The topic of surgery seems to be a 100% thing. They feel I will need it to prevent dislocations in the future. The PT is my attempt to perhaps avoid 2 months of sitting at home and 6 month of further pt. I am stubborn about missing work.
The radiology report from the mri indicate "extresive tearing from 11 to 7 o'clock." It is almost completely torn. The only good news is I am currently able to move and function with mild pain. Usually you are poorly mobile.
I understand I will be compensated for work but there are many factors like lost clients, lost income to the practice, and inability to get new disability insurance etc.... that I will not ever gain. I am just trying to let things absorb. |
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donti32
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| Posted: Sun Oct 04, 2009 8:07 pm Post subject: |
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Let us know if we can be of further assistance.
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Lori
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| Posted: Wed Oct 07, 2009 2:08 am Post subject: |
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well, just got off the phone with the third party insurance. They want an letter indicating my wages from the owners of the practice and a letter from the surgeon's office indicating that surgery is necessary. She told me they will need a supervisor's approval but be is ready to offer the policy limits of 100k. I have already notified my UIM policy. She did say that i would only be able to get 150k additional from my 250/500k UIM policy. I doubt things will get that nasty but ???
My car appraisal was sad. They reduced my trade by $7000 due to the fact the car cannot br sold as certified. How much will I see in a dv claim? I was told to send the estimates over and they will pay. |
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donti32
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| Posted: Wed Oct 07, 2009 11:07 am Post subject: |
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It sounds like you are having an easy time with the at fault party's carrier..that's good news.. | Quote: | | I have already notified my UIM policy. She did say that i would only be able to get 150k additional from my 250/500k UIM policy |
Wait! What? why? How could your carrier possibly say this? How could they have already evaluated your injury, and determined it's worth 250? instead of 350K? Who told you this? | Quote: | | They reduced my trade by $7000 due to the fact the car cannot br sold as certified. How much will I see in a dv claim? I was told to send the estimates over and they will pay. |
I would think 7k....It will depend if your state has anything on the books that limits the amount of DV...
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Lori
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| Posted: Wed Oct 07, 2009 3:38 pm Post subject: |
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| The third party ins. told me they feel the claim will only get more expensive in light of the recent mri findings. They want to pay the maximum so I can pay my bills from lost wages etc... She then told me she will, when the supervisor approves the claim, notify my UIM rep. and arrange the payout. She also said my insurance needs to apprve this and I would only be able to get another 150k from mine. She specifically said these do not "stack" on each other. 250k would be the max of all benefits, she claimed. |
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donti32
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| Posted: Wed Oct 07, 2009 9:35 pm Post subject: |
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oh, ok...then you have 125/250 UIMBI per car right? I misunderstood your post and thought you had 250/500 per vehicle... If that's correct and you have 125k per person UIMBI, and your state does not allow stacking then she is correct. | Quote: | | She also said my insurance needs to apprve this |
Yeah, that's what I told you earlier. It might take alittle while too, most carriers will complete a very thorough asset (on the at fault party) check before approving it.
What about your DV claim?
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Lori
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| Posted: Wed Oct 07, 2009 10:06 pm Post subject: |
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I actually have 250/500 in UIM. That is why I am confused.
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| Posted: Thu Oct 08, 2009 12:19 am Post subject: |
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| My dv claim is going to be mailed out in a few days. Carmax has the car's value at 18k. Excellent to good Kelly value on a trade is 25k. Will they use this as a value, or Kelly retail value of 31k? I feel I should ask and not wait for an offer. |
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donti32
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| Posted: Thu Oct 08, 2009 11:11 am Post subject: |
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| Quote: | | I actually have 250/500 in UIM. That is why I am confused. |
Well then she's wrong, or misunderstood you. The max you could get from your carrier for UIM is 250k. You might ask her about that, how she came up with 150k being the most you could get from your carrier, I'd be interested in that answer. | Quote: | | My dv claim is going to be mailed out in a few days. |
Without you discussing it first? hmm, ok, never heard of that, but I'd personally talk to her about it first. I'd want to know how they arrived at their amount etc. Re: Kelly Blue book. I personally don't know any carrier that uses the Blue book. You'd be better off to ask the adjuster what system they use to determine a vehicles ACV (actual cash value). Then if you have access to that system, (ie NADA, Edmunds, or market surveys) you can determine the value. If they use something like CCC, you won't have access to it, but you can still check on line with NADA, Edmunds, or do your own market survey. Which requires you calling about three reputible used car dealers in your area, and talking with the used car sales manager, and seeing if he/she will spend a few minutes with you. You tell them what your vehicle is (warts and all if it has any). They will then give you the amount they would 'ask' or 'take' for your vehicle on their lot.
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Lori
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| Posted: Thu Oct 08, 2009 11:45 am Post subject: |
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| Quote: | | My dv claim is going to be mailed out in a few days. Carmax has the car's value at 18k. Excellent to good Kelly value on a trade is 25k. Will they use this as a value, or Kelly retail value of 31k? I feel I should ask and not wait for an offer. |
Noone uses Kelly's anymore. Like I was telling another poster, you should consider hiring an adjuster to a appraise the vehicle and handle the dv claim. The problem with the books, is that they only give you of an example of your vehicle. All aspects of the vehicle need to be evaluated to determine it's true value. Places like Carmax do not give you an accurate appraisal. This is the same system that you hear on the radio when the say they will buy your car. Not accurate one bit. And they don't provide you with any "real" documentation and most of their practices are not any different if you researched it on your own. I suggest you make some phone calls to some adjusting firms in your area to see what they have to say and if they can help you. |
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Trench
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| Posted: Fri Oct 09, 2009 3:22 pm Post subject: |
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okay, here is the story. My policy has something written that in UIM they can receive a credit for the amount the other policy pays out. Therefore, no stacking. 100k from 3rd party and up to 150k to reach the 250k policy limits on UIM.
Go figure? |
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donti32
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