How to file a BI settlement

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PostPosted: Tue Nov 03, 2009 11:09 pm   Post subject: How to file a BI settlement  

I was involved with a no fault accident. The other person rear ended me. I had my car totalled. I went to doctor after a week or so, as the day of accident was friday and could not get doctor appointment. I just went to chiro. The final bills run to 3K or so. I still need to pursue treatment for 2 more months. Now, I wanted to know what can I include in the claims in order to get the claims settled? Can I include future claims, loss of wages, hardship? For loss of wages, I did not miss a day at work, but I had to adjust timings during the work to get the treatment. The chiro said that it's normal after the treatment, although I do experience some pain in neck and back, but it's mild now. Do I need to visit any specific doctor now?

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PostPosted: Wed Nov 04, 2009 12:31 am   Post subject:   

Quote:
I wanted to know what can I include in the claims in order to get the claims settled?
Obviously all the bills, and doc reports, but the adjuster will likely need/want to order them theirselves..
Quote:
Can I include future claims, loss of wages, hardship
"future" anything is hard to get paid for because it's so subjective. Some adjusters and/companys will offer 'x' amount of money set aside in an opened ended release which is for medical bills only..others might offer, 'here's another 500 bucks, if you need it use it for doc bills if not it's yours' still other carriers will not pay at all on subjective future bills, most certainly not future loss of wages...and in fact you shouldn't even CONSIDER settling your BI until you are released from the doc and back to 100%.
Quote:
For loss of wages, I did not miss a day at work, but I had to adjust timings during the work to get the treatment
If you didn't lose any wages, you can't get loss of wage. You can usually get mileage etc...to and from the doc.
Quote:
The chiro said that it's normal after the treatment, although I do experience some pain in neck and back, but it's mild now. Do I need to visit any specific doctor now?
You and only you know your own body...if you're hit, you're going to be sore...Most agree that you have gotten all the good you're going to get (soft tissue injury) from a chiro in 30-60days of treatment. Soft tissue injuries typically resolve themselves with or without treatment, this of course is dependent upon your general health, prior physcial condition, age, and activity level.



I'm assuming the adjuster knows you have an injury claim? They will want you to sign a medical authorization form (most likely) so they can get copies of your bills, reports etc.



You should have kept a diary of how this injury affected your daily life, (ie, couldn't sleep good for a week, couldn't pick up my kids, couldn't mow grass etc). if you have not try to compile one now.



Let me ask you a couple of questions...

What state are you in? (want to make sure not a PIP state)

Have you EVER had another injury claim?

Were there any passengers, and were they injured as well?


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Lori
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PostPosted: Wed Nov 04, 2009 3:21 am   Post subject:   

Thanks for reply Lori. I don't have PIP, neither my state requires. I have not filed another injury claim before, there were no other passenger



Reg questions:



1 future claims: the doctors report states I need further treatment, he was suggesting to continue treatment to be 100 percent fit, however I relied on scan reports and feel that I can get normal without that treatment but scanned reports certainly requires more of treatments.



2. The adjuster asked me to send med authorization signed but I did not yet, waiting for treatment to get over



3. Why do I need a diary what will that help?

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PostPosted: Wed Nov 04, 2009 12:29 pm   Post subject:   

Quote:
Why do I need a diary what will that help?
Had you kept one from the date of loss..you'd be surprised the things that you'd forgotten, ie, first two days I couldn't do any chores, had to rely on help, etc.



It's just and easier way to document how your injury has affected your daily life.



It wouldn't hurt for you to go ahead and get the med auth to the adjuster that way she/he can get ongoing info and review it as it comes in.


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PostPosted: Sat Dec 12, 2009 7:36 pm   Post subject:   

How long does it take for BI claim to settle, or the insurance company to respond to me? I have submitted bills more than a month back, last I verified with my doctors they have provided information that Insurance Carrier had asked for and it's one month past. I haven't heard back from insurance

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PostPosted: Sat Dec 12, 2009 10:43 pm   Post subject:   

Quote:
How long does it take for BI claim to settle, or the insurance company to respond to me?
have you made a demand? While the insurance adjuster should keep an unrepresented person informed as to the status of the claim, they might not realize that you are done treating or that you are willing to settle. They also have many other claims they are handling. Have you called the adjuster to find out the status of the claim? This should get the ball rolling.
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PostPosted: Sun Dec 13, 2009 11:59 am   Post subject:   

Absolutely, and let the adjuster know you are ready to settle.



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PostPosted: Tue Jan 12, 2010 7:19 pm   Post subject: BI Claim  

I have made a demand. The adjuster came back and told that they are investing whether the PD claim that they paid was overpaid? They say that they wanted to see the photographs of the other vehicle to ascertain the extent of the damage to the other vehicle. They can start the BI portion of the claim only after they investigate whether the PD portion of the claim was overpaid or not. just to let you know that the PD claim was paid by them 4 months ago. The BI claim I submitted a month ago and haven't heard back.

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PostPosted: Tue Jan 12, 2010 7:39 pm   Post subject:   

Where you pushed into a 3rd vehicle? I get the impression this is what happened since you mention the "other" vehicle.



I think what they are doing it determining if you were pushed into the front vehicle or if you first hit the front vehicle and then were rear ended. It's a question of % of liability. That is, they are seeing if you might have caused some of your loss by rear ending the front car first. To be honest, all of this should have been done a long time ago. I'm guessing that perhaps that carrier has separate injury adjusters and only now is that new adjuster looking at the claim. If this is correct, there is no good reason why they should now delay in addressing your demand. But your only recourse is to hire an attorney and file suit. Problem is, the attorney won't file suit right away and you'd end up waiting anyway.



My recommendation... file a complaint with your states Dept of Ins and light a fire under the carriers/adjusters butt. As you mentioned, it's 4 moths after they issued a PD payment... there is no reason to be addressing liability at this point.

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PostPosted: Tue Jan 12, 2010 7:46 pm   Post subject: BI Claim  

Hi tscope, thanks for your response. Sorry, if there's any misunderstanding. There are only 2 vehicles involved. I was rear ended. Let's say mine is 1st vehicle and other person (who rearended) is 2nd vehicle. I filed claim with 2nd persons vehicle for PD and BI. 2nd Persons claims adjuster reviewed my car and extent of damage and gave me a check for the value of damage that they felt was required to repair my car (1st vehicle). It's now 4 months. I also filed BI claim with 2nd vehicle's insurance carrier. Now, the 2nd vehicles carrier came back and tell that they have overpaid the PD portion of claim and they will hold BI claim until further investigation. They say that they have requested driver of 1st vehicle for photographs and it's delayed. Also let me tell you that the 1st vehicle was a rented vehicle that the driver was driving. I hope I have explained though I am not sure if this is extensive or there's more clarification required which I will be glad to provide. I only want to know whether they can go back and forth on the PD claim that they already paid?

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PostPosted: Tue Jan 12, 2010 8:29 pm   Post subject:   

Something is wrong...



I see no reason why they would want to go back and adjust what they paid on the property damage. Did they go by an estimate you submitted or write up their own appraisal? In either case I'd think if they made some type of mistake that they'd just eat it and not bring it up as an issue. I'm kind of wondering if this is just an excuse. They can ask for the property damage payment back... but this does not mean that they are going to get it. If you don't offer to return a portion of it, I don't see that there is really much that they can do. You've "already paid that money toward the repairs" so it's gone.



This all sounds like crap. I'd file a complaint and get them back on track. Complaints are almost always sent to the top of the company for answers. This is what you want.

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PostPosted: Tue Jan 12, 2010 8:42 pm   Post subject: BI Claim...  

Hi tscope...



Thanks again. Here's the thing. The appraiser wrote the estimate. Then when I went to Body shop, it was determined that there is more repair work. The same appraiser came back to repair shop and then they revised the estimate/claim amount and then gave me the check.



What they are arguing is that the total PD paid, whether it was related to the same accident or not? To do that they are requesting the person who rear-ended to provide pictures of the car at the time of accident. I am not sure how to handle this issue.



Regarding BI Claim, I paid doctors bills and the doctor gave a medical report that I need further treatments. I filed a BI claim, and I included the future claims as well, since I need money for the same. They are declining future claims, but worst part is that they are going back and forth on PD claim, and are not starting the BI claim process until the investigation is done.

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PostPosted: Tue Jan 12, 2010 9:23 pm   Post subject:   

I'm not understanding the PD... was their prior damage to the same area of your vehicle? Even if so, they should have thought about this 4 months ago. What started them looking at it now?



If you need future meds paid before the are incurred, ask your doctor to write up his evaluation and state this. Otherwise you can wait until you have that treatment and then add it in. I'm betting if you pressed the issue the adjuster would include something for future meds.



Your BI settlement is completely different then the PD settlement. They have no right to hold up one because of the other.

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PostPosted: Tue Jan 12, 2010 9:34 pm   Post subject: BI Claim..  

Well tscope, thanks for the response.



reg:

"I'm not understanding the PD... was their prior damage to the same area of your vehicle? Even if so, they should have thought about this 4 months ago. What started them looking at it now?"



Whatever my vehicle had before the accident is not considered. they are currently going by the photographs of the vehicle that rear-ended me to determine the extent of the damage. They are in process of investigation now. I am not sure what brought them to investigation now after 4 months. Is it just to stall the BI payments? I can file a complaint as you have said. But I am not aware of the legalities. I just wanted to know whether they have a right to demand the PD claim back, after 4 months? If they do not have a right, then I can go ahead and file a complaint, but I need to be sure that everything I do is in compliance with the law

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PostPosted: Tue Jan 12, 2010 11:50 pm   Post subject:   

Do they have a right could only be determined by a judge. Your view is that they told you how much the damage would cost to repair and they paid you for your loss. If they want some of that money back because now they think it's too much... well, that is their problem. I can tell you that they are not going to file a claim in court and pay some attorney to collect what the _voluntarily_ paid... and that is key.. _they_ came up with the amount and made the payment. If it's wrong, this is their problem not yours. They made the error. But they'd also need to prove it's an error. All in all, it's really not your problem. It's theres. I suspect that this is really some type of stupid 1/2 truth.



The PD is separate then the injury claim. You file a complaint stating that you sent a demand and that there is no reason for it not to be paid. You can complain about anything you want, the color of the sky, the phase of the moon... you don't have to be right about anything. It's just a complaint. The DOI will investigate. Your reason for doing this is so the claim will be seen my some higher up management person and special attention will be given to it. Insurance companies _do not_ like DOI complaints. They can be fined if they did something wrong. Get to many and the DOI might audit more files. It's not a good thing for the carrier.

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