At Fault Insurance Carrier response to demand letter

by Guest » Wed Jul 28, 2010 10:41 am
Guest

My lawyer sent at fault insurance carrier a demand letter and their response was a request for medical records five years prior to my accident. (10/5/09) My medical bills exceed $26k and my property damage was $24k (they already paid).
We do not know their insurance limits but I am hoping they are at least $50k for bodily injury and not $25.

I am a diabetic with diabetic neuropathy and on long term disability from my employer due to the neuropathy therefore loss of wages were not included in the demand letter.

I have had notprior injuries and my current disabilty claim is all related to the neuropathy. (loss of sensation in my feet)

My injuries from the accident were a fracture to my arm and right wrist, bruised sternum and soft tissue issues in my neck and right shoulder.

What are they looking for?

Is this a good sign that the at fault policy limits are more than $25k? If they were not wouldnt a adjuster just settle for the $25 and be done with this claim?

Total Comments: 18

Posted: Fri Jul 30, 2010 01:01 pm Post Subject:

wow I didnt know to send adjuster weekly updates on my condition and my attorney didnt ask either he said "just check in every few weeks or so" then once I finish treatment he would send a demand letter to the adjuster. Oh well too late now darn. I am going to the attorney office today anyways to sign medical releases again and give name of the doctors treating me for my diabetic complications ie., neuropathy and kidney disease preventing me from working at this time.

Posted: Fri Jul 30, 2010 01:56 pm Post Subject:

I don't know about "weekly" updates, monthly would probably have been fine (up to the insurance company to decide).

The point is, the insurance company is maintaining a file that essentially nothing has been done with, thanks to your attorney, and now they're going to receive everything in a "lump" (assuming your doctors all cooperate and send in copies of your records in a timely fashion -- some, however, may expect the insurance company to send a person to their office to gather the records that are needed, in which case nothing will happen until someone visits the doctor's office -- if the insurance company wants it, the doctor is not obligated to spend money to provide it), and will have to start combing through the material page-by-page looking for whatever it is they think they want or need to see.

How long will that take, considering there could be five years of treatment records and thousands of pages total? Two months, four months, six months? Longer? Your attorney did your matter no small disservice by choosing to "wait" until your treatment was finished. What if that was going to be a never-ending thing?

And each of these "visits" to your attorney to review your case, sign release forms, discuss response letters, etc . . . they are not free. You could just as easily sign those release forms at your kitchen table and mail them back. $0.44 vs $200+. Who's "winning" here?

Truly, when it comes to insurance matters like this, the only time an attorney may truly be necessary is AFTER the insurance company denies your claim, or you believe is dragging its feet unnecessarily. People often rush to hire an attorney because they have a very misguided view of insurance company claims departments, mostly due to anecdotal information, which is usually wrong (just read some of the posts on this website), that insurance companies "never" pay claims.

Just isn't true. Companies pay billions of dollars of claims every year. They just don't want to pay claims they have no responsibility to pay -- and sometimes that can take a few weeks or longer to determine. And despite their best efforts, insurance companies get hit with hundreds of millions of dollars in fraudulent claims each year, too, much of which they have paid before the fraud is discovered.

Still, long before a person retains an attorney, the free services of the state's Dept. of Insurance can sometimes get the insurance company to change its attitude or move more quickly, if an insured or claimant feels they are being mistreated by the company in some way. (When you look at the statistics, the number of "justified" complaints vs. total complaints against insurers is relatively low, so what does that reveal?)

Generally, you have two years (or more, I've learned, depending on the state) from the date of loss to file a legal action (i.e., civil suit) against an at fault party or an insurance company over a claim, so rushing off to find an attorney is not an immediate need. In your case, it would be a suit against the at fault party, not the insurance company, since it is a third-party matter.

Posted: Fri Jul 30, 2010 02:17 pm Post Subject:

Most people don't get it. Attorneys sign people up. The more people they sign up the more money they make



Exactly! When you see all those ads on TV for personal injury attorneys, what they don't tell you is, "How many times have we actually taken a case to trial? Uh . . . none."

Pay close attention to the language of the advertisement and you will hear, "If your case doesn't settle, you won't owe us anything." Funny, but your idea of the word "settle" probably means going to trial, their idea is, we get an offer from the insurance company.

Here's the real issue: if the insurance company makes an offer, but you don't really like it, you can continue to negotiate for a better offer. Happens all the time. But when you have a lawyer involved, they don't always have the negotiation skills their ads lead you to believe they do.

If they tell you, "Well, I think this is the best we'll be able to do," you might reply, "Then I think we should go to court and get more."

Then you'll hear this, "Well, if we go to trial and lose, it's going to cost you thousands of dollars for my time, the cost of investigators, all of the court fees and costs, like the jury and court reporter and all, and you may even have to pay the other party's attorney's fees and all their expenses."

"But you told me that if I lose, I won't have to pay you anything."

"No, what I said was if your case doesn't settle, you won't owe me any money. That means if the insurance company doesn't pay your claim because they don't have to, then I don't charge you for my time. But, see, they offered $5,000. And I think that's the best we can expect. So if you take that offer, I get $1500 and you get $3500. I've never gone to trial before, and I could lose. If I do, you'll have to pay me for all my time, all the costs, everything."

So you take your $3500 and go away mad at the insurance company and mad at the attorney, when you should only have been mad at the attorney. If the insurer will only pay $5000, they would have paid the $5000 to you . . . without the attorney.

Live and learn.

Tom Hanks said it best in Philadelphia to Denzel Washington: "What do you call 100 lawyers at the bottom of the ocean? A good start."

Posted: Fri Jul 30, 2010 11:17 pm Post Subject:

wow wishing I tried it solo now..darn..:(

Posted: Sat Jul 31, 2010 12:54 pm Post Subject:

And the adjusters who post here might also tell you that if you feel an insurance company is jerking you around on a claim (property moreso than personal injury), before you paid an attorney 30%+ to argue your case, you could hire a public adjuster for about 10% of the ultimate recovery.

They'll tell you upfront if they believe they can get a better result for you, because they know it's not in your interest to pay 10% to them if they can't get you at least 15% more.

Posted: Mon Sep 13, 2010 03:52 pm Post Subject: Personal injury question

I have $14.000 in medical bills &$32.000 in lost wages from a auto accident , I was rear ended at a stop light,also I have two rupture disk between c-2&c-4 &3 herinated that my neurosurgon said was cause by the accident . The accident was in may. I also went to pt. For 5 weeks which it didn't help at all . I am going back to work this week, but I can hardly move my neck, I live in the sate of ky.

Posted: Mon Sep 13, 2010 03:57 pm Post Subject:

Um... okay? You don't ask a question and you did not start a new thread as you should have.

Posted: Tue Apr 30, 2013 07:28 pm Post Subject: my attorney is not effective

after 2/12 years on clear cut liability of drunk driver we are just getting to discovery he says may take over another year i dont know of a demand letter or offer, just stalling i get n o facts 3 phone calls not telling me much what is happening after this long were back to day one,what the hell do i do cant work he say hang on.

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