QuestionI was involved in a rear-end accident on the freeway in So. Caliornia. The driver was going about 75 slammed into the back of me and was subsequently arrested for DUI. Immediately saw primary doc and subsequently referred to PT. Have undergone about 5 months of treatment for soft tissue injuries with a chiropractor as a result. Total medical costs are $9K. Other special damages are about $3K (wage loss / rental car, etc). Property damage was about 12K (which they've already paid).
Two questions (1) I'm concerned about the policy limits on the driver as he stated this was his 3rd DUI so I'm assuming his insurance may not be the best. It's a large company however out of Texas. How do I find out the policy limits?
(2) I'm not sure how much is appropriate to request in the demand letter?
Thank you!
AnswerHi Bob,
I am glad you wrote to me because I think you need some "WHOA!!" formula applied to your race horse idea of settling this case so soon. Yes, I AM a "doctor", but not a medical one, although you might think that I THINK OTHERWISE by the time you are done with my propaganda against settling your claim too early. IMHO, it is unwise both medically and legally to close out a claim so early after a VERY HARD IMPACT.
So, Bob, here is how I am going to answer your question, and the problems your early settlement desire poses. I have decided to give you well over one hour of my time since I believe you were in a significant crash, with TREMENDOUS TRAUMA SUFFERED, and I DO expect you to have problems later this year should you quit treatments now. Given also the possibility of a low policy limit and a DUI, there is need for an exposition on that topic alone.
FIRST, I am going to give you a bit to think about regarding sending out a demand letter so soon.
SECOND, I will address your issues with the tortfeasor's probable low policy limit.
THIRD, I will give you some tips on valuing personal injury claims.
FOURTH, I will give you some free legal information www.SettlementCentral.Com insurance settlement tips on how to make an auto injury claim.
FIFTH, I will suggest a means to communicate with the adjuster.
Ready, Bob—then here we go!
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#1. DO NOT SETTLE TOO SOON. Could this be a bit early to settle?
In the first place, do you think it is OK to settle now? Is your back OR neck OR both completely healed such that after a full day at work you have no residual pains at night or soreness the next morning? Healed such that you can lift things and do the same activities as you did last summer without any worry that you will have pain that night? If that is the case, go ahead and settle. If not, it seems a little early to quit your treatments and early to settle. If you do have some pains, then Continue Medical Treatment for Residual Injury Pains and do NOT Settle too Soon
Since your crash was at highway speed and must have nearly totaled your vehicle, then you were in a crash hard enough to cause serious injuries. I am willing to bet that even after your treatments, once you start to get more active, you will notice pains once again. Mark my words that at first you will have a dull ache, and that ache will become a nagging pain with your increased physical activity if it is not treated.
Listen to your body and to get medical attention when you feel any aches or pains that continue for a day or more. GET MEDICAL CARE FOR YOUR INJURIES—if you have any aches, DO IT NOW. You were involved in an accident with a lot of impact. It is likely your body suffered trauma sufficient to cause injuries. And there is no reason why you should suffer.
It seems like you are trying to get a quick settlement, but that is instead the goal of the insurance adjuster. SHE wants the quick settlement, NOT you.
DO NOT SETTLE YOUR CLAIM UNLESS YOU ARE ABSOLUTELY CERTAIN THAT SOFT TISSUE INJURIES WILL NOT REAPPEAR ONCE YOU STRESS YOUR BODY WITH PHYSICAL ACTIVITIES OR JUST DAILY LIVING AND WORKING. That Plays Right Into an Insurance Tactic Regarding Inducing Early Settlement of Injury Claims.
Let's just finish up this topic of early settlements Bob, so you get the full picture of the advantage to them and the risks to you. Insurance companies like to settle early because the general damages—claims for pain and suffering—are always minimal, but continue to grow with continued medical/therapeutic care over the months. Therefore, the insurance adjuster will try to settle before the claim merits a larger pain and suffering element. This makes good sense for the insurance company. A claim that is still active after 12 months, with an injured claimant still undergoing treatment, will settle for a lot more pain and suffering money than a claim that is settled after five months of treatment.
In soft tissue cases such as this, the full extent of most injuries is not known immediately after finishing early rounds of treatment, because the injured person has to undergo some of the wear and tear of everyday life, including the pounding his body will receive from a day's work. Even jobs that appear not to be physically demanding can be hard on an injured body.
For example, have you ever stood all day with few breaks, as a store checkout clerk or a jewelry salesperson does? Or sat all day at a computer, as a secretary or phone service center employee does? Many jobs will interfere with healing, and you have no way to know how your body will respond until you have experienced sufficient physical exposure to load-test the ligamentous scar tissue as you heal.
Plus, who will pay for your medical care incurred AFTER you settle? What if you were to settle now and nine months later when you are suffering at work and the pain starts to become too much, and you go to a chiropractor only to discover that you can expect a course of treatment that will cost a lot of money? After you settle your claim, all further treatment is YOUR responsibility. Except in specific, unusual situations, you cannot go back and re-open a settlement.
Here is page from my website that shows in detail why you should never make an early personal injury insurance claims settlement http://www.settlementcentral.com/page0211.htm
And, of course, once you settle, THAT IS IT: you will never see another dime in pain and suffering money. By the way, did you know that getting an early settlement is a favorite trick of the insurance adjusters? Please see my website wherein we show Insurance Claim Adjuster Secret Tactics http://www.settlementcentral.com/page0092.htm
I know that you think this is going on too far with this one topic, Bob, but I HAVE TO TELL YOU that this is a REAL danger that I have seen many times. So just have patience a bit longer and commit yourself to read the following:
There may be a dull ache at night following a day at work driving truck, or some physical activity or pain the next morning. DO NOT LET LITTLE PAINS GO UNATTENDED SINCE YOU DO NOT KNOW WHETHER THEY WILL CONTINUE OR GO AWAY. We all hope and believe that such little pains will disappear soon. But on the other hand, we have no way of knowing since this is the way serious fractures and soft tissue injuries can behave.
So, when this happens, even if a couple months or more post-treatment (i.e. this August), do not hesitate to SEE A DOCTOR AND ATTRIBUTE THE PAIN TO THE ACCIDENT WITHOUT EQUIVOCATION. It is NEVER TOO LATE TO REPORT PERSONAL INJURIES FROM A FALL ACCIDENT http://www.settlementcentral.com/page0104.htm
"No medicine: no money"; medical costs increase worth of personal injury insurance claims http://www.settlementcentral.com/page0045.htm
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#2. What to do about the tortfeasor's probable low policy limits?
I agree with your suggestion that a three time DUI loser likely has no more than the minimal policy limits, which are only $15,000 in your state. It makes no difference that he is with a large insurer from Texas—the laws of California apply, and all companies, large and small, have by now all sold the market of your state those little $15K policies.
"How do I find out the policy limits?"
The only for sure ways I know of are to ask as a part of the "discovery" process in litigation (Interrogatories, etc) OR to induce the adjuster to disclose the limits when she sees that the value of your claim far exceeds those low limits.
We do have a set of policy limits interrogatory questions (identical to those we use in litigation) for members of www.SettlementCentral.Com to ask policy limits information. Often the adjuster will obtain permission from her insured and respond to such a request on an informal basis. But there is no duty on the adjuster to answer such a set unless the claim is in litigation.
As for the other method, once you can demonstrate that the claim has substantial value above the limits, the adjuster will most often reveal the limits in her offer back to you. That is, she will offer ONLY the limits in exchange for your release of all claims.
TRICKY PART. You cannot accept that offer unless and until your insured subrogees (see subrogation link below) or your Underinsured Motorist Carrier (UIM) have an opportunity to "buy out" that offer of limits. If they were to do that, then they would have seen some benefit of paying you directly the amount of the offer and suing the tortfeasor directly. That would mean that the tortfeasor has assets that can be executed upon as part of a big judgment obtained against him.
ONE NOTE HERE FOR YOU. Why settle for his policy limits if your UIM coverage is skinny IF
(1) you have a higher value claim; and
(2) the guy has substantial assets.
Because DUI is a CRIMINAL OFFENSE, he cannot discharge your judgment in bankruptcy court. Hence, your judgment can always be there to execute upon his assets, his wages, his bank accounts, his investments, his house, etc.
So, if you were to continue on without settling for a bit and if it were to develop that your condition became chronic, there is the possibility that you may have sustained a very serious injury. In that case, you would need to consult an attorney BEFORE you ever agree to accept the offer of policy limits.
http://www.settlementcentral.com/page0459.htm
Introduction to Subrogation—Forced Payback to YOUR OWN Insurer From Your Personal Injury Award
http://www.settlementcentral.com/page0451.htm
Directory of Legal Information on Liability Insurance Policy Limits Settlements in Personal Injury Insurance Injury Claims: Car Accident Injuries, Dog Bites, & Slip and Fall Insurance Claims
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#3. How valuations are established
Here are some valuation factors in personal injury claims; INSURANCE INJURY CLAIM VALUATION TIPS follow.
At the outset, let's note that "duty under duress" is a BIG item for Colossus valuation. Hence, I WOULD DOCUMENT ALL OF THE DAYS YOU RETURNED TO WORK AND PERFORMED YOUR JOB EVEN THOUGH YOU WERE IN PAIN THEN AND ESPECIALLY LATER THAT NIGHT. Mention all of those times under a paragraph titled "duty performed under duress of injuries."
Now, as for valuation itself, you have given me nothing at all to go on insofar as your continuing injuries, or whether you are totally healed after such as minimal treatment regimen.
How does one figure out what to ask for? Quick Answer: get as much as you can. Figure out what would make you happy, and increase that amount by at least 50%! The value is what you and the adjuster agree it will be. Well, if that is not scientific enough for you, let’s learn a bit more about valuation of personal injury claims.
Valuation is not like going to a drive-in for a fast food meal. It takes time and study of many factors, including liability and medical records. Plus, one would like to meet the claimant to see how she will “sell” to the other side and to the jury. Those online sources that mention a "rule of thumb" is just that: a gross estimate.
SHORT ANSWER: A common theme among those who still think a “rule of thumb” formula will put you in the valuation ballpark is to multiply the medical specials times a number from ONE to FIVE (depending upon factors, some of which I will give you later—or all of which are fully discussed in the members' side of my website, dealing with insurance settlements www.SettlementCentral.Com ). Then that figure is the total value of the personal injury portion of the claim. Of course there is a long list of factors to consider for adding or deducting from the total.
Let's take a look just one factor that puts the lie to the general use of this rule of thumb. Let's start with geography. Values differ from state to state, and within each state. City values are often different than rural values on claims, especially if the economy is tenuous in small towns. And the differences can be HUGE between these areas, even if only 30 miles apart.
Here is a listing of factors that will affect both the multiplier you will use, as well as the value of the claim inasmuch as they will increase or decrease the product of your multiplication.
1. LIABILITY DISPUTE
This is a big one because it most dramatically affects value. You should NOT ACCEPT any reduction in value for fault.
2. Trauma suffered
The value of your claim increases with a bigger crash, and decreases with a low damage tripping wherein one catches himself. Why? Just human nature. You had a HUGE crash, so this is a PLUS for your side.
3. Medical special damages
Cost of medical and related health care expenses; higher costs usually equate to an increase in value (excepting, of course, cases of gross overtreatment).
4. Type of injury
Where does the injury fall within the insurance industry's "hierarchy list" of valuing injuries? Irrespective of which injury may cause more pain, injuries are valued according to seriousness, tendency to be persistent or permanent, and whether or not they need objective proof to be believed (e.g. a broken bone versus soft tissue strain). Soft tissue injuries are at the bottom of the list since they cannot be proven with objective evidence.
5. Type of medical care
Where does the medical care fall within the insurance industry's "hierarchy list" of valuing medical care? Orthopedists at the top, chiropractors near the bottom.
6. Prognosis- future care—permanency of injury or pain and suffering—does your doctor recommend 6 months of care, or were you done treating 2 months ago? Even if you were done treating, will the doctor predict future problems?
7. Your medical and claims history, prior accidents, prior injuries or treatment of the same area of the body.
8. Impairment of quality of life. Emotional distress fits in here.
9. Quality and persistence of pain suffered.
10. Quality and thoroughness of your medical records.
11. Lost wages. In this aspect I would make sure that the adjuster knows how your work taxes your body. Consider using a work witness statement regarding how difficult your work was for you.
Also, if your medical records are not in good simple narrative format (as opposed to shorthand version of hand written notes), then consider obtaining a narrative report from your doctor. We have a lot of free legal tips on insurance claims settlements using doctor narrative reports http://www.settlementcentral.com/page8003.htm You can get information there as to how to ask for a narrative letter and what it might cost. Talk to the doctor's office manager about it. This is also a good way to boost the value of the claim. And whatever you pay will be repaid to you from her settlement.
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#4. How to make your own insurance settlement with free legal auto insurance information www.SettlementCentral.Com Learn DO IT YOURSELF INSURANCE CLAIM SETTLEMENTS
OK, Bob, let’s Look at self-help methods of resolving your daughter's claim. Learn how to settle her personal injury insurance claim AND DO IT YOURSELF.
Here is a series of pages that you can review. Take what makes sense to you and don't worry about the rest. Just get a flavor of how the system works without spending a ton of time right now.
Just skim this one and don't spend much time on it: overview Tort Law Personal Injury Legal Claims http://www.settlementcentral.com/page3000.htm
Managing Medical Care After Auto Accident: http://www.settlementcentral.com/page0203.htm
Medical Care Documentation-the Key to Successful Personal Injury Insurance Claim Settlements
http://www.settlementcentral.com/page0217.htm
Keys to a MAXIMUM INSURANCE INJURY CLAIM SETTLEMENT http://www.settlementcentral.com/page0089.htm
Use a Confidential Personal Injury Diary for TOP DOLLAR Insurance Claim Settlements http://www.settlementcentral.com/page0208.htm
Outline of questions to be expected from insurance claims adjuster http://www.settlementcentral.com/page0190.htm
Detailed listing of questions to be expected from insurance claims adjuster http://www.settlementcentral.com/page0207.htm
By the way, did you know that getting an early settlement is a favorite trick of the insurance adjusters? Please see my website wherein we show Insurance Claim Adjuster Secret Tactics http://www.settlementcentral.com/page0092.htm
Responding to Settlement Offer From Insurance Claims Adjuster http://www.settlementcentral.com/page0244.htm
Do It Yourself Advantages, or do these claims need an attorney? As for an ATTORNEY, this does not seem to be a case that involves any legal issues in dispute nor any large or complex damages. Why should you pay someone one-third to do what you can do yourself? Do-It-Yourself Personal Injury Claims; Eliminate Personal Injury Attorneys' Fees; Save Thousands of Dollars Settling Your Own Insurance Claim http://www.settlementcentral.com/page3011.htm
Without having to join my website, I have given a lot of free information on handling insurance claims without having to join as a member. Read the module at "5 Easy Steps to Do-it-Yourself Insurance Claim Settlement" http://www.settlementcentral.com/page0102.htm
This stuff is not rocket science, but it will take some effort on your part to read and cut and paste letter examples and to communicate. But hundreds of people are doing it each day, and they are getting good results.
What if you get only two-thirds the way to your settlement goal? Well, you can get as big a settlement as you can and then turn it over to an attorney and save a lot of fees. Thus, you could go it alone just to get an insurance settlement offer, and then take that insurance settlement offer to a personal injury attorney, thus exempting the amount of the offer from her fees. Do It Yourself Personal Injury Settlement Offer Reduces Personal Injury Attorney Fees http://www.settlementcentral.com/page0109.htm
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#5. Learn about how to communicate with the insurance adjuster: FINAL TOPIC—COMMUNICATE IN WRITING AND "DEMAND" NOT "ASK"
FINAL TOPIC, Bob: Effective communication with insurance claims adjusters. Establish Firm, Professional, and Positive Relationships With the Insurance Injury Claims Adjuster http://www.settlementcentral.com/page0059.htm
Always communicate with the adjuster in writing, showing your own analysis of value. E-mail is best: quick and leaves a solid record of who said what. It is OK I guess to have one call or so, but no more. Always have your information and ammunition in writing to give to the adjuster.
Let him know that you are FIRM IN YOUR RESOLVE to get what you are demanding (NOT "asking", since that invites a counter-offer, but instead "demanding" as fair and reasonable compensation) by asking him what the options are to resolve the matter fairly should he not agree to a reasonable claim value. In other words, let him know that you will go through with a court filing if need be.
Remember these tips, do your homework, print out your evidence, show resolve to get your fair settlement, and you will DO JUST FINE.
I trust that my extra time here has produced some information that has been of value to you, and thus I would respectfully request that you take the time to locate the FEEDBACK FORM on this site and leave some feedback for me.
Best Wishes,
Dr. Settlement, J.D. (Juris Doctor)
http://www.SettlementCentral.Com
