QuestionQUESTION: I was vacationing in California last fall and traveling with my husband in a rental car. I was the passenger. A woman pulled out from a shopping center in front of us and the police report confirms that she was at fault for failure to yield right of way. There was an eye witness. Our car was totaled, and the other party's insurance settled with the rental car company. I was taken by ambulance to local hospital. X rays confirmed broken wrist. Our vacation was ruined. When we got home I went to an ortho surgeon who put my hand in a cast. I was in a cast for six weeks followed by several months of therapy. During this time it became apparent that the injury had triggered two other problems: one was carpal tunnel and another is a condition that starts as nodules in the hand and eventually causes the little fingers of the hand draw up. I had surgery for the carpal tunnel, had to wear a brace, etc. and went for another round of physical therapy. My doctor has released me as he says there is nothing more he can do although I still have pain in tingling at the end of one of my fingers. I do not have full flexibility of my wrist, still have some wrist pain when I put weight on my hand or twist the wrist, and it has affected my life style (sports, hobbies) but won't go into all the details about that. The condition that leads to my fingers drawing up has no cure and may involve surgery down the road to straighten the fingers. I have been researching how to file claims on the internet and I'm preparing a letter of demand. I'm trying to understand how much to ask. I am retired so can't claim lost wages. Most of my research says to expect 3x one's medical bills so I should start higher than that. My total bills are $30,000+ as billed plus $3,000+ out of pocket. My own med. insurance paid $13,000, and $14,000 was adjusted off. So, my questions: 1. Do I use the original $30,000 as the basis for settlement calculations? and 2. How much should I reasonably expect? Thank you very much for any advice you might have.
ANSWER: Mary,
It's good that you have done your research. First of all, use the actual medical bills incurred, vs. what was paid. The carrier that paid the bills can get reimbursed for the $13000.00 and the other $14000.00 is lost except for your calculations.
The venue where this occurred is important as well as the venue where you live. California has a large liberal base and your claim would be worth more litigated there than in a more conservative venue like Fort Worth, TX or such.
Your future medical should be factored in, and with a claim of the caliber that you have, I would advise to figure out what the policy limits are. You may be in a situation where the case is under-insured. You want to know this up front if at all possible.
Your case is tough to evaluate based on the limited information you are able to provide in this forum, but if you had no previous medical issues with your wrist, nothing that indicates a degenerative condition, clear medical doctor diagnosis and prognosis pointing to the injury as the cause of all the issues, and a clean claim history, then I would expect your case to be worth $150K to $175K. The 3x rule is malarcky. Generally speaking, juries fall into that range on their awards, but in no way can we compare general jury awards with specific injuries.
All injuries are different, and all people are different. If you make a good witness for yourself, meaning you don't come across as fishing for money, and you have evidence and testimony of an active lifestyle that has been thrown for a loop because of this accident, then you'll fare better.
I am sorry I cannot be of better assistance, but there is just so much I can say in a written answer. If you feel like you would like more information or have specific questions, you can always visit www.pettydetailsllc.com and find my direct contact information. I hope this helps!
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QUESTION: Thanks for your reply. Yes, it is helpful, and I must say that your estimate is a lot more than I expected. How can I find out what the policy limits are? If I ask outright, is the insurance agent going to tell me? Would seem doubtful. Or do I just specify a demand amount in my letter and wait to see what she says? Again, many thanks. P.S. I do live in Texas. North of Dallas.
AnswerThere is no reason that the company should refuse to give you policy limit information, but sometimes they use "privacy laws" as a way to avoid providing the information. There is no harm in asking for the information.
You may be familiar with the Stower's doctrine, and if you are not, search for it and read up. The main thing about that doctrine is that in order for there to be a real threat of a large verdict over the limits, the demand must be within policy limits and not be "unreasonable". This is why knowing the policy limits is important. If you know the limits and they are $100k or less, then I would think you could demand $1 less than the limits and be done with it.
Your future medical will be an important part of your claim, make sure it is documented properly with quotes from doctor's on what the likelihood of needing surgery to fix the pinky issue is, and whether or not it is a speculative injury that is likely, or if it is a certainty that it will progress to that level. Physical deformity is a big money maker, even in conservative venues, and rightfully so. The mental issues that come along with having any physical deformity are almost impossible to predict and could have severe effects on the quality of your life.
