QuestionEarlier this year, my husband was involved in a automobile accident. He was traveling north on a two lane high way when on oncoming car decided to turn east right in front him. The other driver assumed 100% responsibility at the accident scene and admitted he and his passenger had been drinking before heading out on the road, although the driver did test below the legal limit.
My husbands injuries consisted of lumbar strain, cervical sprain, bruised ribs, and lower extremity hematomas, contusions, and chemical burns from the close proximity of the lower airbag deployment.
Our van was totaled, with an estimated $10,000+ in damage. The total loss payment left us $4000 shy of what we owed on the van. We are commuters and unfortunately, our miles dropped the value of the van considerably. While I realize it is our own fault for not having GAP insurance, this would not have been an issue if the accident had not happened.
My husband spent hours in the ER immediately following the accident, had several follow up visits with our regular physician, and had months of physical therapy.
He was unable to work for a month before being forced to go back as he is self employed and we needed the income.
In addition to the $4000 extra we had to come up with to pay off the van, we have $12000+ in medical bills and $1600 in lost wages.
We have received our first, and what they are calling final, settlement offer from the responsible parties insurance, they are offering payment of the medical bills in full and $4000 in pain and suffering to us. Despite the medical records stating that he needed bed rest and to avoid heavy lifting, standing, etc. (basically no activity other than his physical therapy, they are refusing compensation for loss of wages because we do not have a “Doctor’s note” excusing him from work. I asked why we needed a specific note to give to ourselves (he is self-employed) and of course just got the run around and no satisfactory answer.
Does this offer seem fair? We are contemplating talking to an attorney. Our insurance agent told us that in his experience, this type of situation usually settles for around 2 to 3 times the amount of medical bills/loss of wages, etc.
We are not out for a frivolous lawsuit by any means but I do want to make sure we are treated fairly and we are really unsure of what our next step should be. Any advise would be greatly appreciated.
AnswerThe offer sounds low and I'm sure you can get more.
The $4000 for the van is not an issue - they do not legally owe this. They owe the value of the van and nothing more. The loan is irrelevant, so do not bother talking about it to them - it will lower your credibility.
Call you doctor and ask him to write a note stating what dates your husband was physically unable to work because of his injuries. This should not be a problem. Once you get this note, submit it to the insurer and they should cover the lost wages, assuming you can document your husband's earnings.
The 2-3 times value your agent mentioned is an old fashioned rule of thumb and not very accurate. There are a lot of factors they will conasider, including the severity of the impact, type of injuries, and type of treament. The impact was heavy, so that increases the value of your claim. The injuries were soft tissue, so that lowers the value. I do not have the medical records, so i can't comment too much on the type of treament. But $12000 seems high of r the type of injuries you described.
Diagnostic medical bills are usually counted 1 for 1 with no pain and suffering. This includes things like xrays, tests, medicine, and sometimes doctor visits. 2-3 times is sometimes allowed for pain and suffering on physical therapy or surgery.
Once you have considered all this, try to estimate your value and negotiate for something close to this. The adjuster will want to settle the claim and get it off his books, so time is on your side if you can be patient. Keep negotiating and don't be in a rush to settle. Make good arguments that favor your claim being worth more. Do not get emotional or rude as this will not help. You do not want to make it personal or give the adjuster a reason to dislike you. You want him to like you.
You can hire a lawyer, but he/she will take 33% if the case settles, and 40-50% if you go to court. You will probably end up with more $ on your own. If you can't settle for something fair, then you may have to hire a lawyer.
Good luck! Please keep in mind I am not an attorney and this is not legal advice.
