QuestionI was involved in an auto. accident of which the other driver was 100% at fault. Rear end collision into my vehicle. I live in Ohio but the accident happened in Pennsylvania. It occurred in early Jan. 2009 and I did not treat until mid Jan. 2009 since that's when the pain and associated problems began. The insurance company of the at fault driver had settled the claim with me as my car being a total loss. (Age of vehicle/cost to repair more than the blue book value). That was fine. The total of my medical bills, of which my own Auto Insurance carrier in Ohio, has paid thus far; totals near $9,500.00 for more than 5 doctor visits, 10-12 weeks physical therapy, medications, x-rays, etc. I am at the limit of my own personal auto insurance policy. My question then is what is my pain and suffering injury going to be worth from the insured's company that was at fault? My injuries are such that my lower back, my right leg, and foot, were affected by nerve and soft tissue type injuries.
AnswerHi Maurizio,
I think two things here: (a) you need to take a look at the risks of early settlement of your claim; and (b) you need to consider getting a narrative report to explain the prognosis. Hence, I suspect that either you are going to love what I tell you and thank me one year from now, or you will not comprehend why I took the course I am going to take and grade me down for not answering your question. The truth is: you have a (potentially) very serious claim, and it is waaaay too early to even contemplate settlement at this stage. Nerve involvement claims are not "matured" and ready for settlement until we know the extent of the damage AND THE PROGNOSIS FOR FUTURE PAIN AND SUFFERING.
Not to be flippant, but who knows what your claim is worth? I surely could not venture even a ballpark guess since you have not let me know the most important facts: what are you suffering now and what is your prognosis.
I say this since yours in NOT a garden variety soft tissue claim. You had a good hard crash and you now have nerve involvement. Any time you get nerves involved in a serious way as in your claim, all bets are off on value UNTIL you get a firm prognosis of future problems.
Hence, I could respond with an opinion that $20,000 in general damages (pain and suffering, etc.) would be fair on top of medical expenses and lost wages. Or, if the facts were known, I could say that $85,000 in general damages is a more likely figure because you have semi-permanent nerve involvement.
How would you like it if I told you to settle for $20K and you got $18K in negotiations, but 18 months later you could hardly walk or stand up without shooting pain?
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#1. Bottom line, Maurizio, you are WAY TOO EARLY TO CONTEMPLATE SETTLEMENT OF A NERVE CASE. We often did not see full involvement of nerve damage until one year post accident. What makes you so anxious to settle now?
Is your nerve damage 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 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. Shooting pains will resume and then it will be difficult to move without pain.
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 continuing 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 severe 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 NERVE DAMAGE AND 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 Maurizio, 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 two or three months of treatment.
In NERVE DAMAGE and 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 doctor 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, Maurizio, 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, 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. Narrative reports can settle personal injury claims
Here is another idea, Maurizio, to make your medical record into an asset for settlement. Get a narrative report from your doctors regarding your HISTORY and treatment and prognosis and FUTURE medical care. CONSIDER USING A DOCTOR'S NARRATIVE REPORT to assist in settling your insurance claim.
It sounds like an adjuster might not appreciate the seriousness of your injury given the relatively short term of your medical care. If you have only written notes as evidence of the seriousness of your injuries, then maybe the records she is using to value your claim are not all that good. Have you seen any of the doctors' records that have gone to the insurance adjuster? If not, it is easy enough to get a copy so you can make sure that everything of importance you discussed is included therein IN READABLE FASHION.
Cryptic medical notes may be medically significant, but why make the insurance adjuster struggle to figure out the significance of the injuries? A narrative report or letter spells things out so the adjuster can see, read, and understand the doctor's diagnosis and prognosis and her record of the problems and pain and suffering you have endured.
Plus, narrative letters can tie together the trauma and its after-effects in a way that is authoritative.
Www.SettlementCentral.Com recommends that insurance claimants almost always include some type of typewritten medical information to accompany to computer coded medical records and/or handwritten records. That is the first clue as to when to use the narrative report: if you are asking the adjuster to evaluate your claim on the basis of handwritten records and/or computer coded records that indicate diagnosis and treatment codes, then you need to supplement the record with a narrative report.
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.
Make darn sure your doctor does have updated full information in his records, or the adjuster may not give you credit for what you have been through. For example, if you just ask for a narrative letter now, three months after your last appointment, then you best go in for another appointment first and document for the doctor recent examples of pain. While I have no idea of your current condition, it is not unreasonable that you would still have a lot of residual pains. Maybe such things as nagging signs of soft tissue injuries you are noticing following a full day of sitting at your computer or doing physical activities. Personal Injury Medical Records http://www.settlementcentral.com/page0114.htm
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#3. Learn how to handle a SELF-HELP INSURANCE SETTLEMENT—this is just in case you want to take a shot at doing some of this on your own. OK, Maurizio, let’s look at self-help methods of resolving your claim. Learn how to settle your 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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#4.. Learn about valuation topics. SOME TIPS ON VALUATION—these are loose guidelines only, since we are prohibited from giving valuation on big cases in light of the exposure to a malpractice claim.
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 he 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 two factors that put the lie to the general use of this rule of thumb. An obvious one is that of the radiating pain issue that you mentioned. There may have been just average treatment costs per se, yet those dollars should be valued at more than office bodily treatment dollars since they would be for a significant interference with your life and well-being inasmuch as the nerve damage is likely NOT HEALED, and will continue.
A second, not so obvious, but very important factor that shows how inaccurate a “rule of thumb” formula can be is just plain location of the trial. 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 20 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 hard trauma it sounds like. Perhaps a big hard hit and a traumatic assault on your body from within the vehicle. So this is a PLUS for your side. Terror fits in here.
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). Most often, radiating nerve damage can be objectively documented. It is in a different category than "mere" soft tissue injury.
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. Hopefully your doctor has REFERRED YOU TO A NEUROLOGIST. That is the ONLY specialty that deals directly with your problem.
6. Prognosis- future care—permanency of injury or pain and suffering—does your doctor recommend 6 months of care, or were you done treating 4 months ago? Even if you are 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 her medical records.
11. Lost wages.
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#4. Learn how to communicate with the insurance adjuster: FINAL TOPIC—COMMUNICATE IN WRITING AND "DEMAND" NOT "ASK"
FINAL TOPIC, Maurizio: 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. 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
