QuestionMy wife and two boys were in a recent automobile accident. They were t-boned on the driver's side by a ford f-150 @ 60 mph. Our car, a was totaled,my wife and one of my sons was taken to the hospital in an ambulance and, my other son was life flighted to the hospital. They were checked out and released that same day. A few weeks later my wife got in to see an orthopedic surgeon and had x-rays taken of her ribs where they found 3 possibly 4 broken ribs. So far we have settled the property side of this but not even close to settling the medical side, so needless to say we will need as much advice as possible. Please help. Thank you
AnswerHi William,
My first advice is to totally ignore any idea of settling the personal injury claims at this time, and just give thanks that your family is alive and hopefully on the way to restoration of their health. This could have been a lot worse. As it is, I would expect that it will take a minimum of six months before you will want to consider making any settlement demand.
Here is what I want you to do. Ask the three of them if any of them hit their head on anything. I am almost certain that your wife would have had contact between her head and the side window inasmuch as that was the direction of the force.
It is important to get back to me right away if any of them recalls hitting their head, or if any of them had a knot or bruise on their head. I will then send you some specialized information dealing with post concussive syndrome.
It makes no difference that they may have denied hitting their head or denied any loss of consciousness. That, in fact, is common—even when the victim clearly DID hit their head—to deny any head trauma or any loss of consciousness. More on this later, if you write to me on the topic.
As for what to do right now, I would learn about the tort system and decide whether or not you want to try to do this yourself or if you need an attorney. One way to determine that is to take a look at a lot of pages from the premier self help insurance settlement guide: www.settlementcentral.com Just so you know where I am coming from, William, Dr. Settlement teaches do it yourself insurance claims at www.SettlementCentral.Com So now you know my bias, and of course you can ignore what I have to say. But all that is needed for right now is to learn how to make the claims, including how to pay for medcial care while the claim is pending.
Here is a series of free pages from my website. Take what makes sense to you and ignore the rest until later. 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
Introduction to Subrogation— http://www.settlementcentral.com/page0459.htm Forced Payback to YOUR OWN Insurer From Your Personal Injury Award.
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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Consider using witness statements to settle insurance claims
It sounds like your submission to the adjuster might have been perhaps a bit light. Did you give a lot of information as to how your pain and suffering impacted your life? And what about that driving distress you mentioned—and work problems, if you have started?
Maybe you should think about using lay witness statements from family, friends, and co-workers? Some of these people do have relevant evidence to document what you went through. List those things that you still cannot do. And be sure to include those things that you CAN do, but for which you will suffer that night or for the next few days. Witness Statements http://www.settlementcentral.com/page0196.htm Settle Personal Injury Insurance Claims.
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Consider using a narrative letter from the main 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. In your letter seeking a narrative report, make sure to tell the doctor (this is to be from your wife or from you on behalf of your sons, of course) that you are going to resolve your injury claim on the basis of the prognosis given. If there is the likelihood of further pain associated with his work, then the doctor needs to address it, or else the claim will be settled on the basis of what he (the doctor) says. The reason for that caution IN WRITING is to make the doctor take another look at making a positive prognosis when there is a good chance of your wife or son experiencing pain with continued daily living and work.
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Learn about valuing insurance claims with www.SettlementCentral.Com topics insurance adjusters use.
Since you already did put in your valuation on the demand letter, what I would do is to go over these factors and pick out two—or maybe three—factors from valuation list. Then in your second salvo presentation, expound upon those in your response to the adjuster.
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 injury claim valuation). 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. A 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. Since you are already well underway in this process, just pick out two strong points and argue those in your response.
1. LIABILITY DISPUTE
This is a big one because it most dramatically affects value.
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. Here, your family will have a very big advantage.
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).
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 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.
12. Loss of relationship, aka loss of consortium. Not just sexual relations, but loss of the whole range of benefits a loving relationship provides. This claim belongs to the uninjured spouse.
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Learn how to communicate with the insurance adjuster: FINAL TOPIC—COMMUNICATE IN WRITING AND "DEMAND" NOT "ASK"
FINAL TOPIC, William: Effective communication with insurance claims adjusters. Establish Firm, Professional, and Positive Relationships With the Insurance Injury Claims Adjuster http://www.settlementcentral.com/page0059.htm
How about avoiding those phone calls and try to 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 her 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
