QuestionHi,
I have been going through a claim with an insurance company because of an auto accident I had nearly 2 years ago, where the other driver was at fault. I have received a fair amount of medical attention which was paid for by the insurance company - physio, GP appointments and psychology appointments (I was having panic attacks while driving for awhile after the accident) They also paid for a month's gym membership for rehab with the physio. They have offered what I believe to be a fairly small amount, considering my lower-back pain is ongoing(whiplash/muscle injuries) and I have had to not go back to work (I wasn't working at the time of the accident, but was planning on finding a job within the next few months that would suit my young family). I want to place a counter offer, but am not in a financial position to hire a lawyer - is it even worth my time? How would I go about it? Is there any advice you can give me?
Thanks in advance,
Bec
AnswerHi Bec,
Personal Injury Auto Insurance Claims http://www.settlementcentral.com/page0452.htm Statute of Limitations is Doctor Settlement's recommended starting place for you since this claim is nearly two years old. Just make sure of your own expiration date and keep that in mind and leave plenty of time in case you need to hire an attorney.
If you are too close to that date to negotiate your own deal, then you need to see an attorney ASAP. It is too complex to explain here, but at www.SettlementCentral.Com members learn insurance claim self help instructions that will allow them to get the clamik filed, BUT MORE IMPORTANTLY, how to keep the claim with that adjuster, rather than have her transfer it off to the legal department. That is the only way I know to retain control of the claim negotiations without involving an attorney.
Now, on to your questions. First, I am concerned that two things did not get proper valuation from the adjuster. The smaller item is the emotional distress. There is no place for that in her computer valuation software, so one would have to be sure that the psychological reports are thorough. This is also an area where witness statements could help.
The second area of concern for me is your lost wages. It is tough to make such a claim if you did not have a job and there is no evidence that you had begun your search for a job at the time of the accident. Yes, those claims CAN be proven, but it will take some witness statements to do that. I have proven some, but I have lost some, too.
It is difficult to convince a jury that you were just now getting ready to go for a job interview once you got home from your drive, except that this accident happened. "How convenient is that story?"—is what some skeptical jurors might wonder. Still, you have the prospect of fighting for a job in this market. You will have to convince the adjuster that you had a good prospect of landing a job based upon your specialty, your skills, or your history and qualifications.
I suspect that you have not built up this aspect of your claim, so get with it in terms of documenting your skills, your wage range, and don't forget to include some witness statements to back this up. It is going to be difficult if you have returned to good work condition ten months ago and still do not have a job. Easier if you did get a job once you could go back to work.
NOW, on to some miscellaneous ideas to buttress up your claim. Insurance claim negotiation tips—at www.SettlementCentral.Com members learn insurance adjusters like getting new material if they are asked to give a new look at valuation. This is akin to sending a second salvo attack, and we load the bombs with new information—or repackaged old info!
First off, send back a letter explaining that while you do appreciate the offer, it is nowhere near the value of your claim, and so you accept the blame for failing to produce sufficient information. Tell her that you will be providing some additional information that you are sure will assist her in paying a fair and reasonable sum for all that you have suffered.
Next, take a look at these four ideas:
#1. Consider using narrative reports
#2. Learn about the auto insurance claims at www.SettlementCentral.Com free legal info pages.
#3. Consider using witness statements
#4. Learn about valuing insurance claims with www.SettlementCentral.Com topics insurance adjusters use.
#5. Learn how to communicate with the insurance adjuster.
OK, Bec, if you are ready, here we go:
#1. Narrative reports can settle personal injury claims
Here is another idea 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, especially if you have a sum for medical care costs. If you have only written notes as evidence of the seriousness of your injuries, then maybe the records the adjuster 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.
For maximum insurance injury settlements, 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 to settle insurance injury claims. 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 her 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, ten months after your last appointment, then you best go in for another appointment first and document for the doctor examples of any pains and problems you have had since the last visit. 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 for top insurance claim settlements.
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#2. Learn about the auto insurance claims at www.SettlementCentral.Com free legal info pages.
OK, Bec, how about doing a little skimming to learn a bit about the insurance claims process? There are a lot of pages of free legal information www.SettlementCentral.Com helps settle insurance claims. Why not take a look at some of these and get a flavor of how to go about settling your own personal injury insurance claim?
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
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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#3. 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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#4. 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.
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.
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#5. Learn how to communicate with the insurance adjuster: FINAL TOPIC—COMMUNICATE IN WRITING AND "DEMAND" NOT "ASK"
FINAL TOPIC, Bec: 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
