QuestionQUESTION: I was injured in a car accident. I filed a personal injury claim with the at fault insurance upon request but the offer was lower than my demanding.
1)Can I take the offer and demand the difference from the at fault driver directly or the claimant must either accept the offer as the final or demand the full from the at fault driver?
2) What should I do if the at fault car insurance does not concede in the difference between the demanding and offering?
Can you answer my two questions above? Thank you.
ANSWER: Hi Ray,
It is surely frustrating to get lowballed by the adjuster, but that is what happens most of the time. So, the key is what to do now. First off, I am wondering what exactly happened here. The questions you ask reveal to me that you had no guidance in making up your demand letter—is that correct? If so, perhaps there are some things that you could add to the next go-round of negotiations. I will suggest those below.
First, though, let’s look at your questions and get those answered, and THEN I will give you some ideas for your reply to the adjuster. One thing on that reply: make it in writing (e-mail is OK).
On your questions: your demand is pretty much irrelevant with regard to having any legal impact on a duty for the other side to split the difference with you. Think about it for a second and you will see that such a system would make no sense since both sides would exaggerate their positions. For example, if what you propose were true (i.e. that the difference between your demand and their offer had any impact upon settlement), then why wouldn’t the claimant always demand five times what he wanted?
Hence, while the positioning of the demand and the offer DO mean something regarding negotiations, they are meaningless when you try to enforce some splitting between them. What they accomplish initially is to signal the intention of the parties. One reason we teach our members settling insurance claims at www.SettlementCentral.Com to get out their demand before the adjuster so that they can define the size of the ballpark in which both sides will play out this game. This is called taking the initiative, and it sounds like you did just that, so that is something good that you did.
What I want you to do now is to get ready to send back a counteroffer. You will read below that I want you to do that in writing, NOT in a phone call.
Let's start with these topics, and see where that gets you.
#1. Second salvo www.SettlementCentral.Com negotiation strategy
#2. Narrative reports can settle personal injury claims
#3. Pick out two factors from valuation list
#4. Get a witness statement
#5. Respond in writing—e-mail is OK
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
#1. Second salvo www.SettlementCentral.Com negotiation strategy
I do not think that it would pay you to join my website at this late date in your negotiations. While it is true that www.SettlementCentral.Com teaches insurance negotiations, a big part of the benefit of membership is helping the victim throughout her claims and medical treatment process. Our members report that the insurance negotiation tips at www.SettlementCentral.Com are most helpful in learning how to take on a professional adjuster, but I think I can give you a little information from which you can go forward with a strong and effective negotiation.
The basic idea is to put a halt to negotiations in favor of furnishing new information or information in another form. I am talking about FOUR things you should do.
A) Do not be in any hurry to respond. Let the adjuster know that while you do appreciate her offer, you blame yourself because you must have failed to furnish additional information. And hence, you will not respond to her offer until you are able to furnish more information.
B) Do NOT promise what kind of information you will furnish since you have no idea that all you promise (i.e. a new medical report) will be favorable.
C) Consider the term "second salvo" from www.SettlementCentral.Com negotiation tips. What we mean is you are loading up another round of ammo and firing back at the adjuster with something of SUBSTANCE, not just hot air. You want to give her some meat with your response since that will support your continued insistence on a higher insurance settlement.
D) Take a look at our ideas at using witness statements and/or a narrative report. You probably do not need both—but there is nothing wrong with furnishing both.
Xxxxxxxxxxxxxxxxxxxxxxxxxx
#2. Narrative reports can settle personal injury claims
Here is another idea, Ray, 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.
Do you think that the adjuster might not appreciate the seriousness of your injury given the low offer it sounds like she made? 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.
For maximum insurance 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 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 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
Xxxxxxxxxxxxxxxxxxxxxxx
#3. Pick out two factors from valuation list
Here is a list of valuation factors. Pick a couple of them and expound on those two 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 ). 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.
Xxxxxxxxxxxxxxxxxxxxxxx
#4. Get a witness statement
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-home and work? For example what 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 Settle Personal Injury Insurance Claims http://www.settlementcentral.com/page0196.htm
xxxxxxxxxxxxxxxxxxxxxxxxxxx
#5. Learn how to communicate with the insurance adjuster: FINAL TOPIC—COMMUNICATE IN WRITING AND "DEMAND" NOT "ASK"
FINAL TOPIC, Ray: 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
---------- FOLLOW-UP ----------
QUESTION: Thank you for your answer. The procedure seems like this: demand->receive an offer->counteroffer by providing something NEW. I do not understand what new could be provided in a counteroffer if everything has been provided when demanding the damage.
1) Do you mean the claimant should NOT provide everything when demanding damage so that s/he has a chance to submit something new in a countoffer?
2) Should the claimant demand more in purpose such as more than five times of the economic loss in order to concede such as three times of the economic loss in the late negotiation?
AnswerHello again, Ray,
1) No, we do not hold back valuable info on purpose. But there is ALWAYS going to be something you can think of to add later. Be creative and think up the kinds of testimony that I suggested. Most people do not do this, so it is not essential. But it is just a little tip to get additional consideration of your claim.
2) NO--as discussion of the spread of factors above shows, three is about the goal, not the bottom position. Most settlement offers these days are to pay just the medicals and maybe one times the medicals. It is up to negotiations to move it upward.
Making a hugely overvalued demand does two things: A) it shows that the claimant is totally uneducated about the process, so it costs him credibility—his opinion is worthless; and B) it is a turnoff to the incentive to negotiate—we create negotiation leverage by an offer just out of reach of the reasonable range of value.
For example, Doctor Settlement drives ONLY American made Cadillacs, and my 2005 SRX is in good shape. If it is worth $19,000, what incentive would you have to make a counteroffer if I offered it to you for $45,000? NONE. But if I asked for $22,000, you would be more inclined to make a counteroffer. See how it works, Ray?
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
