QuestionAbout a year I was on the highway and traffic slowed down but the guy
behind me wasn't paying attention and rear ended me while going at a
pretty high speed. I was hospitalized multiple times, went to a ton of
doctors appointments and physical therapy appointments. I was also on
bed rest and not able to work at either of my two jobs for about two
months (my lost wages totalled aproximately. $7,000). I couldn't afford
my apartment so I had to move in with my dad. I was told by multiple
doctors that my neck and back will never be fully healed and I will have
to live with that pain. His insurance company had paid for my medical
bills thus far and now they are trying to settle, how much do you think I
could settle for?
AnswerHi Jonny,
It would be wrong for me to even speculate on the value of your claim, given the lack of information. I have no idea whatsoever about the liability picture, or about the amount of damage to the vehicles, or about your prior claims history, or about the quality of your witnesses, or even what your injuries were, or why you were hospitalized multiple times, or what your pain and suffering was, or how this impacted your life, or what your prior medical condition was, or what the residual injuries will be, or what future medical care your doctor recommends, etc, etc. Hence, I would never even venture a guess at the value of your claim. BUT, I can give you some factors that adjusters will consider in valuing such a claim. Then you can go from there, although you might find out that the tortfeasor has only minimal limits, and then you will have to use your own Underinsured Motorist Coverage (UIM).
A non-scientific response would be: I think that you should get as much as you can or as much as the tortfeasor's policy limits are. Usually the value of a claim is going to be either the policy limits, or whatever the adjuster and the victim agree it should be. You get in there Jonny and make up your evidence, as I will show you, and present your case and fight for $100,000. Now, of course that is not what you should put in the demand letter, since an outrageous demand does not gain you any credibility. But fight as hard as if that were the value of your claim.
There are FIVE IMPORTANT aspects to your claim that I want to convey.
#1. You are right to wait and NOT SETTLE your claim too soon.
#2. DO TAKE THE INITIATIVE with a demand letter once it is time to settle
#3. DO LEARN about how to make your own personal injury insurance claim settlement www.SettlementCentral.Com free legal information will help.
#4. DO LEARN about valuation factors in personal injury claims
#5. DO NOT get involved with the adjuster in a detailed discussion until you make your demand, AND DO LEARN how to communicate with the insurance adjuster.
OK, Jonny—if you are ready, let's get started in the order I have written above.
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#1. You have some pretty serious injuries, and so you were right: to wait and NOT SETTLE your claim too soon. I DO NOT EVER like claims settled within six months or so when the forces of trauma to the body were as significant as these apparently were since you would need some time to heal.
Tell yourself to listen to your body and to get medical attention when you feel any aches or pains that continue for a day or more. DO NOT QUIT, BUT CONTINUE TO GET MEDICAL CARE FOR YOUR INJURIES. You were involved in an accident with a lot of impact. There is no reason why you should suffer in the future if you were to discontinue your treatments."
DO NOT SETTLE YOUR CLAIM UNLESS YOU ARE ABSOLUTELY CERTAIN THAT 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.
Is this an early settlement? One would say "No" in most cases, because a year has passed. BUT if the injuries are serious enough to require "multiple" hospitalizations, I am going to take the position that one year is too early. That is because I must protect your interests, and to do that, I must assume that these injuries are very serious. Hence, lacking any information to the contrary, I am going to consider these to be still unresolved serious injuries, and that you have no yet been restored to good health.
Does that make sense, Jonny? PK, let's just finish up this topic of early settlements 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 18 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 ten months of treatment.
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, highly 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
"No medicine: no money"; medical costs increase worth of personal injury insurance claims http://www.settlementcentral.com/page0045.htm
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#2. DO TAKE THE INITIATIVE with a demand letter once it is time to settle
Take the initiative and DO NOT LET THE ADJUSTER DICTATE THE SIZE OF THE BALLPARK you are going to play in: Get your demand letter out there once you are ready to settle, AND REBUT AND REJECT "SUGGESTIONS" that your award is going to be "a little cash" or some other idea to convey a small settlement.
You asked: “What can I expect for a settlement?”" Unless you take the initiative in this claim, what you "can expect" is to become another success story for an adjuster who has run over uninformed claimants and denied them a fair settlement award. She will be the company adjuster of the month and you will be the poster boy for claimants to abuse.
An adjuster may suggest that you are entitled to "a little something for pain and suffering." This is an attempt to lower your expectations. If that language is used, then go RIGHT AFTER HER when you speak and bring up that statement and remind her that you expect FULL AND FAIR compensation for your pain and suffering. "Well, what did you have in mind?" she will ask. Tell her that it is way too early to know how your healing will be made, and hence, you will NOT speculate.
You should be commended for having the initiative to seek out a website such as this and to ask for help, but the most important part of achieving a successful personal injury claim HAS TO START WITH YOU, NOT THE ADJUSTER. Do NOT let the adjuster set the parameters of the negotiation: get your demand letter out there FIRST, but ONLY after you have reached maximum medical improvement. It is not all that hard or mysterious to put together an Effective Personal Injury Insurance Demand Letter http://www.settlementcentral.com/page0170.htm It does not have to be "fancy" or complex; just hit the main points and get it out to the adjuster soon.
If I were you, what I would do right now is to become as fully informed about the insurance injury claims process as you can, with the objective of seizing the initiative in prosecuting my claim, instead of taking a passive, reactive role. Can you see the difference in postures and how one works to your advantage and the other to your disadvantage?
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#3. DO LEARN about how to make your own personal injury insurance claim settlement www.SettlementCentral.Com free legal information will help. Learn how to handle a SELF-HELP AUTO ACCIDENT INSURANCE SETTLEMENT www.SettlementCentral.Com free information—this is just in case you want to take a shot at doing some of this on your own. OK, Jonny, 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. DO LEARN about valuation factors in personal injury claims
What about valuation of your 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%, and that is your first offer! 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.
In your case, I would tell the adjuster that if her insured's policy limits are $50,000 or less, you will settle for that, assuming your own insurer does not object (Your own insurer—which has subrogation rights AND may have to pay under your UIM coverage, does have the right to pay you the tortfeasor's policy limits and pursue the tortfeasor on its own. This is rarely done, though.)
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 she 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.
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 pretty good crash, so this is a PLUS for your side if your crash was as big as it sounds from your injuries.
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 this week? Even if you are done treating, will the doctor predict future problems?
Your claim value gets a boost if your doctor specifies that you will need some future treatment.
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.
9. Quality and persistence of pain suffered.
10. Quality and thoroughness of her medical records.
11. Lost wages. You will get all the wages you lost, BUT it sounds like you also may have worked through some pains. Hence, make sure to note that you have returned to work even with pains. Note this for sure, and label it as "duties under duress" inasmuch as that is the latest thing for computer-generated insurance software valuations. It gets a special valuation if you can show that you did work even though you were hurting.
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. And whatever you pay will be repaid to you from her settlement.
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#5. DO NOT get involved with the adjuster in a detailed settlement discussion until you make your demand, AND DO LEARN how to communicate with the insurance adjuster.
First things first: why don't we start planning for that meeting the adjuster has asked to schedule with you. I would suggest that you be general, not specific, regarding your injuries and activities that you cannot now do. ALSO, make sure that you distinguish between activities that you "CANNOT" do, versus those that you CAN do, but for which you will pay a price in pain later that night or the next day.
She is sure to ask that question, and most of us will not give but a couple of activities we "cannot" do. Instead, be ready to give her a list of things at work or in daily life or in your workout and physical recreation that you CAN do, but which will give you pain later on.
Be Prepared for the Kinds of Questions they Might Ask of you.
Of course we would like to avoid giving any recorded statement, so ask the adjuster to send a list of questions since you "do not think well in quick pressure situations". Tell her that you will be able to give a more thorough response if she were to send you a list of topics or questions she wants answered. Fat chance she will do that, but you could try. At a minimum, you need to be prepared for an interview.
This is a list of questions insurance adjusters ask http://www.settlementcentral.com/page0207.htm injured claimants.
Here are two pages that tell what to do now if you have already given a recorded statement to the adjuster.
http://www.settlementcentral.com/page0058.htm Recorded or Written Statement To The Adjuster After Injury Accident?
http://www.settlementcentral.com/page8014.htm What to do if you have already given a recorded statement to the insurance adjuster
Learn how to communicate with the insurance adjuster: FINAL TOPIC—COMMUNICATE IN WRITING AND "DEMAND" NOT "ASK"
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 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 her what the options are to resolve the matter fairly should she not agree to a reasonable claim value. In other words, let her 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
