QuestionMy family was involved in a bad accident which resulted in our vehicle being
totaled-- we were all taken on stretchers via an ambulance to the ER. The
other driver was ticketed with running a red light and was found to be at
fault. My medical bills from the ER total almost $25,000 (as do my
husband's). They performed CT scans, x-rays, and EKGs. Thankfully, I only
sustained a broken rib, burns on my chest and hand, neck spasms, and
significant bruising. Of the $25,000, my personal medical insurance
(unrelated to the automobile insurance) "allowed" and paid $790-- I paid an
additional $100 copay at the ER. When stating my demand to the other
driver's automobile insurance company, do I claim the entire $25,000 that
was billed by the ER? Or, do I claim the amount allowed from my insurance
company $890? They are such drastically different numbers, I'm a bit
confused.
AnswerHi Kimber,
Likely you know by now that Doctor Settlement teaches auto accident victims how to settle their own insurance injury claims via legal forms and self help information at my website, www.SettlementCentral.Com. But I am NOT going to recommend that you go any further on this claim on your own, particularly if your "FAMILY" that was "all taken on stretchers" has minors that were injured. I will answer your direct question at the end, but I DO want you to consider some other issues you did not ask about.
There are FOUR really important issues here REQUIRE LEGAL HELP ASAP. In other words, these four reasons show why I do not want victims in your position buying a membership at my site and trying to go it on a self help basis. There is just too much at stake that only an attorney can do.
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FIRST, the tortfeasor total limits and your own Underinsured Motorist coverage (UIM) limits BOTH HAVE MAXIMUMS PER ACCIDENT. Since you all were seriously injured, there will surely be competition for those limits: that means someone has to decide who gets what amount. And only a court can divide those limits when children are involved. You have no authority to bind your family into a division of those limits, since that decision will rest with a court, sitting with the benefit of a report from a Guardian ad Litem, appointed for the minors. Hence, you must seek legal counsel in making a unified claim inasmuch as there will be competing interests with such serious injuries. . Injury claims of minors http://www.settlementcentral.com/page8017.htm insurance settlement procedures
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SECOND, if there are minimal or even $50K limits, then you likely have subrogation defense opportunities. These are worth a ton of money, unless your state requires full payment of subrogation with no regard to the made whole rule. Your attorney can guide you in this.
But in most states, such serious injuries working against $50K or less limits will result in most of your family NOT receiving full compensation for general damages (i.e. pain and suffering and the like). And hence your attorney can make a good play for a complete waiver of subrogation, or sharing in the costs of obtaining the recovery for the insurer, which will mean a one-third attorney fee added to your award. Introduction to Subrogation— http://www.settlementcentral.com/page0459.htm Forced Payback to YOUR OWN Insurer From Your Personal Injury Award.
Bottom line is that when you medicals are so high, there is a lot on the line in potential subrogation defense. In layman's terms, your settlement is insufficient to cover your general damages, so why should your health or auto insurer be allowed to take any of that award to pay itself back? That is what we mean by defending against the subrogation money grab.
The sharing of expenses is also a means to require your own insurance companies to give up some of their subrogation rights.
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THIRD, this requires that you make your companies pay the medical bills NOW. Otherwise, you are giving up a valuable right. For example, let's say that both you and your husband have medicals totaling nearly $50K, as you state. Unless the other side has very high policy limits, what you have done is to allow your own auto and health insurance companies to cheat you out of some of that money the tortfeasor's company should be paying into YOUR pockets.
You MUST get those bills paid by YOUR OWN insurance, be it auto or health insurance. Hence, the fact that they are not at all being paid by your insurance is a real problem that an attorney must work on right away. If your own first party insurance refuses to pay you MUST file complaints with the state insurance commissioner
You paid for auto or health insurance, so USE IT. If they do not want to pay, ask your attorney about immediately filing a complaint with the state insurance commissioner http://www.settlementcentral.com/links.php
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FOURTH, you need to learn about policy limits claims and how to preserve your rights to make a claim versus your UIM, and also how to defend against subrogation. Directory of Legal Information http://www.settlementcentral.com/page0451 htm Liability Insurance Policy Limits Settlements in Personal Injury Insurance Car Accident Claims.
In one simple claim, we can teach you how to do this, but you have a few claims, all with competing interests, so an attorney is best to handle this for you. The point being: you have to jump thru a couple of hoops in order to make a policy limits settlement whilst preserving your UIM rights and the opportunity to fight subrogation.
Of course I have no idea whether or not your family includes any children. But on the chance that children were involved, I invite you to learn about insurance settlements for children.
You cannot settle these claims for your child without a court review. That is because the personal injury claims of minor children are usually subject to review of a court and the settlement awards must be invested in a blocked account.
That does not mean that parents must always hire an attorney; parents are allowed to negotiate the settlement. And www.SettlementCentral.Com includes instructions for minor claim settlement procedures on a self-help basis. BUT the court approval process will require an attorney. The key here is for the parent who negotiates the settlement to MAKE THE COURT APPROVAL PROCESS THE DUTY OF THE INSURANCE COMPANY.
In other words, just before the parent agrees that the claims are settled, she will make sure that she has also demanded that the insurance company MUST, AT ITS SOLE EXPENSE, obtain court approval.
The expenses for attorney fees must be approved by the court, so even if you did hire an attorney to represent your children, there will be a court review process at the end to ensure that the fees the attorney proposes to charge your children are reasonable.
The claims of minors for personal injuries suffered are strictly controlled. Attorney fees are CONTROLLED BY THE COURT, not the attorney. Parents must invest the funds in the name of the child in a blocked account. Injury claims of minors http://www.settlementcentral.com/page8017.htm insurance settlement procedures.
AS for your direct question, you would include the actual full bill from the hospital and any other medical care providers, just as it was issued, not as it was paid. Hence, that will usually be the larger amount.
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
