QuestionQUESTION: I was sitting at a stop light and was rear ended. The person that hit me has a large provider for insurance. The driver supplied me with his police and has 50,000/100,000 limits, the police reports the driver was at fault with witnesses and the company took full liability. The impaact was so hard that their vehicle was totalled and mine was pushed into the vehicle in front of me. I went to the emergency room and was released to my doctor's care, she referred me first to physical therapy and then to a Ortopedic doctor, he diagnosed me with a shoulder injury that required 6 weeks of physical therapy followed by surgery and physical therapy post surgery. The type of injury I sustained is something that will require life long treatment and pain, my medical bills are over $30,000 alone. I am a 34 year old very active male that won't ever be able to enjoy outdoor sports or activities the way I did before the accident. My insurance agent feels that I should be paid the policy limit of $100,000 for the settlement based on these facts, does this sound accurate in any way?
ANSWER: Most insurance agents are not very familiar with handling of complex claims. Their expertise is in selling and servicing policies, not claims.
A 50/100 policy means the policy limit is $50,000 per person and $100,000 per accident if there are multiple injured parties. So the max you can get is $50k from the other driver's insurer.
If you have Underinsured Motorist coverage, it may provide some extra coverage beyond the 50k. Check with the clam rep at your insurer.
If not, you should consider whether the at fault party has assets you could sue for. For example, if the value of your claim is $75k, you could sue the other driver for the $25k above his policy limit.
Without seeing all the medical records, I can't say for sure what the value of your claim is. In addition, this is a subjective thing and 2 experts may come back with different values. But my rough guess based on what you provided would be a value of about $75k.
Many people handle claims like this on their own. But there is risk involved in doing so without an attorney, as you might miss an important detail. But the cost of an attorney would likely be about 30% of the total, which would be a very large fee in your case, so your net might well be more if you handle on your own.
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QUESTION: My 20 year old daughter was also in the vehicle, but did not receive any medical attention. Could this be used toward my settlement or is it completely seperate? I do have $50,000 in uninsured on my policy, is it my understanding that I can use this as well? And I guess I am confused on who actually decides what my claim is worth and how do they decide? Thank you for all the information it is greatly appreciated.
AnswerMy 20 year old daughter was also in the vehicle, but did not receive any medical attention. Could this be used toward my settlement or is it completely seperate? -- No, her claim is separate from yours. And it appears she has no injury claim.
I do have $50,000 in uninsured on my policy, is it my understanding that I can use this as well? --In most states, this would equate to no Underinsured Motorist coverage for this loss because your 50k equals that of the at fault driver. Underinsured Motorist coverage applies when the at fault part has insufficient policy limits, and applies only as excess coverage after the underlying policy limit is exhausted. For example, if you had an 80,000 underinsured motorist policy, it would cover up to 30,000 as excess after the underlying limit of 50,000 was paid by the at fault driver's policy. In a few states, coverages from multiple policies for Underinsured Motorist can be stacked, providing more coverage. This applies only in a few states. You should ask the claim rep for your policy if you have any Underinsured Motorist coverage available.
And I guess I am confused on who actually decides what my claim is worth and how do they decide? Thank you for all the information it is greatly appreciated. --- This is a subjective process. The claim rep will evaluate your injury, medical bills, lost wages, pain, suffering, inconvenience, etc. He/she will consider prior trial outcomes for similar cases and then estimate a likely trial outcome for your claim if you filed a lawsuit. You should do the same. One of you makes an offer and then you negotiate a settlement. If you can't agree on a settlement, you file a lawsuit against the at fault driver, and the insurer provides a lawyer to defend the suit. In your case, it appears the process should be simpler as they will likely offer the policy limit of 50k. The main thing you need to decide is whether or not there is any other source beyond this 50k - like your policy or assets owned by the at fault driver.
