Auto Insurance Claims: Auto insurance claim settlement, auto insurance claim, uninsured motorist coverage

Question
My husband and I were rear ended on the freeway, the other driver was going 65mph, was found to be 100% at fault but didn't have insurance. I was about 6mnths pregnant and was admitted to the hospital for three days because of concerns about my contractions and going into preterm labor. I ended up being fine and my baby was fine as well (I have not given birth yet so we are still unsure if she is 100% ok) i was put on a modified bed rest for a few days after. The hospital bills totaled to 13316 and my wage losses were $400, my health insurance covered 12316 of the medical bill. We had uninsured motorist coverage and my insurance sent a settlement letter saying that they would pay the $1000 of remaining med bill and the full wage losses. They calculated pain and suffering at $7000. My husband and I were thinking that insurance should pay out the full amount of the medical bill to us and not just the 1000 (We feel the cost should be paid in full by the auto insurance not my health insurance and if my health insurers try to recoup that loss then they will come after us and not the third party) We Also feel that the pain and suffering is worth 1.5 times the amount of the medical bill. Does our demand seem reasonable and how can we present this counter to the claims adjuster?

Answer
Jennifer,

Thank you for the question and I'm sorry this happened. It must be a disconcerting time for you and your husband. While I am not an attorney, and cannot and do not lend legal counsel, I can offer you the following personal thoughts and what I may do if I were you:

1.) While I would surely initiate negotiations with your insurer to get full entitlements under
   the terms of your policy, including:
        a. Full and proper settlement for the sustained collision damages (repair or total
         loss) If repair, a proper and thorough repair with factory parts. If totaled,
         sufficient funds to replace the vehicle you had, plus sales tax and tag and
         title/registration fees etc.
        b. Compensated for your 'Loss of Use' (if you didn't get a rental car or had out of
         pocket expense during the repair or the time without a vehicle in the event it was
         totaled.
        c. If repaired, after repair I would seek compensation for your loss in value
         otherwise known as "Diminished Value". ADE can help in this regard.
        d. Recovery of any other damages sustained such as lost wages, medical insurance
         deductibles etc.

Basically speaking, Un-Insured Motorist coverage is to place your insurer in the position of the at-fault party and for them to step in and indemnify you. Unfortunately, you and your insurer become adverse parties inasmuch as your needs are diametrically opposed to theirs wherein you want their money and they don't want to part with it!

With that said I would likely not make any final settlements or sign a "release of all claims" until such time as the baby is born and you and the baby are given a complete good health report.

I believe, if your health insurer comes after you for recovery, your insurer, again, standing in the shoes of the liable party, will be forced to resolve the issue under the Un-Insured portion and terms of your policy. This would call for a legal opinion which I cannot provide.

Also... because this is something you may not be readily familiar with, thus the reason you came here to ask questions, I would strongly suggest you seek legal counsel to assist you in the valuation of your damages and guiding you through the process.

Like entering a dense foreign jungle full of danger, you need an experienced guide to help you reach your destination and keep you safe. This is exactly what a good attorney will do.

Select a competent attorney based upon referrals and recommendations of others who have used them...don't select one merely because they spend allot advertising. You want one who will handle your claim on its individual merits...not one who handles high volume.

Just like choosing a quality body shop, selecting a competent attorney is a very important decision and it should not be taken lightly!

I hope this will help you to reach a full and satisfactory settlement.

Good luck and best wishes to you and your family!! If I can assist further let me know.

Barrett, Auto Damage Experts (ADE)