QuestionMy wife broke her heel bone in an accident that was determined to be the other driver's fault (in the police report and by both ins. companies). Surgery was required and she has been nonweight bearing for over 2 months. We are now entering the middle stages of her recovery and were wondering which medical cost should we use to formulate the demand letter when that time comes? The hospital bills for her surgery list two amounts: the billed amount ($112,000) and the negotiated amount ($14,000). This is not the only med bill she has. There is another $15,000 in other med costs so far. Also, this whole thing happened a few weeks before our wedding and although we were able to still get married, it impacted both the wedding and our honeymoon. Is she entitled to compensation? Finaly, after doing some investigating, this seems to be a pretty big deal. Would it be in our best interest to get an attorney?
AnswerHi Frank,
You didn't mention the date that the accident occurred.
Every state has a Statue of Limitations on settling an injury claim.
If you live in Tennessee or Kentucky, that limit is one year. The majority of states allow two years, a small number allow 3 or more.
If there is adequate time left on the statue of limitations, this is something that you can easily help settle without an attorney.First built two identical files containing copies of each and every medical bill (the actual amounts paid) not the billing amount.
(The high billing amount vs a lower negotiated amount is a ploy used by the hospital for tax write-off purposes.)
Any ER visit bill, CT scan or MRI, any prescription drugs, Physical Therapy bills and a log of the round-trip mileage for each and every doctors visit, trip to the pharmacy,and trips to physical therapy @ $0.43 per mile and any documented wage losses. Total the actual expenses and multiply by 3.2. Your wife should make a written demand for this amount and within this demand, also demand that the adverse insurance company respond within 10-15 days. She will include on copy of the file of bills with her demand so the company can thoroughly review her expenses. They are required by law to respond with an offer within the time frame that she has stipulated within the demand. I'm sorry, but she is not entitle to recovery for inconvenience. The insurance company will respond with a low offer of probably 2 times her losses. You now have two separate amounts on the table and the negotiation process begins. This could take from one to several months. The insurance company will slowly increase their offer and your wife will slowly lower her lower her demand with a counter offer. Expect to settle this loss for anywhere 2.5 and 2.75 times the expenses. If she has not settled this claim within 16 months (assuming that your state has a 2 year statue of limitations, it's time to have a consultation with the very best Personal Injury Attorney in your area.
In practically all states this first consultation is free.
She will need to take this second file of expenses along with any written offers of settlement to the attorney.
After this consultation, she will be better able to decide if she wants to retain the attorney. The attorney works on a contingency agreement which allows him to deduct his expenses of the top and then retain 33% of the remaining balance as his fee, or 40% of the remaining balance if the case goes to trial. If you retain an attorney, be sure he has trial experience. The majority of personal injury attorneys have never tried a case in front of a jury and are willing to settle for an amount less than the true value of the claim to avoid a trial.
I trust that my answer has been of help. Please write again if I can be of more assistance.
Your feedback to my answer will be greatly appreciated.
Sincerely,
Bennie
San Francisco Bay Area 10-30-07 2:20 PM PST
