QuestionDear Experts,
We were rear ended by another vehicle. It will reach the two year mark this year and we have to settle with the "at fault" ins co. Can the adjuster change the settlement amount after the settlement has been agreed to and a release signed? Why were the bills owed not just paid by to the providers and Ins co instead of taking that from our final offer after the fact. It seems like it is a sneaky tactic. Is there anything we can do?
Thanks,
JRene'
AnswerHI Rene’,
It sounds like you may be locked in on an agreement that you do not like, and you would like to get out of the settlement. Yes, there MIGHT be a way to do that, if the terms were misunderstood to the point that there was not a “meeting of the minds” in contract terms. BUT that is a lot easier said than done because our laws favor the certainty of contracts made, and the proof of misunderstanding must have some basis in fact OTHER THAN inattention to the details of the agreement.
Insurance personal injury claims Dr. Settlement knows and insurance settlements we teach at our site SettlementCentral.Com. Even if you never visited our site or did any research into personal injury claims, I have empathy for you because this IS a complex area and it sounds like an adjuster may not have explained things as well as he should have. Hence, I am going to give you at least an hour of my time in order to let you know where I think you stand, and what you need to tell me in a response so we can work together to get you better situated.
Let’s go back to the beginning of your question and address each topic raised. It sounds like you may need to write to me again ASAP with more facts, as I will set forth below. I am going to segregate your question into four parts and comment on each. Since I do not know how to make my text differ in appearance from yours, I WILL START MINE IN ALL CAPS, OK?
#1. “We were rear ended by another vehicle. It will reach the two year mark this year and we have to settle with the "at fault" ins co.”
COMMENT: IT APPEARS THAT YOU HAVE NOT YET HAD MONEY DISBURSED, BUT APPARENTLY YOU HAVE SIGNED A SETTLEMENT AGREEMENT, is that correct, Rene’?
Second question: were you represented by an attorney? That could make some difference and may provide a small avenue for relief is she did not explain things to you.
#2. “Can the adjuster change the settlement amount after the settlement has been agreed to and a release signed?”
COMMENT: NO ONE CAN UNILATERALLY CHANGE THE AGREEMENT ONCE IT HAS BEEN SIGNED. But both parties can increase the amount, if that is your goal. You are not clear here since I am left to wonder what exactly is going on, so please fill me in on this with your response.
#3. “Why were the bills owed not just paid by to the providers and Ins co instead of taking that from our final offer after the fact.”
COMMENT: AGAIN, I AM LEFT TO WONDER WHAT IS HAPPENING. IF YOU WERE TO USE YOUR OWN INSURANCE FOR PAYING THE MEDICAL BILLS, then that amount would be owing to your insurance out of the settlement amount. This would have been a subrogation claim by your insurance company against your award.
But from your question, my thought is that nobody paid the bills. This is a common third party tactic to put pressure on the victim to settle early. In this case, I am left to guess that you left it to the third party to pay the medical bills. Whether they paid the bills before settlement or paid them from the total of the settlement makes no difference.
This is one reason I wanted to know if you had an attorney since she should have explained that the total settlement amount MUST ALWAYS include the medical bills. For example, if you incurred $5,000 in medical bills, and you agreed to $1,000 in lost wages and travel expenses to the doctors, and $14,000 in general damages (pain and suffering), then your total settlement is $20,000. If the tortfeasor’s insurance company paid the doctors just as the bills came due, then they would still include the $5,000 in the settlement total. If they did not pay the bills, but ask you to pay them (or, as is more likely the practice, withhold the $5,000 and pay them as part of the settlement process), then the $5,000 is still part of the settlement total: $20,000.
#4. “It seems like it is a sneaky tactic. Is there anything we can do?”
COMMENT: THIS IS PROBABLY THE STANDARD PRACTICE IN THE SETTLEMENT OF INSURANCE CLAIMS. It is up to the claimant to ascertain how to proceed in an insurance claim, and either they get an attorney or they use a site such as ours for insurance injury claims www.SettlementCentral.Com free legal information. Although serious claimants will become members of SettlementCentral.Com, we do have enough on our free site to provide claimants basic information on how the insurance injury claims work.
If you had an attorney, it sounds like she needed to do a better job of clearing up what the settlement amount includes. When you write me in response, let me know whether you had an attorney so we can get the facts of her comments on the record between us and I can help you go from there.
#5. If you did not have an attorney, but proceeded on your own, then that does not mean you are out of luck. What I would like to know is precisely what communications between you and the adjuster led to this settlement. My guess is that the adjuster said (as in the example above), I am willing to settle at $20,000. You were thinking that the $20K was going to be A NET figure, AFTER they paid the medical bills. It is possible that there could be grounds to set aside the settlement agreement, but we do not have the facts known at this time.
When you respond, make ALL of the details known, especially the amount of medical bills, whether any were paid, what is owing, the amount of the settlement, etc.
What is it that you WANT to do? It sounds like you want to set aside the settlement agreement and try for more so that the amount you discussed for settlement is a net amount, with the medical bills added on to that, correct?
Have you asked the adjuster to rescind the agreement? Maybe he will do so. But if he does agree to set it aside, then you can bet he is NOT going to roll over and add the medicals to the total. And if he does not pay the medicals, as there is no obligation to do so, will they go to collection or some other adverse consequence against you?
An attorney might well see a LOT LARGER settlement than what you agreed to, and might be willing to get involved with your claim. She could get a settlement that would include her fees (a contingency percentage—usually one-third) and still net you a goodly amount. OR she might not be able to raise the settlement much at all.
If the adjuster is not willing to rescind the agreement, let me know that as well. Maybe there are sufficient grounds to write a letter showing the basic lack of agreement on account of his failure to fully explain how the settlement amount was calculated. He DOES have some basis duty to make things clear and not play “hide the ball”.
Let me know the answers to my questions, Rene’ if you want to go further on this case.
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
medical bills, settlement agreement, settlementcentral.com, insurance claim
