QuestionI was involved in an automobile accident in March 2006. Both vehicles were totaled, and I was injured by the airbag.
The other party's insurance accepts full responsibility.
The adjuster has been very pleasant to deal with over the past year.
Four of my front bottom teeth were knocked loose and moved several millimeters. For weeks, I had to hold my teeth steady whenever I sneezed, because the teeth were so loose that the force would move them, and it was quite painful. I could not bite down with my teeth and was unable to eat very much. I was pregnant at the time, and not being able to eat caused me to become anemic.
I had a lot of pain, but worse than the pain was the nerves of all of my teeth being on edge. I also began having severe headaches. The muscles in my neck and upper back were so much in knots that by June, I was having difficulty breathing. This was not a lung issue but due to the stress and tension in my muscles. I did see a chiropractor once but was not able to go back at the time because I was just so large from the pregnancy. I have begun seeing a chiropractor and massage therapist in the past couple of months.
My most extensive injuries involve my mouth and teeth, though. I saw my dentist the day following the accident and an oral surgeon and an orthodontist soon after that. They all agreed that the only way to repair my mouth is with braces.
Treatment could not begin, however, for several months for two reasons. One was that the orthodontist said it would be irresponsible to start moving the teeth around until they had a chance to settle down and the extent of the damage could be assessed. Secondarily, since I was pregnant, X-rays could not be taken. I have had periodic visits for the orthodontist to monitor the situation.
After finally being able to do X-rays and a thorough evaluation, the orthodontist sent me to an endodontist, who determined that two of the teeth are dead and will require root canals to begin with. The orthodontist believes that I could end up having to have those teeth extracted, but right now, the effort is to try to save them if possible. The orthodontist is also referring me to a periodontist, because my bottom gums receded significantly during the past year, a result of the trauma. Also, the orthodontist informed me that I will require a full set of braces and that I may have to wear them for as long as 22 months. He added that before they come off, I will need oral surgery to complete the treatment and get my mouth back in proper working order. I have always had excellent dental health. A few fillings were the extent of work that I have ever needed. I did wear braces on my teeth for two years as a teenager, and I am less than enthused about having to endure that again. My dentist had taken a full set of X-rays six months before the accident, so there is no question that all of this is from the accident and not a mouthful of teeth that were already falling apart.
I am already a year into this without treatment even being started, so obviously, my treatment time will last long past the time that the statute of limitations (2 years in my state) runs out.
I have three questions.
1. Is it feasible or even wise for me to settle this on my own, which is what I've been planning to do? Or will I essentially have no choice but to hire a lawyer and sue in order to protect my rights since my treatment cannot possibly be completed in the timeframe given?
2. Since I don't know the other party's policy limits, how can I decide if hiring an attorney will merely eat up as much as 1/3 of any award or would be more likely to help me to get a more fair settlement than I might be able to negotiate on my own?
3. If it makes sense for me to settle it myself, how can I make sure that there is provision enough for expenses that could end up exceeding the original estimates, and how do I handle the issue of possibly losing two of my teeth? I understand that you can't offer an amount, but what method should I use to begin to arrive at an amount that is fair?
Thank you in advance for any advice that you can offer.
--Eleanore
AnswerDear Eleanore,
I am sorry to hear of your serious injuries. Hopefully your reconstructive work will all turn out OK and you will not have any residual damages.
As for your question, you did a good job with all of the details you gave me and you did an excellent job of focusing on the three important issues. I will answer all in depth, but for now let me just respond in one sentence.
You can and should settle this claim yourself ON CONDITION that the tortfeasor has policy limits of $50,000 or less; otherwise, you need to get an attorney and to provide for lower fees in the event of an easy policy limits settlement.
First things first: while you CAN settle the claim yourself—or get some good offers on your own—BUT NEVER LET IT DRAG ON TO WITHIN FOUR MONTHS OF THE STATUTE OF LIMITATIONS without getting an attorney involved. http://www.settlementcentral.com/page0452.htm
POLICY LIMITS SITUATION—try to get cooperation from the tortfeasor’s adjuster by offering to settle for the policy limits (subject, of course, to the concurrence of your Underinsured Motorist (UIM) carrier.
Consider a POLICY LIMITS situation for the tortfeasor, resulting in an Underinsured Motorist Claim (UIM) against your policy. Why would you need an attorney to get at low hanging fruit that will be picked easily without much work?
What if the tortfeasor has coverage of only your state minimum insurance liability policy limits http://www.settlementcentral.com/page8008.htm? Look up the state where the tortfeasor resides to see what the minimum liability insurance policy limits are. It looks like most states require only 25/50. That means that $25,000 is the bodily injury liability for one person in an accident, and $50,000 is bodily injury liability for all people injured in an accident. Thus, if the tortfeasor has just the minimum, then $25,000 would be all that is available to you.
Given the medical costs and pain and suffering of your claim, the value is in excess of $100,000, and you might be able to get that on your own. But for now, let’s just use $50K as a limit for the tortfeasor, since you ought to be able to get that amount without any legal help.
If that were all the insurance that is available, then you likely would be in a policy limits situation if your dentist and the specialists are attributing all of these problems to the accident. Take a moment and become familiar with some of the issues in policy limits insurance claims http://www.settlementcentral.com/page0451.htm
POLICY LIMITS—SETTLE OR SUE AND GO AFTER TORTFEASOR'S ASSETS?
SECOND, figure out whether or not this tortfeasor has any assets that are in excess of your state's exemptions for bankruptcy. The tortfeasor can discharge your judgment in bankruptcy (unless he was committing a crime such as DUI at the time). He gets to claim as exemptions some value in his home, some limited value in his car, some tools, some cash, etc.
But, as to the rest of the assets, they are subject to execution to satisfy your judgment. In other words, you get to sell them and take the proceeds in partial payment.
But, if he is driving an older car or lives in a not-too-upscale neighborhood or has just minimal state policy limits, what are the chances that he has any real assets that you could go after?
If you want to take a crack at it, contact an attorney. If not, proceed to settlement, BUT MAKE SURE YOUR OWN INSURANCE Underinsured Motorist (UIM) claim is protected by giving them notice of your settlement.
HANDLING YOUR OWN TORTFEASOR AND UIM CLAIMS TO SAVE THOUSANDS OF DOLLARS ON DO IT YOURSELF BASIS, especially in a easy case such as this one.
If your UIM policy has limits of $50,000 or less, and if you are competent to read and send mail, I would consider handling the UIM myself. They will pay the FULL POLICY LIMITS INSURANCE SETTLEMENT to you without anything more than your demand letter and your medical records. Why should you pay someone one-third to do what you can do yourself? Do-It-Yourself Personal Injury Claims; Eliminate Personal Injury Attorneys' Fees; Save Thousands of Dollars Settling Your Own Insurance Claim http://www.settlementcentral.com/page3011.htm
WHAT ABOUT HIRING AN ATTORNEY FOR PART OF THE SETTLEMENT?
Yes, you can and should use an attorney when you get a serious defense to your claim. You can contract for a fee by the hour, not to exceed $1,000 if limits are $25,000 or less and not to exceed $2,500 if the limits are $50,000.
I would make the attorney an offer of that as a basis, with fees of twenty-five percent of settlement achieved from $50K to $100K, and fees of one-third for all settlement monies above $100,000. Does that make sense?
Let's say you settle the tortfeasor’s limits at $50,000 and you have $100,000 policy limits of your UIM available to you on top of that. In some states you get to claim the full $100K in a UIM claim, but since in many states, the insurer gets to deduct the tortfeasor’s limits from your UIM, be sure to check with your insurance commissioner http://www.settlementcentral.com/links.php
For our purposes, pretend that you have $100K UIM available. And assume that you do your own work and get an offer from your UIM insurer of $50,000. You can contract with an attorney to go after the remaining $50,000, leaving your $50,000 in your pocket. The fees to get the remaining $50K will be higher, probably the full one-third or a bit more because the attorney knows that she is going to have to fight harder for that part of the claim remaining.
Thus, you could go it alone just to get an insurance settlement offer from your own company, and then take that insurance settlement offer to a personal injury attorney, thus exempting the amount of the offer from her fees. Do It Yourself Personal Injury Settlement Offer Reduces Personal Injury Attorney Fees http://www.settlementcentral.com/page0109.htm
You need to read up a bit on policy limits claims. There is nothing you cannot handle yourself, including a subrogation reduction letter to your own insurance (PIP or health, or both).
You can learn how to do this yourself, BUT ONLY FOR THE EASY PART OF THE CLAIM. Directory of Legal Information Liability Insurance Policy Limits Settlements in Personal Injury Insurance Injury Claims http://www.settlementcentral.com/page0451.htm This stuff is not rocket science, but it does require some reading and some work on your part. Still, the savings in a big and obvious claim such as yours is tremendous.
FINAL TOPIC: Effective communication with insurance claims adjusters. Establish Firm, Professional, and Positive Relationships With the Insurance Injury Claims Adjuster http://www.settlementcentral.com/page0059.htm
Always communicate with the adjuster in writing, showing your own analysis of value. It is OK I guess to have one call or so, but no more. Always have your information and ammunition in writing to give to the adjuster.
Let him know that you are FIRM IN YOUR RESOLVE to get what you are demanding (NOT "asking", since that invites a counter-offer, but instead "demanding" as fair and reasonable compensation) by asking him what the options are to resolve the matter fairly should he not agree to a reasonable claim value. In other words, let him know that you will go through with a court filing if need be.
Remember these tips, do your homework, print out your evidence, show resolve to get your fair settlement, and you will DO JUST FINE.
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
