QuestionWithout the assistance of an attorney, I filed an auto accident claim against USAA after I experienced lower back pain after being rear-ended. My medical expenses totaled $873 and I asked for $3,400, but they are only offering me $1,400. I based my settlement sum on a previous claim against Geico about two years ago where my med bills were $1,200 and the insurance company paid $3,900, with the assistance of an attorney. USAA has examined the medical records from the previous claim, but those records indicate that my primary injuries were my neck and middle back area, not my lower back. USAA has said that their offer is fair and if I can't justify any loss wages or any additional medical treatment they see no reason to offer me more money. Should I keep counter-offering?
AnswerDear Rick,
Don’t take the following bawling out too personally: most people have no idea how to settle their own claims until they get some guidance, which I will provide below. But first, let’s look at the kind of information you provided. Your question is impossible to answer in that I have no idea about your injuries, your treatment, your prognosis, or the way in which your injuries interfered with your life.
If you did the same kind of job in failing to communicate these things to the insurance adjuster as you did here, then you probably do not deserve any more money. They don’t hand out settlement awards of any substance unless they are convinced that there is some good reason to do so.
It is the claimant’s duty to carry the burden of proof, and there is nothing presented in your question upon which one could even guess at the seriousness of your injuries. Thus, it would be malpractice to venture any advice whatsoever inasmuch as I could be 180 degrees off if your injuries have the possibility of bothering you for years in to the future. Low treatment costs do not mean the injury is not long term; if depends upon the type of treatment you had.
You are in essence asking me whether or not you should fight USAA’s excuses for a low-ball offer of settlement or roll over and let them have their way with you. The insurance industry did not become the wealthiest in America by paying fairly on claims: they did it by screwing over as many people as they could. Don’t you be one of them IF you were injured and still carry some residual pains.
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#1. IF YOU ARE TOTALLY HEALED, SETTLE NOW.
Of course, maybe you have no residual pains at all and you can mow your grass and sweep the driveway and all of the other physical activities you used to do with no problems whatsoever. In that case, just make a token counter-offer and be done with it. In your counter-offer you can threaten to file the claim in small claims court if you want. They might toss in some more—BUT it would be better if you did the following.
A better counter offer technique would be to add in a witness statement first, see what they say, and THEN approach the small claims court threat. Witness Statements Settle Personal Injury Insurance Claims http://www.settlementcentral.com/page0196.htm
On the small claims threat, it is best for you to actually spend the $50 to commence the litigation. The forms are easy to complete, or you can always ask me for help if you get stuck. The defendant is not supposed to be allowed an attorney, and you should strongly resist if the insurance company moves to allow counsel for the defendant.
Once you either fill out the form—or better yet file it—then you can expect the insurance company to make a substantial increase in their offer.
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# 2. IF YOU SUSPECT LONGER TERM CONSEQUENCES OF YOUR INJURIES, DO NOT SETTLE NOW.
You know, Rick, since you have had two accidents now, your body has been subjected to enough trauma to subject you to a potentially long term soft tissue injury. I would be hesitant to settle too soon. Unless you are close to the statute of limitations, I would take your time and see how you respond during the coming season when you will be spending more time with outside physical activities.
Thus, UNLESS you are ABSOLUTELY CERTAIN that you will not feel the aches and pains of your injuries after physical activities, I want you to consider sending in a “thanks-but-no-thanks” letter and just see how things go for the Spring and Summer.
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# 3. DO NOT SETTLE YOUR CLAIM UNLESS YOU ARE ABSOLUTELY CERTAIN THAT YOUR SOFT TISSUE INJURIES WILL NOT REAPPEAR ONCE YOU STRESS YOUR BODY WITH PHYSICAL ACTIVITIES. That Plays Right Into an Insurance Tactic Regarding Inducing Early Settlement of Injury Claims.
Let's just finish up this topic of early settlements so you get the full picture of the advantage to them and the risks to you. Insurance companies like to settle early because the general damages—claims for pain and suffering—are always minimal, but continue to grow with continued medical/therapeutic care over the months. Therefore, the insurance adjuster will try to settle before your claim merits a larger pain and suffering element. This makes good sense for the insurance company. A claim that is still active after 12 months, with an injured claimant still undergoing treatment, will settle for a lot more pain and suffering money than a claim that is settled after two or three months of treatment.
In serious soft tissue cases, which this COULD BE if you aggravated an earlier stress on your lower back, the full extent of most injuries is not known immediately after finishing one early round of treatment, because the injured person has to undergo some of the wear and tear of everyday life, including the pounding his body will receive from a day's work. Even jobs that appear not to be physically demanding can be hard on an injured body.
For example, have you ever stood all day with few breaks, as a store checkout clerk or a jewelry salesperson does? Or sat all day at a computer, as a secretary or phone service center employee does? Many jobs will interfere with healing, and you have no way to know how your body will respond until you have experienced sufficient physical exposure to load-test the scar tissue as you heal.
Plus, who will pay for your medical care incurred AFTER you settle? What if you were to settle now and three monts later when you mow the grass and the pain starts to become too much, you go to a chiropractor only to discover that you can expect a course of treatment that will cost a lot of money?
After you settle your claim, all further treatment is your responsibility. Except in specific, unusual situations, you cannot go back and re-open a settlement: when you cash the check, you agree to close your claim in all aspects. Check with your PIP adjuster to find out whether they will pay anything once you close the claim against the tortfeasor.
Here is another page from my website that shows in detail why you should never make an early personal injury insurance claims settlement http://www.settlementcentral.com/page0211.htm
And, of course, once you settle, THAT IS IT: no one will be there to pay for your future medical or chiropractic care; nor will you ever see another dime in pain and suffering money. By the way, did you know that getting an early settlement is a favorite trick of the insurance adjusters? Please see my website wherein we show Insurance Claim Adjuster Secret Tactics http://www.settlementcentral.com/page0092.htm
There may be a dull ache at night following some physical activity or pain the next morning. DO NOT LET LITTLE PAINS GO UNATTENDED SINCE YOU DO NOT KNOW WHETHER THEY WILL CONTINUE OR GO AWAY. We all hope and believe that such little pains will disappear soon. But on the other hand, we have no way of knowing since this is the way serious soft tissue injuries can behave.
So, when this happens, even if a couple months or more post-treatment, do not hesitate to SEE A DOCTOR AND ATTRIBUTE THE PAIN TO THE ACCIDENT WITHOUT EQUIVOCATION. It is NEVER TOO LATE TO REPORT PERSONAL INJURIES FROM A CAR ACCIDENT http://www.settlementcentral.com/page0104.htm
According to Our http://www.SettlementCentral.Com Members, Chiropractors are Most Effective in Severe Whiplash and Soft Tissue Car Accident Injuries http://www.settlementcentral.com/page8010.htm
Managing Medical Care After Auto Accident: http://www.settlementcentral.com/page0203.htm
"No medicine: no money"; medical costs increase worth of personal injury insurance claims http://www.settlementcentral.com/page0045.htm
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#4. USE WITNESS STATEMENTS: USE NARRATIVE LETTERS FOR YOUR “SECOND-SALVO” RESPONSE TO THE INSURANCE ADJUSTER
Rick, if you are OK and want to settle now, just use the small claims route to shake a few more bucks from the tree. If possible, you might also want to consider use of witness statements and/or a narrative letter.
If you want to delay settlement, then send the adjuster a letter telling him that the amount is insufficient, THAT YOU ARE RESCINDING YOUR SETTLEMENT DEMAND, and that you will see how your back responds to the coming season of physical activity. THAT TECHNIQUE in and of itself is a powerful statement; he will have to explain how and why he lost the chance to settle at the level you were asking.
Here is some information on witness statements and narrative reports.
Witness Statements Settle Personal Injury Insurance Claims http://www.settlementcentral.com/page0196.htm
We have a lot of free legal tips on insurance claims settlements using doctor narrative reports http://www.settlementcentral.com/page8003.htm You can get information there as to how to ask for a narrative letter and what it might cost. Talk to the doctor's office manager about it.
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#5. DEMAND LETTER—COMMUNICATE IN WRITING
I want you to be an effective communicator of your demand for settlement. Don't just call up the adjuster and start discussing your demands. Instead take the time to make your own demand letter—that is one step that will really pay dividends for you. I cannot tell whether or not you sent a formal demand letter. But it is best to think about that now if you did not.
Write Effective Personal Injury Insurance Demand Letter http://www.settlementcentral.com/page0170.htm
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#6. 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
