QuestionI was recently hit by an uninsured motorist who did not obey my right a way in an intersection. I was however insured for up to $50,000 by my own insurance company against bodily injury incase of this scenario. I was wearing my seatbelt but still ended up with multiple contusions, whip lash and a broken rib. I will be out of work for about 6 weeks. My insurance company tells me, I can claim my lost wages, all my medical bills and also the pain I suffered. Is there a standard $ amount for pain? How can I tell what my pain is worth?
Thank you for your time!
AnswerSmart way to buy auto insurance
Uninsured Motorist Coverage (UIM) Insurance Claim
Policy limits insurance settlement
Policy limits insurance claim— Uninsured Motorist Claim (UIM) against your policy;
UIM arbitration or jury trial?
Do I have the right in UIM claim for arbitration?
UIM dispute resolution arbitration or jury trial?
Managing Medical Care After Auto Accident
Overview Tort Law Personal Injury Legal Claims
Do-it-Yourself Insurance Claim Settlement
5 Easy Steps Self Help Insurance Claim Settlement
5 Easy Steps to Do-it-Yourself Insurance Claim Settlement
Insurance claim valuation; how much is my claim worth?
Valuation computation personal injury claim
Factors influence valuation bodily injury claim
Do NOT settle your personal injury claim too soon
Dear Regine,
I am sorry I left town for a trip and didn't see this on the website waiting for me. Hope you did not suffer from my delay in seeing this upon my return. Maybe I can make it up to you by spending some extra time to introduce you to the concepts that you need to know in order to settle your own personal injury insurance claim.
I have structured your answer in to eight separate topics to allow for easier access and referral as you proceed in the claims process. It seems that you do not have a clue about things, so I am going to give you some homework to do.
Now, Regine, please don't get all discouraged and think that this is way to complex. For example, the topic #2 seems to be a little complex, so just ignore it for now. Pass it by until much later when you are ready to submit your demand letter. Plus, if you have any questions on any of this stuff, all you have to do is just ask me again.
Really it is simple to present your own claim: just set aside a little time every now and then to read up on some of the info I am going to present. Pick and choose what makes sense to you! Here, then, are your eight topics:
1. About your UIM insurance limits—good consumer kudos.
2. About your UIM insurance dispute resolution—does if FORCE YOU INTO A JURY TRIAL—or can you choose arbitration if you desire?
3. Learn a little about Uninsured Motorist (UIM) cases.
4. Arm yourself to deal with the insurance claims adjuster: learn about personal injury insurance claims and insurance settlements.
5. Why not take a shot at making your own personal injury insurance settlement instead of hiring a personal injury attorney?
6. Do NOT settle your soft tissue personal injury claim too soon.
7. Valuation computation and factors that influence valuation.
8. FINAL TOPIC: Effective communication with insurance claims adjusters.
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
1. About your insurance—good consumer kudos to you for BUYING INSURANCE SMART WAY WITH HIGH UIM LIMITS
You were very smart to buy a good limit on your UIM coverage. Now the job we have is to go for it and to get a full value for your claim. Take a quick look at some of the other considerations in the smart way to buy auto insurance and maybe there is additional coverage you have not thought of. Again, thank yourself for ALWAYS thinking ahead: there are a lot of drivers who waived any UIM insurance.
Here are a couple of background pages to read up on insurance as you have the time. The Smartest Way to Buy Auto Insurance http://www.settlementcentral.com/page8006.htm
Also consider the information regarding high UIM coverage in Smart Protection Auto Insurance http://www.settlementcentral.com/page8008.htm
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
2. About your UIM insurance dispute resolution—does if FORCE YOU INTO A JURY TRIAL—or can you choose arbitration if you desire?
Do you have the right to choose arbitration to resolve a UIM dispute? Or, did your company include a little clause that removes your rights to arbitration?
THIS IS VERY IMPORTANT BECAUSE IT AFFECTS YOUR ABILITY TO RECOVER FULLY AND THUS IMPACTS THE VALUE OF YOUR CLAIM.
Without calling the attention of anyone to your inquiry, maybe do two things. First, please check your policy to be sure that your carrier does not reserve the right to a jury trial in its UIM disputes. I will tell you how to check below.
The second thing is to call anonymously to a sales agent or to claims (without identifying yourself) and ask whether or not the company can force an insured who is claiming under UIM to undergo a jury trial or whether you have the right to arbitration.
Why is this so important? Because if you are forced to go through a jury trial your claim will not be worth as much in settlement value. The reason for that is because in a jury trial there are a lot of extra expenses and impediments to easy resolution of the claim.
Here are some good reasons why you do not want a jury trial (as opposed to arbitration) to resolve your uninsured motorist claim.
• First, you will have to pay to use the court system. You must file the lawsuit, and you will have to serve it (although they will likely accept mail service).
• Second, there is likely a much longer wait (currently one and a half to two years is common) for you to obtain a jury trial date than there would be to put together an arbitration panel of attorneys. Who wants the delay? The insurance industry makes a lot of money on investments, whereas you will always need the cash to make up for some of the problems caused by the accident. So they want the delay.
• Third, it is tremendously more expensive than any other forum for resolution in your time and your costs. In arbitration, you can submit medical records to be read by the arbitration panel, and perhaps call just one of your doctors. You will pay for any time your doctor has to spend in preparation and testimony, so you will want the less formal proceeding (such as arbitration) because her fees will be a fraction of those at a jury trial.
• At a jury trial, you must present some live testimony from your doctors. (Although some records can be admitted without the doctor present, attorneys usually want the doctor present to speak to the jury; whereas at UIM arbitration, the attorney knows that the panel of trail attorneys will have some familiarity with the medical specialty, medical terms, prognosis, etc., and your attorney therefore can simply admit the records and argue from them.)
• The jury testimony of your doctor is expensive, because you will likely pay their full time away from the office, including courtroom waiting time, regardless of the results. It is a delay of a year or two, depending upon your jurisdiction, and it takes a much greater effort to succeed with higher risks than at arbitration.
• Therefore, the company knows that you are more likely to compromise and accept a lower award than if you went to arbitration. So please consider this an important issue in how you value your claim and in your strategy to achieve a settlement.
How do you find the clause in your own policy? Look under the section entitled "disputes" or something similar to that. Here is the most popular version of the poison pill clause, so look for something like this:
"disputes hereunder will be resolved by arbitration, unless either of the parties elects to have the dispute resolved as in other civil matters".
How are disputes resolved in "other civil matters"? By a jury trial! So much for all the insurance industry hype about easy to read policies, right?
You probably would not see anything wrong with that phrase, but it is deceptive in its apparent innocence. It.
That phrase is a powerful tool and will only benefit the insurer because it gives the insurance company the right to a jury trial in resolving your UIM dispute with your own company, even if you wanted to go to arbitration. If you and they disagree, you will NOT HAVE THE RIGHT to arbitration; they will just tell you to go file a court action. And the insurer will always ask for a jury trial.
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
3. Learn a little about Uninsured Motorist (UIM) cases.
Directory of Legal Information Liability Insurance Policy Limits Settlements in Personal Injury Insurance Injury Claims http://www.settlementcentral.com/page0451.htm
Read that page for information on how to proceed with your UIM claim.
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
4. Arm yourself to deal with the insurance claims adjuster: learn about personal injury insurance claims and insurance settlements.
Here is a series of pages that you can review. Take what makes sense to you and don't worry about the rest. Just get a flavor of how the system works without spending a ton of time right now.
Overview Tort Law Personal Injury Legal Claims http://www.settlementcentral.com/page3000.htm
Medical Care Documentation-the Key to Successful Personal Injury Insurance Claim Settlements http://www.settlementcentral.com/page0217.htm
Keys to a MAXIMUM INSURANCE INJURY CLAIM SETTLEMENT http://www.settlementcentral.com/page0089.htm
Outline of questions to be expected from insurance claims adjuster http://www.settlementcentral.com/page0190.htm
Detailed listing of questions to be expected from insurance claims adjuster http://www.settlementcentral.com/page0207.htm
Responding to Settlement Offer From Insurance Claims Adjuster http://www.settlementcentral.com/page0244.htm
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
5. Why not take a shot at making your own personal injury insurance settlement instead of hiring a personal injury attorney?
DO IT YOURSELF INSURANCE CLAIM SETTLEMENTS
Do It Yourself Advantages, or do these claims need an attorney? As for an ATTORNEY, this does not seem to be a case that involves any legal issues in dispute nor any large or complex damages. 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
Without having to join my website, I have given a lot of free information on handling insurance claims without having to join as a member. Read the module at "5 Easy Steps to Do-it-Yourself Insurance Claim Settlement" http://www.settlementcentral.com/page0102.htm
This stuff is not rocket science, but it will take some effort on your part to read and cut and paste letter examples and to communicate. But hundreds of people are doing it each day, and they are getting good results.
What if you get only two-thirds the way to your settlement goal? Well, you can get as big a settlement as you can and then turn it over to an attorney and save a lot of fees. Thus, you could go it alone just to get an insurance settlement offer, 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
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
6. DO NOT SETTLE YOUR SOFT TISSUE PERSONAL INJURY CLAIM TOO SOON. The rib and the contusions tell me you may have also suffered some deep soft tissue injury, which can be lit up months after ending treatment. Wait until you have gone through your usual physical activities.
I am worried that if you were to go through even half of your usual activities, you will start noticing pains at night or the day following physical activity.
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
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
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
7. VALUATION COMPUTATION AND FACTORS THAT INFLUENCE VALUATION—you value your UIM claim just the same as you would for the claim against the tortfeasor.
In fact, your insurance company kind of steps into the same position as the tortfeasor, and it has all of the defenses available to it as the tortfeasor might have used against you. Examples would be such things as "assumption of the risk", "last clear chance to avoid the accident", "comparative negligence", etc.
In direct answer to your question, yes, you do get reimbursed for all provable lost wages and medical bills. Of course, if you had a health care provider pay for your medical bills, then they would likely be claiming subrogation against your award since their rights to go after your settlement from the tortfeasor.
Regine, in the first place, we are not allowed to give legal advice here, and some bar associations have taken the position that evaluating personal injury claims is the practice of law. Furthermore, how could one possibly give any feedback with such limited information? Even if you hired an attorney for valuation, she could never venture an estimate so little information.
Valuation is not like going to a drive-in for a fast food meal. It takes time and study of many factors, including of course liability and medical records, but also an evaluation of the plaintiff—what kind of person will she present to the jury is a most important consideration (i.e. is she credible, does she elicit empathy, etc.).
So, I have a short answer and a longer more detailed answer for you.
SHORT ANSWER: A common theme among those who still think a formula will put you in the valuation ballpark is to multiply the medical specials times a number from ONE to FIVE (depending upon factors, some of which I will give you later—or all of which are listed in the members' side of my website, www.SettlementCentral.Com). Then that figure is the total value of the personal injury portion of the claim. Of course there is a long list of factors to consider for adding or deducting from the total.
LONGER ANSWER:
Here are some of those factors (as set forth in MORE DETAIL IN the members' section of http://www.SettlementCentral.Com Dr. Settlement's website):
There are changes in the formula approach, DEPENDING UPON SERIOUSNESS OF INJURIES.
The typical formula approach you mentioned to determine the value of general damages, i.e. pain and suffering, permanent disability and emotional damages, is to multiply the amount of the MEDICAL specials by a factor between 0.5 and 3 if the injuries are relatively minor or continue less than one year, or by a factor of 4, 5, or more when the injuries are very painful, serious, long-lasting or permanent. You have mentioned the lost income component, so it is added on at the end.
Once the computations called for above are completed, add another 50% of the total to determine the starting amount for beginning negotiations on the total value of the compensation due you on your claim.
Here is a listing of factors that will affect both the multiplier you will use, as well as the value of the claim inasmuch as they will increase or decrease the product of your multiplication.
1. LIABILITY DISPUTE & comparative negligence
This is a big one because it most dramatically affects value: minus if you have any fault.
2. Trauma suffered
The value of your claim increases with a bigger crash, and decreases with a low damage fender bender. Why? Just human nature.
Therefore, the total value of the property damage (e.g. cost to repair or replace a motor vehicle) becomes significant.
3. Medical special damages
Cost of medical and related health care expenses; higher costs usually equate to an increase in value (excepting, of course, cases of gross overtreatment).
4. Type of injury
Where does the injury fall within the insurance industry's "hierarchy list" of valuing injuries? Irrespective of which injury may cause more pain, injuries are valued according to seriousness, tendency to be persistent or permanent, and whether or not they need objective proof to be believed (e.g. a broken bone versus soft tissue strain).
5. Type of medical care
Where does the medical care fall within the insurance industry's "hierarchy list" of valuing medical care? Orthopedists at the top, chiropractors near the bottom.
6. Prognosis- future care—permanency of injury or pain and suffering—or were you done treating 4 months ago?
Your claim value gets a boost if your doctor specifies that you will need some future medical care.
7. Your medical and claims history, prior accidents, prior injuries or treatment of the same area of the body.
8. Impairment of quality of life.
9. Quality and persistence of pain suffered.
10. Quality and thoroughness of your medical records.
11. Lost wages.
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
8. 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
