Auto Insurance Claims: Head injury; post concussive syndrome; DO NOT settle BI claims too early, post concussive syndrome, urgent care center


Question
I was involved in an auto accident 2 days ago.The driver of the other vehicle ran a red light causing me to strike him with a fairly hard hit.He admitted complete fault to the police officer at the scene as well as a witness who told the officer what happened.The officer noted that I hit my head and that my neck hurt but did not ask me if I wanted an ambulance.Later on that day I became dizzy,developed a headache and my neck and shoulders began to hurt.I went to the Urgent Care center and was checked out by a doctor.He said I had cervical strain/sprain.I have been drugged up for the past few days as well as being in quite a bit of pain.I cannot move my head around,my back aches and I have headaches and dizzyness.Now here is my question.My car was a 94 acura integra,it is only valued at around 2,800.The cost of replacing it would be somewhere around 5,000 if I were to go buy it off a lot.The car was bought and paid for and I had no payments on it.Im afraid the insurance company is just going to try and give me just that amount.I don't want to sue them for massive amounts of money.Just what I believe would be a fair settlement.I believe 10 - 15 thousand would be a fair settlement.I just want to be able to buy another decent car and have no payments and be compensated for time off work,being without a car for however long this will take,medical bills and of course pain and suffering due to the fact this should not have happened in the first place and I had no fault in the accident whatsoever.Do you think 10 or 15 thousand is a reasonable amount to ask for when I talk to the adjuster?

Answer
Remember loss of consciousness
Report loss of consciousness
Loss of consciousness remembered later
Post concussive syndrome
Neuropsychologist post concussive syndrome
Never too late to correct medical records
Add to medical records afterwards
Never too late to correct medical records
Must correct medical records ASAP
DO NOT settle BI claims too early
Settling one insurance claim too early
Do not settle personal injury insurance claim too soon;
Research highest actual cash value totaled car
Most money totaled car high fair market value
Car Accidents: Totaled, Repair, Valuation, Your Rights
Insurance Claim Rights totaled car undervalued
Totaled older car
Repair with non-OEM parts
Repair with used parts
Salvage totaled vehicle
Higher actual cash value research





Dear Casey,

You present five major areas that are all quite complex, so I am going to have to put in  a lot of time to sort things out and to make some suggestions.  So I am hoping that you will also take the time to read what I am preparing for you.  The figures you suggest ARE WAY TOO LOW if you have any head injury.  Your continuing symptoms may be the sign of a post concussive syndrome, in which case your claim will have substantial value, well above the figures you suggested.

1. I am worried that you suffered a head injury and that the doctors do not even know it.

2. I want you to read up a bit on head injuries.

3. If you believe you may have suffered a head injury, then you MUST CORRECT your doctor's record NOW.  Do it in writing only.  Do not just tell the nurse; write to the doctor.

4. I want you to TOTALLY SHUT OFF ANY IDEA OF SETTLING YOUR CLAIM until you have been restored to health, or until you have a clear prognosis that you have reached maximum medical improvement.

5. I am going to give you three choices regarding keeping your car or researching for higher value.

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1. I am worried that you suffered a head injury and that the doctors do not even know it.

Let's start with two of your statements:
1.   the officer noted that you hit your head; and
2.   you have developed headaches and dizziness.

Those two areas needed more medical workup than you have given them (if your statement to me is complete with doctor visits).  The reason is that for the first one, you should have had a post concussive workup.  Please do some Internet searching on that term and see how many of the symptoms you may have had.  I bet you will be surprised.  

I bet you hit your head hard enough to temporarily lose consciousness, but that you never even realized it or mentioned it to the emergency room people.  Thus, it is not now in your medical records.  If this was the case, you should write to your doctors to tell them that you realize you did lose consciousness and thus you are updating your records.  (See my website below for contacting me and I will send you a letter from our members' side of our site.  Be sure to mention where we met so I will remember you.)

Doctors are not going to lead you by the hand through the consultations and referrals that they should be making unless you know enough about the injury you have to make the requests.  It is kind of a two way partnership that way.  

So I am guessing that you never had even one workup done for post concussive syndrome.  Am I right?

If after reading all of this you think you have even a few seconds where you could not recall, then PLEASE DO YOURSELF A FAVOR AND CORRECT YOUR RECORDS ASAP, AND ONLY IN WRITING.

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2. I want you to read up a bit on head injuries.

First is your long term health.  I have handled my share of head injury cases, and I can tell you that some of the description you gave to me is compatible with the symptoms of head impact from a serious trauma.  If you were my client, I would have sent you to a clinical neuropsychologist for a functional workup, including an evaluation of emotional impacts of the damage.  From what you mentioned, this has not been done at all.  Your medical doctors worked on the mechanical side of things, but the trauma you suffered to your head could have been severe, and I would be very surprised if you did not carry forward some functional problems.  

Here is some information from the Internet, and you may wish do find your own:

Signs and symptoms of a Concussion
The signs and symptoms of a concussion can be subtle and may not appear immediately. Symptoms can last for days, weeks or longer.
Your behavior, mental ability and physical skills all are linked to specific areas of your brain. The severity and side effects of a head injury depend greatly on which area of your brain was most affected.
Immediate signs and symptoms of a concussion may include:
   Confusion
   Amnesia
   Headache
   Loss of consciousness
   Ringing in the ears (tinnitus)
   Drowsiness
   Nausea
   Vomiting
   Unequal pupil size
   Convulsions
   Unusual eye movements
   Slurred speech
Delayed signs and symptoms may include:
   Irritability
   Headaches
   Depression
   Sleep disturbances, including insomnia or difficulty waking
   Fatigue
   Poor concentration
   Trouble with memory
   Getting lost or becoming easily confused
   Increased sensitivity to sounds, lights and distractions
   Loss of sense of taste or smell
   Difficulty with gait or in coordinating use of limbs
If you experience any of these signs and symptoms after suffering head trauma, see your doctor.
A concussion causes at least a temporary loss in brain function. Although losing consciousness is a common sign of a concussion, it's possible to suffer a concussion without being completely knocked out.

Headache immediately following a head injury usually clears after minutes or days but sometimes headaches may persist for months or rarely years. The long term headaches are called post traumatic or post concussion headaches.

One can understand why headaches may follow a moderate or severe injury to the brain such as a concussion (bruise) or laceration (tear). What has been more difficult to understand and has presented an ongoing controversy are chronic headaches following mild head injuries.

Mild injuries of the brain are characterized as a concussion (a brief disturbance of brain function causing loss of consciousness or transient difficulty in thought processes).

Because the neurological examination after mild head injury is normal and standard tests as well as imaging studies (such as MRI or CT of the head) similarly fail to reveal abnormalities, many thought that the symptoms following mild head injury were psychological.

But microscopic studies have shown disruption of the nerve fibers in the brain due to the stretching or shearing forces of the trauma. Other subtle changes have been noted in brain functioning.

The clinical features of post traumatic headache may vary from one individual to another. Most headaches would be now classified as chronic tension-type headache. These headaches are typically a steady ache affecting both sides of the head and occurring daily or almost everyday. They are of slight to moderate intensity but intermittently, upon this base of low grade headache bouts of severe or moderately severe headache may occur and these often are similar to, if not identical with migraine (one sided throbbing pain associated with nausea and sensitivity to light and noise).

Unfortunately people who experience post traumatic headaches also experience other symptoms of the post traumatic or post concussion syndrome. There may be other neurological symptoms such as dizziness, ringing in the ears, vague blurring of vision, psychological symptoms occur such as depression, anxiety, personality change, disturbance in sleep and impairment libido.

Finally people with the post concussion syndrome have changes in their mental functioning, primarily difficulty in concentration, inability to work efficiently and associated difficulty maintaining attention and retaining memory.

The treatment of post traumatic headache, as well as other features of the post traumatic syndrome is symptomatic. That is each symptom is treated individually because, unfortunately, there is no medication that will alter the underlying disturbance in the brain.

Most often treatment of the chronic tension-type headache consists of such medications as the tricyclic antidepressants (for example amitriptyline). These agents not only diminish depression but also decrease pain.

The periodic worsening of headaches, if they have characteristics of migraine, are treated with typical migraine medications (for example sumatriptan for an acute attack).

Non-drug methods of therapy are also advisable. Healthy habits should be encouraged by elimination of nicotine and alcohol, by recommendations for regularity with regard to sleep and meal time and by exercise at least every other day. Relaxation techniques may be helpful. These can be learned by biofeedback techniques as well as by such methods as medication.

Last by not least is attention to psychological factors. The family, friends and employer or teacher should be educated so the fact that headaches are not purely psychological but have a basis related to the disturbed structure and chemical functions of the brain. A psychologist may be helpful in teaching pain coping techniques and in treating the psychological symptoms that are part of the post traumatic syndrome.

Fortunately most headaches following head injury gradually taper off within the first 3 to 6 months. Even those unfortunate individuals who experience symptoms much longer can be helped


After a concussion, the brain needs time to heal. It's really important to wait until all symptoms of a concussion have cleared up before returning to normal activities. The amount of time a person needs to recover depends on how long his or her symptoms last. Healthy teens can usually resume their normal activities within a few weeks, but keep in mind that each situation is different. A doctor will monitor the person closely to ensure everything's well.

Temporalmandibular Joint Syndrome: TMJ
An adjunct of that head trauma is the possible displacement of the disc upon which your condyle rotates in your jaw joint.  That can be the explanation of some of your symptoms regarding headaches and general pain.  I am surprised that your doctor did not ask about this or have you see your dentist.  Check it out here:
http://norcalpt.com/jawjoint.htm
http://www.paulsethpt.com/excersises/unrestricted/headneck/tmj.html

http://www.mayoclinic.com/health/concussion/DS00320/DSECTION=2

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3. If you believe you may have suffered a head injury, then you MUST CORRECT your doctor's record NOW.  Do it in writing only.  Do not just tell the nurse; write to the doctor.

You MUST get this into your medical records.  All doctors must know that you hit your head.  All doctors must know that you had a brief period of loss of consciousness, presuming of course that you did in fact suffer a loss of consciousness, albeit a brief one.  

What is loss of consciousness?  You were asked that by the police and the first clinic, and you probably denied ever having a loss of consciousness.  That is the same for a great many head injury cases.

What you can do when you correct your records is to tell them that you thought a loss of consciousness meant that you blacked out completely for a minute or more.  Thus, since you did not do that, you figured that you did not suffer a loss of consciousness.  But in fact it later came to your attention that by loss of consciousness the police and the doctor were not discussion just a black out for a minute of more, but also any time, even of a few seconds where I was out of it and cannot recall what happened.

Then go on to explain what you hit your head on and the fact that you cannot recall a few seconds there.  Thus, it is not now in your medical records.  If this was the case, you should write to your doctors to tell them that you realize you did lose consciousness and thus you are updating your records.  (See my website below for contacting me and I will send you a letter from our members' side of our site.  Be sure to mention where we met so I will remember you.)

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4. I want you to TOTALLY SHUT OFF ANY IDEA OF SETTLING YOUR CLAIM until you have been restored to health, or until you have a clear prognosis that you have reached maximum medical improvement.

Let's say that you do not in fact have any long term brain issues to resolve.  You still have a serious soft tissue injury claim judging by the symptoms you present.

DO NOT SETTLE YOUR SOFT TISSUE PERSONAL INJURY CLAIM TOO SOON.  "Deep" soft tissue injury can be lit up months after ending treatment.  Wait until you have gone through your summer season with all if its physical activities.  

I know your car was hit with some pretty good momentum from the fact the damage will be so high.  And, of course, that trauma was passed along to your body, where the soft tissue injury was DEEP.

What that tells me is that your body may not have had sufficient time to heal from just passive treatment.  I am worried that if you were to go through even half of your summertime outdoor 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

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5. I am going to give you three choices regarding keeping your car or researching for higher value.

THREE IDEAS FOR COMBATING AN OFFER OF AN UNDERVALUED VEHICLE THAT THE INSURANCE AGENT WANTS TO TOTAL


Here is some general information on how to get the most value for your damaged car: Car Accidents: Totaled, Repair, Valuation, Your Insurance Claim Rights http://www.settlementcentral.com/page0007.htm

DO NOT "JUMP" JUST BECAUSE THE INSURANCE ADJUSTER IS PUTTING PRESSURE ON YOU.  The only time frames that are worrisome for getting a TOTALED CAR paid off are two:
•   They can terminate the rental that they gave you once they make a fair offer of settlement for your totaled car; and
•   If you owe money on the car and you are short for making the current payment, you might feel some pressure to get the settlement so the loan can be paid off.

Thus, you have NO OTHER INCENTIVE TO MAKE A BAD DEAL JUST TO MEET AN ARBITRARY DEADLINE.  Make sure you get the best deal you can, which may include a DECISION TO KEEP THE CAR, rather than let them total it.  

So, here are THREE CHOICES.  The first two deal with keeping your ride.  Many people elect to fight to keep their cars by using one of the following two methods.


A.) SAVE YOUR CAR FROM BEING TOTALED BY REPAIRING WITH USED and/or NON-Original Manufactures' Equipment (OEM) PARTS and STIPULATING TO IGNORE SOME COSMETIC DAMAGE.

Before we get started, have you thought about keeping your car? Many times people have put a lot of money into maintenance OR EXPENSIVE REPAIRS (i.e. new transmission) in a high mileage vehicle, and they KNOW what they have will work as reliable transportation for them.

So, rather than taking the low offer of cash and trying to find a vehicle that will be reliable, they put the money into fixing the wreck with used parts, leaving aside cosmetic damage (who cares if you drive a nine year old car with some bumps and bruises -- especially when that will reduce the repair bill a ton??).

So the first thing, if you are happy with the performance of your car, and/or if you have put a lot of money into maintenance or repair, as you have, would be to explore ways to keep the car.

Ask what the body shop would charge to repair your vehicle with USED and/or NON-OEM parts.  You can negotiate to leave some cosmetic damage showing to save money.  I would not be surprised to see up to 40% come off their repair bill in that case. If you have a car that was running fine, why not keep it, even if you have to drive around with some dents showing?

Find out the maximum amount that the insurance company will pay for repairs before they elect to total your vehicle.  Then arrange for your repairs to be done within that limit.  This is my first choice and better if you can make it happen.  If the adjuster still wants to total your car, then you have to go to the next step.


B.) BUY BACK CAR FROM INSURANCE COMPANY, REPAIR IT, RE-TITLE AND RE-LICENSE IT, AND KEEP IT.  YOU GET YOUR EQUITY, LESS THE SALVAGE VALUE THAT YOU PAY TO BUY IT BACK AND THE COST OF REPAIRS PLUS INSPECTION AND RE-LICENSING COSTS.

Here is one way to get the insurance adjuster at her own game.  Let's say that you value your car at $4,500, but the insurance adjuster, after considering the latest documentation you have to offer, values it at only $2,200.  Don't forget, that is her value BEFORE THE ACCIDENT.  

One would have to consider the amount of damage done in the accident to come up with a salvage value, but it should be a lot lower than the value before the accident, which the adjuster already told you was only $2,200.  So, before you decide to total the car, ask the adjuster what the salvage value would be.  That is the amount that the company will get for the car after the accident, in its post-accident state, without any repairs having been made.  In this example, depending upon the cost of the repairs, the salvage value could be around $300.  Hey, this is ONE advantage of having them give your car a low actual cash value: the salvage value should be pretty low!

NOW, if you were to pay that amount and then to set up the repairs to be done with USED and/or NON-OEM PARTS, and perhaps forgoing some of the strictly beauty finishing items, you could GET THE REPAIRS DONE FOR A LOT LESS THAN THE ESTIMATE GIVEN TO THE INSURANCE COMPANY.  

Plus, once the car is repaired, you will have to take it to the state patrol to be inspected as a salvaged vehicle.  You will need paperwork from both the insurance company and the auto body shop that confirms both the amount you paid for the salvage, the fact that you are authorized to title the vehicle, and a receipt for the work and parts from the auto body shop

In summary, people often make out pretty well by buying their car as salvage and by following the route listed above to repair and re-title the vehicle.

C.) THIRD, FIGHT THE ACTUAL CASH VALUATION WITH YOUR OWN RESEARCH AND COMMUNICATE IN WRITING.
Now, changing topics back to how to get that value up for the insurance adjuster, let's get started for you.  The first tasks are to get at the actual cash value and next throw out that outrageous offer that they made you.

But your own purchase price is not determinative.  You will need to muster a lot of other evidence, as suggested below.  DO NOT BE INTIMIDATED by the written "report" the insurance adjuster is likely using.  It is just a BS computer product that DOES NOT HAVE ANYTHING TO DO WITH REAL CARS IN YOUR LOCATION.  If you do your own research, you will be able to counter their so-called "report" with ACTUAL FACTS based upon real cars!

My favorite sites for valuation are www.Edmunds.com and www.autotrader.com.  They want to know your zip code, and then they ask for a range in miles to search. Don't limit yourself to your city: it is reasonable that someone could go up to 300 miles to pick up a used car. That way you will get a lot more information.  Be aware that you should pick the option "any distance" from your zip code.  You can use information from local papers, advertising flyers, car dealerships, and the Internet.

Be aware that the prices shown are the "asking" price, not the actual cash value.  But also be aware that the insurance adjusters have used a computer scan of sales that were at the trade-in value, NOT the actual cash value.

If you have made major item replacements, above and beyond normal maintenance, you need to document them and ask for a review of those extras.  For example, a rebuilt transmission or the like will add value to a used car. How about new tires or a new stereo system? The issue is: how much (if any) did they increase the FMV or actual cash value of the car. See this link and scroll to the bottom for more information on that topic.   Car Accidents: Totaled, Repair, Valuation, Your Rights http://www.settlementcentral.com/page0007.htm

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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