Questionwhat is considered a fair settlement with medical expenses totaling 10,000, loss wages totaling 4,000 and still having shoulder pain following the accident and it occurred in march of this year? what are the time limits on settling? after a claim settlement amount has been set and no check received is it considered final?
Answer
Verbal Agreement to Settle Insurance Injury Claim Enforceable?
Contract to settle insurance injury claim
Terms of agreement to settle claim
Overview Tort Law Personal Injury Legal Claims
Valuation personal injury insurance claim
Factors influence valuation bodily injury claim
5 Easy Steps to Do-it-Yourself Insurance Claim Settlement
Eliminate Personal Injury Attorneys' Fees
Doctor narrative reports settle insurance injury claims
Relationship Insurance Injury Claims Adjuster
Write to insurance settlement adjuster
How to deal with insurance claims adjusters
No phone calls insurance claims adjusters
Dear "syjcruiser"
You have asked two questions: (1) what is my injury claim worth; and (2) is the agreement to settle an insurance injury claim binding if the check has not been cut or sent to the claimant.
Let me answer the second question first, inasmuch as that may obviate the need for you to read any further. It sounds to me like you may have already agreed to a settlement but that you are now having second thoughts and in the true spirit of those with "buyer's remorse", you are seeking for me to tell you that your settlement amount was just right or too high or too low.
As you will see below, I cannot address specific settlement values here inasmuch as the various bar associations consider that to be the practice of law. Furthermore, it would be malpractice suicide for me to offer any value estimate without meeting with the claimant and reviewing all medical records.
But I can address the question of whether the parties to a settlement agreement are bound.
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
(1.) Can a Verbal Agreement be Binding in an Insurance Injury Claim Settlement?
Yes, a verbal agreement to settle a personal injury claim is a binding contract, PROVIDED that all the elements of a contract do exist.
Here is the background. A contract of compromise is binding on the parties because compromises are favored in all states as tending to prevent litigation. I know of no rule of law which places it in the power of either party to an insurance compromise, to disregard it, if it was formed in accordance with basic contract principles.
Here is what is needed to make a binding insurance settlement agreement, even if it is only verbal. The formation of a valid contract requires an offer encompassing all essential terms, unequivocal acceptance by the offeree (the one who is accepting the offer), consideration, and an intent to be bound.
So, the valid offer to settle must encompass all essential terms, such as the total amount and how it will be paid and how the subrogation liens will be paid. Whether it is you or the insurance company that is the offeree, there cannot be any question about being bound by the agreement.
Sometimes settlements can be set aside if, for example, some material issue was not agreed upon, such as who is to pay the subrogation claim. Sometimes the terms of payment or the amount or the need to cover future medical expenses are not reasonably certain and one of the parties can claim that there was not a "meeting of the minds" as is essential to form a contract.
Absent any of the defenses raised above, an agreement to settle is enforceable. Does that mean you cannot challenge it if you do not like it? Think of it this way: you can challenge it all you want and make arguments to avoid the settlement UNTIL the insurance company tells you that they are going to sue to enforce the agreement. THAT is the time to cut the best new deal you can since it is possible for them to get some attorney's fees and costs should they prevail.
But if you do have some grounds to avoid the agreement, then go ahead and write to me again, and I will help to organize your arguments so you can try to negotiate a higher award.
Now, assuming that you have not already settled or that you will get a second chance, I will give you some pages to read to help you to make your own personal injury claim on a do it yourself basis. So, if you have not already done so, let's start at the beginning.
Xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
(2.) Learn about how to submit and settle your own personal injury insurance claims—DO IT YOURSELF 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
Managing Medical Care After Auto Accident: http://www.settlementcentral.com/page0203.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
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
Responding to Settlement Offer From Insurance Claims Adjuster http://www.settlementcentral.com/page0244.htm
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
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
(3.) VALUATION COMPUTATION AND FACTORS THAT INFLUENCE VALUATION
"syjcruiser", 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). Here you have a serious amount of medical expenses, so that would tell the adjuster that your injuries were on the more serious side.
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. Undergoing a shoulder surgery and rehabilitation is highly compensable.
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.
WHERE DO YOU GO FROM HERE? Given all that above, I would think that what you are now missing is a good solid narrative report to tie things together and to get you some future medical costs added in at this time.
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
(4). New topic: CONSIDER USING A DOCTOR'S NARRATIVE REPORT to assist in settling the insurance claims.
Have you seen any of the doctors' records that went to the insurance adjuster? If not, it is easy enough to get a copy so you can make sure that everything of importance you discussed is included therein IN READABLE FASHION.
Cryptic notes may be medically significant, but why make the insurance adjuster struggle to figure out the significance of the injuries? A narrative report or letter spells things out so the adjuster can see, read, and understand the doctor's diagnosis and prognosis and her record of the problems and pain and suffering you have endured.
Plus, narrative letters can tie together the trauma and its after-effects in a way that is authoritative.
We recommend that claimants almost always include some type of typewritten medical information to accompany to computer coded medical records and/or handwritten records. That is the first clue as to when to use the narrative report: if you are asking the adjuster to evaluate your claim on the basis of handwritten records and/or computer coded records that indicate diagnosis and treatment codes, then you need to supplement the record with a narrative report.
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.
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
(5). 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
