Question
dr settlement:
thanks for your candor... i rated your answer, and mentioned the same... i do have the nolo (how to win) and dan's online book.... i've done quite a bit of research, and put off getting an attorney, but you've spurred me on to make an appt... thank you for the negotiating tactics with fees!
Q: i'm assuming you mean my own "under"-insured motorist policy.... how exactly does that work when you're basically talking about excess "pain & suffering"? is that basically, my insurance co will try and make me a "go away and stop bothering me offer", rather than go to court? and then subrogate thru the other insurance co?
again, thanks....
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Followup To
Question -
involved in an auto accident, in which a young lady ran a red-flashing stop sign full speed into my right of way. absolutely nothing was left of my truck (after hitting her, i was turned and t-boned into the vehicle coming the other way--the pictures are horrendous). left the hospital that evening with a fractured pelvis, two fractured ribs and enormous amounts of bruising (from the seatbelt, et al). spent two months out of work, first month confined to a recliner. later on, found a blood clot in my injured side shin. spent 6 months on blood thinners. unfortunately, my veins in that shin are shot, and i have to wear a compression stocking for the rest of my life (cuz my shin swells). $14K in lost wages, 22K in medical bills (including about $4K for compressions stockings).....
Q: how does the "disability" that i now have come into play? how would you evaluate my case in $$? when i run the #'s, best case scenario, it's around $140K (that i'm assuming an atty would try for). policy limits are $100K, and obviously, i'd rather not go to trial or hire an atty, cuz i'll get less than what it's worth after paying out. thing is, i assume they won't pay out policy limits unless i have an attorney and force the issue. is there any leverage i have to use during settlement without an attorney?
Answer -
Dear Greg,
Sorry, but you NEED AN ATTORNEY ASAP.
Even thouigh we operate a website for people to make policy limits claims on a do it yourself basis, I think our concept will not apply here.
We think that self-help is great when the policy limits are an obvious "push". For example, if the limits here were just $50K, then you could do this on your own and make your own underinsured motorist (UIM) claim on your own insurance.
But when there is far more at stake and the limits are not going to be given away, one needs professional help. At this level, your failure to make a well documented case will hurt you in both the third party claim and your own claim.
In other words, there are things an attorney might have you do right now that will enhance the value of the claim. But since you do not know, you will miss that opportunity.
Here is an idea: take the evidence and policy limits info to the attorney and negotiate a fee of less than one-third inasmuch as there is NO RISK TO THE ATTORNEY.
Tell him you could get an offer of $50K just by putting a note in the mouth of a blind dog and sending him to the adjuster. Thus, try to get the first $50K exempt from fees. Or go for a lower overall fee of something like 20%.
Those tips can save you thousands of dollars and still you will have the professional help that you need.
If you insist on going forward on your own, either join our site or buy both of the books from nolo.com and dan baldyga (caraccidents.com?)and get some assistance that way.
As for value, one has no idea of how to place a value given no information on the critical issues. Furthermore, we are not authorized to place valuations. Instead, in a policy limits case, I will tell you to ask for a lot more than the limits for two reasons.
First, no one is going to pay $100K if they think the claimant only values the claim at #110K. Second, your demand letter to the third party will also be the basis of your own UIM claim, and since the third party limits are deducted first from the total value of the claim, you want to leave plenty of room above the $100K to negotiate your own UIM claim.
Best wishes,
Dr. Settlement, J.D. (Juris Doctor)
www.SettlementCentral.Com
Answer
Dear Greg,
Thanks for the nice comments in the feedback forum. I will see if I can earn the praise you gave me!
You are asking four questions about UIM claims, plus I have a separate topic for you regarding narrative reports.
First, what do we call UIM?
Yes, we DO use the terms interchangeably, but you are right: uninsured is when there is no insurance, and underinsured is your situation. Both are covered under your UIM provisions.
Second, you asked about subrogation by your company against the third party award. USUALLY, you will want to get that third party award taken as all yours (i.e. none going to subrogation) BEFORE you settle with the third party.
What? Those two books you bought for self-help insurance claims don't have good through instructions on this UIM and subrogation topic? Pity.
Looks like we need to add UIM and subrogation instructions to this page that shows how SettlementCentral.Com far exceeds nolo and baldgya in providing the most thorough information on personal injury claims. http://www.settlementcentral.com/page0036.htm
You can get a flavor of what the steps are on our free side, but all the details and forms are on our members' side. Here is the free info on personal injury insurance policy limits http://www.settlementcentral.com/page0451.htm
In summary, it will be up to you to get your company to waive subrogation (for the reasons stated). Since your company may not have a good idea of how much they stand to lose in a UIM payment when you are dealing with the tortfeasor, we usually like to get the third party settled first, and that includes the waiver of subrogation. (Unless, as pointed out, your company wishes to "buy out" the settlement, pay you the third party limits, and sue the third party directly--rarely done.)
Third, you kind of made light of the UIM process "is that basically, my insurance co will try and make me a "go away and stop bothering me offer", rather than go to court?"
NO, YOUR OWN COMPANY WILL FIGHT YOU TOOTH AND NAIL just as hard as the third party carrier will fight. AND, in fact, if you have one of the growing number of companies that have done the dirty sneaky deed in your policy terms, you may be forced to go to a jury trial for UIM. Do you have the right to choose arbitration in UIM? Is your company deceiving you with a clause that removes your rights to arbitration?
Please check your policy to be sure that your carrier does not reserve the right to a jury trial in its UIM disputes.
The tricky little phrase used in policies issued in recent years was to the effect that "disputes hereunder will be resolved by arbitration, unless either of the parties elects to have the dispute resolved as in other civil matters".
You probably would not see anything wrong with that phrase, but it is deceptive in its apparent innocence. It is a powerful tool and will ONLY benefit the insurer. Forcing UIM claims into a jury trial format (instead of arbitration) is nothing but losing proposition for you. Very much more difficult and expensive than the universally-used three member panel UIM arbitration of years past.
http://www.settlementcentral.com/page8008.htm
So, that is why you want a good solid third party demand letter up front, with a lot of money in the demand column. You will be sending that to your own insurer along with notice that you will pursue under your UIM, plus your request for waiver of subrogation.
Fourth, you wondered "how exactly does that work when you're basically talking about excess "pain & suffering"?"
Look, Greg, you have a LOT MORE AT STAKE than just some pain and suffering to date. You stand a chance of future problems with calcification and other complications in the future.
Your injuries will have their own life. And it is up to YOU to get your doctor to make a good solid prognosis regarding the prospects of future problems. NOTE: it is not good enuf for him to say that there is the "possibility" of this or that future problem: instead, he has to say that it is "more likely than not" that you will suffer such and such problem in the future.
Finally, my new topic: CONSIDER USING A DOCTOR'S NARRATIVE REPORT to assist in settling the insurance claims.
You might want to consider the use of a good narrative report on those future medical problem topics in order to raise the value of the claim.
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.
Well, that is about it for your claim. Best wishes with it, Greg
Dr. Settlement, J.D. (Juris Doctor)
www.SettlementCentral.Com
