QuestionMy daughter was in a friends car that was rear ended and she incurred a back injury which requires a visit to a chiropractor a couple of times a week. She works part time for me and has missed some work because of it. She isn't in a lot of pain etc. but it is very time consuming etc. for her to take this treatment, which the insurance company has been paying for. What can I ask for in terms of a pain and suffering settlement that would be fast simple and wouldn't involve an attorney, etc. Friends have asked us if we got the standare 1500 dollar settlement for pain and suffering, but we have never dealt with this ever. Advice?
Answer
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Dear Notto,
I could provide you the easy answer: ask for $7,500 in general damages and settle for $3,500. But what sense would that possibly make? I know nothing whatsoever about your daughter's accident, her injuries, or her prognosis. Plus, since this is a public answer, it would be grossly misleading to others who seek information by reading archived answers.
If her claim is minor, as your post seems to indicate, just take the advice above and submit the claim. On the other hand, if there is a possibility your daughter did sustain a substantial trauma, you may wish to invest some time to read on. I have no choice but to invest a lot of time in this because from lack of information presented to me, there are many possibilities. Thus, for my part, it is my duty to lay out the full scenario just in case this could be a more serious injury.
I have handled dozens of cases of soft tissue injury to teens and young adults. Two things have been pretty common in those cases. First, the young adult or teen is not "into" focusing on her injury in the sense that it could be something that needs some care. They are, after all, invincible in their eyes.
It is not cool to be seen as still hanging on to treatment months after the accident, especially when the other kids in the car wrapped up their treatment early on. Second, they invariably fail to report pain accurately, and thus they tend to terminate medical treatment too soon.
It is frustrating for the parent, but also for the attorney, who can see that this is the type of soft tissue injury that will not just go away. We always try to get thru to the teen or young adult and encourage them to take a look at the big picture whereby the injury that appears such a minor thing to them now can easily show up again six months after they quit treatment.
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DO NOT SETTLE HER SOFT TISSUE INJURY CLAIM TOO SOON.
I know that you did not ask about this, but premature settlement is the primary mistake made in the case of soft tissue injuries to teens and young adults. Yes, I know that kids never want to drag things like this out, especially when they have to go to the doctor. But please try to let things go for some time so you can see how your daughter reacts to physical demands of her daily life, her work, and her recreational activities.
And by the way, if she should quit treatment for some time and feel fine, but four months later complain of pain again, BY ALL MEANS RETURN TO THE DOCTOR AND MAKE SURE HIS RECORDS reflect that this is the same injury.
I am sure the third party adjuster who has been paying the bills will not be happy to pay a bill for such delayed treatment. Thus, OPEN A CLAIM WITH THE FRIEND'S Personal Injury Protection (PIP), or use your own insurance to do that.
Why have you asked for a solution that would be "fast and simple"? By this, I presume you are telling me that the injuries to your daughter are not all that serious. If that is the case, read no further, but just do as I suggested above and submit the claim for $7,500.
On the other hand, if there was any significant impact in the accident, then you may wish to read further to see the advantages of giving her some MORE TIME to live with injuries, and thus to also get a better doctor work-up of medical aspects of claims. THAT work-up in and of itself, will increase the value of the claim.
And, of course, once you settle, THAT IS IT: no one will be there to pay for your daughter's future medical care; nor will she 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
Managing Medical Care After Auto Accident: http://www.settlementcentral.com/page0203.htm
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VALUATION COMPUTATION AND FACTORS THAT INFLUENCE VALUATION
Valuation is not like going to a drive-in for a fast food meal. It takes time and study of many factors, including liability and medical records. The "rule of thumb" is just that: a gross estimate.
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 TWO 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.
Let's start with geography. Values differ from state to state, and within each state. City values are often different than rural values on claims.
First is the liability question. In this case, there can be NO DEDUCTION for liability since your daughter was a passenger: if the third party contends the friend was partly to blame (i.e. it is becoming more common for adjusters to "invent" defenses in rear-enders, such as alleging that the victim's car actually hit a car ahead of her first, thus causing the first injury—can you believe the nerve?), then she will just make a claim versus both policies.
Next, the seriousness of the injury, and of course, whether or not the injury can be proven by objective evidence (for example, if the doctor has x-ray proof or a muscle spasm), or whether the only proof is subjective (for example, your daughter's statements that she feels pain).
Seriousness can be shown by the use of Witness Statements Settle Personal Injury Insurance Claims http://www.settlementcentral.com/page0196.htm
Does she have friends or family who can attest to how the injury impacted her life?
The quality and quantity of medical care is also important, as are the records of the doctors.
I am going to give more factors that we look at in valuing a personal injury insurance claim in my LONGER ANSWER, as follows:
Here are some of those factors (as set forth in MORE DETAIL IN the members' section of www.SettementCentral.Com, Dr. Settlement's website):
There are changes in the formula approach, DEPENDING UPON SERIOUSNESS OF INJURIES.
The typical formula approach in determining 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 1.5 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 not mentioned the lost income amount, but if applicable, add it on too.
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—no problem here, as noted above. But for other claims, 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 was your daughter done treating 4 months ago?
Her claim value gets a boost if her doctor specifies that she will need some future medical care.
7. Her 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.
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CAN A PARENT SETTLE THE INJURY CLAIM OF A MINOR CHILD?
If your daughter is an adult, skip this part. But since you did not state her age, it is my duty to you and to other readers to let you know about this part of the claims process in the case of those who are minors.
Personal injury insurance claims for minors; GAL and COURT APPROVAL process
A parent may NOT SETTLE her child's personal injury claim UNLESS it is small, or until a court approves the settlement AND the investment protection for the funds. The reasons for that are sound, and if you want you can read an exposition on the entire process to settle minor insurance claims http://www.settlementcentral.com/page8017.htm Guardian ad Litem (GAL) will interview you and your daughter, investigate the accident facts, review the medical records and talk to doctors, write what is called a "GAL report", and present it to the court. The order will be entered and filed with the clerk. Thereafter, the GAL may become involved in setting up the "blocked accounts" in their names, or verifying that the funds were disbursed as ordered by the court.
But to summarize here in my answer, if your daughter does have a very small claim, it can be worked out with the insurance company to settle the claim yourself, to sign the release yourself, and to guarantee the settlement for the security of the insurance company.
The insurance company will forego the court approval process only on SMALL insurance settlements, and ONLY if the parent gives it a hold harmless agreement in exchange (i.e. to protect the insurance company should the minor later try to repudiate the insurance settlement agreement and release). But this is unusual, inasmuch as the insurance adjuster is instructed to get a full and effective release of the claim.
Since there are examples of former minor settlements being reopened when done without court approval, most adjusters do not have authority to let a parent sign a release on behalf of her child unless the claim is very small.
Plus, who is to guarantee that the parent will invest the proceeds in a blocked account for the minor instead of using the money herself to buy things that she would like her child to have but cannot afford on her own? That is part of the reason for a court process.
We believe that in many cases, parents CAN AND DO make good settlements of their child's insurance injury claim. There is no reason that a parent cannot negotiate a fine settlement for her minor child. The only catch is that the insurance settlement and the investment of the insurance proceeds MUST BE APPROVED by a court of general jurisdiction in your state.
It is possible for the parent, with guidance and proper forms, to present the case yourself for approval. However, in most jurisdictions, an independent Guardian ad Litem (guardian for the litigation—most often an attorney) will be appointed to review the settlement and report to the court whether the terms and conditions are satisfactory. THE GAL REPORT will NOT RECOMMEND approval of settlements if it does not include consideration of long term consequences to the child. If appropriate, the court will then give approve the settlement, issuing a formal order approving the settlement and requiring investment of the proceeds in a safe and prudent manner.
A common question from parents is whether or not the money can be used to buy something that the child really wants, but which the parent cannot afford. All the cases I have seen the parent's request to use the child's money is refused, excepting in two instances: first, where the child wants a car and has a job that is so far that he requires a car to get to and from the job; and second, where the child is in poor physical and mental condition and the expenditure would, according to the child's doctors, go a long way in cheering him up and thus promoting his healing.
Other than those two kinds of examples, the court is not going to allow any parent to use the child's money for any other purpose.
Read about Guardian ad Litem for the minor, his attorney's fees, procedures for court approval of minor insurance settlements, paying fees and court costs, and asking for insurance company payment of all fees and costs http://www.settlementcentral.com/page8017.htm
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CAN YOU DO THIS YOURSELF FOR YOUR DAUGHTER?
Absolutely, for most claims such as this you do not need an attorney, BUT YOU STILL DO HAVE TO PUT IN SOME WORK TO BECOME INFORMED.
Arm yourself to deal with the insurance claims adjuster: learn about personal injury insurance claims and insurance settlements.
Here is some easy reading for free to brush up on the tort system and to help you deal with the insurance adjuster.
Overview Tort Law Personal Injury Legal Claims http://www.settlementcentral.com/page3000.htm
Establish Firm, Professional, and Positive Relationships With the Insurance Injury Claims Adjuster http://www.settlementcentral.com/page0059.htm
"No medicine: no money"; medical costs increase worth of personal injury insurance claims http://www.settlementcentral.com/page0045.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
Write Effective Personal Injury Insurance Demand Letter http://www.settlementcentral.com/page0170.htm
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
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
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USE DOCTOR'S NARRATIVE REPORTS FOR MORE VALUE
Consider asking for NARRATIVE LETTERS to assist in settling the insurance claim.
Have you seen any of the doctors' records that will go to the insurance adjuster? If not, it is easy enough to get a copy so you can make sure that everything of importance your daughter and the doctor 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?
Plus, narrative letters can tie together the trauma and its after-effects in your daughter's life 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.
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. NOTE: as for the minor claims, any money you pay out of pocket for a narrative report is going to be reimbursed to you at time of settlement; it will be a deduction from that particular child's insurance settlement.
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FINAL TOPIC:
Always communicate with the adjuster in writing, showing your own analysis of value. It is fine to call him or her, but have your 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 on behalf of your daughter if need be.
Remember these tips, do your homework, print out your evidence, show resolve to get your daughter a 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 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
