QuestionI was in a car accident back in November 25, 2005. We was in a 5 car accident. I was the passenger in the car who was hurt the most. My mother was the driver and had already settled and they only gave her medical expenses and about 1000.00 Pain and suffering. My Brother who was in the back seat didn't really have anything wrong with him but he still go like $1000.00. I have been going to the Chiropactor for my back, neck and Knee and the only thing that has really affected me was my knee. My back and neck is better but i was told i was going to have Knee problems until i get a bigger car to drive.
With my knee i can't drive no more than 45mins before i start to have aches and pains and it use to be i could drive for hours. All i do for my business is drive so it kinda affects my business.
The Insurance company is getting a settlement offer together and i was just wondering what would be a reasonable amount to ask for.
So how should i handle it?
AnswerDear Gary,
Knee problems ARE FOR LIFE. DON'T SETTLE TOO SOON. It has only been eight months—that is nothing at all in terms of putting a stress test on a bum knee. You need to get a bit of your summer activity on it to see how it holds up.
Keep good notes as to how it reacts with this first summer post accident. Note those nagging pains at night after some physical activity you used to do before your knee was injured.
GET AN ORTHOPEDIC SURGEON TO EXAMINE YOUR KNEE IF IT IS INTERFERING THAT MUCH WITH YOUR DRIVING LIVLIHOOD.
Use your own PIP or health insurance to go and see an orthopedist. DO NOT TELL HIM YOU ARE COMING IN TO HAVE HIM WRITE A REPORT TO HELP YOU WITH YOUR PERSONAL INJURY CLAIM BECAUSE HE WILL THEN MAKE A "POISON PILL" REPORT, which will not support your claim.
Instead, tell him about the accident, tell him about your livelihood and how your knee interferes with your driving.
ACT INTERESTED IF HE TALKS ABOUT SURGERY. That doctor is not there to hold hands with those whose knees hurt. He makes his money cutting on people, and so if you want the full good treatment, then you have to ACT LIKE YOU WILL GO FOR A SURGERY IF HE RECOMMENDS IT.
Then, you can later ask for his medical chart and a copy of type written office notes will tell the insurance adjuster that you have a serious knee problem.
Much as we like chiropractors at our website, you need a medical doctor to address a knee problem, ESPECIALLY WHERE YOU NEED A DIAGNOSIS AND A PROGNOSIS FOR FUTURE PROBLEMS.
NOW, on to your question regarding valuation.
VALUATION COMPUTATION AND FACTORS THAT INFLUENCE VALUATION
Gary, no valuation of your claim is possible with so little information. How would I even guess your state of residence, or what other pain problems you had, or may have, or the amount of your medical bills, or your lost wages or work productivity, or the prognosis of future knee problems that you have not yet obtained in writing??
Until you get a typed office note FROM A MEDICAL DOCTOR, NOT A CHIROPRACTOR, with a full prognosis for your knee, it is WAY TOO EARLY TO BE THINKING ABOUT VALUATION OF YOUR CLAIM. What if you go through a course of chiropractic treatment and then get better, only to have aggravation six months later and end up at a pain clinic eventually? There will be no one to pay for your treatment or continued pain if you settle too soon.
THAT kind of chronic knee injury I would not wish on anyone, but I have handled a number of like injuries that would just not go away, either because of the initial severity or because of the load put on the body by the daily work of the injured person. In your case, you need to ask for a lot more money because your knee is ESSENTIAL TO YOUR DAILY WORK.
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 the website "how much is my personal injury claim worth" http://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.
Next, the seriousness of the injury, and of course, whether or not the injury can be proven by objective evidence (that nerve conduction study), or whether the only proof is subjective (your statements that you feel pain).
LONGER ANSWER:
Here are some of those factors:
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 component, but if applicable, add it on too.
NEGOTIATING AMOUNT—what to ask for: 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 plus for your claim as you cannot be negligent.
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.
LAST "SIDEBAR" TIP:
Communicate with the adjuster in writing, showing your own analysis of value. It is fine to speak over the phone, but have your ammunition in writing to give to the adjuster. Take the time with your correspondence to show that you care enough about this claim to do a spell check. Otherwise sloppy writing can be a sign to the adjuster that you could also be a sloppy historian to the doctor. And hence, your medical record would be a little suspect.
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.
http://www.SettlementCentral.Com
