QuestionHi, Insurance company made first offer today for $18,000.00. Their insured driver ran a red light 8 months ago and hit me causing 11,000 worth of dental damage. I have suffered alot of pain and depression.I had asked for $200,000.00, that is with the future in mind. I think the offer is too low,should I say triple that amount and then we will talk or what ? thanks
Answer
Dear Beverly,
PLEASE HAVE NO FURTHER CONVERSATIONS WITH THAT ADJUSTER UNTIL YOU HAVE DIGESTED WHAT I HAVE TO SAY AND YOU PROVIDE ME WITH SUFFICIENT INFORMATION TO ANSWER YOUR QUESTION.
Right off the bat, the offer seems INANE. It is not even in the ballpark if my experience means anything.
But first, let's back up and talk about valuing a personal injury claim. Then we will discuss what additional information I need for you to send to me. Finally, we will discuss what you should do next.
You have asked me to comment on the value of your claim when I have absolutely no idea what it is about. You did not mention anything at all about your injuries or how they may have impacted your life, or what exactly have you been told about the future. Thus, I am left to wonder if your communication skills were also this poor in telling the adjuster how the accident has impacted your life. If so, I cannot blame the poor adjuster, since you give no details in your communication.
The value of a personal injury claim is not like ordering up a part from a automobile dealer. It just is not that simple. I hope you will read the following and then you will provide me the information you think will fit into the various categories.
You can come back here to allexperts.com and answer me, or you can write to me in private at our website on personal injury insurance claims self-help http://www.SettlementCentral.Com Just make sure if you write to me in private that you mention allexperts.com so I will remember you and where we met.
VALUATION COMPUTATION AND FACTORS THAT INFLUENCE VALUATION
First of all, it could be WAY TOO EARLY TO BE THINKING ABOUT VALUATION OF YOUR CLAIM. Dental and jaw trauma injuries can be tricky; for example, jaw joint problems can come upon one slowly and manifest themselves in unusual ways. If you were hit hard enough to cause that much dental work, then you likely also are subject to a jaw joint problem that may not have fully manifested itself yet.
Has anyone asked about your occasional headaches? Do they diagnose them as mere cervical strain, or has anyone told you that you may be in the midst of developing signs of a full blown temporalmandibular joint disease (TMJ/TMD)?
Any hint of that condition and I will guarantee you that you will be sorry if you settle just eight months post accident. You need to go through some time with your appliance and diet changes to see how much relief you will get.
We had a lady who was not even diagnosed with TMJ until she was 10 months post accident, and the condition worsened unfortunately, but we were able to arrange for her FUTURE care and a substantial increase in her award.
Plus, don't forget that you mentioned to the adjuster that you wanted money for future care. What made you think of that? Has anyone told you that you will need future care? If so, let me know and I will show you a better way to get the cost of that care included in your settlement.
Next, even if you are all cured and ready to go, I know you have to have soft tissue injuries if you hit your head that hard. I am a little worried that anyone with THAT MUCH DAMAGE inside her head likely sustained some pretty good trauma, and soft tissue injuries have a way of coming back to haunt you later when you start to get active in your first summer season since concluding your treatments.
I am also worried that the insurance adjuster will just offer a small sum "for your inconvenience and any aches and pains you might have." DON’T TAKE THEIR MONEY TOO SOON.
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
Here is another page from my website that shows in detail why you should never make an early personal injury insurance claims settlement http://www.settlementcentral.com/page0211.htm
OK, enough of this, let's get back to valuing your claim so you will know what information to give to me. 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" you may have read about 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 our website, 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 (your x-rays and whatever was broken), or whether the only proof is subjective (your statements that you feel pain, i.e. in your neck or low back).
It sounds to me like you have sustained some serious injuries, and I don't want you to throw away what could be substantial value of your claim by dealing with the adjuster on an uneven playing field. I am suggesting that you spend a little time giving me some more information and then doing some reading to learn how to submit your own claim.
LONGER ANSWER: Here are some of those factors (as set forth in MORE DETAIL IN the members' section dealing with "what is my insurance personal injury claim worth?" http://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. (SEEMS LIKE YOUR CLAIM WOULD COME MORE TOWARD THIS END.) You have not mentioned the lost income component, but if applicable, add it on too.
BUT THIS MAY BE TOTALLY INAPPLICABLE TO YOUR SITUATION IF YOU HAVE SOME SERIOUS INJURIES THAT I SUSPECT YOU HAVE. THE "FORMULA" DOES NOT WORK INASMUCH AS YOUR CASE COULD BE WORTH A LOT MORE.
In other cases, here is a listing of factors that will affect both the multiplier one 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. Sounds like you must have had a pretty big crash.
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).
In this case, you will be AT OR NEAR THE TOP PART OF THE LIST. Dental work, if it can be traced back to the accident for causation, pays better dollar for dollar spent than, say physical therapy or chiropractic work. Sorry to sound so crass about it, Beverly, but I thought you would like the straight-up facts.
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. Dentists are going to be more toward the top than a general practitioner medical doctor.
6. Prognosis- future care—permanency of injury or pain and suffering—or were was the claimant done treating 4 months ago?
Your claim value gets a boost if your doctor specifies that you will need some future dental or medical care. Please let me know about this item since you were concerned enough to ask the adjuster to award on this item.
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. NOBODY EVEN LIKES TO THINK ABOUT DENTAL PAIN, SO YOU HAVE TO GO INTO THAT IN WRITING WITH THE ADJUSTER.
10. Quality and thoroughness of your medical records.
11. Lost wages.
LAST "SIDEBAR" TIP: First of all, Beverly, I should not be giving this to you now, since I want to hear from you in response to my questions. But sometimes people get busy or do not want to write for whatever reason, so I am going to pass along this now.
In getting back to the adjuster, DO IT IN WRITING ONLY. We teach our members how to send off a "second salvo" with some new information to get him to bump up his offer. You need to do something like that.
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.
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, on condition that you write to me first so I can give you some more pointers!
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
