QuestionI have a son in elementary school who rides his bike to school with a classmate that lives across the street. About 3 months ago, he was struck by a vehicle. He was taking a right turn and she was coming from the opposite way taking a left turn onto the same street. She hit his bike from behind and knocked him off, sending him flying in front of her vehicle. At first there seemed to be little bruising on the head and scrapes, so he went to school. At noon the nurse called telling me he was complaining about his head. We took him to his pediatrician, than emergency to get a cat scan..it came out negative. So far bills are around 5k. He complained about headaches for a while after the accident. At the advise of his pediatrician, we took him to a neurologist. They did diagnose him with a concussion. They did not prescribe any meds yet..we are waiting for 2 weeks. He has to be on bed rest. Now here's the heartbreaker, he is a very active kid and when he heard the doctor say..he can't go outside and play, ride his bike, skateboard, play football watch tv, do nothing for 2 weeks he broke down and cried in the car. To him its like being grounded for getting hit.
We have a claim with the other's party insurance. One of the things they have not come out and admit is fault. So that is the first issue. I guess the lady is not claiming 100% fault. I used my health insurance to pay the hospital bill. But I received a phone call from the hospital saying that my health insurance will not paying for the bill until they receive a "no fault" letter. I called my insurance and they said the other carrier should provide me with the letter. The other carrier says i should just mail the bill.which i already sent him and they have yet to pay it. I opened a claim with my insurance to help pay for the hospital bill. I have UIM. I opened it but they declined the claim, something about it covering the bill only if the sum of the settlement is more than the other insurers policy limit. Whatever that means.
So here is my question. When all is said and done, how do i find out what their policy limit is and how do I negotiate this with my UIM? The doctor said this can heal quickly or it can take a couple of months and possibly years. And here is the horrible truth..because of this injury if he has another concussion say..do to sports..It can be worse because of this original concussion. What is the value of this claim and how do I get the negligent insurance company to admit 100% fault. We do have a kid witness. I told the claims guy that his friend is a witness but he kind of dismissed it saying he's just a kid, and the reliability of a kid witness is not that great. If they have a max of say the state minimum which is 25k how do I get my UIM to compensate for what I feel is more than 25k. Lastly should I hire a lawyer. The claims guy is being very nice and he hasn't given us a settlement offer. I guess he's waiting for the all clear on our end...but what if it never ends..
AnswerI think you should wait to settle until the doctor has released your son from medical care or provided a clear prgnosis as to what the ong term effects, if any will be.
The lady's insurer is not obligated to tell you their policy limits and they probably will not do so unless they determine the value of the claim exceeds that amount. Your UIM coverage stands for Underinsured Motorist coverage and it means just that - it only applies if the at fault party was underinsured. So unless your claim exceeds the value of her coverage, UIM does not apply.
Once your son has complted medical care, you can negotiate the claim with the lady's insurer. If they deny liability, then you will need a lawyer to use them. But if not, you can probably handle this on our own. A lawyer will charge a very large contingency fee, a percentage of the settlement or award. Probably betwen 25% an 50%. Sometimes you need a lawyr and sometimes you will clar more money without one. If it were me, I would tell th claim rep that I need him to advise whether or not they plan to settle my claim. They should have decided liability by now. If he cannot give an answer, then tell him you'll be getting an attorney.
As to value, I can help you with this once the medical treatment is complete. At this point, it does not sound like it is worth over $25,000 to me. Unless there are more long term problems.
