Auto Insurance Claims: Car accident with soft tissue injury/pain & suffering, soft tissue injury, exempt employee

Question
Hi,
I have read numerous threads on pain and suffering calculations  and am still somewhat unclear on how to handle my case.

I had an accident in California and was rear ended, resulting in a severe whiplash for me. Miraculously the two kids in the car had no injuries since they were safe in carseats, I was turned , talking to them, which is why the whiplash was painful and took long to heal.

The lady that rear ended me was in a rental car, since she had just been in an accident the week before and this was her loaner. Based on the reports given by both parties, the rental car's company insurance (self insured) has admitted liability. I had protocolled at the time that the lady seemed under the influence of some drugs, however the Police refused to do a drug test since she did not smell of alcohol.

At the time of the accident I was an exempt employee with no sick policy in place, meaning based on how the weekday of the accident and my resulting "sick" days fell I had no loss of wages.

Since I had a policy with PI coverage my insurance took care of all medical bills as well as all material damage bills (new car seats, repair to my car etc), so in effect, I had no out of pocket expenses.

My insurance however encouraged me to seek pain and suffering from the opposing insurance, since that is my right, I was told.

Now what do I ask for in pain and suffering? It seems to be industry standard  that one extrapolates the pain and suffering claim from the total of losses, explicitly the medical cost. I have seen here answers that lead me to believe anywhere between 1.2 times to 3 times amount of medical expenses, depending on one's negotiating skills and I have some good negotiating skills.

I have calculated that my medical expenses hypothetically were about 4100,-- for chiropractic care, physical therapy, not considering two medical doctor's visits and a set of X-rays and prescription meads that were all covered and fully paid by my regular health care provider, so I have no number for these expenses, likely they would hike the amount by another 2k.

If I use the most conservative factor (at 1.5 for the sake of argument)and let aside the medical expenses that I have no record of, I would come out at around $6200. Would I get that amount (if the insurance settles for the factor of 1.5) or would they just deduct the expenses that I, in fact did not have and I would get the balance of $2100 ???

Thanks for your reply,

Katie  

Answer
Hi Katie,

Although, in general, the info you found of 1.5 to 3 times the medical bills is correct, that is based on older historical settlement and averages of those settlements. Insurance companies today will make you jump through many hoops before reaching a settlement. Their job is to frustrate you to the point of madness so that you go away with as little as possible. Regardless of how nice the claims adjuster may seem, you should always remember that they will cut your heart out if given a chance.

You will first have to obtain copies all of the medical bills that were paid by these other insurance companies. Then you will prepare a demand package outlining all of your injuries and the needed treatment and an explanation of all of the medical bills and the extent of pain and suffering you endured. Finally you will indecate that you demand payment of a certain amount of money.

The first tactic used by insurance companies is to claim that your medical treatment and resulting bills were excessive and unnecessary. They will require you to sign a medical release form so that they can get information on your complete medical history. They will then send all of your medical bills to an outside medical review company whos job it is to say thet most of your treatment was unnecessary and cut your medical bills in half. Then they will start negotiating from there. They will likely claim that you only had a soft tissue injury and offer only about $500.00 above the medical expenses. From there it is up to you to negotiate to reach an ultimate settlement. If at anytime you feel you are not being treated fairly, you should seek the advice of an attorney.

I hope this helps
Richard Hixenbaugh