QuestionI apologize in advance as this is a very long question. The accident occurred in Davidson County, NC in June 2009. The injuries I sustained include a broken/shattered clavicle and “joint pain” in my right thumb. I was a passenger in an automobile and the driver (not the owner/insured of the vehicle) pulled out in front of another vehicle. The driver of the vehicle I was a passenger in received the citation. The owner of the vehicle I was a passenger in has $1,000 medical pay insurance and $50,000 per person bodily injury and $100,000 per accident bodily injury. Her insurance company said they would cover me for bodily injury, medical pay, lost wages and pain & suffering. I had one surgery in June 2009 to put in a metal plate because of the severity of the broken clavicle and had another surgery in October 2009 to remove the metal plate as it was causing me tremendous pain (broken/shattered collarbone). After removing the plate the bone was still broken (I don’t know how this could have happened – the doctor claims it was a non-union but if that’s the case why did he remove the plate once he saw that?) As of March of this year the bone was finally starting to heal, although it is not in a straight line and I still have pain from it. The doctor says the pain I have is nerve pain. I tried a medication which did not work then found out I am pregnant and have discontinued medication until after the birth. The doctor said that there are other medications I can try after the birth and worst case scenario I can have a nerve block in my shoulder but he doesn’t want to do that as the shoulder is the hardest place to do a nerve block. I have been unable to wear a bra for over a year now due to the pain and can not drive a car due to the pain of the seat belt on the clavicle. Also, I have mental issues and freak out when I am in a car – I am terrified it is going to happen again. My medical bills to date are $30,000 approximately. Since the bodily injury limit is $50,000 for the owner of the vehicle, the insurance adjuster has offered me the full $50,000 and advised me to file an underinsured motorist claim with my own insurance, which I have done. He did not advise me as to a breakdown of what is included in the $50,000 and since he is offering me the full amount, I didn’t ask. I have also received $1,000 medpay from the owner’s insurance company as well as $5,000 medpay from my own insurance company. My underinsured has decided to give me consent to settle with the owner’s insurance (I am assuming this means they will waive their rights to subrogation on the driver since she had no insurance at the time of the accident – but have not received anything in writing yet). My underinsured rep also advised me that I have $100,000 underinsured insurance which would give me up to an additional $50,000 in coverage but that my claim is not worth the full amount. He said what gives my claim value is the broken collarbone and asked how big my scar is. He asked me to send photos of it to him for evaluation and then asked me if the metal plate is permanent or not. I advised him it was removed in Oct. 2009 which concerned me that he doesn’t have all of my medical records. I spoke to the owner’s insurance company today and he advised he only sent my insurance company bills and records through Aug. 2009 as he didn’t need the other bills to offer me the full amount. By him saying this, it seems to me my claim should be worth much more than $50,000 if he didn’t even include the second surgery in his calculations. I know I am entitled to have my medical bills paid, pain and suffering, and lost wages. I ended up having to move in with my boyfriend which I didn’t want to do as I couldn’t do anything for myself. The accident and resulting injuries substantially affected my everyday life for at least six months and continues to affect me in a less way through the present. I also can’t wait for my baby to pinch my shoulder and me scream in pain. So my questions are (1) Will the medpay amount I have received be deducted from my final bodily injury settlement or is that a whole separate insurance and in essence I can collect twice for the same medical bills? (2) Is there anything you can think of I need to be aware of before settling with the owner’s insurance? He said something about he can settle with me based on a covenant not to pursue judgment but he is going to try to get something from my underinsured insurance saying it is ok for me to settle with him. (3) Based on the information I have given, do you have any idea what I could reasonably expect for my claim settlement to be? Thanks so much for taking the time to read all this and respond.
Answer1. The medpay can usually be offset from the UM settlement.
2. Your claim with your own carrier should be worth the entire $50K, just explain to the adjuster like you did to me. Before settling, obtain a breakdown of what you are getting paid for. . . then provide the documentation that shows what the first settlement includes to your carrier and that should increase your final settlement.
3. As far as your settlement, I would expect if you properly document everything, you will get the limits on every available coverage.
I am sorry for the delay in my response, my life has been hectic lately. I hope this helps and feel free to followup if anything isn't clear.
JP
