QuestionI was involved in a head on collision on February 15, 2009 by boyfriend was driving my car and is at fault, I was on the passenger side we were hospitalized for 3 weeks and i suffered a shattered hip broken ankle fractured rib and both legs were broken was in wheelchair for 3 months and therapy since May, I had full coverage insurance how much is my settlement worth?
AnswerHi Veronica,
No one can ever answer your question with so little information. It would be like throwing a dart at the wall. There are at least eleven factors that go into the valuation, and you have not told me but four of them. What I will do for you here is to frame the context of your claim vis-à-vis insurance limits, and then I will list those eleven factors of valuation.
OK, then Veronica, let's put this in perspective with respect to your liability limits and any medical insurance you might have. I would start with the question of what is your liability policy limits, and make decisions from there. For example, if your liability limits are only $50,000, then you can settle this yourself, without an attorney, EXCEPTING the subrogation issues. Introduction to Subrogation— http://www.settlementcentral.com/page0459.htm Forced Payback to YOUR OWN Insurer From Your Personal Injury Award.
In other words, a dog with a note in its mouth could get that $50K limit, so why hire an attorney for something you can do yourself? BUT, your health insurer and your first party PIP or MedPay may try to subrogate against that award. Let's say that your health insurer paid out $30K for your treatments: they want that back.
By the way, unless you have HUGE limits, I hope you did not let your liability part of your coverage pay for your medical bills if a health insurer could have done so. Why? Because whatever your liability adjuster paid to you will come off the policy limits that is available to stick in your pocket.
For example, what if your liability limits were $50K and your PIP or MedPay limits were $10K and your medical bills of $30K were all paid by your insurance. Thus, your liability side would have paid everything left over after the PIP—or $20K for the doctors and hospital. Guess what—that $20K comes OFF your $50K limits, leaving only $30K to go in your pocket when all is done.
If you DO have health insurance, I would try to get them to pay the bills and repay your auto insurance liability side. Tough to do, but NOT impossible. Then you will fight your health insurer on its subrogation claim since paying that subrogation will leave you less than "made whole" because your general damages (pain and suffering) will be compromised.
Sorry if that is confusing to a layman, Veronica, but subrogation is a very important concept to master since it can really impact the bottom line. Hence, I want you to be able to at least have a working knowledge of what it can do, and an idea or two about how to fight it.
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Now we go on to valuation of your claim, and you will get an idea as to why no one can give you any ballpark idea of valuation with so little information. But let's take a moment to learn about valuation topics.
SOME TIPS ON VALUATION—these are loose guidelines only, since we are prohibited from giving valuation on big cases in light of the exposure to a malpractice claim against us and this site.
How does one figure out what to ask for? Quick Answer: get as much as you can. Figure out what would make you happy, Veronica, and increase that amount by at least 50%! The value is what you and the adjuster agree it will be. Well, if that is not scientific enough for you, let’s learn a bit more about valuation of personal injury claims.
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. Plus, one would like to meet the claimant to see how she will “sell” to the other side and to the jury. Those online sources that mention a "rule of thumb" is just that: a gross estimate.
SHORT ANSWER: A common theme among those who still think a “rule of thumb” formula will put you in the valuation ballpark is to multiply the medical specials times a number from ONE to FIVE (depending upon factors, some of which I will give you later—or all of which are fully discussed in the members' side of my website, dealing with insurance settlements 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 take a look just two factors that put the lie to the general use of this rule of thumb. An obvious one is that of the multiple fractures that you mentioned. There may have been just moderate treatment costs per se, yet those dollars should be valued at more than doctor office visit bodily treatment dollars since they would be for a significant interference with your life and well-being inasmuch as the pains from those sites could show up again.
[[TWO SIDEBARS HERE, Veronica:
Sidebar #1: make sure you study up on barometric pressure changes and pain from fracture sites. Many victims of fractures have "weather change" pains many years after the doctors pronounced them as completely healed.
Sidebar #2: be wary of your doctor's attempts to put you into the "completely healed and rosy future" category. Bone doctors—orthopedists—are the most guilty of this. Why? Who knows for sure, but three factors are at play, it is suggested. I will take the time to let you know of these observations of plaintiff trial attorneys regarding the rosy prognosis one is likely to get from an orthopedist so that you can provide information on any continuing pains to avoid letting him put this kind of crap into your medical prognosis.
#1: They want to avoid being called to a trial so they put a "poison pill" into their reports—or make the reports so rosy that there is likely not going to be a trial.
#2. They cannot cut on you after the fractures heal, and they do not want whiners coming back into their offices just to consult on pain since there is nothing that they can do for you once the fractures heal. They make their money by cutting on people, not by holding their hands in office visits.
#3. Their egos are so big that they believe their work will cure all of their patients and they do not want to know about any residual pains after a patient has completed their course of treatment.
The bottom line is to carefully monitor the dictated notes from your orthopedist. Make sure that what he told you and what you told him are ACTUALLY reflected in the narrative he dictated following your visits and treatments.]]
OK, Veronica, now back to valuation tips.
A second, not so obvious, but very important factor that shows how inaccurate a “rule of thumb” formula can be is just plain location of the trial. 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, especially if the economy is tenuous in small towns. And the differences can be HUGE between these areas, even if only 20 miles apart.
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
This is a big one because it most dramatically affects value. You should NOT ACCEPT any reduction in value for fault, UNLESS your boyfriend had consumed intoxicants with you—or some similar reason.
2. Trauma suffered
The value of your claim increases with a bigger crash, and decreases with a low damage tripping wherein one catches himself. Why? Just human nature. You had a big crash.
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). Fractures will be worth more than a sore back or neck.
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—does your doctor recommend 6 months of care, or were you done treating 2 months ago? Even if you are done treating, will the doctor predict future problems? This is a BIG ISSUE in your case, and one you may have to fight over with your doctor.
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. Emotional distress fits in here.
9. Quality and persistence of pain suffered.
10. Quality and thoroughness of her medical records.
11. Lost wages.
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Learn how to communicate with the insurance adjuster: FINAL TOPIC—COMMUNICATE IN WRITING AND "DEMAND" NOT "ASK"
FINAL TOPIC, Veronica: Effective communication with insurance claims adjusters. Establish Firm, Professional, and Positive Relationships With the Insurance Injury Claims Adjuster http://www.settlementcentral.com/page0059.htm
Always communicate with the adjuster in writing, showing your own analysis of value. It is OK I guess to have one call or so, but no more. Always have your information and 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.
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. (Juris Doctor)
http://www.SettlementCentral.Com
