Questionhello! My daughter was involved in an auto accident on dec.13 2008. she was traveling southbound on hwy37 in missouri heading home from Christams shopping with her boyfriend. an suv that had been stopped at an intersecting hwy pulled out in front of her at the last minute. she was doing about 45 mph as it was a reduced speed zone through our home town and she was very familiar with it. the man driving the suv was in fact not the owner of the vehicle. her car was totaled for sure and we are guessing the suv was as well. both her and her boyfriend had sternal pain from the airbags deploying. they both said they felt ok and we were at the accident scene for over an hour with her boyfriend's father. they did not seek ER tx. days later boyfriend is fine, my daughter's pain is getting worse in her sternal area. ok.. time for medical intervention. xrays revealed a sternal fx with eggshelling of the sternum. she is on nsaids and no lifting over 10#. several weeks to heal. the pain and discomfort come and go. she's only 17 so her income is not alot but she has missed some time from work right after the accident and for dr appts. the dr is now looking at a ct scan for her. my question is this: we have no idea how complicated a sternal fracture can be and it's implications long term. we have no idea as to where the cost of the medical expenses will end up, and she is severely restricted on her physical activity for a long time. getting an attorney may be an option, but they can be very costly! i would like some useful information for dealing with the insurance adjusters. i do not want to be a greedy person. i gripe myself over insurance costs. but what is fair for this situation for pain and suffering? she has a legitimate bodily injury as a result of the wreck. the insurance co. has tentatively admitted 100% fault but is waiting on an accident report. i just want an idea so when they are making their settlement offer, i know if it sounds way off base. i also want to say that i do not plan on signing off for a length of time until i know she is healed and ok.
AnswerHi Stacy,
Well, your daughter has a good Mom who is wise enough not to sign off on a settlement too soon. Beware, however, as the insurance adjuster will be pushing that. I will address your three questions, and I will add three topics of my own. Here is where we go from here:
There are SEVEN IMPORTANT aspects to your claim that I want to convey.
#1. You are right: DO NOT SETTLE her claim too soon; make sure the boyfriend gets to the doctor.
#2. Get info on fracture of sternum from the doctor, not from someone who has never seen your daughter. Do your own inquiry on the Internet as to her particular situation so that you will have better questions for her doctor.
#3. DO TAKE THE INITIATIVE with a demand letter once it is time to settle
#4. DO LEARN about how to make your own personal injury insurance claim settlement www.SettlementCentral.Com free legal information will help.
#5. DO LEARN about valuation factors in personal injury claims
#6. DO LEARN about claims of minors and court approval and blocked bank accounts.
#7. DO NOT get involved with the adjuster in a detailed discussion at this time, AND DO LEARN how to communicate with the insurance adjuster.
OK, Stacy—if you are ready, let's get started in the order I have written above.
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#1. You are right: DO NOT SETTLE her claim too soon; make sure the boyfriend gets to the doctor. You correctly concluded that it is to the adjuster's best interest to settle your daughter's claim as soon as he can.
So, the best thing for her is that she DOES NOT discontinue her treatments for soft tissue injuries or settle the claim too soon. In addition, she needs to get her boyfriend to see a doctor about the pains he is having. NO, he DID NOT go through a serious crash and escape injury. He is having pains at night following a busy day, but he thinks they will go away. Make him get treatment ASAP since those little dull aches he fees ARE IN FACT evidence of injury.
It sounds like they were in a crash hard enough to cause serious injuries. I am willing to bet that even after your daughter's treatments, once she starts to get more active, she will notice pains once again. Mark my words that at first she will have a dull ache, and that ache will become a nagging pain with her increased physical activity if it she were to discontinue her treatments.
Tell her: "Listen to your body and to get medical attention when you feel any aches or pains that continue for a day or more. DO NOT QUIT, BUT CONTINUE TO GET MEDICAL CARE FOR YOUR INJURIES. You were involved in an accident with a lot of impact. There is no reason why you should suffer in the future if you were to discontinue your treatments."
DO NOT SETTLE HER CLAIM UNLESS YOU ARE ABSOLUTELY CERTAIN THAT SOFT TISSUE INJURIES WILL NOT REAPPEAR ONCE SHE STRESSES HER BODY WITH PHYSICAL ACTIVITIES OR JUST DAILY LIVING AND WORKING. That Plays Right Into an Insurance Tactic Regarding Inducing Early Settlement of Injury Claims.
Let's just finish up this topic of early settlements Stacy, so you get the full picture of the advantage to them and the risks to you. Insurance companies like to settle early because the general damages—claims for pain and suffering—are always minimal, but continue to grow with continued medical/therapeutic care over the months. Therefore, the insurance adjuster will try to settle before the claim merits a larger pain and suffering element. This makes good sense for the insurance company. A claim that is still active after 12 months, with an injured claimant still undergoing treatment, will settle for a lot more pain and suffering money than a claim that is settled after two or three months of treatment.
In soft tissue cases such as this, the full extent of most injuries is not known immediately after finishing early rounds of treatment, because the injured person has to undergo some of the wear and tear of everyday life, including the pounding her body will receive from a day's work. Even jobs that appear not to be physically demanding can be hard on an injured body.
For example, have you ever stood all day with few breaks, as a store checkout clerk or a jewelry salesperson does? Or sat all day at a computer, as a secretary or phone service center employee does? Many jobs will interfere with healing, and you have no way to know how your body will respond until you have experienced sufficient physical exposure to load-test the ligamentous scar tissue as you heal.
Plus, who will pay for her medical care incurred AFTER she settles? What if you were to settle now and nine months later when she is suffering at work and the pain starts to become too much, and she goes to a doctor only to discover that you can expect a course of treatment that will cost a lot of money? After you settle her claim, all further treatment is YOUR responsibility. Except in specific, highly unusual situations, you cannot go back and re-open a settlement.
Here is 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
And, of course, once you settle, THAT IS IT: you will never see another dime in pain and suffering money. 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
I know that you think this is going on too far with this one topic, Stacy, especially since you are the one who already noted that you will not settle early. But I HAVE TO TELL YOU that this is a REAL danger that I have seen many times. So just have patience a bit longer and commit yourself to read the following and convey it to her AND TO HER BOYFRIEND:
There may be a dull ache at night following a day at work or some physical activity or pain the next morning. DO NOT LET LITTLE PAINS GO UNATTENDED SINCE YOU DO NOT KNOW WHETHER THEY WILL CONTINUE OR GO AWAY. We all hope and believe that such little pains will disappear soon. But on the other hand, we have no way of knowing since this is the way serious fractures and soft tissue injuries can behave.
So, when this happens, even if a couple months or more post-treatment, do not hesitate to SEE A DOCTOR AND ATTRIBUTE THE PAIN TO THE ACCIDENT WITHOUT EQUIVOCATION. It is NEVER TOO LATE TO REPORT PERSONAL INJURIES FROM A FALL ACCIDENT http://www.settlementcentral.com/page0104.htm
"No medicine: no money"; medical costs increase worth of personal injury insurance claims http://www.settlementcentral.com/page0045.htm
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#3. DO TAKE THE INITIATIVE with a demand letter once it is time to settle
Take the initiative and DO NOT LET THE ADJUSTER DICTATE THE SIZE OF THE BALLPARK you are going to play in: Get your demand letter out there once you are ready to settle, AND REBUT AND REJECT "SUGGESTIONS" that your daughter's award is going to be "a little cash" or some other idea to convey a small settlement.
An adjuster may suggest that she is entitled to "a little something for pain and suffering." This is an attempt to lower your expectations. If that language is used, then go RIGHT AFTER HIM when you speak and bring up that statement and remind him that you expect FULL AND FAIR compensation for your daughter's pain and suffering. "Well, what did you have in mind?" he will ask. Tell him that it is way too early to know how her healing will be made, and hence, you will NOT speculate.
You should be commended for having the initiative to seek out a website such as this and to ask for help, but the most important part of achieving a successful personal injury claim HAS TO START WITH YOU, NOT THE ADJUSTER. Do NOT let the adjuster set the parameters of the negotiation: get your demand letter out there FIRST, but ONLY after your daughter has reached maximum medical improvement. It is not all that hard or mysterious to put together an Effective Personal Injury Insurance Demand Letter http://www.settlementcentral.com/page0170.htm It does not have to be "fancy" or complex; just hit the main points and get it out to the adjuster soon.
If I were you, what I would do right now is to become as fully informed about the insurance injury claims process as you can, with the objective of seizing the initiative in prosecuting my claim, instead of taking a passive, reactive role. Can you see the difference in postures and how one works to your advantage and the other to your disadvantage?
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#4. DO LEARN about how to make your own personal injury insurance claim settlement www.SettlementCentral.Com free legal information will help. Learn how to handle a SELF-HELP AUTO ACCIDENT INSURANCE SETTLEMENT www.SettlementCentral.Com free information—this is just in case you want to take a shot at doing some of this on your own. OK, Stacy, let’s look at self-help methods of resolving your daughter's claim. Learn how to settle her personal injury insurance claim AND DO IT YOURSELF.
Here is a series of pages that you can review. Take what makes sense to you and don't worry about the rest. Just get a flavor of how the system works without spending a ton of time right now.
Just skim this one and don't spend much time on it: overview Tort Law Personal Injury Legal Claims http://www.settlementcentral.com/page3000.htm
Managing Medical Care After Auto Accident: http://www.settlementcentral.com/page0203.htm
Medical Care Documentation-the Key to Successful Personal Injury Insurance Claim Settlements http://www.settlementcentral.com/page0217.htm
Keys to a MAXIMUM INSURANCE INJURY CLAIM SETTLEMENT http://www.settlementcentral.com/page0089.htm
Use a Confidential Personal Injury Diary for TOP DOLLAR Insurance Claim Settlements http://www.settlementcentral.com/page0208.htm
Outline of questions to be expected from insurance claims adjuster http://www.settlementcentral.com/page0190.htm
Detailed listing of questions to be expected from insurance claims adjuster http://www.settlementcentral.com/page0207.htm
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
Responding to Settlement Offer From Insurance Claims Adjuster http://www.settlementcentral.com/page0244.htm
Do It Yourself Advantages, or do these claims need an attorney? As for an ATTORNEY, this does not seem to be a case that involves any legal issues in dispute nor any large or complex damages. Why should you pay someone one-third to do what you can do yourself? Do-It-Yourself Personal Injury Claims; Eliminate Personal Injury Attorneys' Fees; Save Thousands of Dollars Settling Your Own Insurance Claim http://www.settlementcentral.com/page3011.htm
Without having to join my website, I have given a lot of free information on handling insurance claims without having to join as a member. Read the module at "5 Easy Steps to Do-it-Yourself Insurance Claim Settlement" http://www.settlementcentral.com/page0102.htm
This stuff is not rocket science, but it will take some effort on your part to read and cut and paste letter examples and to communicate. But hundreds of people are doing it each day, and they are getting good results.
What if you get only two-thirds the way to your settlement goal? Well, you can get as big a settlement as you can and then turn it over to an attorney and save a lot of fees. Thus, you could go it alone just to get an insurance settlement offer, and then take that insurance settlement offer to a personal injury attorney, thus exempting the amount of the offer from her fees. Do It Yourself Personal Injury Settlement Offer Reduces Personal Injury Attorney Fees http://www.settlementcentral.com/page0109.htm
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#5. DO LEARN about valuation factors in personal injury claims
What about valuation of your daughter's claim? How does one figure out what to ask for? Quick Answer: get as much as you can. Figure out what would make you happy, 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 one factor that puts the lie to the general use of this rule of thumb. A 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.
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. Your daughter had a pretty good crash, so this is a PLUS for your side.
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).
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 her doctor recommend 6 months of care, or was she done treating this week? Even if she is done treating, will the doctor predict future problems?
Her claim value gets a boost if her doctor specifies that she will need some future treatment.
7. Her 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.
10. Quality and thoroughness of her medical records.
11. Lost wages.
We have a lot of free legal tips on insurance claims settlements using doctor narrative reports http://www.settlementcentral.com/page8003.htm You can get information there as to how to ask for a narrative letter and what it might cost. Talk to the doctor's office manager about it. This is also a good way to boost the value of the claim. And whatever you pay will be repaid to you from her settlement.
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#7. DO NOT get involved with the adjuster in a detailed discussion at this time, AND DO LEARN how to communicate with the insurance adjuster.
First things first: why don't we start planning for that meeting the adjuster may try to schedule. I would suggest that you be general, not specific, regarding your daughter's injuries and activities that she cannot now do. ALSO, make sure that you distinguish between activities that she "CANNOT" do, versus those that she CAN do, but for which she will pay a price in pain later that night or the next day.
He is sure to ask that question, and most of us will not give but a couple of activities we "cannot" do. Instead, be ready to give him a list of things at work or in daily life or in your daughter's workout and physical recreation that she CAN do, but which will give her pain later on.
Be Prepared for the Kinds of Questions they Might Ask of you.
Of course we would like to avoid giving any recorded statement, so ask the adjuster to send a list of questions since you "do not think well in quick pressure situations". Tell him that you will be able to give a more thorough response if he were to send you a list of topics or questions he wants answered. Fat chance he will do that, but you could try. At a minimum, you (and likely your daughter) need to be prepared for an interview.
This is a list of questions insurance adjusters ask http://www.settlementcentral.com/page0207.htm injured claimants.
Here are two pages that tell what to do now if you have already given a recorded statement to the adjuster.
http://www.settlementcentral.com/page0058.htm Recorded or Written Statement To The Adjuster After Injury Accident?
http://www.settlementcentral.com/page8014.htm What to do if you have already given a recorded statement to the insurance adjuster
Learn how to communicate with the insurance adjuster: FINAL TOPIC—COMMUNICATE IN WRITING AND "DEMAND" NOT "ASK"
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
